The 23rd International AIDS conference took place entirely online this week, for the first time in the conference’s history. It brought together scientists, policymakers, healthcare professionals and activists in over 600 virtual sessions.
Important HIV prevention, treatment and cure research was unveiled while a closer look was given to the impact of the COVID-19 pandemic on HIV services around the globe.
The Desmond Tutu Health Foundation was honoured to present some of its research and findings at the conference.
Professor Linda-Gail Bekker served as moderator and panellist for several conference sessions, on topics including impediments to ending HIV in America, optimizing ART in women, the latest developments in HIV treatment and sustaining research capacity in low- and middle- income countries.
DTHF Social Behavioural Divisional Head Millicent Atujuna, also participated, speaking on methods and tools to stimulate remote qualitative data collection during pandemics, at the “Vulva puppets, home mapping & tea pots: How to enhance biomedical research and understand the context of HIV prevention through innovative and interactive qualitative methods ” session.
DTHF Research Fellow Danielle Giovenco from University of North Carolina presented a poster on “Understanding PrEP interest among South African adolescents: The Impact of Perceived Parental Support and PrEP-related stigma”.
DTHF doctoral candidate and Social Behavioural Scientist Elzette Rousseau also presented in the symposium “It’s a Man’s World: Are Women losing out when it comes to biomedical HIV prevention?”
Here are some highlights from the conference:
UNADS 2020 Global Update shows that despite some wonderful progress, the overall 2020 HIV treatment targets will not be met due to the “deeply unequal success” of the global HIV response.
In the report, titled “Seizing the Moment: Tackling Entrenched Inequalities to End Epidemics” UNAIDS warns that progress is too slow – particularly for children and adolescent girls. Although some countries have achieved the targets, there remain too many regions, communities and individuals being left behind.
Promising developments in the field of PrEP
Updated results from the HPTN 083 study found that cabotegravir for long-acting injectable PrEP is not only just as effective, but superior, to daily oral Truvada for PrEP, in preventing HIV in cisgender men and transgender women who have sex with men.
Interim SEARCH study results from Kenya and Uganda were also presented, reporting a 74% reduction in HIV infections in people at high risk of infection who were offered intensified healthcare and enrolled on PrEP.
Updates from cure research: News of Long-term Remission Patient welcomed with caution
One of the conference highlights was the early report that a Brazilian patient has sustained an HIV-free status despite relatively simple interventions that included antiretroviral therapy. Experts cautioned that more information and time is needed to feel sure that this represents possibilities for an HIV cute. Before this case, only 2 other individuals have sustained long-term virus-free status, only after gruelling bone marrow transplants and other difficult treatments.
Encouraging ART developments
Incidence of neural tube defects among children of pregnant women taking dolutegravir is substantially lower than initially suggested at AIDS2018. The Tsepamo study has seen a decrease from 0.9% to 0.19% (Neural tube defect has a background rate of 0.1% in the general public.) This is important, as the first line preferred single tablet regimen of Dolutegravir, Tenofovir and Iamivudine can now be used even by women with less anxiety. This is encouraging news for HIV therapy for women, who make up half of the people living with HIV.
Much discussed at the conference was also the phenomenon of weight gain whilst using some ART regimens. The ADVANCE trial in South Africa found that weight gain was an ongoing issue even out to 96 weeks of follow up for participants on DTG-based regimens and this appears to be particularly so in women and when combined with TAF (the newer version of Tenofovir). The impact was less when DTG was combined with the older form of Tenofovir. This will need further careful monitoring, however, as TLD is rolled out in South Africa.
Gains in HIV response under threat from COVID-19
The UNAIDS report highlighted the significant threat that the Coronavirus pandemic faces to HIV service delivery and research around the world. Despite Dr Anthony Fauci’s reassurances at the conference closing that new resources were being brought in for the COVID-19 response to avoid plundering HIV-designated funds, the WHO also reported dangerously low ARV stocks in some countries due to travel and trade impediments brought on by the pandemic.
DTHF COO Linda-Gail Bekker warned, during an AVAC Roundtable, that the pandemic is drawing attention away from HIV focus and services, and that all health priorities need to move forward in an integrated way. Global Fund Executive Director Peter Sands emphasized in closing that massive effort and large additional resources are needed to regain the ground lost in the fight against HIV, TB and malaria during the Coronavirus pandemic.
Keep an eye on our website and social media feeds for more news from the AIDS2020 COVID-19 Conference.