HIV Prevention

March 2022 – February 2023

Throughout the past year, the Desmond Tutu Health Foundation has been instrumental in driving HIV prevention research. By focusing on key populations and novel biomedical interventions, DTHF continues to champion innovative strategies to reduce HIV incidence globally.

Clinical Trials and Studies

Purpose 1 Study: The teams at the Masiphumelele, J52 Groote Schuur and Emavundleni sites, successfully enrolled participants for a study that could revolutionize HIV prevention for at-risk adolescent girls and young women through long-acting, subcutaneous Lenacapavir and daily oral Emtricitabine/Tenofovir Alafenamide. In total, the DTHF contributed 400 out of the 5639 participants globally.

Insight Study: The work with the Insight study across DTHF sites provided critical insights into oral PrEP adherence, allowing for the tailoring of approaches in consideration of young women’s needs and preferences. This trial was done at Masiphumele and Emavundleni, and they contributed an impressive 301 participants to the study.

VUKA+ App Trial: The effectiveness-implementation trial of the Vuka+ app for PrEP adherence, which enrolled 330 participants, exemplifies DTHF’s commitment to leveraging technology to empower young women in South Africa.

Purpose 2 Study: DTHF’s significant enrollment achievements in the lenacapavir Phase 3 study (Groote Schuur’s J52 site) underscore the efforts to extend cutting-edge HIV prevention options to key populations, including MSM and transgender individuals, who are often at higher risk and face barriers to accessing care.

Advancements in Pharmacologic Prevention:

CAB LA Implementation: Following the successful HPTN 083 and 084 trials, the implementation of long-acting injectable Cabotegravir (CAB LA) stands as a testament to DTHF’s contribution to the advent of new, highly effective HIV prevention methods.

HIV Prevention in Key Populations

DTHF’s efforts in reaching key populations have been expansive and diverse:

Youth Engagement: Tailored programs for adolescents and young adults, focusing on both education and practical prevention tools like PrEP, have been crucial.

MSM and Transgender Populations: Trials such as the lenacapavir study for cisgender men and transgender individuals have brought groundbreaking prevention methods to the forefront, addressing the unique challenges these groups face.

Mobile Clinics and Accessibility: FASTPrEP’s mobile clinics have been critical in overcoming geographical and systemic barriers, ensuring that HIV prevention methods are within reach of those most in need.

Vaccine and Monoclonal Antibody Research

The foundation has actively engaged in the exploration of monoclonal antibodies for both the prevention and treatment of HIV. Our participation in Phase 1 and 2 experimental vaccine programs also demonstrates our commitment to long-term solutions for HIV prevention.

Experimental Vaccines: The ongoing research into HIV vaccines promises a future where HIV can be prevented before exposure, potentially eliminating the virus altogether.

Monoclonal Antibodies: The development and testing of novel monoclonal antibodies could offer a new dimension to HIV prevention, potentially providing long-lasting protection with fewer administrations.

Capacity Building: The expansion of our capacity to conduct Phase 1 trials with specialized procedures like leukapheresis and biopsies places us at the forefront of HIV research infrastructure in Africa.

In April 2022 the Bill & Melinda Gates-funded FastPrEP study was launched within DTHF’s mobile services and adolescent division. FastPrEP is an implementation science project that aims to scale up oral pre-exposure prophylaxis (PrEP) and new biomedical HIV prevention products (including the dapivirine vaginal ring and long-acting injectable cabotegravir) through differentiated models of service delivery to adolescent and young people. Moreover, FastPrEP is not just a youth focused service but a youth co-created service. During the planning of this project in 2021 we established a youth reference group including 80 young people as expert consultantsco-creating, monitoring, and evaluating the implementation of the FastPrEP project.

FastPrEP delivers PrEP within a seroneutral and integrated sexual and reproductive health package from 4 mobile clinics as the “hub” and a combination of local government clinics (n=12) and other community-based delivery options (youth club, courier delivery, schools) as the “spokes”. By the end of February 2023, 3160 adolescent and young people (aged 15-29) had initiated PrEP through the FastPrEP project platforms.

As we conclude a year marked by scientific achievement and innovation, the Desmond Tutu Health Foundation renews its commitment to the elimination of HIV/AIDS. The work in clinical trials, key population outreach, and advanced biomedical prevention strategies, including vaccines and monoclonal antibodies, stands as a beacon of hope and a clear path forward in the global fight against HIV.

In partnership with communities and the foundation’s valued stakeholders, DTHF moves into the next year with the promise of reducing the burden of HIV through prevention, research, and unwavering dedication to the health and well-being of all populations at risk of HIV.

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