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San Francisco HIV experts: What did you learn at AIDS 2016?

, by Emily Land

conferenceThe HIV community has a lot of information to digest after an International AIDS Society Conference. This year, the 21st International AIDS Conference (AIDS 2016) was held from July 18 to 22 in Durban, South Africa.

The conference brought together HIV researchers, community members, clinicians and activists (not to mention celebrities!) from all over the world, with hundreds of presentations, posters, and panel discussions held during that time. Nearly 20,000 attendees packed conference halls and poster sessions to hear the latest HIV research on prevention, treatment, care and public health interventions. It was easy to get lost in all of this exciting research!

BETA wanted to distill some of these important findings by asking some prominent San Francisco Bay Area HIV experts to give us their take on the conference. We asked, “What did you find interesting? What did you find exciting? And, what did you learn?”

Here’s what they had to say.

Judith Auerbach, PhD, from University of California, San Francisco

Judith Auerbach

Judith Auerbach, PhD

“There were many important and poignant things that struck me at AIDS 2016 having to do with advances HIV cure research, development of new drugs and methods for PrEP and ART (e.g., long-acting injectables), and increased engagement in the AIDS response from a new generation of young people.  But what really hit me most was the epidemiologic data showing that reductions in new HIV infections globally have stalled. This reflects two simultaneous realities: On the one hand, in places like San Francisco, concerted efforts to make treatment, PrEP, and social support services available to all have contributed to significant declines in new inflections and make us think we can really “get to zero” in short order. But, on the other hand, in places like the province of South Africa where the conference was held, as many as 1 in 2 young women has HIV infection and the rates are not declining, even with scale-up of treatment for those already infected. This makes us realize we still have a long way to go to understand and address the social, as well as biologic, factors that fuel the epidemic in various settings. It is imperative that all stakeholders and the general public understand these realities so that political and financial support for the HIV response doesn’t abate at this very crucial moment.”

Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, from San Francisco AIDS Foundation

Pierre-Cedric Crouch

Pierre-Cédric Crouch, PhD, ANP-BC

“PrEP took a center stage and was part of almost every presentation though it remains only available to a privileged few. Social justice issues continue to be a struggle for sex works and trans* men and women. Children are still being infected with HIV and dying in parts of the world. In all, it was a humbling experience and a check on my privilege to live in San Francisco. It is easy to forget how far we’ve come and yet we have still so much more to do.”

 

Shaun Barcavage, NP, from San Francisco AIDS Foundation

Shaun Barcavage

Shaun Barcavage, NP

“It was clear from the conference that we have made headway in terms of HIV treatment and prevention, but we have globally lagged in equity and access to care. This year the International AIDS Conference focused on equity, access and human rights and this theme was intertwined throughout the week long event. The conference emphasized the need to decriminalize HIV, reduce drug costs, increase access to health services, and bring marginalized groups such as adolescents, transgendered persons and sex workers out of the shadows and into care. In the fight against HIV, it was made clear that no one can be left behind if we are to achieve any of our goals.

On a more technical level the conference gave us hope with new vaccine trials and continued research into injectable, longer-acting medications. The conference also affirmed the effectiveness of PrEP, but highlighted the slowness to reach at risks groups worldwide. Of course this made witnessing Magnet’s nurse-led PrEP model presented in the international arena both inspiring and relevant. In the struggle for increased global access to PrEP, our model was well received and sparked keen interest among the participants.”

Robert Grant, MD, MPH, from the Gladstone Institutes at University of California, San Francisco and San Francisco AIDS Foundation

Robert Grant, MD, MPH

Robert Grant, MD, MPH

“For me, the AIDS 2016 conference was about women’s experience.  We saw clear evidence that PrEP should be continued during pregnancy and breast feeding, as the safety of the medications is clear from treatment experience and pregnancy is associated with much higher risk of transmission.  We also saw new information about why some African adolescent girls and young women acquire HIV at such high rates, often 5 to 10 per 100 per year.  The reasons include age differences in partnerships and the bacterial biome.  Finally, as PrEP rolls out among male and female sex workers in South Africa, as part of the first ever African government sponsored program, I became more convinced than ever that decriminalization of all consensual sex is key to ending the epidemic.”

Diane Havlir, MD, from the University of California, San Francisco

Diane Havlir, MD

Diane Havlir, MD

“Back to Durban [The AIDS Conference was held in Durban 16 years previously, in the year 2000]—some monumental  accomplishments in the AIDS response celebrated—but some gigantic challenges ahead. To name a few:

–17 million persons on ART!!!—but we need the wherewithal and funds to treat 17 million more;

80,000 persons on PrEP in the US—but global access remains a barrier for millions more to benefit; and,

–Youth were well represented and vocal at Durban—but they are still disproportionately being infected by HIV, particular young women for reasons that we have yet to fully understand.”

Taft Weber-Kilpack, youth reporter from HIVE

Taft_68“I learned that diversity in conversation is key. This means that all stakeholders must be present at the table and included in the discussion if we are going to be the generation to end HIV.”

(See Taft’s reporting from AIDS 2016, here)

 

Shannon Weber, MSW, from HIVE

Shannon Weber, MSW

Shannon Weber, MSW

“Fun fact: AIDS 2016 had a majority of submissions from women first authors as well as a majority of presenters being female. Many promising PrEP updates including CAPRISA 009 showing high rates of adherence among women receiving PrEP in a family planning setting, Partners Demo reporting a 95% reduction in HIV among serodifferent couples offered ART & PrEP, and advances in intermittent dosing strategies for gay and bi men.”

 

Read AIDS 2016 conference coverage on BETA, including research on new PrEP drugs and delivery methods, a drug pricing protest, zero risk of HIV transmission during anal sex for men with undetectable viral loads, the number of people taking PrEP in the U.S., and more.  

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