 Hi everyone, Raif Derrazy here, and this is your weekly roundup of the latest HIV news for the week of October 9th through October 15th. Today, I'll be going through seven articles covering topics ranging from how neutralizing antibodies may prevent HIV transmission, how the timing of HIV treatment can affect gut health, tensions grow as resources for HIV dwindle at UNAIDS, and more. I won't be reading the articles per se, but I will give you a brief summary, and sometimes throw in my own opinion and or commentary. If you'd like access to the complete articles, all links will be available in the description box below. But first, a massive thank you to a few subscribers for their recent super thanks and donations. Dennis Nelson for a $50 super thanks. Tan Anderson for a $29 super chat. Mark Tuckfield for a $12 donation to PayPal for the folks in Australia. Thank you all of you. While I'm not able to make a living off of YouTube yet, your support certainly helps. All right, diving in. Number one, JMIR, Journal of Medical Internet Research, moderating effect of pre-exposure prophylaxis use on the association between sexual risk behavior and perceived risk of HIV among Brazilian gay, bisexual, and other men who have sex with men, a cross-sectional study. And a study among Brazilian men who have sex with men, MSM, researchers explore the relationship between sexual behavior, perceived risk of HIV, and the use of pre-exposure prophylaxis. They found that current PrEP users had higher behavioral risk scores, but lower perceived risk of HIV scores compared to non-PrEP users. The study suggests that PrEP users may have confidence in the effectiveness of PrEP, thank God, leading to a moderated relationship between sexual behavior and perceived HIV risk. PrEP's effectiveness, its positive psychological impact, and the frequent HIV testing and interaction with health services required of PrEP users may jointly influence the relationship between sexual behavior and perceived risk of HIV among PrEP users. Good to see that there were great findings that people who are on PrEP are doing better overall psychologically, have a better grasp on their sexual health and their risk for HIV transmission. Number two, nature communications. HIV-1 treatment timing shapes the human intestinal memory B cell repertoire to commensal bacteria. Okay, and now in English. In this research on people with HIV-1, scientists studied how the timing of starting antiretroviral therapy, otherwise known as ART, affects certain antibodies in the intestines. What they discovered was that there are clear differences in the antibodies produced by memory B cells. Depending on whether the treatment for HIV begins during the early or late stages of infection, those who started treatment later showed more reactions to common bacteria in both the gut and throughout the body, implying that delaying ART might cause the buildup of problematic memory B cells in the intestines. This could potentially harm the body's ability to fight HIV-1. The findings stress how important it is to start treatment early to prevent issues with intestinal B cells in people living with HIV. The study used samples from individuals with HIV to examine B cell patterns, antibody responses, and how microbes interact. It suggests that larger studies should be conducted to confirm these results. So, what I do want to kind of like italicize and underline is the fact that this study focuses on the risk as associated with HIV and the body's ability to fight off HIV may be decreased because ART was started later and these problematic B cells are more prevalent. However, I'm interested not just in how it affects the body's ability to fight HIV, but everything else, like it says, bacteria in general. I've certainly talked about my gut health in previous videos and in posts online. Things like this make me wonder just how much my very late stage diagnosis, I was diagnosed when I had AIDS, had a significant impact on my gut health. I frequently struggle with gas and other kinds of discomfort, constipation, diarrhea, what have you. These are the kinds of risk factors and comorbidities that need to be studied further so we can hopefully begin to mitigate and treat these conditions in those of us living with and thriving with HIV. Number three, contagion live rejected claims for PrEP linked to new HIV diagnoses. In a recent study presented at ID Week, ID stands for Infectious Disease Week 2023, researchers delved into the real-world impact of obtaining pre-exposure prophylaxis PrEP for preventing HIV infections in the US. The investigation led by Dr. Lee Tao assessed patients' ability to access PrEP, the time it took to receive it, and its potential connection to HIV risk. Analyzing data from over half a million individuals, that's a lot, they categorized them based on PrEP claims status. Those who faced rejection or abandonment of claims had significantly higher risks of new HIV diagnoses, emphasizing the importance of overcoming barriers to PrEP prescriptions. The study also highlighted demographic differences with cisgender men having the lowest new HIV diagnosis rates, underlining the need to address disparities in PrEP access to curb HIV transmission effectively. Imagine that if you reject the opportunity for people to safeguard their sexual health by not allowing them to start on PrEP or by making it access so cumbersome and so difficult that they give up on PrEP, they're more likely to consequently get an HIV diagnosis. Who to thank? I was curious to see who would initiate such a study, whose findings seem like such a given, so I looked up the first author on the article and it was Dr. Lee Tao, and she is the director of real-world evidence at Gilead. You know, some of these studies I find to be so obvious in their outcomes, so it's just interesting to kind of get an idea or a perspective of why this study was done or who did it. And so seeing Dr. Lee Tao, part of Gilead, it makes sense. Gilead also manufactures PrEP. That is, I'm not saying that there's anything like insidious or malicious there at all. In fact, I think it's a powerful resource to have this data and this study in light of the current political climate in that there are people actively trying to prevent health insurance coverage for things like PrEP, especially here in the U.S. And I imagine that that is and will continue to be a problem, not just here but elsewhere in the world with the increasing politicization that's happening lately. So thank you to Dr. Lee Tao and thank you for Gilead for putting this data into a study that's irrefutable. Number four, UNAIDS. UNAIDS welcomes new decision in Colombia, allowing more affordable access to quality HIV medicines. The government of Colombia has declared the HIV medicine as a matter of public interest, allowing them to issue a compulsory license and break the monopoly on the medication. This move is a significant step in public health, potentially reducing the price of the life-saving medicine by up to 80%. That's eight zero percent. The World Health Organization recommends Dalu-Tegravir as a preferred HIV treatment and this decision in Colombia could have a positive impact across the region. By making the medicine more affordable, the government aims to treat 28 people for the same cost allocated today for treating just one person. This decision is crucial for expanding access, especially considering the high HIV prevalence among Venezuelan migrants in the country. It not only saves lives in Colombia, but sets an example for other middle-income countries facing similar challenges and accessing crucial health products. The article states that quote the World Health Organization recommends Dalu-Tegravir as the preferred first line and second line HIV treatment for all populations, as well as being effective treatments incorporating Dalu-Tegravir based regimens have demonstrated greater adherence due to fewer side effects while presenting enhanced safety and reduced likelihood of drug resistance and quote. I didn't know that this was an option, but that's great to hear that Colombia was able to get this past and will be able to either manufacturer and or purchase the generic version of this drug to help so many more people. Number five, DevEx. As resources for HIV dwindle, tensions grow at UN AIDS. Funding challenges threaten the effectiveness of UN AIDS with donor contributions declining and tensions rising over budget allocations. The Multilateral Organization Performance Assessment Network, MOPAN, report reveals growing concerns among donors and co-sponsors about the allocation of resources accusing UN AIDS of quote mission drift, end quote. The secretariat's focus on global advocacy beyond HIV related issues has raised tensions impacting relationships with co-sponsors. The report recommends a reassessment of UN AIDS structure and collaboration mechanisms to address the funding constraints and ensure a more streamlined and effective response to ending AIDS by 2030. The need for dialogue between the secretariat and co-sponsors is emphasized along with the potential shift of some functions to other entities and a more focused vision for the joint program's future. I don't know if there's politicization going on here like with PEPFAR reauthorization here in the US and politicians opposing it are not allowing the reauthorization to happen because they are claiming that it supports abortions in other countries although I think that claim is very shaky. I don't know if that's a concern here that there's politics involved or if there's legitimate, like it says, the secretariat's focus on global advocacy beyond HIV related issues because if UN AIDS, if their directive is specifically to target HIV aid I do wonder because with HIV because it's so specific and then we've talked about this before, Dr. Monica Gonda, we've talked about it with her the idea of a wraparound care and that there are so many components that contribute to successful treatment and adherence and support for people living with HIV. It's such a tricky thing and there's so much involved making sure that people have housing needs met, food insecurity, financial insecurity, mental health support, dealing with stigma and things like that and being able to have transportation to and from healthcare facilities and so many things that combined lead to better health outcomes for people living with HIV. So I couldn't see how the secretariat at UN AIDS would want to focus on maybe some of these other things. I don't know enough so I'm not going to comment too much but there you have it, something to keep an eye on and I'm noticing now it just in general with the world and how much there's a lot of volatility going on in the world economically, financially, with governments, there's social uprising, there's like more wars happening, there's so much going on. I have a very strong gut feeling that as time moves on into this era, whatever this is that's going on, there's so much upheaval and volatility in the world that more attention and more focus is going to be on the current established funds for things like HIV and other things around the world and there's going to be a lot of scrutiny and there's going to be a lot of fighting over it. So it's good for us to keep an eye on these things and see how they progress and I will be covering all of that here. So stay tuned. Number six, the Lancet online distribution of HIV self-testing kits to promote HIV testing among men who have sex with men, discontinuing pre-exposure prophylaxis after demonstration project completion in China, a multicenter open label randomized control trial. Who writes the titles of these scientific journal articles? I swear these run on sentences that get me so bamboozled and confused. Researchers conducted a study in China to explore the effectiveness of HIV self-testing abbreviated as HIV ST self-testing as a prevention strategy for men who have sex with men. MSM discontinuing pre-exposure prophylaxis. The China real world study of oral prep project involved a randomized control trial with 620 participants. The intervention group received online access to free HIV self-testing kits while the control group received information about free site-based HIV testing. So one received online access to free HIV self-testing and the other one was given information about places they can go to get HIV testing. Results showed that the intervention group had a higher proportion of participants undergoing HIV testing at both the three month and six month follow-up periods. The study suggests that providing online distribution of HIV self-test kits effectively promotes HIV testing among men who have sex with men with prep discontinuation offering a convenient and confidential testing option. The findings highlight the potential of digital approaches to improve access to HIV testing for at-risk populations. Providing ease of access and convenience to something gets a better outcome. Who to thank. But again, it's good to have this data to refer to in future arguments, debates, etc. when when those things are being considered. I wondered for the longest time, why don't we under at least here, I'm just talking about the US because that's what I'm that's what I have experience with. Why don't we in the US have access to HIV self-testing kits online that we can order to our home in an anonymous package knowing, you know, we have our privacy and that is covered by healthcare covered by our health insurance. We should be able to go on a website, one to click something, get a test kit sent to our home as needed, take the test at home, get the results and wham bam. Thank you, ma'am. If you do have a positive, then you can do a follow up at a clinic. It's said or what have you talked to your talk to a doctor or healthcare professional. I know it's a little more complicated that that, but at least have the opportunity to do that. There are so many people who won't go to a healthcare center to get tested because of stigma or because they're scared or, you know, the clinical setting can be intimidating or they don't want to be seen by their peers. It might be, you might be in a small town and like there might be like five people that you know of that are gay or men who have sexual with men or bisexual and God forbid you, you are not out to the world and you show up and now all of a sudden all eyes are on you. What was, what was right you doing at that clinic? That's weird gossip, gossip, gossip, gossip, you know, things like that. Those are real world practical concerns that people have and being able to get something in the mail anonymously covered by health insurance wipes that out. Why don't we have that yet? Number seven and final article cell reports medicine HIV one neutralizing antibodies provide sterilizing immunity. Ooh, and I am going to get back to that word because I don't like it. Let me, let me start that over HIV one neutralizing antibodies provide sterilizing immunity by blocking infection of the first cells. In this study, researchers explore the ability of neutralizing antibodies targeting HIV one ENV to prevent infection of the first cells during mucosal exposure. They developed challenge viruses based on Simeon immunodeficiency virus Simeon is nonhuman primate version of HIV SIV that initially use HIV one ENV for entry into target cells but then switch to SIV ENV antibodies binding to HIV one and were found to effectively block HIV one and mediated infection events after rectal exposure in nonhuman primates. This suggests that such antibodies may reduce the number of first infection events potentially providing quote sterilizing immunity and quote. I believe what this is saying and this is the summary of the article. This is even like simpler than that and I'm still it's still very confusing. I apologize for that. Some of this stuff is very hard to translate. They're saying they in in the rectum, which is within the anus the inside of the buttocks area, they were able to have neutralizing antibodies that prevented HIV infection at that mucosal level at the surface level and therefore it was never able to go inside the body and begin infecting other cells is what what I'm taking from this now about this word. Now you won't hear me personally using the term sterilizing immunity or sterilizing cure. I stay away from the word sterilizing. It's part of our stigmatizing language document that the MDC's or Martin Delaney collaboratories. It's the 10 collaboratories I've spoken of previously. I'm in the hope collaboratory that what we have put together is this document that is a suggestion for the scientific research clinical medical community to consider not using certain language when they are writing these articles and science speak and what the suggested alternative would be. So in this case, a sterilizing immunity. It's like why why doesn't need to be sterilizing immunity? Why can't you just say provides immunity? It's that that gets the point across sterilizing is very confusing. It implies sterilization in terms of fertility in terms of your ability to have children. And even recently, I've covered this in my weekly news articles, females in certain parts of the world who are living with HIV have been sterilized from no longer being able to have kids without their prior consent without their knowledge. That is a major crime. It's happening. It has happened and it continues to happen in parts all around the world to women living with HIV. They're being sterilized against their will. That is a huge problem. So this language is therefore problematic when you're associating with HIV, something so closely related to horrible events that are going on in the world, especially if a vaccine or a cure is developed. And it is labeled as sterilizing. I mean, can you can you imagine the rollout of such a treatment and how that could snowball? Oh, there's a sterilizing cure. There's a sterilizing vaccine in all the conspiracy theories that would grow out of that the distrust or at the very least resentment by different communities. It's clumsy. It's confusing and it's insensitive. Anyway, back to the article, preventing infection of this this first cell line is crucial as it avoids the formation of latently infected cells. We've talked about this and reduces the risk of emergence of antibody resistant mutants, making it a promising mode of protection against HIV. So you can have HIV transmission that happens that happens to a person or in this case, a nonhuman primate. And as long as the HIV doesn't go inside a cell and become latent, then something like PEP post exposure prophylaxis can wipe out all the HIV and you will be fine. But once those latent cells, once the HIV goes into cells and it becomes latent, it goes dormant, it hides, then no amount of ART is going to help you get rid of those cells. That is the problem. That is why we don't have a cure yet those latent cells. So this specifically is talking about preventing the formation of latently infected cells. So that's a great thing. All right, links to all these articles can be found in the description box below this video. Be sure to like this video, subscribe if you haven't already hit that bell so you get a notification every time a new video comes out. They are coming out more frequently and they are more interesting and they are more entertaining. So watch out and please share this with anyone who might find value in this content. It's one of the best ways that you can help support me and my channel. Until next time, cheers.