 Hey everyone, Rajiv Dharazi here and this is your weekly roundup of the latest HIV news for the week of November 6th through the 12th. Today I'll be going through 13 articles covering topics ranging from once a year injectable HIV medication, a study of 4,000 people in South Africa found nearly 13% of them were able to control HIV without medication, running out of options for gonorrhea treatment, potentially free PrEP for one group in the US 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 couple of subscribers for their recent Superthanks and donations, Dennis Nelson $50 Superthanks on the Positive Plus One Christian Philip Mercer Hall interview, and Tan Anderson for $30 Superthanks on the Joni Evans Gay Games interview. By the way, Positive Plus One, the new app for our HIV community, will be coming out this Friday, November 17th. If you haven't seen the video talking about the app, here's a card to watch it and be sure to pre-register at the link below in the description box. Alright, jumping right in, number one, the San Francisco Chronicle, US to cover HIV prevention drugs for older Americans to stem spread of virus. The Biden administration proposes a federal policy to offer free HIV prevention medication for older Americans. Under the plan, Medicare would cover the full cost of pre-exposure prophylaxis drugs, PrEP, for those 65 and older, including long-acting injectables. This move is crucial, as those 50 and over represent half of all people in the US living with HIV. The proposed policy, a significant shift, would cover even the costly long-acting injectable versions of PrEP drugs. While this aims to reduce infections in older Americans, it also highlights disparities as many under 65 may still struggle to afford PrEP. The proposal raises questions about taxpayer costs and offsets for future HIV-related care in Medicare patients. Number two, AIDS United, tell Congress no HIV funding cuts. House Republicans have proposed a spending bill for 2024 that would severely undermine efforts to end the HIV epidemic by 2030. Endangering federal HIV programs, the bill includes a staggering $767 million cut in spending on crucial initiatives, such as defending the Ending the HIV Epidemic Initiative, all of Part F of the Ryan White HIV AIDS Program, and cutting over $150 million for the Minority AIDS Initiative. This jeopardizes the well-being of millions of people affected by HIV. Centers from both parties are resisting these drastic cuts, proposing spending bills that, at the very least, maintain HIV funding at last year's level. And just for reference, Part F of the Ryan White AIDS Program includes AIDS Education and Training Center Program, which provides training and technical assistance to providers treating patients with or at risk for HIV, special projects of national significance, which develops innovative models of HIV care and treatment to respond to the Ryan White HIV AIDS Program client needs, dental programs, providing oral health care for people with HIV and education about HIV for dental care providers, and Minority AIDS Initiative, helping the Ryan White HIV AIDS Program recipients improve access to HIV care and health outcomes for minorities. So that gives you an idea of the proposed cuts. Number three, Contagion Live, political and social barriers to ending the HIV epidemic. Ending the HIV epidemic is within reach with the right strategies, but significant social and political barriers persist. The 95-95-95 framework proposes that 95% of individuals living with HIV know their status, 95% are retained in care, and 95% reach an undetectable status, U-Equals-U. Currently in the US, 87% know their status, 50% are retained in care, and 57% achieve undetectable status. Social barriers, including stigma and systemic racism, contribute to health disparities. Stigma around the virus, transmission, sex, and sexuality discourages testing and treatment. Systemic racism leads to racial disparities with two-thirds of individuals living with HIV being people of color. Political barriers involve inadequate funding, legislative morality, criminalization laws, and failure to expand Medicaid. Sustaining these barriers requires building political will, addressing social determinants of health, and sustaining investment in testing, prevention, and management programs. Number four, AIDS Map, HIV services in Ukraine resilient, but starting to feel the strain. Ukraine faces challenges in sustaining HIV services due to the war and reliance on external funding. With 414 hospitals damaged or destroyed and 254 healthcare workers killed or injured, the state of HIV services in some regions is unknown. HIV testing rates have declined and the number of people on antiretroviral therapy has fallen. The proportion of late diagnoses has increased, highlighting delayed testing and diagnosis. Political barriers include inadequate funding and a reversal in government support for HIV services, with external funding covering 85% of the budget in 2022 and none from the government in 2023. The war's impact on health infrastructure and population displacement complicates the situation, requiring substantial investment to restore the healthcare system. I mean, the title says HIV services in Ukraine resilient, but based on what I read in the article on the summary, it seems like it's not doing so well already. Number five, DevEx. Regulations the top hurdle to making medicines in Africa officials say. Ukraine faces challenges in developing local pharmaceutical manufacturing due to regulatory hurdles. While the European Union plans to shift manufacturing to African countries, officials express concerns about fragmented and weak regulatory systems in African countries. The lack of common regulations across the continent poses difficulties for pharmaceutical companies. The slow establishment of the African Medicines Agency, a central regulatory agency for harmonizing regulations, exacerbates the problem. The need for common regulations and joint procurement mechanisms is emphasized to streamline processes and ensure that locally produced medicines can be used across all African countries. The EU's efforts to invest over one billion in projects to strengthen Africa's capacity for vaccine and medicine manufacturing aim to address these challenges. I mean, first of all, Africa is such a huge continent. We so commonly just toss around Africa, Africa, Africa the continent. Let's help Africa as though it's like this singular place that's easily managed. But Africa's huge. Africa's ginormous. I mean, the way we see it on a map, on a flat map, isn't really accurate in relation to other continents and other countries, vastly larger than Europe. And just being able to get all of the European countries to be cohesive and work together, the UK no longer part of the EU and having regulations and all these things be harmonious seems like I feel like we're almost addressing it as though it should be easier than it is. It's very complicated. And there's just an enormous amount of countries to try to get all the countries, at least all the countries that are heavily impacted by HIV on the same page before we're able to make a movement as far as them being able to manufacture pharmaceuticals in those countries is a losing battle in comparison to, say, they accept medicines from outside of Africa, from Europe. So why not just establish those regulations that are already in place in European countries and pick a country that's well suited, well ready and capable to handle those same regulations. And so now you have this, let's say, let's just, for example, say, we'll we'll choose South Africa. Okay, South Africa. All right, we're going to hold you to these regulations that we have outside of Africa in said European European country. Great. Now, there's no reason why South Africa couldn't then deliver the medicines to all these other countries that need it in Africa, because those other countries presumably accept medicine from Europe. And if South Africa is held to the same regulation standards as those countries in Europe, then ta-da, you have a country that is manufacturing pharmaceuticals in Africa under regulations. Yes, all the countries aren't under the same regulations, but you have one that is tied to European regulations. And voila, I'm sure it's more complicated than that. But I'm just surprised that it's not being addressed specifically in that way, because I think that's the more logical, more direct, quick way of going about it. So I'm just throwing that out there. Anyway, moving on. Number six, NBC News. New antibiotic shows promise for drug-resistant gonorrhea. Though we are not talking about HIV here, it's important to keep an eye on gonorrhea in particular as it can increase the risk of contracting HIV. A new antibiotic called Zolaflotisim has shown effectiveness in treating gonorrhea, including the efficacy of the current recommended treatment, a combination of ceftriaxone and azithromycin. Gonorrhea has developed resistance to all antibiotics used to treat it, except for the recommended combination therapy. Zolaflotisim, developed by the Global Antibiotic Research and Development Partnership, demonstrated its effectiveness in a late-stage clinical trial offering a new tool in the treatment of gonorrhea. The antibiotic expected to be available in 2025 could address the growing concerns about drug-resistant strains of the sexually transmitted infection. The World Health Organization estimates over 82 million new gonorrhea cases globally each year, with rising cases in the US. Number seven, Global Equality Today. Uganda's AGOA trade status terminated. President Biden has informed Congress of his intention to terminate preferential trade status for four African countries, the Central African Republic, Gabon, Niger, and Uganda. Under the African Growth and Opportunities Act, AGOA enacted in 2000 to support economic development in Africa, grants preferential trade access to US markets for qualifying countries. Uganda's termination from AGOA was expected due to a significant deterioration in human rights, notably the passage of the Anti-Homosexuality Act, also known as AHA. The AHA imposes harsh criminal penalties on LGBTQI-plus individuals and contravenes human rights ideals, prompting the termination of Uganda's AGOA benefits. The decision signals consequences for countries engaging in LGBTQI-plus persecution and reinforces the link between human rights and preferential trade relations. I am keeping an eye specifically on Uganda because, though these political and economic moves don't impact HIV directly, there may be tangible consequences as time passes, and I have a feeling that there will be. Number eight, Scoop Health, Sex, Drugs, and Health Checks. New research in New Zealand indicates that gay and bisexual men who engage in more sexually adventurous behaviors, such as group sex and using drugs to enhance sexual experiences, are also more proactive in managing HIV transmission risks. The study involving 739 participants found that over a third reported recent group sex and a similar proportion used drugs to enhance sexual experiences. These individuals were more likely to engage in regular testing, pre-exposure prophylaxis, and HIV treatment, highlighting their vigilance in HIV prevention. This study suggests that HIV prevention efforts have been effective, especially among those participating in behaviors posing a risk of HIV transmission. I think this study helps dispel the myth and the stigma that those who are sexually active in this way are careless, selfish, and unaware of the consequences of their actions. Number eight, AIDS Map. Nearly 13% of participants in an African cohort maintain HIV control off treatment. A study involving over 4,000 South African and Zambian participants with HIV found that nearly a quarter were off treatment, and 13% of them were able to control the virus without medication. Women were found to be twice as likely to be a, quote, controller, while other demographic characteristics did not influence viral control. The prevalence of controllers in this cohort was at least three times greater than similar studies in other countries raising questions about the genetic makeup of the local population of the virus subtype. The study suggests that both viremic and elite control in people with HIV may lead to less immune exhaustion and improved long-term health outcomes. I've talked about this term, quote, controllers before, meaning people who are either able to control their HIV without any medication, or once they've been on ART for a period of time and then come off of it are then able to control HIV in their bodies. And studying people with this ability can help us find a potential avenue towards cure. Number 10, the Lancet, the effect of combination prevention strategies on HIV incidents among gay and bisexual men who have sex with men in the UK, a model-based analysis. In the UK, HIV diagnoses among gay and bisexual men have significantly decreased thanks to interventions like pre-exposure prophylaxis and increased HIV testing. A study using a simulation model found a 77% decline in HIV incidents since 2014, estimating 597 infections in 2022. Prep and enhanced testing with antiretroviral therapy played crucial roles. Without prep, infections could have doubled. The study projects a decline in incidents to 388 HIV infections in 2025 and 263 in 2030 if current interventions continue. To further reduce infections, increased testing and prep use are recommended, with an additional annual cost of 1.62 million pounds to be cost effective. The study emphasizes the importance of reducing testing and prep costs for continued effectiveness. Number 11, DevX, too big to fail, how USAID's $9.5 billion supply chain vision unraveled. The largest ever project funded by the United States Agency for International Development, or USAID, a $9.5 billion initiative led by US contractor Chemonix International aimed to transform global health supply chains. But a new investigation by DevX and the Bureau of Investigative Journalism raises questions about its performance. Former project staff and officials reveal serious problems during its early years, allegations of performance manipulation, arrests, and indictments related to illegal activity, and concerns about the project's impact on building lasting supply chains. Despite public narratives of recovery, the investigation challenges the notion that the project has effectively strengthened the global supply chain for life-saving medical supplies. Chemonix, a major consulting firm, claims to have overcome challenges. While USAID prepares for a new $17 billion project, USAID's next-generation global health supply chain suite of programs known as NextGen. I think we are talking about some such staggering amounts of money here and in other programs. It's easy for inefficiencies to take hold for money to be misused, misappropriated, corruption, etc. While I strongly support funding global projects to fight the HIV epidemic, I do think there is room for more accountability and oversight to make sure that these funds are actually going to the programs they're supposed to and helping the people in the way that they're supposed to. This is a much better strategy than just broadly slashing funding across the board, and that also doesn't address the actual issue of clearing the system of major issues. Number 12. The Daily Mail. HIV could become like receiving a flu jab and require only one injection a year to keep it under control. Deborah Waterhouse, the CEO of Vive Healthcare, a company specializing in HIV AIDS treatment and owned by GlaxoSmithKline, has revealed plans to develop an annual injection for HIV treatment within the next decade. Currently, Vive offers an injection, Cabanuva, that needs to be taken every two months to keep virus levels suppressed. The company aims to extend the gap between injections to four months and envisions a path towards a twice-a-year injection. Dennis Waterhouse believes that achieving a once-a-year treatment for HIV, similar to a flu vaccine, is on the horizon, potentially available in the early 2030s. Vive plans to introduce the four-monthly injection by 2027 and the six-monthly dose by the end of the decade. Links to all these articles can be found in the description box below this video. Be sure to like this video, subscribe, and hit that bell so you get a notification every time a new video comes out. And please share this with anyone who might find value in this content. These are the best ways that you can help support me and my channel. Until next time, cheers!