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Biomedical Prevention 101 for Journalists

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Biomedical Prevention 101 for Journalists The Science Biomedical HIV Prevention
Lesson 1, Topic 8
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Biomedical HIV Prevention

Internews February 7, 2024
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Everyone knows about HIV Prevention, but what is Biomedical HIV Prevention?

The need for an HIV vaccine

Worldwide, vaccines play a critical role in preventing and controlling infectious disease outbreaks.

Vaccines are products made from very small amounts of weak or dead germs (such as viruses, bacteria, or toxins) that can cause diseases. They help train your body’s immune system to fight off future infections faster and more effectively.

When you get a vaccine, it sparks your immune response, helping your body fight off and remember the germ, so it can attack it if the germ ever invades again. And since vaccines are made of very small amounts of weak or dead germs, they won’t make you sick.

Vaccines are usually administered by a shot, but sometimes can be administered by mouth or nasal spray. They are widely used to prevent diseases like polio, chicken pox, measles, mumps, rubella, influenza (flu), hepatitis A and B, and human papillomavirus (HPV).

💉 Learn more about vaccines and how they work: https://www.hhs.gov/immunization/basics/index.html

Currently, there is no vaccine available that will prevent HIV infection or treat those who have it. Developing an HIV vaccine has proven challenging, as HIV mutates rapidly and has unique ways of evading the immune system. However, scientists worldwide are working hard to develop a safe and effective preventive HIV vaccine – which is key to realizing a durable end to the global HIV / AIDS pandemic.

Biomedical HIV Prevention

In the absence of a safe and effective preventive HIV vaccine, current Biomedical HIV Prevention encompasses the use of medical treatments such as antiretroviral drugs (ARVs) for prevention or post-exposure prophylaxis, barrier methods such as male and female condoms, procedures such as medical male circumcision, or other methods to reduce the chance of transmission of HIV.

This is a dynamic time for the HIV response overall:

  • We are witnessing the greatest number of trials of new concepts ever in the field. Programs are beginning to deliver Pre-Exposure Prophylaxis (or PrEP) – which is medicine that can reduce a person’s chance of getting HIV. As of July 2022, the WHO is recommending injectable cabrotegravir, following results from two large scale efficacy trials showing their efficacy for the prevention of HIV. See this FAQ on the topics of PrEP (including injectable PrEP). Be on the lookout for other forms (such as implants and longer-acting injections) in development.  
  • The HIV Prevention Trials Network (HPTN 083) study found the long-acting injectable antiretroviral drug cabotegravir (CAB LA), for pre-exposure prophylaxis (PrEP) to be safe and highly effective in preventing HIV infection in cisgender men who have sex with men and transgender women who have sex with men
  • The success of injectable cabotegravir for PrEP in reducing rates of HIV infection in two large-scale efficacy trials led to regulatory approval in 2022 by the US FDA in December 2021 and subsequent approvals by the regulatory agencies in various countries. Full list of approvals and regulatory submissions can be accessed at https://viivhealthcare.com/content/dam/cf-viiv/viivhealthcare/en_GB/pdf/cab-prep-wwrs-for-external-use.pdf or https://www.prepwatch.org/products/injectable-cab-for-prep.
  • The World Health Organization has recommended the Dapivirine Vaginal Ring as a new and additional option for HIV prevention for women at substantial risk of HIV infection “The Ring” received initial regulatory approvals in 2021 and was recommended as an additional prevention
    option by World Health Organization (WHO). As of December 2022, Kenya, South Africa, Uganda, Zambia and Zimbabwe have approved the dapivirine vaginal ring.
  • The scientific evidence is clear on U=U (Undetectable=Untransmittable). People living with HIV can feel confident that if they have an undetectable viral load and take their medications as prescribed, they cannot pass on HIV to sexual partners (U=U).
  • Results of the innovative Antibody Mediated Prevention (AMP) studies show the first evidence in humans that intravenous infusions of a broadly neutralising HIV antibody can reduce a person’s risk of acquiring HIV via sex.
  • Also, in what has been described as the “most significant HIV prevention result for women”, the HPTN084 study tested the same injection in women and found it to be safe and superior to a daily oral pill.

See AVAC’s  Biomedical HIV Prevention Research in 2022 and Beyond for an update on the full landscape of biomedical interventions.

This landscape is changing dynamically. Always consult the AVAC website for updates.

📚 Additional Resources to learn more:

This trial search tool gives an overview of all Biomedical HIV Prevention options currently being investigated.

The IAS 2023 Conference Report gives the highlights of the 12th IAS Conference on HIV science. It covers HIV Prevention (including highlights on PrEP) and Treatment, co-morbidities in people living with HIV, and HIV cure and remission, as well as topics related to structural and social issues.  

Click here for a look at the conference through the eyes of partners, including the WHO and experts from Sub-Saharan Africa.  

Be on the lookout for news from AIDS 2024 in July: the 25th International AIDS Conference which will feature new insights on long-acting PrEP as well as the impact of climate change on HIV vulnerability. 

The following links introduce new interventions and provide further explanations of key concepts:

This new U=U resource from AIDSMAP emphasizes the message that “the science is now overwhelmingly clear: a person living with HIV who is on successful treatment and has maintained an undetectable viral load for six months or more cannot pass the virus on through sexual contact. This latest edition of the booklet fully reflects important scientific findings from the past few years and shares these findings in a clear and accessible manner.”

 

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