Highlights from Black AIDS Institute Delegation at CROI 2016

Matthew Rose, Program Coordinator, Black AIDS Institute

Every year the top scientists in HIV, HCV and other retroviruses gather at CROI, the Conference on Retroviruses and Opportunistic Infections. CROI has become a place to break new science; where careers are made, and new paths are revealed toward ending the epidemic. At CROI 2016, held in February in Boston, the Black AIDS Institute partnered with AVAC and the Community Liaison Subcommittee of CROI for the second year in a row to bring a delegation of community advocates to this formidable conference and help them understand and bring science presented at CROI back home to their communities. Here are five highlights BAI delegates took away from the conference.

Vaginal Ring

One of the more exciting breakthroughs involved two large-scale research studies looking at a new prevention technology: the vaginal ring. Researchers examined whether a vaginal ring that released an antiretroviral medication would protect women from HIV during vaginal sex. In two trials conducted among African women, Dapivirine Vaginal Ring was shown to reduce risk in women by 27 and 56 percent. This technology could have profound prevention implications in countries with severe general epidemics.

Rectal Microbicide

Following years of strong advocacy, for the first time research on a rectal microbicide yielded promising results. A study conducted in gay men and transgender women compared a rectal microbicide formulation of Tenofovir gel to daily oral Truvada and found that the gel was safe and well tolerated. Study participants also accepted the gel at the same level they did oral PrEP. Furthermore, they preferred to use the gel on an event basis rather than daily like the oral regimen.

Broadly Neutralizing HIV-1 Antibodies (bNAbs)

Researchers have identified many antibodies that have the potential to neutralize more than 90 percent of known HIV strains. Yet the idea of giving people HIV-neutralizing antibodies through an IV drip is fairly new concept. The Antibody Mediated Prevention study is exploring whether infusing people with antibodies will actually protect them from acquiring HIV in real-world conditions.

PrEP

The conference had a large focus on PrEP's use in the field as well as updated data from various studies. Two studies provided considerable insight into the side effects of PrEP most common among users.Their results reinforce the importance both of adherence and monthly routine kidney screening tests for PrEP users. Another study examined bone density and PrEP. Researchers learned that the Tenofovir component of Truvada tends to cause a small drop in bone mineral density; however, this reversed after participants stopped taking the drug.

PrEP in Black Gay Men

One of the large PrEP findings came from HPTN 073, the first studies to look at PrEP among U.S. Black MSM that offered a client-centered care strategy to support men's PrEP use. The study found that not only was PrEP acceptable and tolerated among Black gay men but also found that the client-centered care coordinated counseling (C4) model enhanced the uptake of PrEP among the population.

Long-acting Injectables

Multiple presentations looked at PrEP in the long-acting injectable (LAI) formulation cabotegravir. In one study that looked at the forumulation for prevention, LAI cabotegravir was well-tolerated in MSM who were at low risk for HIV infection and preferred daily oral PrEP. Cabotegravir was also studied as an ingredient in what, if successful, would be the first injectable antiretroviral treatment option. In latebreaking research, 91 percent of patients in a study of the 8-week, LAI combination regimen cabotegravir and rilpivirine maintained viral suppression and also expressed satisfaction with this new treatment.

No silver bullet will end this epidemic; however, the more options that become available, the more tools we will have in our epidemic-ending toolkit. You can find most of the major content from CROI 2016 online at http://www.croiwebcasts.org/y/2014?link=croi

Matthew Rose is HIV/AIDS, and Social Justice advocates with over a decade of experience. He works at the Black AIDS Institute in the Training and Capacity Building Department. He works to increase the capacity of partner organizations and community members to understand, engage, and utilize HIV sciences and to mobilize their local communities. He serves as the biomedical lead at the Institute specializing in knowledge about HIV science for both prevention and treatment.