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AIDS and HIV

AHF Marks 30th Anniversary with documentary, aid for Puerto Rico

‘Keeping the Promise—AHF 30 Years’ feats archival footage, life & death stories

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AHF President President Michael Weinstein and In The Meantime Men Executive Director Jeffrey King at AHF 30th Anniversary Oct. 19, 2017. (Photo by Karen Ocamb)

Family, friends and staff packed into Hollywood’s Arclight Cinerama Dome Theater Thursday night to celebrate the 30th anniversary of AIDS Healthcare Foundation and screen the premier of a documentary, ‘Keeping the Promise—AHF 30 Years.’ The hour-long film, filled with critical archival footage of the early days of the AIDS crisis, depicts the organization’s growth from a small group of Los Angeles AIDS activists providing dignified hospice care to dying young people into a worldwide healthcare organization delivering services to more than 821,000 people in the US and 37 other countries in Europe, Africa, Latin America/Caribbean and Asia.

But first there was a short montage of news clips about AHF’s surprising help as essentially a First Responder to the humanitarian crisis in Puerto Rico after the devastating impact of Hurricanes Irma and Maria. Thursday morning, with Gov. Ricardo Rossello at his side for a photo opportunity in the Oval Office, President Trump gave himself a “10” for the federal government’s response, while also claiming local corruption is hindering their efforts. As of Friday, Oct. 20, one month after the hurricanes hit, 80% of Puerto Rico is still without power. The video showed how AHF chartered a cargo plane and flew from Opa-Locka, Florida to San Juan on Sept. 29 loaded with supplies, satellite phones and 50 generators, 48 hours after receiving a call for help.

“We’ll be getting them out to health departments so that we can take some of the burden off the hospitals that they’ve been experiencing as it relates to dealing with chronic disease issues and dealing with the challenges of those folks that have some time-sensitive medical needs,” AHF staffer Imara Canady told WSVN TV News. 

At the end of the video, a tearful San Juan Mayor Carmen Yulín Cruz expressed her gratitude to AHF and asked for more help. AHF has set up a site, POWER 2 PUERTO RICO, http://www.power2pr.org/ with ways to contribute to help them get more supplies to the island, an American territory since 1898. Text “Power2PR” to 41444 to donate.

In another move in keeping with their ongoing mission challenging Big Pharma’s profiteering from outrageous drug pricing, on Oct. 17 AHF called on Gilead Sciences, Inc. “to reduce the price of its tenofovir-based drug regimens—including Truvada—by as much as 90%,” the press release says, since their patent on tenofovir disoproxil fumarate (TDF), (branded as Viread) is set to expire on December 15, 2017. AHF notes that since the FDA first approved the drug on October 26, 2001, “the TDF formulation of tenofovir has become a cornerstone of other big money Gilead combination HIV/AIDS treatment therapies beyond Viread.” That includes Truvada, which AHF describes as “(tenofovir disoproxil fumarate + emtricitabine), Gilead’s blockbuster HIV/AIDS treatment that is also the medication component used for pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. AWP (Average Wholesale Price https://www.verywell.com/average-wholesale-price-of-hiv-drugs-49622) $1,759.73 USD per month / $21,116.76 USD yearly.”

“Gilead has made untold billions off of tenofovir in its various treatment combinations since its introduction in 2001. More recently, it tried to extend its patent monopoly on tenofovir in order to maintain enormous profit margins on the drug. But the tenofovir patent expires in just a few short weeks, meaning the generic market for the drug will open widely,” said AHF President Michael Weinstein in an extensive press release about drug pricing. “As a result, with the patent ending and generic versions on the horizon, we call on Gilead for an immediate ninety-percent reduction across the board on the price of all tenofovir-based drugs—including on Truvada, as well as combination therapies using tenofovir that Gilead makes in partnership with companies like BMS and Janssen.”

The battle against Big Pharma is prominently featured in “Keeping the Promise—AHF 30 Years,” in which Weinstein calls drug pricing “obscene,” noting that the cost of the latest combination therapy is $28,500.

“The issue today is whether the Congress has the guts to stand up for their constituents. People are being ripped off,” says Vermont Sen. Bernie Sanders in the film. Sanders came to California to back AHF’s Prop 61, an unsuccessful statewide drug pricing initiative last year. “Every single day, people are choosing between medications and food,” Weinstein said urging a Yes on D vote.

While the film documents AHF’s evolution from grassroots activism lead by ACT UP best friends Weinstein and Chris Brownlie —to whom the film is dedicated—to organizer of last year’s historic concert and march for AIDS awareness and services in Durban, South Africa, the film also chronicles the devastating reaction to HIV/AIDS itself.

Fade up: 1982. NBC anchor Tom Brokaw tells the world that “the lifestyle of some homosexual men has triggered an epidemic.” Also triggered is fear and the “blame the victim” approach that would excuse federal, state, local governments, civil institutions, churches and families to eschew seeing the building crisis as confined to icky gays instead of a healthcare emergency requiring immediately attention and action. That lead to the 1986 effort by extremist Lyndon LaRouche to push a ballot initiative, Prop 64, quarantine people with AIDS. http://articles.latimes.com/1986-09-21/opinion/op-9036_1_public-health-authorities Weinstein, Brownlie and their activist friends organized a march to LaRouche’s headquarters in Atwater Village, bringing along actress Patty Duke, head of the Screen Actor’s Guild. Many thought Prop 64 would pass, but when it failed the activists asked themselves what they should do next. With people dying in the halls of county hospital and overcrowded 5P21, at least they could give people a “dignified death.” (This teaser is edited excerpts from the film).

They set up a “blue ribbon panel” that included prominent local gay activists Morris Kight and Jackie Goldberg (then still in the closet) in which people said they would rather die at home than at USC County hospital. In 1987, the group became the AIDS Hospice Committee and approached gay ally LA County Supervisor Ed Edleman for $400,000 for a hospice. When anti-gay Supervisor Mike Antonivich asked why that money should be allotted, Edleman turned it around and said he was right—it should be $400,000 from each of the five supervisors.

“There is a new sense of urgency in the county. In October, 192 new cases of AIDS were reported–the highest number recorded here. Most of the care is now hospital-based, and most of the deaths are away from home and away from hospices because of the lack of alternative facilities. That is cruel to those burdened with the disease, and it is wasteful of resources,” the Los Angeles Times reported Dec. 10, 1987.  “Michael Weinstein, chairman of the AIDS Hospice Planning Commission whose work inspired the county AIDS Commission recommendations, was elated after the meeting of the supervisors. He had met earlier with scores of people with AIDS, and with the mothers of some who already have died. ‘They needed a victory,’ he said. ‘They face so many defeats.’”

In the film, Weinstein recalls that was the first time in history a group walked into a supervisors board meeting asking for $400,000 and walked out with $2 million.

The group later became the AIDS Hospice Foundation, establishing the Chris Brownlie Hospice, the first of three hospices in LA County. As longtime AHF staffer Terrie Ford says, “There was no other place for these people to go and be treated like human beings because there was so much stigma.” There was also a great need for AIDS awareness—with Weinstein going on the Oprah Winfrey show and Bill Rosendahl’s Century Cable shows for AIDS Updates, sometimes with longtime AHF friend, Morris Kight. Fear and ignorance were pervasive.

“We are having to go to a system where we’ll probably have to breathe from outside the operating room because when we drill and ream on bone we are most likely aerosolizing blood products and the virus,” says a nurse on a talk show.

The film has a number of memorable and historic moments, including changing their name to AIDS Healthcare Foundation in 1990 and expanding their mission to going where the need is with advocacy, “a positive healthcare plan,” mobile testing, treatment and care, regardless of the ability to pay—which they sustain with a social enterprise business model (thrift stores, pharmacy).

The documentary also tells of how AHF came perilously close to bankruptcy and Weinstein faced a possible coup when in 1996, he decided to give the miraculous triple drug cocktail to the patients who needed it the most—those who lay dying in AHF hospices, even though the organization would not be compensated by the government. Nonetheless, Weinstein saw it as a “moral imperative” to not let people die if they had a chance to live—and many did.

There’s also an incredible story of a man being delivered to an AHF clinic in India. He’s brought in enclosed in a satchel, with no one wanting to touch him as he exhibited sores and rashes everywhere. Four months later he returns to the doctor, unrecognizable in how healthy he is. In another, tragic story, a young boy dies because he doesn’t have access to life-saving drugs as his distraught mother sobs in the car of a healthcare worker trying to help. Another story finds AHF healthcare workers ominously stopped by security in Uganda—after a few harrowing moments, it turns out the police officer only wants to thank them for saving his brother’s life.

There is also a full embrace of AHF’s often controversial marketing. “That’s intentional,” says Weinstein. “We want people to pay attention.”

“On this occasion of the 30th anniversary of the founding of AHF, I want to thank our board of directors, our staff of 5,600, our 821,000 patients and the community of supporters we have around the country and the world. Everything we have accomplished is because of your dedication. AHF stands as living proof that the world can be changed for the better if you are willing to work hard and dedicate yourself to a mission,” Weinstein said. “I really wish that Chris Brownlie, my dear friend and co-founder of AHF, could be alive today to see what his voice inspired. While we celebrate this milestone, we recognize that there is still so much more work to be done before we defeat AIDS once and for all time.”

There will be more staff and public screenings of the documentary through the end of the year. On Dec. 1, World AIDS Day, AHF will host a number of World AIDS Day/AHF 30th Anniversary concerts and community activations around the globe, including screening the film in several different languages.

AHF Board Chair Cynthia Davis and Corey Lyons, President of Impulse Orlando and AHF Board member. (Photo by Karen Ocamb)

“Congratulations to all of the AHF staff, Board members, volunteers, partners and our patients for contributing your best to help AHF meet this remarkable thirty-year milestone with over 821,000 patients now in AHF’s care somewhere in the world,” said Cynthia Davis, MPH, Assistant Professor, College of Medicine, Charles R. Drew University of Medicine and Science and Chair of AHF’s Board of Directors. “On behalf of the Board, we are honored and proud of the work done—and to work alongside you—in the fight against AIDS each day.”

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AIDS and HIV

U.S. announces more funding for HIV/AIDS fight in Latin America

Jill Biden made announcement on Saturday in Panama

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Former Panamanian first lady Lorena Castillo and UNAIDS in 2017 launched a campaign to fight discrimination against Panamanians with HIV/AIDS. Panama will receive $12.2 million in new PEPFAR funding to further combat the HIV/AIDS epidemic in Latin America. (Washington Blade photo by Michael K. Lavers)

PANAMA CITY — First lady Jill Biden on Saturday announced the U.S. will provide an additional $80.9 million to the fight against HIV/AIDS in Latin America.

Biden during a visit to Casa Hogar el Buen Samaritano, a shelter for people with HIV/AIDS in Panama City, said the State Department will earmark an additional $80.9 million for President’s Emergency Plan for AIDS Relief-funded work in Latin America. A Panamanian activist with whom the Washington Blade spoke said LGBTQ+ people were among those who met with the first lady during her visit.

Pope Francis visited the shelter in 2019.

“I’m glad we have the opportunity to talk about how the United States and Panama can work together to combat HIV,” said the first lady.

Michael LaRosa, the first lady’s spokesperson, noted Panama will receive $12.2 million of the $80.9 million in PEPFAR funding.

“This funding, pending Congressional notification, will support expanded HIV/AIDS services and treatment,” said LaRosa.

UNAIDS statistics indicate an estimated 31,000 Panamanians were living with HIV/AIDS in 2020. The first lady’s office notes the country in 2020 had the highest number of “newly notificated cases of HIV/AIDS” in Central America.

The first lady visited Panama as part of a trip that included stops in Ecuador and Costa Rica.

The Summit of the Americas will take place next month in Los Angeles. The U.S. Agency for International Development and PEPFAR in April announced they delivered more than 18 million doses of antiretroviral drugs for Ukrainians with HIV/AIDS.

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AIDS and HIV

New highly-infectious variant of HIV discovered by Dutch scientists

This new variant of HIV-1 damaged the immune system twice as fast, “placing individuals at risk of developing AIDS much more rapidly”

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The human immunodeficiency virus in the bloodstream (Photo Credit: NIH/CDC)

CAMBRIDGE, UK – A study published this week by Science (journal) detailed an alarming discovery by researchers, clinicians and epidemiologists in the Netherlands of a new, highly-infectious mutated variant strain of the human immunodeficiency virus, (HIV), circulating in the country.

The BEEHIVE project – which stands for “bridging the epidemiology and evolution of HIV in Europe and Uganda,” detailed the findings which showed that a distinct subtype-B viral variant of HIV-1 damaged the immune system twice as fast, “placing individuals at risk of developing AIDS much more rapidly”, and those with this variant were at a higher risk of transmitting the virus to others.

The variant, known as the “VB variant”, causes CD4 cell decline to occur twice as fast in infected individuals compared with other viral variants. This is a clinical hallmark, or “signature” of the extent of damage caused by the HIV virus. In addition, those infected with the VB variant also demonstrated an increased risk of transmitting the virus to others, the data suggests.

Individuals infected with the new “VB variant” (for virulent subtype B) showed significant differences before antiretroviral treatment compared with individuals infected with other HIV variants:

  • Individuals with the VB variant had a viral load (the level of the virus in the blood) between 3.5 and 5.5 times higher.
  • In addition, the rate of CD4 cell decline (the hallmark of immune system damage by HIV) occurred twice as fast in individuals with the VB variant, placing them at risk of developing AIDS much more rapidly.
  • Individuals with the VB variant also showed an increased risk of transmitting the virus to others.

The project’s researchers, clinicians and epidemiologists did determine however, that those infected with the VB variant had “similar immune system recovery and survival to individuals with other HIV variants.”

However, the researchers stress that because the VB variant causes a more rapid decline in immune system strength, this makes it critical that individuals are diagnosed early and start treatment as soon as possible.

BEEHIVE project‘s lead author Dr Chris Wymant, from the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, said: “Before this study, the genetics of the HIV virus were known to be relevant for virulence, implying that the evolution of a new variant could change its impact on health. Discovery of the VB variant demonstrated this, providing a rare example of the risk posed by viral virulence evolution.”

“Our findings emphasize the importance of World Health Organization guidance that individuals at risk of acquiring HIV have access to regular testing to allow early diagnosis, followed by immediate treatment. This limits the amount of time HIV can damage an individual’s immune system and jeopardise their health. It also ensures that HIV is suppressed as quickly as possible, which prevents transmission to other individuals,” Senior author Professor Christophe Fraser from the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, added.

In its Global HIV & AIDS statistics — Fact sheet, the UNAIDS Secretariat detailed the statistical data: 

GLOBAL HIV STATISTICS

  • 28.2 million people were accessing antiretroviral therapy as of 30 June 2021.
  • 37.7 million [30.2 million–45.1 million] people globally were living with HIV in 2020.
  • 1.5 million [1.0 million–2.0 million] people became newly infected with HIV in 2020.
  • 680 000 [480 000–1.0 million] people died from AIDS-related illnesses in 2020. 
  • 79.3 million [55.9 million–110 million] people have become infected with HIV since the start of the epidemic.
  • 36.3 million [27.2 million–47.8 million] people have died from AIDS-related illnesses since the start of the epidemic.

People living with HIV                                                                          

  • In 2020, there were 37.7 million [30.2 million–45.1 million] people living with HIV.
    • 36.0 million [28.9 million–43.2 million] adults.
    • 1.7 million [1.2 million–2.2 million] children (0–14 years).
    • 53% of all people living with HIV were women and girls.
  • 84% [67– >98%] of all people living with HIV knew their HIV status in 2020.
  • About 6.1 million [4.9 million–7.3 million] people did not know that they were living with HIV in 2020.

People living with HIV accessing antiretroviral therapy

  • As of 30 June 2021, 28.2 million people were accessing antiretroviral therapy, up from 7.8 million [6.9 million–7.9 million] in 2010.
  • In 2020, 73% [56–88%] of all people living with HIV were accessing treatment.
    • 74% [57–90%] of adults aged 15 years and older living with HIV had access to treatment, as did 54% [37–69%] of children aged 0–14 years.
    • 79% [61–95%] of female adults aged 15 years and older had access to treatment; however, just 68% [52–83%] of male adults aged 15 years and older had access.
  • 85% [63– >98%] of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2020.

New HIV infections

  • New HIV infections have been reduced by 52% since the peak in 1997.
    • In 2020, around 1.5 million [1.0 million–2.0 million] people were newly infected with HIV, compared to 3.0 million [2.1 million–4.2 million] people in 1997.
    • Women and girls accounted for 50% of all new infections in 2020.
  • Since 2010, new HIV infections have declined by 31%, from 2.1 million [1.5 million–2.9 million] to 1.5 million [1.0 million–2.0 million] in 2020.
    • Since 2010, new HIV infections among children have declined by 53%, from 320 000 [210 000–510 000] in 2010 to 150 000 [100 000–240 000] in 2020.

AIDS-related deaths

  • AIDS-related deaths have been reduced by 64% since the peak in 2004 and by 47% since 2010.
    • In 2020, around 680 000 [480 000–1 million] people died from AIDS-related illnesses worldwide, compared to 1.9 million [1.3 million–2.7 million] people in 2004 and 1.3 million [910 000–1.9 million] people in 2010.
  • AIDS-related mortality has declined by 53% among women and girls and by 41% among men and boys since 2010.
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AIDS and HIV

‘Promising’ HIV vaccine study conducted at George Washington University

“We are tremendously excited to be advancing this new direction in HIV vaccine design with Moderna’s mRNA platform”

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Courtesy of the George Washington University School of Medicine and Health Sciences

WASHINGTON – D.C.’s George Washington University School of Medicine and Health Sciences is one of four sites across the country in which a preliminary component of an experimental HIV vaccine is being given to volunteer participants in a study aimed at reversing years of failed attempts to develop an effective HIV vaccine by pursuing what study sponsors say is a new, promising approach.

The study, which involves 56 healthy, HIV-negative volunteer participants, is being conducted by the nonprofit scientific research organization known as IAVI and the biotechnology company Moderna, which developed one of the coronavirus vaccines now being used throughout the world.

In a Jan. 27 joint statement, IAVI and Moderna said their study is part of a Phase 1 trial designed to test newly developed experimental HIV vaccine antigens to determine if they will lead to the development of an effective HIV vaccine.  

According to scientific literature, antigens are substances such as bacteria, viruses, and chemicals that induce the body to release antibodies that fight off infections. The statement by IAVI and Moderna says a vaccine technology developed by Moderna to use another component of the human body called messenger RNA or mRNA to strengthen a potential vaccine’s ability to fight off infection by HIV is also a part of this vaccine study.

“We are tremendously excited to be advancing this new direction in HIV vaccine design with Moderna’s mRNA platform,” Mark Feinberg, president and CEO of IAVI, says in the statement. “The search for an HIV vaccine has been long and challenging and having new tools in terms of immunogens and platforms could be the key to making rapid progress toward an urgently needed, effective HIV vaccine,” he says in the statement.

The statement says that scientific teams at IAVI and the biotechnology firm Scripps Research helped to develop the HIV vaccine antigens being tested in the trials taking place at the GW School of Medicine and Health Sciences and at locations in Atlanta, Ga., Seattle, Wash., and San Antonio, Tex.

It says the trial involving the 56 volunteer participants — who are divided among the four sites — began on Jan. 27 and is being funded by the Bill & Melinda Gates Foundation.

Among those calling the IAVI-Moderna trial an important step in HIV vaccine development is Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergies and Infectious Diseases (NIAID), which is part of the U.S. National Institutes of Health.

“This is a variation of a theme,” Dieffenbach told the Washington Blade. “IAVI in collaboration with NIH did a version of this study already with a protein form of this immunogen,” Dieffenbach said. He said that study worked out well and was published in a scientific journal.

“What’s unique about this latest study is they’re using RNA to deliver the vaccine rather than a protein,” said Dieffenbach. “So, this is an important step for us in the vaccine field, that they can now compare the protein to the RNA.”

Dieffenbach said the IAVI-Moderna trial is taking place after two other recently completed HIV vaccine studies involving human trials that NIAID was involved in resulted in findings that the two experimental HIV vaccines were ineffective. He said a third HIV vaccine study NIAID is involved in that is taking place in the U.S. and South America is expected to be completed in about a year.

The ongoing study in the Americas involves men who have sex with men and transgender individuals as those participating in that vaccine trial, he said.

Dieffenbach said in addition to the vaccine studies, NIAID is monitoring at least two studies of medication aimed at curing HIV. One of the studies was conducted by HIV researcher Dr. Timothy Schacker, who serves as Vice Dean for research at the University of Minnesota Medical School.

Schacker arranged for human trials of people who are HIV positive and taking standard anti-retroviral HIV medication to be given an experimental HIV cure medication developed by the biotechnology company ImmunityBio called Anktiva, according to a Jan. 31 statement released by ImmunityBio.

The statement says the trials showed promising results in the ability of Anktiva to induce the immune system of HIV-positive patients under standard HIV treatment who participated in the study to “kill” the latent or “hidden” HIV in their body that would otherwise reactivate and cause illness if they stopped taking HIV medication.

The goal of the development of Anktiva is to “rid the body of the virus for good and eliminate the need for antiretroviral therapy,” the company’s statement says.

Dieffenbach said his office was also monitoring an HIV cure study being conducted by the Rockville, Md., based genetic engineering company called American Gene Technologies. The company is conducting a human trial for a therapeutic treatment it has developed that’s intended to enable the immune system of HIV-positive people to permanently eliminate HIV from their bodies. The company has said it was hopeful that early results of the effectiveness of the treatment would become available this year.

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