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AIDS and HIV

National AIDS Memorial posts Quilt online mirroring COVID crisis

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The 23rd International AIDS Conference made history when it opened its July 6-11 conference this year. Scientists and AIDS activists were forced to deal with the twin pandemics of both AIDS and the novel coronavirus – both of which severely impact the LGBTQ community.

That prompted many to compare President Donald Trump’s failed response to COVID-19 to President Ronald Reagan’s disastrous neglect of the AIDS crisis in the 1980s. From June 1981 to Nov. 2018, more than 700,000 people have died from AIDS in America.

In just four months under Trump, 135,279 people have died from COVID-19, though the number from March 2 to July 9, 2020 may actually be under-reported.

The comparison between the twin pandemics was underscored on May 24 when the New York Times filled its entire front page with the names of those lost as the number approached 100,000 COVID dead.

The gasp heard around the world was similar to the tears shed when the Names Project AIDS Memorial Quilt was unfurled on the Washington Mall in 1993.

The Names Project AIDS Memorial Quilt was displayed on the Washington Mall during the March on Washington in 1993 (Photo by Karen Ocamb)

This year’s international AIDS conference returned to San Francisco, though under very different circumstances than the explosive 1990 conference where ACT UP demanded urgency and accountability. Because of the coronavirus, AIDS/2020:Virtual (AIDS2020.org) was virtually attended by delegates from 175 countries with talks and debates that included ending systemic racism and how COVID-19 has disrupted HIV/AIDS services, especially for LGBTQ people.

“Epidemics run along the fault lines of inequalities and we can and must close the gaps,” UNAIDS Executive Director Winnie Byanyima said at the opening news conference.

Byanyima presented findings from the UNAIDS 2020 Global AIDS Update report, Seizing the Moment: Tackling entrenched inequalities to end epidemics. World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus, also presented findings of a new WHO survey showing significant disruptions caused by the coronavirus pandemic in access to HIV treatment. Recently, WHO confirmed that COVID-19 is an airborne virus.

“A survey of 13,562 people in 138 countries conducted from mid-April until mid-May showed that COVID-19 is having a devastating impact on the LGBTI+ community worldwide,” according to an AIDS/2020:Virtual press release. “Nearly half the survey participants faced economic difficulty, with many unable to meet their basic needs, skipping meals or reducing meal sizes. Further, nearly half of those who were working expected to lose their employment in the wake of the pandemic, and 13% had already lost their jobs. Of concern, 26% of participants living with HIV reported that they had experienced interrupted or restricted access to refills of antiretroviral treatment.”

Additionally, the economic impact of the COVID-19 crisis has forced 1% of survey respondents into sex work with the reduced ability to negotiate safer sex. 

“The findings of this survey are deeply concerning,” Tedros said. “We cannot let the COVID-19 pandemic undo the hard-won gains in the global response to this [HIV/AIDS] disease.” 

Meanwhile, on July 6 at the White House, the same day the AIDS conference opened, Trump spun a Twitter storm about confederate statues, China, NASCAR driver Bubba Wallace, the “Sanctuary City card,” “angry, violent, criminal mobs taking over certain (Democrat run) cities,” the NASDAQ, the Washington Redskins & Cleveland Indians, opening schools, and spouted more dangerous COVID-19 lies about hydroxychloroquine, the success of US testing and “lowest” mortality rate.

Trump not only failed to acknowledge the International AIDS Conference – he went one cruel step further, as the State Dept. “notified the [UN] Secretary-General … of its withdrawal from the World Health Organization, effective on 6 July 2021,” NPR reported. 

Two days later, on July 8, the US reported more than 3 million COVID-19 cases and 134,000 reported deaths, though how many of those deaths are LGBTQ is still unknown as LGBTQ data collection has not been an urgent priority.

The tale of two pandemics did not escape the attention of the San Francisco-based National AIDS Memorial.

Coinciding with the AIDS conference, the non-profit that oversees the AIDS Memorial Quilt launched a new interactive website displaying the entire 48,000 Quilt panels online, as well as a new initiative to collect and share stories about those who died and those impacted over the 40 years of the AIDS pandemic.

The timing is ironically important as State Sen. Scott Weiner and Equality California indicate in pressing for LGBTQ data collection during the COVID crisis – lack of which they explicitly tie to Reagan’s neglect of AIDS.

“We know that COVID-19 is harming the LGBTQ community, but because no data is being collected, we’re hamstrung in making the case to devote attention and resources,” Wiener said before introducing SB 932. “The history of the LGBTQ community is a history of fighting against invisibility. Without data, we quickly become an invisible community and risk being erased. California must lead and collect this critical health data.”

Fearing erasure is precisely why gay activist Cleve Jones started the AIDS Quilt in 1987.

“Within just a few years, almost everyone I knew was dead or dying or caring for someone who was dying. And one of the things that frightened me and led really to the creation of the quilt was my fear that all of these people would just disappear, that their stories would not be known,” Jones said during a Zoom news conference July 6. “And my friends were such remarkable people and I wanted them to be remembered….Now when we look at the complexities of COVID-19, there are just so many parallels — the importance of testing; the significant racial disparities that we’re seeing; the importance of community action; the difficulties, the challenges of persuading people to modify their behavior in ways that can save lives. So, I think it just underscores that this Quilt still has a role to play.”

Jones added:

“The Quilt was never intended to be a passive Memorial. The Quilt was about revealing the lives and the humanity behind the statistics. It was about shaming a government whose inaction had created such a catastrophe. It was a tool for the media to help them understand how the disease was spreading and communities that it was affecting. So, uh, it was never intended to be just a passive thing. And today, as we see people hoping for a vaccine, hoping for a cure, it brings back a lot of very painful memories for me — and I think all of us. This is just bringing back a lot of really, really difficult memories — but those are exactly the memories we need to keep in the front of our minds right now, as we endeavor to face this new challenge.”

Honoring and mourning a person lost to AIDS (Photo by Karen Ocamb, 1993)

John Cunningham, Executive Director of the National AIDS Memorial, underscored the importance of honoring and telling the stories of those lost and inspire a new generation to take action.

“We do have a pandemic we’re in the middle of right now and there are lessons that we can carry forward to bring about solutions,” said Cunningham. “And I think the most profound one is for us to ensure that we stand up and that we take action and become activists as we were back in the day, to hold our elected officials in our government responsible for the inaction that they are taking at the present time for stigmatizing a virus as was done in the early days of the epidemic.”

Turning the actual tactile fabric of The Names Project AIDS Memorial Quilt into a metaphor, Cunningham said: “That’s part of what’s in the fabric of our nation — challenging the bases of power to bring about profound change in our society.”

(Lead photo via Wikipedia)

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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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