Archbishop Desmond Tutu: If we are to toss AIDS into the dustbin...

If we are to toss AIDS into the dustbin, we must do our best to understand the intersections of scientific discovery and community wisdom, address the truths in both, and move forward with decisions that take into consideration a full, robust interpretation of the evidence base.
- Archbishop Desmond Tutu

These are extraordinary times in which we are living. More than three decades into the global HIV pandemic, discussing ‘the end of AIDS’ is more than a rhetorical flourish, more than political grandstanding, and more than wishful thinking.

At this very moment, we have ‘the end of AIDS’ in our collective sights in a way we have never had before. Even as the epidemic continues to wreak havoc in the lives of far too many of our precious daughters, sons, sisters, brothers, mothers, fathers, friends and colleagues across the world – new and exciting scientific discoveries are pointing to a future where AIDS is a brutish artefact of history.

Science has shown us that treating HIV-positive people with a combination of antiretroviral drugs (ARVs) is not only good for the individual being treated, but also imparts a prevention benefit for the broader community as well. People on successful treatment do not get sick and die, and are much less likely to pass their infection to their partners.

Science has also shown that ARV drugs provided to HIV-negative individuals can protect them from the virus if exposed, much like anti-malarial drugs prevent malaria. And there are new, user-friendly ways to deliver ARVs being developed and tested at this very moment.

We simply must take the critical next steps to end AIDS now that science proves it can be achieved. If enough global citizens, people of faith, members of the private sector and world leaders summon the courage to accelerate and increase their investments in the global response to overcome AIDS, we have a very good chance of containing the worst viral scourge the world has ever known.

Conducting research in India, South Africa and the US, Mapping Pathways has taken such a step, one that helps make ‘real-world’ sense of the incredibly dynamic nature of the science. With new discoveries and insights coming so quickly it is hard to keep up.

Much like politics, all science is local. The understanding of what this new science means is local. Its utility is local. Yes, we have compelling results from clinical trials, and make no mistake, we will have more. But the opinions, perspectives and lived wisdom of communities, from the grassroots to the grasstops, matter just as much as the peer-reviewed scientific data that are coming at us fast and furiously. How communities absorb, understand and prioritise the science matters.

Placing a premium on a ‘people-centred’ interpretation of the science, Mapping Pathways has tapped the smarts, and the hearts, of advocates, researchers, clinicians, policymakers, pharmacists, funders, public health workers and people living with HIV. The results of their journey are illustrated in this monograph. I hope these findings will help communities across the globe grapple with the promises, and the marked complexities, of this thrilling new prevention paradigm in which we find ourselves.

I recommend Mapping Pathways – Developing evidence-based, people-centred strategies for the use of antiretrovirals as prevention. If we are to toss AIDS into the dustbin, we must do our best to understand the intersections of scientific discovery and community wisdom, address the truths in both, and move forward with decisions that take into consideration a full, robust interpretation of the evidence base.

Let us map new pathways together, for our generation and for those who follow. Let us be the generation to make the difference.

Let us be done with AIDS.

-Archbishop Desmond Tutu

[This is the foreword penned by Archbishop Desmond Tutu in the new Mapping Pathways report "Developing evidence-based, people-centred strategies for the use of antiretrovirals as prevention."  Click here for podcasts, an infographic, and a video associated with this report.]

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Risk perception, ARV-based prevention strategies and grassroot conversations – a preview of the upcoming Mapping Pathways monograph

Original content from our Mapping Pathways blog team

Risk perception and the consequent behavioral responses has been a theme that has fascinated Philip Smith throughout his professional career.

Smith, a Ph.D. candidate at the Desmond Tutu HIV Foundation (DTHF), a Mapping Pathways partner organisation, first encountered the subject of risk perception as he was completing his masters degree in social science and psychology at the University of Cape Town. Smith realised that scaring people with death as part of a prevention strategy may actually end up leading people to deny their own vulnerability.

“Smoking is an example where a key prevention strategy involves subjecting people to images of death. My research indicates that this kind of messaging actually leads to a psychological tension that can lead to risk-denial or even an increase in self-esteem boosting risky behavior to relieve that tension,” says Smith.

Smith’s interest in risk and the HIV field led him to DTHF and subsequently to a key role in the Mapping Pathways project; writing up the results of the 2011 Online Survey as part of a monograph to be published this spring by project partner, RAND.. The online survey is one of four data collection mechanisms of the Mapping Pathways project: the other three being the ExpertLens, the Literature Review and the Stakeholder Interviews.

“The Online Survey, which happened in India, South Africa, and the U.S. in 2011, seeks to understand what people at the grassroots were thinking about implementation and what the specific challenges are on successfully implementing ARV-based prevention strategies, such as PrEP and TLC+, also known as treatment as prevention, in their communities,” says Smith

The methodology involved first creating a questionnaire with two different sections: a multiple choice section and a qualitative section where respondents were asked about information they wanted and concerns they may have about ARV-based prevention strategies.

Over 1,000 individuals participated in the survey across the three countries. Among other questions, participants were asked how important they thought ARV-based prevention strategies were and what would they find useful in their work. In addition to asking participants to quantify how important they believed the different strategies are in preventing HIV infection in their communities, they were also given the opportunity to share their perspectives of the barriers to implementing successful ARV-based prevention strategies.

Lastly, participants were asked to suggest what kinds of information they would find helpful in implementing community friendly, impactful, ARV-based prevention strategies.

“Most participants felt positively about ARV-based prevention strategies and their implementation. TLC+ was the most favoured strategy and some valid concerns were raised about cost and the lack of access to healthcare, especially in South Africa and India but also in the U.S.,” says Smith.

Smith says that a key conversation that developed revolved around how healthcare systems around the world, currently tailored towards treatment, would have to adapt with a twin focus on prevention to successfully implement ARV-based prevention strategies.

Consequently, participants wanted to know how best to raise awareness about the different prevention strategies, with some participants requesting that information be made available comparing the different strategies to maximise informed choices in communities. Participants also expressed interest in understanding what policy-makers thought about ARV-based prevention methods because this would act as a useful guide for implementation.

Besides data collection and gathering an evidence base, the key mission of the Mapping Pathways project is to disseminate findings and liaise with the global HIV-treatment and prevention community at large around the use of ARVs for prevention. The upcoming monograph, “Developing evidence-based, people-centered strategies for the use of antiretrovirals as prevention” will touch on all these themes and more, including the theme of risk that has so intrigued Smith throughout his professional career.

Stay tuned for the Mapping Pathways monograph, coming soon

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Sustainable HIV prevention possibilities present choices, challenges

via Science Speaks, by Antigone Barton

When he looks at what biomedical science can do in the next decade to prevent HIV transmission, Jim Turpin of the National Institutes of Health said, he thinks of the lyrics of a Timbuk3 song: “The future’s so bright I gotta wear shades.”

By, which, actually, he means — don’t get blinded by the light; the search for answers will require focus.
“The challenge is not the lack of options,” he said, “but prioritizing the best options.”

Turpin, program officer and branch chief in the Prevention Sciences Program in the Division of AIDS at NIH”s  National Institute of Allergy and Infection Disease spoke this morning in webinar titled “The HIV Prevention Pipeline: A Future of Possibilities.” The webinar was sponsored by the International Rectal Microbicide Advocates (IRMA) and AVAC Global Advocacy for HIV Prevention.

After a series of disappointments in the quest for a vaccine or microbicide to prevent HIV transmission, the last two years offered hope, in strategies using antiretroviral medicine to prevent acquiring HIV, organizers point out. But, with a diversity of prevention needs and challenges among women and men worldwide still demanding answers, is that all there is?

Or, as Turpin put it, “Do we currently have what it takes to create a sustainable prevention pipeline?”

Read the rest.


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Three-quarters of clinicians in the US willing to prescribe early HIV treatment for the purpose of prevention

via aidsmap.com, by Michael Carter

There is an overwhelming consensus among clinicians who prescribe HIV treatment in the US that people who are taking antiretroviral therapy are less likely to transmit HIV to their sexual partners, according to results of a study published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Results also showed that over three-quarters of care providers would be willing to prescribe early therapy to people with an HIV-negative partner for the purposes of prevention.

The study involved 165 prescribing clinicians working at HIV clinics in the Bronx, New York, and Washington DC. It was conducted in 2010 and 2011, well before the publication of the results of the HPTN 052 study in the summer of 2012, which showed that virologically suppressive HIV treatment reduced the risk of transmission by 96%. US HIV treatment guidelines were updated in 2012 to endorse early treatment to reduce the risk of transmission.

“This survey of HIV clinicians in two US cities found most clinicians believe that ART [antiretroviral therapy] can reduce HIV transmission, even before the results of HPTN 052 demonstrated ART to be effective for this purpose, and before 2012 treatment guideline changes recommending ART for patients at risk for HIV transmission,” write the authors.

Read the rest.


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Task shifting of antiretroviral treatment from doctors to primary-care nurses in South Africa (STRETCH): a pragmatic, parallel, cluster-randomised trial

via The Lancet, by Lara Fairall et al.

Background

Robust evidence of the effectiveness of task shifting of antiretroviral therapy (ART) from doctors to other health workers is scarce. We aimed to assess the effects on mortality, viral suppression, and other health outcomes and quality indicators of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme, which provides educational outreach training of nurses to initiate and represcribe ART, and to decentralise care.

Read the rest.

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Newly infected individuals sustaining HIV epidemic in Geneva

via aidsmap, by Michael Carter

Individuals with recent HIV infection are sustaining the epidemic, a Swiss study published in the online edition of AIDS suggest. The investigators believe that their results further support the use of antiretroviral therapy as prevention, but also show that its impact on the epidemic will be blunted because of the high number of transmissions which can be attributed to individuals who have been recently infected with HIV and who are not yet taking treatment.

Phylogenetic analysis showed that only a handful of infections in individual diagnosed between 2008 and 2010 could be attributed to patients diagnosed before 2000. Patients with longer-term HIV infection were the group most likely to be taking antiretroviral therapy and to have an undetectable viral load.

“Recent HIV infections were a significant source of HIV spread,” comment the authors. “By contrast, HIV individuals diagnosed before 2000 were rarely the source of new infections before 2008.”

It is now widely accepted that patients who are taking HIV therapy that suppresses their viral load to undetectable levels are highly unlikely to transmit the virus to their sex partners.

Read the rest.


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Helen Epstein's wrong about SA's response to AIDS

via politicsweb, by Nathan Geffen

Helen Epstein is an influential journalist and regular contributor to one of the world's most prestigious literary journals, the New York Review of Books (NYRB). It is therefore unsettling that she has written an article on the NYRB blog that contains serious errors about the South African HIV epidemic and the important prevention benefits of antiretroviral treatment (ART) (see here).

In her first sentence Epstein writes, "When I first visited South Africa in 2000 to report on the AIDS epidemic there, one adult in five was HIV positive, and a million children had lost one or both parents to the disease." These numbers are simply wrong. UNAIDS estimates that by 2001 there were 580,000 children who had lost one or both parents to AIDS. This is a horrific figure, but substantially less than Epstein's. 2 The Actuarial Society of South Africa estimates the number of children who had lost a mother or both parents to AIDS by mid-2000 and they reach a considerably lower estimate of about 120,000. 3 Epstein also overstates the percentage of adults infected with HIV in 2000.

Epstein writes, "Although the HIV infection rate has finally begun to fall in neighboring countries like Botswana and Zimbabwe, it remains stubbornly high in South Africa. After studying the African epidemic for two decades, I've come to believe that shame and silence are the primary reasons ..."

She is wrong that South Africa's infection rate is not falling. Also wrong is her implication that shame and silence make the South African epidemic signally different from those in Botswana and Zimbabwe.

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

The Value Of HIV Treatment In Couples

via NPR, by Richard Knox

Dr. Rochelle Walensky thinks the 19th International AIDS Conference will be remembered as the moment when the world began to mobilize to end the pandemic.

The Harvard researcher probably speaks for many of the 23,000 scientists, activists and policy mavens who came to the Washington conference. But they're going home with a big question on their minds: Can the world afford it?

Walensky and her colleagues provided the beginning of an answer with a presentation on the final day of the conference. They looked at the cost implications of expanding anti-retroviral treatment to all HIV-positive people in couples where one partner is not infected.

"Is it worth paying for? The answer is yes, it's very cost-effective," Walensky told Shots. At least that's the case in South Africa and India, which the researchers chose for their analysis, and for the limited situation of these so-called discordant couples.

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

A World Without AIDS, Still Worlds Away

via the New York Times, by Lawrence K. Altman

WASHINGTON — Is the world on the verge of ending the AIDS epidemic and creating an AIDS-free generation, even though a cure and a vaccine are still distant hopes?

Yes, roared enthusiasts among the nearly 24,000 participants at the 19th International AIDS Conference here last week. Their hopes are based on the extraordinary scientific gains made since the conference was last held in the United States, 22 years ago, when an AIDS diagnosis was a sure death sentence.

Among those gains: antiretroviral drug combinations for women to prevent infection of their newborns; drugs to treat and prevent infection with H.I.V., the virus that causes AIDS, among adults; and evidence that voluntary male circumcision can reduce the risk of female-to-male transmission by 50 to 60 percent.

Today, H.I.V. has become a chronic disease that, if treated appropriately, can be held at bay in a newly infected young adult for decades — if the patient adheres to the rigid daily drug regimen.

Michel Sidibé, the executive director of the United Nations AIDS agency, said that the opportunity to end AIDS will “evaporate” if governments do not show greater political will and increase investments to make gains available to millions more people.

“All that can stop us now is indecision and lack of courage,” he said.

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

PrEP debate is reminiscent of the past

via Global Post, by Emily Judem

WASHINGTON, DC—During the 1996 International AIDS Conference in Vancouver, Dr. David Ho announced that HIV could be suppressed to undetectable levels if patients took a “cocktail” of anti-retroviral drugs.

Time Magazine named him “man of the year,” and according to Rolling Stone, he became the most famous AIDS scientist in the world.

But in the years that followed, ARV distribution was also met with criticism, said Mitchell Warren, director of AVAC, a non-profit that advocates for HIV prevention programs.

“People said we can’t do treatment,” Warren said. “Too expensive. Not feasible. No one’s going to take their pill. What about drug resistance?”

For those who have attended sessions about pre-exposure prophylaxis (PrEP) this week at the 2012 International AIDS conference, this might sound familiar.

When the FDA approved Truvada as a preventative drug against HIV on July 16 this year, leaders of the AIDS fight and news outlets alike began posing questions. How will it be decided who takes the drug? How will the drug be distributed? How will we lower the price tag? Should we be concerned that those taking Truvada will stop using condoms and protecting themselves in other ways?

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

HIV/AIDS: WHO issues guidelines on PrEP

via PlusNews

NAIROBI/KAMPALA, 20 July 2012 (PlusNews) - Days after US officials gave unprecedented approval for the use of an antiretroviral drug by HIV-negative people to reduce the risk of their acquiring the HI virus, the World Health Organization (WHO) has issued guidance to governments on so-called pre-exposure prophylaxis (PrEP).

WHO's guidelines, which call for a cautious and gradual roll-out, will likely see many countries begin to add PrEP to the growing arsenal of tools in the fight against HIV.

The guidance is based on evidence from clinical trials on the daily use of ARVs for HIV prevention among high-risk HIV-negative people. A 2010 study - Iniciativa Profilaxis Preexposicion, or Prexposure Prophylaxis Initiative (iPrEX) - among men who have sex with men (MSM) and transgender people, found that a daily dose of the ARV, Truvada - a combination of emtricitabine and tenofovir disoproxil fumarate - reduced HIV infection risk by about 42 percent.

The 2011 Partners PrEP study in Kenya and Uganda concluded that a daily dose of Truvada, taken by the HIV-negative partner in a heterosexual HIV-discordant relationship - where one sexual partner is infected and the other is not - could reduce the risk of HIV transmission by up to 75 percent.

Read the rest.


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WHO issues first guidance on use of antiretrovirals by HIV-negative people at high risk to prevent infection

via World Health Organization

20 JULY 2012 | GENEVA / WASHINGTON DC - WHO has issued its first guidance to countries that are considering offering HIV medications, known as antiretrovirals (ARVs), to protect people who do not have the virus but who are at high risk of HIV infection.

Pre-exposure prophylaxis (PrEP):

The guidance is based on clinical trials indicating that a daily dose of oral antiretroviral medication, known as pre-exposure prophylaxis (PrEP), taken by HIV-negative people to reduce the risk of infection, is both safe for people to use and effective in preventing HIV. The iPrEX study shows that use of PrEP can reduce HIV infection by around 40% among men who have sex with men – and up to 73% among those who took the medicine regularly. The Partners PrEP study found 75% protection among serodiscordant couples (couples in which one person is HIV positive) in Kenya and Uganda.

The range of results in these studies highlight the potential benefits of PrEP, but also the importance of combining it with consistent use of condoms, as well as frequent HIV testing, counselling, and treatment of sexually transmitted infections.

They also emphasize the importance of taking medicines every day. Many people who are at high risk for HIV may not easily be able to incorporate the diligent treatment regimen required, so the next challenge is to ascertain how best to deliver PrEP to those who would benefit from it in ‘real life’ settings in order to achieve the necessary adherence and maximum public health gains.


PrEP projects in countries:

To better understand how PrEP can best contribute to a combination HIV prevention programme, WHO is encouraging countries wishing to introduce PrEP to first establish small projects to help public health workers to better understand and realize its potential benefits. In these projects, ARVs would be given to people at high risk of HIV infection. These could include uninfected men or transgender women who have sex with men who have a high risk of being HIV-positive. The aim is to identify which groups will benefit most from PrEP, and ascertain the best ways to deliver the services to them.

WHO will evaluate the outcome of these projects, together with the evolving scientific evidence. The results will help determine the best way to integrate PrEP guidance in future consolidated WHO guidelines on the use of antiretrovirals for preventing and treating HIV infection, which are expected in the summer of 2013.


Read the rest.



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US approval of drug for HIV prevention welcomed cautiously in UK

via Pink News, by Stephen Gray

The decision by US authorities to approve the anti-retroviral drug Truvada for groups at risk of contracting HIV has been cautiously welcomed in the UK.

The US Food and Drug Administration approved Truvada for pre-exposure prophylaxis (PrEP), to help prevent HIV infection amongst those at very high risk.

the FDA emphasised the need for other prevention methods, such as safe sex practices, risk reduction counselling and regular HIV testing.

FDA commissioner Margaret A Hamburg said it was an “important milestone” in the fight against HIV.

She said: “Every year, about 50,000 US adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease.

“New treatments as well as prevention methods are needed to fight the HIV epidemic in this country.”

Read the rest.


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Investigating the Impact of Treatment on New HIV Infections

via PLoS Collections

The HIV Modelling Consortium aims to strengthen the support that mathematical modelling and related quantitative disciplines can provide to global decision-making in HIV. In November 2011 the HIV Modelling Consortium held a meeting in South Africa to focus on the cross-cutting issues of the impact of new scientific findings about HIV treatment preventing new infections. The group considered the feasibility of interventions, potential epidemiological impact, affordability, and new scientific observational studies and community trials. The nine reviews and one research article which comprise this collection arose from that meeting and provide insights into the factors which will support evidence-based decision-making in HIV prevention, with a focus on the use of antiretroviral treatment to prevent HIV transmission.

Read the rest here.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

Six Months In…. Highlights from the dynamic world of HIV-prevention and the Mapping Pathways project

Original content from the Mapping Pathways blog team

As the year 2012 passes its halfway mark, it is time to take stock of some of the key events this year in the field of HIV treatment and prevention as well as some of the highlights of the Mapping Pathways project.

The year opened on a slippery note with the January 2012 issue of Sexually Transmitted Diseases – Journal of the American Transmitted Diseases Association publishing data from a rectal health and behavior study whose findings “suggest some lubricant products may increase vulnerability to STIs.”

The paper fueled a tremendous amount of discussion in HIV treatment and prevention communities around the world, including the membership listserv run by IRMA (International Rectal Microbicide Advocates).

“We need to be clear – there are only associations between lube use for anal intercourse and STDs. There is no proof that lube use causes increased risk. We simply don’t know that. Because we don't know, IRMA has long been advocating for a lube safety research agenda to fill in our gaps in the science and the evidence base,” says Jim Pickett, Director of Prevention Advocacy and Gay Men’s Health at the AIDS Foundation of Chicago, chair of IRMA, and a member of the Mapping Pathways team. Click here for more info on lube safety.

In March, important new data, specifically from the FEM-PrEP, iPrEX and 

Partners PrEP trials, was revealed at the 19^th Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington. All the webcasts and sessions from the conference can be viewed online here.

The FEM-PrEP trial’s independent data and safety monitoring board (DSMB) recommended that the trial be halted due to “futility” in April 2011 as the study could not answer the question of whether daily Truvada worked, or not, in terms of preventing HIV among the trial population. New information presented by investigators at CROI suggested that the lack of efficacy was related to low levels of adherence to medication.

While participants in the study stated that they took their pills 95% of the time, drug levels found in the blood of women assigned to the Truvada study wing indicated that less than 50% of the women had actually taken the drug in the last 12 days.

In contrast, the Partners PrEP study indicated adherence to medication at almost 97%. Early results reported in Rome last July showed high levels of effectiveness in both men and women. These findings were reviewed at CROI, with no major changes to the estimated effectiveness of the drug.

At CROI, the Partners PrEP team presented analyses of plasma tenofovir levels in trial participants who became HIV-positive and a group of 1,000 participants who did not.

Two key findings were that individuals who remained HIV-negative had detectable blood levels of tenofovir at 82% of their study visits and that having detectable tenofovir in your blood at any given study visit was highly predictive of being HIV-negative at that visit.

The trial had a tenofovir arm, a Truvada arm and a placebo arm. According to the Partners PrEP team, “TDF (tenofovir) and FTC/TDF (Truvada) PrEP definitely provided 67% and 75% protection, respectively, against HIV-1 acquisition in African men and women at risk for HIV-1 infection, when provided in the context of other HIV-1 prevention services.” In short, women and men who took daily tenofovir-based PrEP had a significant reduction in HIV risk.

The results of the iPrEX trial indicated that gay/MSM participants who took Truvada daily had a 44% reduction in HIV incidence over the course of 1.2 years of follow-up compared with placebo. For individuals who did take the drug, and had detectable levels of drug in their bodies, the efficacy of Truvada as PrEP was approximately 90%.

At CROI, researchers presented new results of a case-control analysis on drug levels of the iPrEx trial participants that indicated that the blood-drug level observed with a dosing frequency of four doses per week was associated with a 95% reduction in HIV risk.

Mapping Pathways presented an oral abstract at the Microbicides 2012 (M2012) conference in Sydney in April. Pickett says the abstract and presentation were well received and generated a lot of interest in work Mapping Pathways has been doing and is planning to do in the coming year.

The importance of adherence was further highlighted at M2012. Says Jim “Adherence, the A-word, was a very big topic throughout the entire conference. We realized that we have to make HIV-prevention or treatment products people like and will want to adhere to. We have to figure out how tools like PrEP and microbicides fit in people’s lives, and funding should be put in place to better understand what people want, how they have sex, and the role of pleasure, love and intimacy, among many other ‘real world’ realities.” (Read our entire interview with Jim here.)

In May, an important landmark was achieved when a panel of experts at the U.S. Food and Development Administration (FDA) recommended approval of Truvada for use in PrEP in HIV-uninfected gay men and MSM, HIV-uninfected partners in serodiscordant relationships and other individuals “at risk” of acquiring HIV through sexual activity.

The webcast can be seen here and copies of all the slide presentations are here. The final FDA decision is expected by mid September.

June saw Mapping Pathways team members disseminating findings at the International Association of Physicians in AIDS care (IAPAC) evidence summit on TasP and PrEP in London. Click here to see Jim’s slides and here to read more analyses of the meeting via aidsmap. .

In light of the FDA panel’s approval of Truvada for PrEP in May, Mapping Pathways U.S. partners, AIDS United and AIDS Foundation of Chicago, presented a webinar June 19 focusing on PrEP. Key U.S.-focused findings of the Mapping Pathways online survey and stakeholder interviews were presented at the webinar helping illuminate diverse perspectives of advocates, clinicians, policy makers and people living with HIV.

In a few weeks, Mapping Pathways team members will be presenting data collected in 2011 from India, South Africa and the U.S. at the International AIDS Conference (AIDS 2012) in Washington D.C. The data presented will include findings related to community stakeholder perspective on ARV-based prevention – “grassroots” and “grasstops” – as well as an extensive literature review conducted by RAND, a Mapping Pathways partner.

Please click here to see the complete list of Mapping Pathways activities at AIDS 2012. And join us! All posters and presentations from AIDS 2012 will be made available on the blog, and archived here.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]