HUD Awards Nearly $9 Million to Provide Rental Assistance to 218 Households with HIV/AIDS

HOPWA LogoCross-posted from HUD Newsroom

The U.S. Department of Housing and Urban Development (HUD) [on September 15, 2022] awarded nearly $9 million to provide tenant-based rental assistance and supportive services to an estimated 218 households where one or more members are living with HIV/AIDS.

The funds were awarded through HUD’s Housing Opportunities for Persons With AIDS (HOPWA) Program, the only Federal program dedicated to the housing needs of people living with HIV/AIDS. Under the HOPWA Program, HUD makes grants to local communities, states, and nonprofit organizations for projects that benefit low-income persons living with HIV/AIDS and their families. HUD will announce additional HOPWA awards in the coming weeks. Click here for the list of the awards.

“Access to affordable housing and inclusive, non-discriminatory supportive services is critical to achieving stability and optimal health outcomes for people living with HIV/AIDS,” said Secretary Marcia L. Fudge. “This funding will provide grantees and their partners the opportunity to make a real impact in their communities.”

HOPWA grants are a part of HUD’s mission to provide access to high-quality and culturally competent services, including housing and supportive services that are non-stigmatizing, non-discriminatory, inclusive, and responsive to the needs of persons living with HIV/AIDS. Housing instability has been a major issue facing many persons living with HIV since the beginning of the epidemic. These grants support HUD’s role in the National HIV/AIDS Strategy; the strategy sets an overarching goal to end the HIV epidemic in the United States by 2030.

Approximately half of all persons living with HIV in the U.S. will experience homelessness or housing instability at some point following their diagnosis. Economic disadvantages, episodes of poor health, and co-occurring health diagnoses make it difficult for many persons living with HIV to secure or maintain housing. Additionally, HIV/AIDS-related stigma, discrimination, and systemic racism contribute to differences in access to housing and lead to ongoing disparities among racial, ethnic, and LGBTQ+ communities.

Updates to the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (September 21)

hivinfo.nih.gov logoUpdates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIVThe Panel on Antiretroviral Guidelines for Adults and Adolescents (the Panel) updated several sections of the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV.

Highlights from the sections are summarized below:

Selection of Antiretroviral Therapy for Individuals Who Acquire HIV After Having Received Long-Acting Cabotegravir for Pre-Exposure Prophylaxis

In this update, several sections of the guidelines have been revised with discussions on factors that clinicians should consider when selecting an antiretroviral (ARV) regimen for individuals who acquire HIV after having received long-acting cabotegravir (CAB-LA) for HIV pre-exposure prophylaxis (PrEP). Because of the long half-life of CAB-LA, the Panel recommends performing genotypic resistance testing, including testing for integrase resistance, before starting antiretroviral therapy (ART). If resistance testing results are not available before ART initiation, the Panel recommends initiating a boosted darunavir regimen while awaiting results confirming no resistance to the integrase strand transfer inhibitor (INSTI) drug class. The sections updated with this new information include the following:

Laboratory Testing for Initial Assessment and Monitoring of Patients with HIV Receiving Antiretroviral Therapy

Drug-Resistance Testing

What to Start

Early (Acute and Recent) HIV Infection

Dolutegravir and Neural Tube Defects

Previously, the Tsepamo study from Botswana reported a higher prevalence of neural tube defects (NTDs) in women who received dolutegravir (DTG) during conception than with other ARV drugs. An updated report from the same study showed that the prevalence of NTDs is not significantly different from those on non-DTG regimens. For persons of childbearing potential who are trying to conceive, DTG-based regimens are among the recommended options for most individuals initiating ART. The following sections have been updated with this new information:

What to Start

Women with HIV

Transgender People and HIV

Laboratory Testing

The Panel updated the following sections relating to laboratory tests to be done at the time of ART initiation and the frequency of monitoring during follow-up:

Laboratory Testing for Initial Assessment and Monitoring of Patients with HIV Receiving Antiretroviral Therapy

Plasma HIV-1 RNA (Viral Load) and CD4 Count Monitoring

Drug-Resistance Testing

This section has been updated with two key new recommendations:

The Panel now recommends drug-resistance testing for people with virologic failure and HIV-RNA levels >200 copies/mL (AI for >1,000 copies/mL, AIII for 501–‍1,000 copies/mL,CIII for confirmed HIV RNA 201–500 copies/mL). For people with confirmed HIV-RNA levels >200 copies/mL but <500 copies/mL, drug-resistance testing may be unsuccessful but should still be considered.

The Panel previously recommended that resistance testing should be done within 4 weeks of discontinuation of an ARV regimen. However, given the long half-lives of the long-acting injectable ARV drugs, resistance testing (including testing for resistance to INSTIs) should be performed in all persons who have experienced virologic failure on a regimen of long-acting CAB-LA and rilpivirine (RPV) or acquired HIV after receiving CAB-LA as PrEP, regardless of the amount of time since drug discontinuation (AIII).

Optimizing Antiretroviral Therapy in the Setting of Viral Suppression

This section has been revised with the following key updates:

The Panel recommends that for regimen optimization in the setting of existing nucleoside reverse transcriptase inhibitor (NRTI) resistance, two NRTIs—tenofovir alafenamide or tenofovir disoproxil fumarate plus emtricitabine (FTC) or lamivudine (3TC)—should be included in the regimen with a fully active drug that has a high resistance barrier, such as DTG, boosted darunavir (BIII), or bictegravir (CIII).

The Panel recommends that pregnant persons who present to care on CAB-LA and RPV should be switched to a Preferred or an Alternative three-drug ARV regimen recommended for use in pregnancy per the Perinatal Guidelines (AIII).

Virologic Failure

This section has been updated to harmonize with the recommendations in the Drug-Resistance Testing section of the guidelines with regard to drug-resistance testing in patients in a failing long-acting ARV regimen and recommendations for resistance testing in patients with HIV viral load >200 copies/mL. The section also added clinical trial data from the DAWNING and NADIA studies, in assessing the roles of an INSTI or boosted protease inhibitor–based regimen in patients with failure to first-line non-nucleoside reverse transcriptase inhibitor–based regimens.

Adherence to the Continuum of Care

This section continues to stress the importance of assessing adherence and assisting patients to ensure uninterrupted access to treatment and care. The section also noted that the Panel recommends against the use of CAB-LA and RPV in people who have detectable viral load due to suboptimal adherence to ART and who have ongoing challenges with retention in HIV care, except in a clinical trial (AIII).

Other Updates

Minor updates have been made to the following sections:

Baseline Evaluation

Hepatitis B Virus/HIV Coinfection

Hepatitis C Virus/HIV Coinfection

Cost Considerations and Antiretroviral Therapy

For a complete list of updates, please see What’s New in the Guidelines. To view or download the guidelines, please see the Adult and Adolescent ARV Guidelines section of Clinical Info’s website. The guidelines tables and recommendations can also be downloaded as separate PDF files.

Clinical Info welcomes your feedback on the latest revisions to the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Please send your comments with the subject line “Adult and Adolescent ARV Guidelines” to HIVinfo@NIH.gov by October 13, 2022.

HIV/AIDS and Aging Awareness Day (September 18, 2022)

Recognizing National HIV/AIDS and Aging Awareness Day

September 18th marks National HIV/AIDS & Aging Awareness Day (NHAAD). We are committed to helping older adults living with HIV to live longer, happy, and meaningful lives. Providers: make sure to speak with your patients age 50+ about HIV. According to the CDC, older adults are more likely than younger people to be diagnosed with late-stage HIV & are less likely to discuss sex & drug use with providers. Explore HIV Nexus for resources. Let us also speak out against HIV stigma and creating a safe space to talk about testing, prevention, and treatment for older adults and those living with HIV over 50.

Visualizing NHAAD:

The following infographics from AIDSVu depict the number of persons aged 55+ living with HIV, social determinants of health and HIV among older people, and more:

AIDSVu infographic mapping locations of persons above 55 living with HIV

AIDSVu Graphic - care continuum among people 55 and older

AIDSVu Infographic depicting social determinants of health and HIV among older adults

Scroll to the bottom for more infographics, and visit AIDSVu for further HIV & Aging data.

PAETC on-demand courses related to HIV and Aging:

Recorded E-Learning: Aging with HIV: Challenges for a ‘New Aging’ Population 22-23 (1.5 CEs)

Description: By the end of the course, students will be able to,

  • Describe real-world challenges and solutions for people aging with HIV.
  • Explain how psychosocial barriers affect people aging with HIV.
  • Strategize realignment of existing services for older adults living with HIV.

HIV Learning Network Logo

HIV Learning Network – Geriatric Assessment for People with HIV, Part I: Multimorbidity & Polypharmacy

Description: According to the CDC, the number and percentage of people ≥50 years old with diagnosed HIV continues to increase, 38% in 2011– to 47% in 2015. In this session, Dr. Meredith Greene, MD will review the changes we as providers can expect in our patients with HIV, and review the essential steps and approach required to complete a geriatric assessment.  She will discuss the complexities of patients experiencing multiple morbidities, and how to manage treatment regimens of medications to treat them.

HIV Learning Network – Geriatric Assessment for People with HIV, Part II: Geriatric Syndromes

Description: We invited Dr. Meredith Greene, MD, back to present part II of her June 2021 talk on geriatric assessments to review the IAS-USA 2020 Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults 2020 Recommendations that added frailty to the list of recommended assessments to make for aging adults with HIV.

Upcoming Webinars:

EHE Regional Learning Collaborative Session: Strategies to Support Individuals Aging with HIV

Ending the HIV Epidemic logo

Date and time: Tuesday, September 20, from 10 – 11:30 AM PT (Zoom)

Description: In honor of National HIV/AIDS and Aging Awareness Day, join this session to learn about strategies and approaches for supporting the needs of older adults with HIV.

Positively Aging Project Yearly Conference! by HIV+ Aging Project

Positively Aging Project Yearly Conference! PromoDate and time: Saturday, September 17, from 9:30 AM – 3:00 PM PDT (In-person OR Zoom)

Location: The Joslyn Center – Arthur Newman Theatre
73750 Catalina Way
Palm Desert, CA 92260

Description: A symposium on living and thriving with HIV, featuring high-profile keynote speakers & other prominent figures from the HIV/AIDS community.

Positively Aging: Thriving and Living Well with HIV by the AIDS Foundation Chicago

Positively Aging Conference Promo FlyerDate and time: September 22 and 23, from 10 AM – 3 PM Central Time

Description: The two-part educational symposium will provide updates on the latest developments and strategies for HIV and aging from subject matter experts and feature voices highlighting the challenges faced by older adults with HIV, such as stigma, mental health, and social isolation. Attendees will interact directly with speakers and examine how multiple needs can be addressed for successful engagement in care.

New: The Care and Wellbeing Center

CWC LogoLearn more about HIV and Aging capacity building through our partner organization, the Care and Wellbeing Center (CWC).

The CWC aims to promote the holistic wellbeing of all people living with HIV over 50. Since 2022, they provide training and technical assistance to HIV and Aging service organizations across the Western United States through the Gilead HIV Age Positively Initiative. Stay up to date on their learning activities and resources by subscribing to their newsletter and following their social media accounts below!

More HIV & Aging Resources from our Partners:

Visualizing NHAAD Part 2:

Additional infographics from AIDSVu. Check out AIDSVu’s post for National HIV/AIDS and Aging Awareness Day 2022 to learn more!

AIDSVu Graphic - Black Americans aged 55 and older

AIDSVu Infographic

New: ACHA Releases Brief “Emerging Considerations for Addressing MPV in Higher Education Settings: Promoting Health Equity and Reducing Stigma” (September 1, 2022)

ACHA logo
The American College Health Association’s MPV Working Group Releases “Emerging Considerations for Addressing MPV in Higher Education Settings: Promoting Health Equity and Reducing Stigma”

The purpose of this brief is to offer considerations and resources for promoting health equity and reducing stigma to assist college health professionals with decision-making as the science of MPV and the current outbreak evolve.

This ACHA series, “Emerging Considerations for Addressing MPV in Higher Education Settings,” aims to supplement available CDC guidance to support college health clinical and health promotion professionals

Authors of the Brief:

  • Blake Flaugher
  • Lindsey Mortensen
  • Trevy Chai
  • Rachel Mack
  • Alex Phelan
  • Danielle Monroe
  • Robyn Buchsbaum

74th Presidential Advisory Committee on HIV/AIDS (PACHA Council) (September 19 & 20)

Announcement: 74th Presidential Advisory Committee on HIV/AIDS (PACHA Council) September 19 & 20 Promo Flyer

The 74th Presidential Advisory Committee on HIV/AIDS (PACHA Council) will be taking place in Los Angeles, CA on Monday, September 19, 2022 and September 20, 2022. The meeting will be hybrid for those who wish to participate virtually. It is open to the public and everyone.

See more details below regarding times and registration information:

  • When: Monday, September 19, 2022 from 4:00 – 10:00 pm (ET)/1:00 pm – 7:00 pm (PT) and September 20, 2022 from a 3:30 – 8:00 pm (ET)/12:30 pm – 5:00 pm (PT).
  • Where: Martin Luther King Jr. Outpatient Building, 1670 E. 120th Street, Los Angeles, CA 90059. (The closest metro stop is the Willowbrook/Rosa Parks station.) To attend the meeting virtually, please visit www.hhs.gov/live on date and time of event.
  • “PACHA-to-the-People”: PACHA wants to hear from you! There will be a Listening Session with audience attendees on September 19. This is an opportunity for our PACHA members and leaders to hear from the community. Please encourage the community to attend.
  • Registration: Due to limited seating, pre-registration for individuals attending in-person is encouraged. To register, please email your name to PACHA@hhs.gov by close of business Friday, September 9, 2022.
  • Public Comment: Pre-registration is required to provide public comment. To pre-register, please send an email to PACHA@hhs.gov and include your name, organization, and title by close of business Friday, September 9, 2022.
  • Agenda forthcoming: The meeting agenda will be posted on the PACHA page on HIV.gov prior to the meeting. The agenda will also be sent out once it is finalized. On the second day, community partners will be invited to participate on a panel to discuss the needs of the community.

For more information, please see the Federal Register Notice: View the Notice here.

Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (September 6)

Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV

Cross-posted from hivinfo.nih.gov

The HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children (the Panel) updated the following section of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected ChildrenHighlights from the updated section are summarized below:

Monkeypox

  • The Panel added a brief statement about monkeypox with links to information from the Centers for Disease Control and Prevention.
  • Information about monkeypox as an HIV-related opportunistic infection in children with HIV will be added to this guideline as relevant data emerge.

For a list of recent updates, please see What’s New in the Guidelines. To view or download the guidelines, go to the Pediatric Opportunistic Infections Guidelines section of Clinical Info’s website. The guidelines tables and recommendations also can be downloaded as separate PDF files.

Clinical Info welcomes your feedback on the latest revisions to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Please send your comments with the subject line “Pediatric Opportunistic Infection Guidelines” to HIVinfo@NIH.gov by September 23, 2022.