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May 19th is National Asian & Pacific Islander HIV/AIDS Awareness Day. According to AIDSVu, the rate of viral suppression among Asian people in the U.S. (68%), is higher than the national average (65%). Today, we recognize the impact of social determinants of health and cultural factors such as stigma, language barriers, and discrimination as challenges to HIV treatment and prevention. Let’s work to combat stigma and increase HIV screening, prevention, and treatment services among API communities.

Pacific-AETC Resources

HIV Learning Network – Culturally-Based Programs to Improve Engagement and Health Outcomes: Addressing Stigma for Native Hawaiian with HIV

Learn more with the HIV Learning Network’s Culturally-Based Programs to Improve Engagement and Health Outcomes: Addressing Stigma for Native Hawaiian with HIV. This presentation was giving on April 23 @ Noon (Pacific) by Malulani Orton, Native Hawaiian Medical Case Manager, Hawai’i Health & Harm Reduction Center.

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HIVLN – Addressing Opioid Use Disorder in Asian Americans, Native Hawaiians and Pacific Islanders with HIV

This presentation was giving on April 23 @ Noon (Pacific): Culturally-Based Programs to Improve Engagement and Health Outcomes: Addressing Stigma for Native Hawaiian with HIV, by Malulani Orton, Native Hawaiian Medical Case Manager, Hawai’i Health & Harm Reduction Center.

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Social Determinants of Health and HIV among Asian, Native Hawaiian, and Pacific Islander people:

More NAPIHAAD Infographics from AIDSVu

Although Native Hawaiians and Other Pacific Islanders (NHOPI) account for a very small percentage of new HIV diagnoses in the United States (US) and dependent areas, HIV affects NHOPI in ways that are not always apparent because of their small population size. In 2018, NHOPI made up 0.2% of the US population. Check out this CDC page to get the latest data on HIV among NHOPI, learn about the prevention challenges that some face, and discover the progress being made.

Through direct, on-site training, and multi-platform distance learning methods, Pacific AETC-HIAPI bridges the enormous distances of the region to strengthen HIV clinical care, testing, and prevention efforts for native Hawaiians and Pacific Islanders.

Learn more about the work of Pacific AETC-HIAPI

CDC Resources on HIV among NHOPI communities:

HIV Vaccine Awareness Day (#HVAD), led by the National Institute of Allergy and Infectious Diseases (NIAID), is observed this Thursday on May 18th. This event is an opportunity to recognize the many volunteers, community members, health professionals, and scientists who are working together to find a safe and effective vaccine to prevent HIV. It is also a day to educate communities about the importance of HIV vaccine research.

Read NIAID’s post on HIV Vaccine Awareness Day last year

Read more about HIV Vaccine Development from NIAID

Join Live with Leadership: A Conversation Commemorating National HIV Vaccine Awareness Day on Thursday, May 18th at 2:30pm ET. The conversation will provide participants with an understanding of recent developments and future opportunities to develop an HIV vaccine. The conversation will also focus on how an HIV vaccine fits into the National HIV/AIDS Strategy and efforts to end the HIV epidemic domestically and around the globe.

Register Now!

In a news release for HIV Vaccine Awareness Day 2019, Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases wrote:

“Since the first cases of what would become known as HIV/AIDS were initially reported in 1981, scientists and public health officials have been working to better understand HIV, develop strategies to effectively treat and prevent infection, and bring about an end to the pandemic. This effort remains a critical focus globally and for the United States.

We have the tools at hand that could—if fully implemented—end the HIV pandemic. Large clinical studies have proven that individuals with HIV who use antiretroviral therapy to achieve and maintain an undetectable viral load do not sexually transmit HIV to others—a concept known as undetectable = untransmittable (U=U). People who are at high risk for HIV can take a single daily pill known as PrEP, or pre-exposure prophylaxis, that is highly effective at protecting them from the virus. In addition, post-exposure prophylaxis, or PEP, provides a highly effective emergency means of preventing HIV transmission from a recent high-risk exposure and can serve as a bridge to PrEP.”

Learn more about HVAD from HIV.gov

View openings for current and future HIV vaccine trials at University of California Health:

UCH Clinical Trials

This toolkit describes how to initiate, enhance, or maintain rapid ART in various settings; develop and sustain linkage to care (LTC) activities; and includes resources to develop staff skills in implementing a rapid ART program. This toolkit outlines promising practices for HDs; CBOs; clinical settings, especially those that do not receive Ryan White HIV/AIDS Program funding, such as Federally Qualified Health Centers (FQHCs); and community-based pharmacies. Finance and training resources are also provided to support rapid ART efforts.

Access the Toolkit Now

Created by Primary Care Development Corporation, My Brother’s Keeper, the San Francisco Community Health Center, and the Denver Prevention Training Center with support and guidance from the Centers for Disease Control and Prevention.

 

Cross-posted from FDA News Release

FDA Finalizes Move to Recommend Individual Risk Assessment to Determine Eligibility for Blood Donations

Today, the U.S. Food and Drug Administration finalized recommendations for assessing blood donor eligibility using a set of individual risk-based questions to reduce the risk of transfusion-transmitted HIV. These questions will be the same for every donor, regardless of sexual orientation, sex or gender. Blood establishments may now implement these recommendations by revising their donor history questionnaires and procedures.

This updated policy is based on the best available scientific evidence and is in line with policies in place in countries like the United Kingdom and Canada. It will potentially expand the number of people eligible to donate blood, while also maintaining the appropriate safeguards to protect the safety of the blood supply.

These final recommendations are consistent with the policy initially proposed in January. The FDA worked diligently to review and consider all comments submitted to the agency to finalize these recommendations as quickly as possible.

“The FDA has worked diligently to evaluate our policies and ensure we had the scientific evidence to support individual risk assessment for donor eligibility while maintaining appropriate safeguards to protect recipients of blood products. The implementation of these recommendations will represent a significant milestone for the agency and the LGBTQI+ community,” said Peter Marks, M.D., PhD., director of the FDA’s Center for Biologics Evaluation and Research. “The FDA is committed to working closely with the blood collection industry to help ensure timely implementation of the new recommendations and we will continue to monitor the safety of the blood supply once this individual risk-based approach is in place.”

This policy eliminates time-based deferrals and screening questions specific to men who have sex with men (MSM) and women who have sex with MSM. Under the final guidance issued today, all prospective blood donors will answer a series of individual, risk-based questions to determine eligibility. All prospective donors who report having a new sexual partner, or more than one sexual partner in the past three months, and anal sex in the past three months, would be deferred to reduce the likelihood of donations by individuals with new or recent HIV infection who may be in the window period for detection of HIV by nucleic acid testing.

Additionally, under these final recommendations, those taking medications to treat or prevent HIV infection (e.g., antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)), will also be deferred. Though these antiretroviral drugs are safe, effective, and an important public health tool, the available data demonstrate that their use may delay detection of HIV by currently licensed screening tests for blood donations, which may potentially give false negative results. Although HIV is not transmitted sexually by individuals with undetectable viral levels, this does not apply to transfusion transmission of HIV because a blood transfusion is administered intravenously, and a transfusion involves a large volume of blood compared to exposure with sexual contact. As stated in the guidance, individuals should not stop taking their prescribed medications, including PrEP, or PEP, in order to donate blood. The FDA remains committed to evaluating additional data and new technological developments as they become available to inform our donor eligibility recommendations.

The FDA has been evaluating alternatives to time-based deferrals for MSM and helping to facilitate the generation of scientific evidence that would support an individual risk based- assessment blood donor questionnaire. This scientific information has given the agency a solid foundation to support this new policy. The FDA strongly believes the implementation of an individual risk-based approach will not adversely affect the safety or availability of the U.S. blood supply.

The FDA carefully reviewed numerous data sources, including data from countries with similar HIV epidemiology that have implemented an individual risk-based approach for assessing donor eligibility, surveillance information obtained from the Transfusion Transmissible Infections Monitoring System, performance characteristics of nucleic acid testing for HIV and the FDA-funded Assessing Donor Variability And New Concepts in Eligibility (ADVANCEExit Disclaimer) study. The ADVANCE study examined the rates of HIV risk factors, such as anal sex and rates of HIV infection, as well as the usage of medications to treat or prevent HIV infection, among MSM study participants.

Related Information

• Recommendations for Evaluating Donor Eligibility Using Individual Risk-Based Questions to Reduce the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products
• FDA Proposes Individual Risk Assessment for Blood Donations, While Continuing to Safeguard U.S. Blood Supply
• Keeping Blood Transfusions Safe: FDA’s Multi-layered Protections for Donated Blood
• Blood & Blood Products

Cross-posted from the HHS Press Office

[On April 27] the Health Resources and Services Administration (HRSA), an agency of the Department of Health and Human Services (HHS), awarded more than $147 million to 49 recipients to advance the Ending the HIV Epidemic in the U.S. (EHE) initiative, which is part of the Biden-Harris Administration’s ongoing efforts to reduce the number of new HIV infections in the United States by at least 90 percent by 2030. This funding will help states and metropolitan areas with the highest levels of HIV transmission link people with HIV to essential care, support, and treatment, as well as support training and other resources for these jurisdictions.

“Ending the HIV epidemic requires us to reach people living with the virus where they are, and that’s exactly what this program allows us to do,” said HHS Secretary Xavier Becerra. “Through this program and others, we will continue our work to destigmatize this deadly disease and ensure equitable access to testing and treatment.”

“HRSA is proud to build on our thirty years of experience in the Ryan White HIV/AIDS Program to help lead the fight to end the HIV epidemic in the United States,” said HRSA Administrator Carole Johnson. “We are expanding treatment and partnering with communities to address critical health-related needs like housing and mental health. These awards expand our efforts to ensure that we can reach people with HIV and connect them with the care they need to not just survive but thrive.”

[The] awards include:

• Nearly $139.1 million to metropolitan areas and states to implement strategies and interventions to provide medical and support services to reduce new HIV infections in the U.S.; and
• $8 million to two non-profit organizations to provide training and other resources to recipients of EHE funds.

The Ending the HIV Epidemic Initiative focuses on four key strategies:

• Diagnose all people with HIV as early as possible.
• Treat people with HIV rapidly and effectively to reach sustained viral suppression.
• Prevent new HIV transmissions by using proven interventions.
• Respond quickly to potential HIV outbreaks.

These strategies build on the continued success of the Ryan White HIV/AIDS Program, which supports medical care, medications, and other essential support services to help more than 576,000 people stay in care. Nearly 90 percent of Ryan White clients who receive care reach viral suppression, meaning they cannot transmit HIV, and can also live healthier lives. This rate exceeds the national viral suppression average of 64.6 percent.

For a list of the FY 2023 HRSA HIV/AIDS Bureau EHE award recipients, visit:
https://ryanwhite.hrsa.gov/about/parts-and-initiatives/fy-2023-ending-hiv-epidemic-awards.

For more information about HRSA’s role in the EHE initiative, visit: www.hrsa.gov/ending-hiv-epidemic.

For more information about HRSA’s RWHAP, visit: https://ryanwhite.hrsa.gov/.

For more about the EHE initiative, visit: https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview.

Updates to the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection

The Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV (the Panel) has reviewed and updated the text and references of previous versions of the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection published on April 11, 2022, and October 11, 2022. Updates were made to the following sections:

• When to Start
• Clinical and Laboratory Monitoring of Pediatric HIV Infection
• What Not to Start: Regimens Not Recommended for Use Antiretroviral-Naive Children
• Special Considerations for Antiretroviral Therapy Use in Adolescents with HIV
• Adherence to Antiretroviral Therapy in Children and Adolescents with HIV
• Management of Medication Toxicity or Intolerance
• Management of Children Receiving Antiretroviral Therapy
• Appendix A: Pediatric Antiretroviral Drug Information

View the What’s New in the Pediatric Guidelines page for a summary of the changes