Is PrEP Prevention Justice?

Over 200 participants joined the HIV PJA Strategy Webinar on February 16th for a robust and wide-ranging discussion of PrEP (Pre-Exposure Prophylaxis) trials and global implications for HIV prevention justice. Moderated by HIV PJA's Dázon Dixon Diallo of SisterLove and Julie Davids of AIDS Foundation of Chicago, the conversation ranged from preliminary analysis of the results of the Global iPrEx clinical trials to implications for women (including transwomen) to strategies for stakeholder involvement in shaping future prevention trials.

You can review the complete slides here. NOTE: Unfortunately we had a formatting error with our recording of the call, however, future HIV PJA Strategy Webinars will continue to be recorded.

Presenters included:

• Jeff McConnell and Pedro Goicochea of the UCSF Gladstone Institute and the iPrEx study team, who discussed the preliminary iPrEx findings and the development of the clinical trials (including response to ethical concerns raised before and during the trials);
• Keith Green of Project PrEPare, who reported on the development of a PrEP trial among young MSM in Chicago, designed to more accurately evaluate PrEP in the context of the American epidemic;
• Anna Forbes, women's health and HIV advocate, who raised issues of drug resistance monitoring and how to ensure that the antiretrovirals (ARVs) go to the people to whom they are prescribed;
• Dázon Dixon Diallo, who briefed participants on the many "moving parts" of prevention clinical trials and the need for coordinated global research; and
• Paul Weidle of the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention, who discussed the CDC's interim guidance regarding PrEP for the prevention of HIV infection among MSM.

Like many fruitful discussions, this latest conversation yielded perhaps more questions than answers:

How are community stakeholders involved in setting research and roll-out agendas?

How can we bring a human rights lens to bear on clinical research to ensure that populations particularly impacted by HIV/AIDS -- such as transgender women, gay men and other MSM of color -- are studied in their specific contexts?

How do we as stakeholders engage with major decision-making bodies (like the Global PrEP Steering Committee chaired by WHO and UNAIDS, who initially agreed to participate in this call but failed to send a representative) to ensure HIV prevention justice?

How do we effectively and broadly communicate what PrEP is and how it is used, and address adherence concerns prior to open label release?

How do we ensure that PrEP implementation occurs as an integral part of a comprehensive HIV prevention package?

We still have more follow-up to do from the call, including sorting through many of the questions that we didn't have time to get to during the call. HIV PJA continue to focus on PrEP and other new prevention technologies in future strategy webinars and workshops; we hope you will join us!