Adaobi Lisa Olisa, FHI 360
Sarah Salinger, FHI 360

Last month, we attended the HIV Research for Prevention Conference (HIVR4P 2024) in Lima, Peru. The conference was jam-packed with new and exciting research being presented on HIV prevention, from new methods in the research and development pipeline to results from implementation studies and insights on advances in HIV vaccine research. We were fortunate to learn from advocates on the importance of access to all pre-exposure prophylaxis (PrEP) options with HIV prevention choice being a major recurring theme across sessions. Reaffirming the importance of PrEP choice, it was exciting to hear our MOSAIC colleagues publicly present data from the CATALYST study for the first time. The following are our reflections from our first International AIDS Society conference.

PrEP CHOICE IS HERE AND IT’S THE TALK OF THE TOWN!

One of the most widely discussed topics at HIVR4P 2024 was PrEP method choice. Through implementation science studies like CATALYST and others, people looking to prevent HIV with PrEP can access more options than just oral PrEP in real-world health care settings. Implementation studies to introduce PrEP ring, CAB PrEP, or both are currently taking place across multiple continents, and these studies are sharing their interim results in real time. What these studies are telling us is that people are excited about having multiple PrEP options, and people are taking advantage of PrEP choice. Conference attendees were eager to understand more about PrEP choice, like who is choosing which methods, and for how long are participants returning for PrEP refills/reinjections? In addition to asking these important questions, conference attendees were keen to understand how people will be able to access these effective and well-accepted methods once studies conclude.

“There are many new and exciting HIV prevention products in the pipeline, but that shouldn’t preclude us from innovating on the delivery of and improving access to products that are currently available.”

Haley Sisel, Research Associate, FHI 360

“THE BEST PrEP PRODUCT IS THE ONE THAT SOMEONE WANTS TO USE AND WILL USE WELL” — WHO

Mateo Prochazka (World Health Organization) presented updates from the WHO implementation tool for PrEP of HIV infection: Provider module for oral and long-acting PrEP. He emphasized that WHO does not support one PrEP product over any other, noting that offering choice for HIV prevention can increase uptake, effective use, satisfaction, and protection; however, all features of each method should be discussed with potential users to allow for informed choice. Hasina Subedar (Department of Health, South Africa) also shared early insights from implementation science and pilot projects in South Africa. She explained that PrEP uptake was notably higher in sites where the three methods were being offered compared to sites with only one or two options, reaffirming WHO’s message about increased uptake as a result of PrEP choice. However, discussions from the conference highlighted that we need more research and better understanding of how to effectively provide choice, and more precision in quantification and forecasting to prevent waste/expiration of products as they become available.

The future of HIV prevention looks bright with diverse PrEP methods like long-acting injectables. The real game-changer is making sure everyone can access these options through flexible service delivery and strong community support. Together, we can make these innovations a reality for everyone and end new HIV acquisitions for good.

Nolwazi Khanyile, Youth Representative & Research Assistant, FHI 360

YOUNG PEOPLE ARE LEADING THE CHARGE ALONGSIDE THEIR COMMUNITIES

MOSAIC’s “Brightest under 30: Celebrating youth voices and promoting meaningful youth engagement in HIV prevention research” satellite session provided a unique opportunity for young advocates and innovators and senior leaders to highlight the important role young people and meaningful youth engagement play in HIV prevention research. While young people are disproportionately affected by HIV, they have also been identified as an important resource needed to accelerate and sustain advances towards achieving HIV epidemic control.

Community engagement was also a major topic of discussion, and the launch of the People’s Research Agenda (PRA) was a huge statement from the community. Developed with input from more than 120 people from 23 countries, the PRA outlines priorities for HIV prevention research and product development. This living document empowers communities to voice their needs and is intended to guide funders, developers, and policymakers in making informed decisions about what to invest in, where to invest, and why. Several sessions at the Advocates Corner were dedicated to enlightening advocates about the PRA and how to take the message back home, share it, and use it effectively. The community presence at HIVR4P 2024 was intentional and impressive.

HOW WE TALK ABOUT HIV PREVENTION MATTERS

We heard how important it is to communicate about PrEP and HIV prevention in ways that resonate with those who might benefit from it. For example, communicating with clients that HIV prevention can support sexual expression, facilitate open communication with sexual partners, and enhance safety and pleasure can support clients to initiate and stay on PrEP while they need it. Incorporating pleasure principles into sexual health services can also support clients in those programs to have better sexual health outcomes. As young HIV prevention researchers, advocates, and implementing partners, these messages resonated with us. We also heard from several presenters that communicating about HIV prevention and PrEP should continue to move away from fear-based messaging toward more joyful, empowering, and pleasure-focused messaging.

Overall, HIVR4P 2024 was an invigorating and momentous few days. The exciting new data shared and important calls to action that were highlighted at this conference will stay top of mind as we continue working towards an HIV-free future.  

Featured Image: MOSAIC’s Nolwazi Khanyile (FHI 360), Sarah Salinger (FHI 360), Margaret Akinyi Atieno (LVCT Health), Adaobi Olisa (FHI 360), and Haley Sisel (FHI 360) pose at HIVR4P 2024 in Lima, Peru (MOSAIC).