Listed below are the most recent findings of Project Achieve’s research studies on the topic of HIV prevention.
- The DNA/rAd5 vaccine regimen did not reduce either the rate of new HIV infection or the HIV viral-load set point among men and transgender women who have sex with men.
- The development of a safe and effective HIV vaccine remains a challenge. The experience highlights the importance of conducting efficacy studies that continue to move us closer toward the goal of a safe, effective, durable, and universal HIV preventive vaccine.
HIV Monoclonal Antibodies
- The AMP studies showed that the VRC01 broadly neutralizing monoclonal antibody can safely prevent the acquisition of some types of HIV. However, the AMP VRC01 infusions did not provide statistically significant prevention of HIV acquisition overall. This means that we will probably need to use more than one antibody to achieve effective antibody mediated HIV prevention.
Pre-exposure Prophylaxis (PrEP)
- In the HIV Prevention Trials Network (HPTN) 083 study, a pre-exposure prophylaxis (PrEP) regimen containing long-acting cabotegravir injected once every 8 weeks was superior to daily oral tenofovir/emtricitabine (TDF/FTC) for HIV prevention among cisgender men and transgender women who have sex with men.
Women at Risk
- A three-city study of women found a high percent of women had male partners at risk. The HIV incidence was 0.3%. New strategies are needed to identify US women at high risk.
- In a collaborative study with University of Pennsylvania investigators, we found high acceptability and feasibility of a woman-focused, Just4Us behavioral intervention to increase PrEP uptake among cisgender women in New York City and Philadelphia.
Black men who have sex with men (MSM)
- In the largest group of Black MSM in the US followed over time, the rate of new HIV infections was high, particularly among young men.
- Black MSM who were newly diagnosed with HIV were more likely to be unemployed, have sexually transmitted infections and engage in condomless receptive anal intercourse than other Black MSM.
- Targeted, tailored and culturally appropriate HIV prevention strategies addressing economic disenfranchisement, engagement in care, screening for sexually transmitted infections with safer sex prevention interventions, and biomedical interventions are urgently needed to lower these rates.
Neighborhoods and gay men’s health in New York City
- In the largest study of urban neighborhoods among MSM, we developed novel approaches used to collect data on the effect of neighborhoods on MSM’s health.
- Using data from qualitative interviews with MSM, we found that neighborhoods can both physically and socially reinforce social class and oppression, which in turn produce disparities in sexual health.
- We found that having multiple partners in overlapping time periods (concurrency) was common among MSM. Concurrency was associated with condomless anal intercourse, substance use during sex, having an anonymous partner, and having many sex partners. This could further increase HIV risk among MSM.Black heterosexual men in New York City
- Our theory-based HIV prevention intervention showed significant declines in the number of total and new female partners, unprotected sex partners, and partner concurrency in both primary and nonprimary sex partnerships between baseline and 3 months post-intervention.
Other HIV Prevention Research
- In the EXPLORE Study, 9.6% of men only had receptive anal intercourse, 16.7% only had insertive anal intercourse, and 63.0% had both receptive and insertive anal intercourse. Having both receptive and insertive anal intercourse was more likely with primary and HIV-negative/unknown status partners and among younger men and substance users but less likely among Blacks and with higher number of partners. Exclusively receptive role was more likely with HIV-negative/unknown status partners and among younger men and substance users but less likely with higher number of partners.
- In a behavioral intervention study of substance-using men who have sex with men, the proportion of substance-using MSM who also have sex with women is low. However, these men engage in unprotected sex with women, particularly with primary female partners.
Behavioral and Social Science in HIV prevention
- Results of recent trials indicate that the division of biomedical and behavioral prevention approaches works against the goal of ending the HIV epidemic. The prevention ‘‘bar’’ needs to move to a place of interdisciplinary, comprehensive, and tailored prevention approaches that are cost efficient and scalable.
- Integration of social and behavioral sciences early in idea generation and study design is imperative for the successful conduct of biomedical trials and for ensuring optimal data collection approaches necessary for the interpretation of findings, particularly in cases of unexpected results.