The 11th International AIDS Society (IAS) Conference on HIV Science took place from July 18th to the 21st and BC-CfE researchers attending the virtual conference used the opportunity to present their latest findings.
Taking place virtually from Berlin, IAS 2021 saw around 6,000 participants and opened with remarks from German Chancellor Angela Merkel and included a panel discussion on the COVID-19 and HIV pandemics with global health experts including Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Disease.
IAS 2021 saw conference delegates showcase the latest advances in basic, clinical and operational HIV research. The virtual setting allowed the global community of scientists, activists, and policy makers to convene safely during the COVID-19 pandemic.
On the topic of Treatment as Prevention, multiple sessions showcased the latest research on PrEP usage, its monitoring, and creating personalized care. Other discussions centered on the benefits and drawbacks of long-acting injectables and antiretroviral-containing vaginal rings. In social and behavioural science presentations, global experts reflected on HIV service delivery systems in Zambia, community-led quality improvement programs in Vietnam, and improvements in viral suppression in Uganda.
Several studies presented examined the intersection of the HIV and COVID-19 pandemics, such as evidence from Uganda showing how women face increased risk of gender-based violence and HIV during COVID-19 lockdowns. And as issues of COVID-19 vaccine uptake continue to dominate headlines around the world, IAS presenters discussed HIV vaccine innovation. One presentation on HIV vaccines looked at potential implications for future vaccine development if current candidates fail.
Rachel Miller, a Graduate Student in the BC Centre for Excellence in HIV/AIDS (BC-CfE) Molecular Epidemiology and Evolutionary Genetics Group, won a scholarship to attend IAS 2021. She also won the prestigious annual “International AIDS Society and Merck Sharpe & Dohme Prize for Operational and Implementation Research in Differentiated Service Delivery” for her abstract titled “SARS-CoV-2 Lockdown Associated with Expansion of HIV Transmission Clusters Among Key Populations”. The prize recognizes “outstanding research that addresses key knowledge gaps and links new evidence to strategic programme priorities in differentiated service delivery”.
Miller’s award winning abstract, which includes Dr. Julio Montaner (BC-CfE Executive Director and Physician-in-Chief) and Dr. Jeffrey Joy (BC-CfE Research Scientist specializing in evolutionary genetics and bioinformatics) as senior co-authors, represents the combined efforts of the BC-CfE as a whole, and showcases the strengths of the BC-CfE’s partnerships across health authorities and agencies. It brought together researchers from the BCCDC, Vancouver Coastal Health, the Faculty of Health Sciences at Simon Fraser University, and the Bioinformatics Program and the Department of Medicine at the University of British Columbia. Within the BC-CfE, Miller worked with the Molecular Epidemiology and Evolutionary Genetics Group, the Laboratory Program, and the HIV Drug Treatment Program.
The research examined how COVID-19 related public health guidelines potentially introduced barriers to care and services for people living with, or at risk of acquiring HIV.
Researchers synthesized available data from BC’s HIV programs together with publicly available data to test SARS-CoV-2 related impacts on HIV transmission over the last year. Following the implementation of lockdown restrictions in late March 2020, there were statistically significant declines in antiretroviral therapy ART initiation, pre-exposure prophylaxis (PrEP) prescriptions, plasma viral load tests, HIV testing episodes, and new HIV diagnoses.
Thankfully, the declines seen for nearly all of these metrics rebounded within the following three months, although below pre-lockdown levels. Phylogenetic analyses revealed increased growth and increases in multiple indicators of transmission events in a limited number of clusters involving people who inject drugs, relative to clusters characterized by gbMSM populations. The difference in level of transmission seen between these groups may be due to differences in how the impact of the restrictions varies by population. For example, while the gbMSM population likely experienced unprecedented decreases in level of contact as a result of restrictions, people who inject drugs likely experienced reduced access to services like supervised consumption sites and harm reduction supplies.
The increased HIV transmission, though limited, shows the need for innovative and targeted solutions to offset potential negative impacts of COVID-19, or any pandemic-related lockdowns on HIV treatment and prevention efforts.