{"id":9058,"date":"2019-09-02T16:59:07","date_gmt":"2019-09-02T20:59:07","guid":{"rendered":"http:\/\/plataformalac.org\/?p=9058"},"modified":"2019-09-02T16:59:12","modified_gmt":"2019-09-02T20:59:12","slug":"what-are-we-left-with-after-ias-2019","status":"publish","type":"post","link":"https:\/\/plataformalac.org\/en\/2019\/09\/what-are-we-left-with-after-ias-2019\/","title":{"rendered":"What are we left with after IAS 2019?"},"content":{"rendered":"\n

In Mexico\nCity, between July 21 and July 24, 2019, another edition of the IAS Conference\non HIV Science (IAS 2019) was organized by the International AIDS Society<\/p>\n\n\n\n

By: <\/strong>Javier Hourcade Bellocq<\/p>\n\n\n\n

Source<\/strong>: Corresponsales Clave<\/a><\/p>\n\n\n\n

Around\n5,000 health professionals and researchers, as well as activists and civil\nsociety leaders in a lower proportion, gathered between July 21 and 24 to\npresent and discuss the latest advances in the fight against AIDS. As usual, at\ntimes there were more people in the halls and walking around than inside the\nsession rooms, but this did not affect the quality of the presentations, which\nhave improved a lot, in my opinion.<\/p>\n\n\n\n

\"\"<\/a><\/figure><\/div>\n\n\n\n

Pharmaceutical laboratories, UN agencies, international NGOs and other entities put all their efforts, as usual, with various events, pre-conferences, remote events and parallel meetings; many of them of very dubious quality regarding contributions to the global HIV response. By doing so, they promote themselves without paying for tickets, hotels or food for our people, but they do not understand that delegates cannot be cut in half so that they can attend parallel events. However, what really matters is being part of the program and not the relevance.<\/p>\n\n\n\n

Before it\nstarted<\/strong><\/p>\n\n\n\n

Latina\nForum<\/strong><\/p>\n\n\n\n

Fundaci\u00f3n\nHu\u00e9sped organized the Latina Forum, a pre-conference training event which\nallowed to train and refresh the knowledge of 120 health professionals and\n10 representatives of civil society. Regarding civil society, Fundaci\u00f3n\nHu\u00e9sped granted 10 full scholarships\u2014without any conditions\u2014so that the\nTeam of Correspondents could bring regional leaders and two correspondents.\nBesides facilitating the participation of important regional leaders, this support\nallowed us to have three correspondents covering the event with a record number\nof articles. Please, check the full coverage here<\/a>.<\/p>\n\n\n\n

Community\nForum<\/strong><\/p>\n\n\n\n

The International AIDS Society (IAS) participated in the organization of a civil society forum two days before the conference. This forum had 345 registered people, so we had to close registration, and many people were not able to join us.<\/p>\n\n\n\n

\"\"<\/a>
Kevin Osborne, CEO of IAS<\/figcaption><\/figure><\/div>\n\n\n\n

The truth is that, when participation reached its highest level, there were only 120 participants in the room. Do we just attend another event and leave our seats empty? Do we tour? This is very unfortunate, since it has been an intense year of work for those who organized the event and got IAS to provide more resources, such as food and delegates. We have to reflect on the reason why we register for everything but do not attend in the end, especially because the Community Forum had the participation of key leaders\u2014who directly engage in the mission of the Global Fund, WHO, UNAIDS, PAHO and UHC\u2014who gave presentations and discussed the topics addressed.<\/p>\n\n\n\n

It was\nalso interesting to see how a significant number of delegates attended a\nsession for a while, then stood up and walked to another one, and so on. They\nspread themselves thin.<\/p>\n\n\n\n

There are\nalways more people outside than inside the rooms, that\u2019s why IAS is discussing\nthe future of conferences. Delegates who travel to conferences to walk around,\ninside and outside, and share very little with their colleagues in their\ncountries and communities have poor accountability and responsibility. It is\ntime for civil society to demand accountability from people with scholarships.\nIf not, we cannot complain later about those who stay at home and call us\n\u201cparticipants of the AIDS tour\u201d.<\/p>\n\n\n\n

\"\"<\/a><\/figure><\/div>\n\n\n\n

Once again, PrEP was one of the stars of the conference. Six months of evidence in the total number of research studies on its effectiveness, adherence and few secondary effects were presented. Finally, WHO and PAHO published guides for the use of PrEP based on events, better known as 2+1+1. In other words, if a person takes two PrEP pills at least two hours before intercourse, and then takes one the next day and another one the third day, that person will be as protected as if they had taken PrEP daily. This improves adherence, lowers the cost and reduces possible toxicities.<\/p>\n\n\n\n

Slow-release\nPrEP is under research, as well as the use of patches, injections and even PrEP\nimplants, which can last for a year with another drug called islatravir. The\ncure, the best ARV, but mainly the best PrEP, are the crown jewels which the\npharmaceutical industry fights for. The question is, will we be able to pay for\nit?<\/p>\n\n\n\n

What is still curious is that the WHO recommendation regarding PrEP based on events is just for gay men. And this is not because it does not work on transgender people or women, but rather because protocols have been created based on one population only. I doubt that the anatomy and molecular biology of a transgender person are far different than that of a gay man, but this modus operandi<\/em> delays the access of other populations to scientific advances. Let\u2019s imagine how many women and transgender women who work as sex workers every week, but on specific days, could benefit from 2+1+1. Science is often comfortable and, when it involves people who will benefit from its findings, it translates into human lives. We must demand studies and recommendations of PrEP based on events for all\u00a0populations.<\/p>\n\n\n\n

Dolutegravir, safe for women<\/strong><\/p>\n\n\n\n

\"\"<\/a>
Linda-Gail Bekker, Desmond Tutu Center, Cape Town University.<\/figcaption><\/figure><\/div>\n\n\n\n

After\ntaking its time, WHO also announced the recommendation of using dolutegravir on\nwomen in reproductive age and pregnant women, since the use of this drug cannot\nbe related to birth defects in babies, as in some cases reported in Africa.\nDolutegravir is a safe drug.<\/p>\n\n\n\n

These new\nrecommendations have a very important impact, for instance, without going that\nfar, on the crisis in Venezuela, as PAHO submitted a recommendation of\nexclusive procurement and distribution of a triple therapy, which included this\nmedicine.<\/p>\n\n\n\n

Antiretroviral\ntreatment with pauses<\/strong><\/p>\n\n\n\n

A series\nof evidence about clinical studies were presented. They showed that taking some\nantiretrovirals only four days a week has the same effect and effectiveness\ncompared to a daily intake.<\/p>\n\n\n\n

\u201cPeople\nwith HIV are advised to take antiretroviral treatment every day, but there is\nevidence that some antiretrovirals maintain a sufficient level in the blood<\/em> for several days, thereby controlling HIV even\nif a dose is skipped. Even though adherence to antiretroviral therapy in the\nlong term is good, many people with HIV find it difficult to stick to perfect\nadherence year after year, and have shown interest in treatment strategies that\nmight reduce the burden of taking <\/em>medicines.\u201d<\/em>\nAidmap on Quatuor, an essay supported by the French National Research Agency.<\/p>\n\n\n\n

Important:<\/strong> There is not enough evidence on the effectiveness of the scheme with interruptions, so this should not be used yet. So far, it is not advisable to implement it.<\/strong><\/p>\n\n\n\n

\"\"
Amaranta G\u00f3mez represented the voice of communities in many spaces of the conference<\/figcaption><\/figure><\/div>\n\n\n\n

Likewise,\nother clinical protocols proved that the combination of two specific ARV is as\neffective as the combination of three. This hypothesis was verified by the\nGardel study, which originated in Argentina and led to updates of the Gemini and\nTango studies.<\/p>\n\n\n\n

In\nconclusion, I believe this conference has provided us with several good news,\nand that people who have been inside the session rooms have been able to\nunderstand the information we have shared above\u2013and much more\u2013with more details,\nwhich is something those who were in the halls have missed.<\/p>\n\n\n\n

The IAS\nConference on HIV Science is the event with the highest scientific quality. Like\nin CROI, researchers present their latest findings to the world. IAS 2019 may\nhave had the highest participation rate of civil society in this type of events,\nsince we know that international conferences on AIDS usually have more\nparticipation at a community level and include a more political discussion.<\/p>\n\n\n\n

I think we\nleft Mexico City with renewed hope about what science offers to reduce the\nnumber of new infections and find the functional cure of HIV. We also left\nMexico wondering who will be able to pay for the new products.<\/p>\n\n\n\n

I want to\nthank IAS for supporting the Community Forum, Fundaci\u00f3n Hu\u00e9sped for the Latino\nForum and scholarships, and UNAIDS for supporting our key correspondents. As\nthe editor, I would also like to thank Francisco, L\u00eddice and Dennis, who have\ncovered the event in an amazing way as correspondents.<\/p>\n\n\n\n

Sources: WHO, PAHO and Aidsmap<\/p>\n\n\n\n

Pictures:\nIAS <\/p>\n\n\n\n

All articles can be shared and published\nprovided the source is cited.<\/p>\n","protected":false},"excerpt":{"rendered":"

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