SEATTLE — President Trump’s new initiative to end HIV in the U.S. has become a recent focus of the public health community, and will be a highlight of this year’s Conference on Retroviruses and Opportunistic Infections (CROI).
CROI takes place March 4-7 at the Washington State Conference Center here, with about 4,000 attendees, including 40% from outside of the U.S. expected to attend. CROI vice chair Sharon Hillier, PhD, of the University of Pittsburgh, told MedPage Today that the meeting has become “increasingly an international meeting, which reflects the global nature of HIV.”
But all eyes will be on the U.S. in a special added session about President Trump’s new initiative, announced during this year’s State of the Union, to end HIV transmission in this country by 2030. On Monday afternoon, the National Institute of Allergy and Infectious Diseases Director, Anthony Fauci, MD, will give a special presentation entitled “Ending the HIV Epidemic: A Plan for the United States.”
“This initiative has energized the HIV community, because there’s been some complacency surrounding HIV in the U.S.,” Hillier said. “But this laser focus and really understanding the epidemic is going to help us marshal the resources we need to make some progress. I’m excited to see the plan and even more excited to see the progress — this has really electrified us.”
CROI sessions will also address the overlapping epidemic of sexually transmitted infections (STIs), Hillier said. She highlighted a plenary presentation given by Jeanne Marrazzo, MD, of the University of Alabama at Birmingham, on Tuesday morning.
Entitled “Denial, Doom, or Destiny? Resurgent STIs in HIV Care & Prevention,” the talk will focus on how, in areas such as San Francisco, HIV has declined markedly but are experiencing “catastrophically high levels” of other STIs.
“We’re also still seeing incredible incidence of sexually transmitted infections in young women globally,” Hillier noted. “[Marrazzo’s] talk is going to unravel some of the complexities of what is happening with HIV versus other sexually transmitted infections.”
Hillier also highlighted a themed discussion section on Tuesday afternoon entitled “The Masked Marvels You Don’t Want to Meet: Syphilis and LGV” that will touch on the topic.
Also that afternoon, a symposium called “ART and Reproduction” will feature a talk on “Challenges in Antiretroviral Research in Women of Reproductive Potential” by Anne Lyerly, MD, of the University of North Carolina at Chapel Hill.
Hillier said that Lyerly, a bioethicist, will bring a fresh voice to the idea that proactive evaluation of drug safety in the periconception period is long overdue.
“We exclude pregnant women from studies because of risk, and then we roll out drugs and programs without being armed with that data,” Hillier said. “It’s a really important discussion for half the world that’s female.”
As always, CROI will feature the latest research in the area of HIV medicine, and HIV prevention, such as the results of the late-breaking phase III DISCOVER trial, testing daily emtricitabine/tenofovir alafenamide (Descovy) against emtricitabine/tenofovir disoproxil fumarate (Truvada) for pre-exposure prophylaxis in men who have sex with men. The former combination is approved for HIV treatment but its effectiveness for prevention hasn’t been established.
“It’s the dawn of a new age in prevention studies,” Hillier said, noting that given the effectiveness of Truvada, “the era of placebo-controlled trials are behind us now.” The study will be presented Wednesday morning at an oral abstract session.
For clinicians attending CROI, Hillier advises studying the program book, especially first time attendees. She also advises to go “back and forth between different sessions” and pick topics that may be unfamiliar, as sometimes those can be the most interesting sessions.
“It’s like a big menu, you have to find the things you’re hungry to learn about. Pick and choose like you’re going out for a really good dinner,” Hillier said.