Clinician's perspective on PrEP - Dr Dan ClutterbuckHIVScotland
This presentation was given by Dr Dan Clutterbuck of NHS Lothian and NHS Borders, at the HIV Scotland 'PrEP Roundtable Discussion' event on 25 August 2015.
An overview of knowledge and use of PrEP among gay men in Australia.
This presentation was given by Dean Murphy, AFAO HIV Education Officer, at the AFAO National HIV Forum, 17 October 2014.
From the event "Specimen Science: Ethics and Policy Implications," held at Harvard Law School on November 16, 2015.
This event is a collaboration between The Center for Child Health and Policy at Case Western Reserve University and University Hospitals Rainbow Babies & Children’s Hospital; the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School; the Multi-Regional Clinical Trials Center of Harvard and Brigham and Women's Hospital; and Harvard Catalyst | The Harvard Clinical and Translational Science Center. It is supported by funding from the National Human Genome Research Institute and the Oswald DeN. Cammann Fund at Harvard University.
For more information, visit our website at http://petrieflom.law.harvard.edu/events/details/specimen-science-ethics-and-policy
FDA Enforcement in the Clinical Research SettingMichael Swit
Presentation reviews analysis done by Mr. Swit of FDA warning letters in the clinical research realm, with a focus on the types of key alleged violations and how those differed by whether the recipient was a clinical investigator, a clinical site, and IRB, or a study sponsor.
Ben Bavinton, (The Kirby Institute) discusses how the Opposites Attract' stdy will address the unanswered questions about wther treatment as prevention will work for gay men. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
Clinician's perspective on PrEP - Dr Dan ClutterbuckHIVScotland
This presentation was given by Dr Dan Clutterbuck of NHS Lothian and NHS Borders, at the HIV Scotland 'PrEP Roundtable Discussion' event on 25 August 2015.
An overview of knowledge and use of PrEP among gay men in Australia.
This presentation was given by Dean Murphy, AFAO HIV Education Officer, at the AFAO National HIV Forum, 17 October 2014.
From the event "Specimen Science: Ethics and Policy Implications," held at Harvard Law School on November 16, 2015.
This event is a collaboration between The Center for Child Health and Policy at Case Western Reserve University and University Hospitals Rainbow Babies & Children’s Hospital; the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School; the Multi-Regional Clinical Trials Center of Harvard and Brigham and Women's Hospital; and Harvard Catalyst | The Harvard Clinical and Translational Science Center. It is supported by funding from the National Human Genome Research Institute and the Oswald DeN. Cammann Fund at Harvard University.
For more information, visit our website at http://petrieflom.law.harvard.edu/events/details/specimen-science-ethics-and-policy
FDA Enforcement in the Clinical Research SettingMichael Swit
Presentation reviews analysis done by Mr. Swit of FDA warning letters in the clinical research realm, with a focus on the types of key alleged violations and how those differed by whether the recipient was a clinical investigator, a clinical site, and IRB, or a study sponsor.
Ben Bavinton, (The Kirby Institute) discusses how the Opposites Attract' stdy will address the unanswered questions about wther treatment as prevention will work for gay men. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
Antonio Boone presented on PrEP campaigns that have been implemented in the US outside Philadelphia at the February 2016 meeting of the Philadelphia HIV Prevention Planning Group (HPG).
David Wohl, MD, prepared useful Practice Aids pertaining to HIV pre-exposure prophylaxis for this CME/CE activity titled "Breaking Down the Barriers to PrEP: The Patient Journey From Misconceptions to Effective HIV Prevention." For the full presentation, monograph, complete CME/CE information, and to apply for credit, please visit us at http://bit.ly/2JovTyb. CME/CE credit will be available until April 19, 2019.
Speakers discuss PrEP eligibility, management, and other topics covered in training modules one and two. During this webinar, expert speakers will review key highlights from the first two modules, share Nigeria specific guidance, and respond to questions from participants.
Part 2: https://www.slideshare.net/jsi/prep-elearning-discussion-2
Speakers discuss PrEP counseling, special situations, and other topics covered in training modules three and four. During this webinar, expert speakers review key highlights from modules three and four, and respond to questions from participants.
Part one: https://www.slideshare.net/jsi/prep-elearning-discussion-i
This presentation on New Zealand's approach to HIV prevention was given by Shaun Robinson, Executive Director NZ AIDS Foundation, at the AFAO Members Forum - May 2015.
Netra is creating the "Quantified Store" using existing in-store video, machine vision, AI and deep learning. Netra's appearance-based approach provides greater accuracy and enables cross-camera search & analytics.
Antonio Boone presented on PrEP campaigns that have been implemented in the US outside Philadelphia at the February 2016 meeting of the Philadelphia HIV Prevention Planning Group (HPG).
David Wohl, MD, prepared useful Practice Aids pertaining to HIV pre-exposure prophylaxis for this CME/CE activity titled "Breaking Down the Barriers to PrEP: The Patient Journey From Misconceptions to Effective HIV Prevention." For the full presentation, monograph, complete CME/CE information, and to apply for credit, please visit us at http://bit.ly/2JovTyb. CME/CE credit will be available until April 19, 2019.
Speakers discuss PrEP eligibility, management, and other topics covered in training modules one and two. During this webinar, expert speakers will review key highlights from the first two modules, share Nigeria specific guidance, and respond to questions from participants.
Part 2: https://www.slideshare.net/jsi/prep-elearning-discussion-2
Speakers discuss PrEP counseling, special situations, and other topics covered in training modules three and four. During this webinar, expert speakers review key highlights from modules three and four, and respond to questions from participants.
Part one: https://www.slideshare.net/jsi/prep-elearning-discussion-i
This presentation on New Zealand's approach to HIV prevention was given by Shaun Robinson, Executive Director NZ AIDS Foundation, at the AFAO Members Forum - May 2015.
Netra is creating the "Quantified Store" using existing in-store video, machine vision, AI and deep learning. Netra's appearance-based approach provides greater accuracy and enables cross-camera search & analytics.
Antiretroviral intensification to prevent intrapartum HIV transmission in lat...Илья Антипин
Lallemant M. и др. «Antiretroviral intensification to prevent intrapartum HIV transmission in late comers» 8th IAS Conference on HIV Pathogenesis, Treatment, and Prevention (IAS 2015), Vancouver, 2015. MOAC0204.
Project RSP Training on PrEP - November 13, 2015Jim Pickett
This training was conducted by AIDS Foundation of Chicago for members of Chicago's HIV workforce - in partnership with the Chicago Department of Public Health. It took place on Friday, November 13, 2015. Presenters included the CORE Center's Dr. Sybil Hosek, Jim Pickett of AFC, and two PrEP consumers - Gabe Bahena and Curtis Lewis.
Project RSP Training on PrEP - September 11, 2015Jim Pickett
This training was conducted by AIDS Foundation of Chicago for members of Chicago's HIV workforce - in partnership with the Chicago Department of Public Health. It took place on Friday, September 11, 2015. Presenters included the CORE Center's Dr. Sybil Hosek, Jim Pickett of AFC, and Gabe Bahena, a PrEP consumer. .
Project RSP Training on PrEP - July 31, 2015Jim Pickett
This PrEP training - a collaboration between AIDS Foundation of Chicago and the Chicago Department of Public Health - was provided to members of Chicago's HIV workforce on Friday, July 31, 2015.
HIV Nursing and Home & Community Care Conference griehl
This joint presentation by Susann Nasewich and Greg Riehl will describe HIV Nursing as it relates to pre and post test counseling, and what is important to know for home and community care nurses and aides.
At the end of the training, participants will be able to:
State the indications for PrEP
State the eligibility for PrEP
Name the 5 main eligibility criteria for PrEP
Explain how to exclude Acute HIV Infection
Chair, Donna E. Sweet, MD, AAHIVS, MACP, prepared useful Practice Aids pertaining to HIV for this CME/MOC/NCPD/CPE activity titled “The HIV Prevention–Certified Provider Program: A Training and Certificate Program Designed to Improve Competencies and Expand the HIV Prevention Workforce.” For the full presentation, downloadable Practice Aids, monograph, and complete CME/MOC/NCPD/CPE information, and to apply for credit, please visit us at https://bit.ly/34T9Mfk. CME/MOC/NCPD/CPE credit will be available until November 11, 2022.
This workshop will cover best practices for HIV prevention in adolescents with a focus on the implementation of Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) in SBHCs. Join this workshop to hear an overview of the HIV epidemic among adolescents in California, best practices for determining eligibility for PrEP and PEP, instructions for labs and prescriptions, and suggestions for case management and training of all SBHC staff.
You Geaux Girl! Internet based Pregnancy Prevention in New OrleansYTH
Jakevia Green at Tulane University presented the results of a clinical trial of the BUtiful program - Be yoU! Talented Informed Fearless Uncompromised and Loved- a social media pregnancy prevention program for New Orleans women.
Project RSP! Training on PrEP - Peoria, IL - August 18, 2015Jim Pickett
This AIDS Foundation of Chicago training on PrEP for the HIV workforce took place in Peoria, IL on August 18, 2015. The training was conducted in collaboration with the Illinois Public Health Association and Central Illinois FRIENDS of PWA, Inc.
Sex, Drugs & Scotland's Health-HPV Vaccine Uptake among eligible GBMSM in the...HIVScotland
Delivered at Sex, Drugs & Scotland's Health Virtual Conference, this presentation was delivered by Dr Jamie Frankis.
More information about the virtual event is available here: http://ow.ly/YntW50GWhJ0
This workshop is designed to talk about the impact of STDs on youth under the age of 25. This workshop will discuss the importance of sexual health screenings, partner management, and current data around STD morbidity rates. We will also talk about current STD clinical recommendations for the treatment of gonorrhea, chlamydia, and syphilis. Participants will engage in an interactive activity where they will sharpen their skills on effective partner management strategies.
Jill Blumenthal, MD
Assistant Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
1. www.ias2015.org
ATN 110:
An HIV PrEP Demonstration
Project and Safety Study for
Young Men who Have Sex with
Men in the United States
Sybil Hosek, Bret Rudy, Raphael
Landovitz, Bill Kapogiannis, George
Siberry, Brandy Rutledge, Nancy Liu,
Jennifer Brothers, Jim Rooney, and Craig
M. Wilson on behalf of the ATN 110/113
study team.
2. www.ias2015.org
Conflicts of Interest
• In 2013, I received an unrestricted educational
grant from Gilead Sciences through a
subcontract with the University of Connecticut
(PI KR Amico) to design and evaluate a PrEP
educational video for use in community settings.
• That video can be found at www.whatisprep.org
3. www.ias2015.org
Background
• Blinded and open label studies among MSM support
the efficacy of TDF/FTC for HIV prevention
• In the US, gay/bisexual/MSM ages 13-24 are hardest
hit by HIV epidemic
– 18-24 year old MSM not well-represented in PrEP safety or
efficacy studies in US
– No PrEP data available on adolescent MSM to date
• Additional safety and behavioral data, as well as
implementation data, in youth are needed to support
a PrEP indication
• Paired PrEP studies:
– ATN 110 (ages 18-22); data presented here
– ATN 113 (ages 15-17); data expected 2016
4. www.ias2015.org
Primary Objectives
• To provide additional safety data regarding FTC/TDF
(Truvada®) use among HIV-uninfected YMSM, ages 18-
22.
• To examine acceptability, patterns of use, rates of
adherence and measured levels of drug exposure when
YMSM are provided open label FTC/TDF (Truvada®)
and information regarding the safety and efficacy of
PrEP from prior studies.
• To examine patterns of sexual behavior when YMSM are
provided a behavioral intervention as well as open label
FTC/TDF (Truvada®) and information regarding the
safety and efficacy of PrEP from prior studies.
5. www.ias2015.org
Eligibility
• Age 18-22
• Self-reports evidence of high risk for acquiring HIV,
including at least one of the following in the last 6
months:
– Condomless anal intercourse with an HIV-infected male partner
or a male partner of unknown HIV status;
– Anal intercourse with 3 or more male sex partners;
– Exchange of money, gifts, shelter, or drugs for anal sex with a
male partner;
– Sex with a male partner and has had a STI;
– Sexual partner of an HIV-infected male with whom condoms were
not consistently used; or
– At least one episode of anal intercourse where the condom broke
or slipped off
• Tests HIV antibody negative at time of screening
6. www.ias2015.org
Study Flow
Pre-Screening Survey
(venue-based or online)
Ineligible or refuse
survey
In-person screening visit
(IC and screening labs)
Ineligible based on
labs
Baseline Visit
(review labs & VL)
Behavioral Intervention
(3MV or PCC)
Week 0 – Dispense PrEP
Follow-up Visits
(weeks 4,8,12,24,36,48)
HIV Seropositive Visits
Week 48:
Evaluate for EPH
Extension Phase
Visits
8. www.ias2015.org
Consort Diagram
Approached for Pre-screening
(N = 2,186)
Refused pre-screening: 921
Pre-screened ineligible: 865
Pre-screened eligible
(n=400)
Refused study participation:
123
In-person Screening Visit
(n=277)
HIV-positive: 11 (4.4%)
No show for visit: 27
Other reasons: 39
200 Enrolled
99 Assigned to 3MV
• 33 Pre-DC
• LTFU (19)
• W/D consent (7)
• Moved (3)
• VL detect (1)
101 Assigned to PCC
• 25 Pre-DC
• LTFU (16)
• W/D consent (3)
• Moved (4)
• VL detect (1)
Other reasons:
- Unable to locate (7)
- Proteinuria (5)
- ≥ gr2 hepatobiliary (5)
- Other chronic disease
(3)
- Acute Hep B (1)
- Bone fracture (1)
9. www.ias2015.org
Baseline Demographics
53%
17%
21%
7%
2%
Black Hispanic/Latino
White Other/Mixed
Asian/PI
Mean age 20.18
Sexual Identity Gay – 77.8%
Bisexual – 13.7%
Highest grade
completed
High School – 33.8%
Some college – 45.5%
Not currently working 30.1%
Ever kicked out 17.2%
Ever paid for sex 28.6%
Partners in past mo 5
Condomless sex 81%
CRAI w/last partner 58%
Any positive STI test 22%
10. www.ias2015.org
Safety
• 25 discontinued PrEP but stayed on study
– Primarily personal choice/decision or side
effects (predominantly GI symptoms)
• 3 adverse events were deemed related to
study drug
–Grade 3 nausea
– Grade 3 weight loss
– Grade 3 headache
• DXA data currently being analyzed (collected
at baseline, 24 and 48 weeks on all participants)
11. www.ias2015.org
HIV Incidence
• 4 seroconversions through week 48
• HIV incidence = 3.29 per 100 person-years
• No drug resistance found
TFV-DP
Level
Study Week
16. www.ias2015.org
Adherence and Sexual Behavior
• Participants that reported engaging in
condomless sex had consistently higher
levels of TFV-DP (p=0.005)
– Remained consistent over course of the study.
• Similarly, participants who reported CRAI
with last partner demonstrated higher TFV-
DP levels over course of the study
– Trend not statistically significant
17. www.ias2015.org
Conclusions
• ATN 110 successfully identified and engaged
YMSM who would be appropriate for PrEP.
– Previously undiagnosed HIV+ youth were linked to
immediate care at youth-focused sites
• PrEP was well tolerated with minimal adverse
events
• STI diagnoses were high at baseline and
remained constant over time
• HIV incidence rate was high compared to PrEP
arms in other open label trials
– Given high number of incident STIs, would likely be
much higher in the absence of PrEP
– Those that seroconverted had undetectable drug levels
18. www.ias2015.org
Conclusions
• Participants who reported condomless sex had higher
levels of TFV-DP
– Thus, those that are most susceptible to HIV infection may also
be most likely to be adherent
• Adherence was good overall, but varied by race/ethnicity
– Consistent with recent research highlighting lack of exposure to
HIV prevention interventions by BYMSM
– CALL TO ACTION for more in-depth understanding of the
historical, societal, behavioral and attitudinal barriers to PrEP
access and adherence among those most impacted in the US –
black/African-American young MSM
• Adherence decreased for all participants as study visits
decreased in frequency, regardless of race/ethnicity
– Youth may need enhanced visit schedules or more frequent
interactions (in-person or via mobile technology)
19. www.ias2015.org
Acknowledgements
• Most importantly, I would like to thank the young men who
participated in this study for their willingness to share their lives and
their time with us.
• My Protocol Co-Chair, Craig M. Wilson, MD
• The 110/113 Medical Monitors - Bret Rudy, MD, & Raphy Landovitz,
MD
• The 110/113 protocol team –Michelle Lally, MD, Kathleen Mulligan,
PhD, Jaime Martinez, MD, Ken Mayer, MD, Greg Zimet, PhD, Kelly
Bojan, DNP, Liz Salomon, MEd
• Protocol Statisticians – James Bethel, PhD & Brandy Rutledge, PhD
• NICHD Program Scientist and Medical Monitors – Bill Kapogiannis,
MD, George Siberry, MD, & Sonia Lee, PhD
• The best Protocol Specialist in the world – Nancy Liu, MPH
• Gilead Sciences for their donation of study drug and assistance with
DBS costs
• Project Director – Jennifer Brothers, MPH; Recruitment Coordinator
– Pedro A. Serrano; and Counseling Coordinator – Christopher
Balthazar
• The Adolescent Trials Network for HIV/AIDS Interventions (ATN) and
its coordinating center (ACC)