The HIV Research for Prevention conference (HIVR4P 2018) brought more than 1,400 attendees to Madrid, including researchers, policy makers and advocates from 50 countries. Here's a wrap-up of the key themes in HIV prevention and vaccine research.
More signposts on the road to a vaccine
The journey of discovery toward an effective HIV vaccine may be longer than many imagined, but the consensus this week is that there are now more signposts than ever to guide the way. HIVR4P included a wealth of presentations exploring our growing knowledge of immune responses, updates from the three vaccine efficacy studies underway, looks at strategies to improve the results of RV144, and an examination of the growing pipeline of vaccine approaches, including bNAb and CD8+ T cell pathways to a vaccine, and DNA, RNA and mosaic strategies. Also on the agenda: the need to further develop the rich pipeline of emerging immunogens and plan for a successful vaccine. Key vaccine sessions making news at HIVR4P included:
The launch of the Global HIV Vaccine Enterprise Strategic Plan (2018-2023) helped set the tone for the way forward on vaccine research, with a five-year strategy to maximize opportunities and address challenges and obstacles in HIV vaccine research and development.
PrEP comes of age…but not everyone can get it
PrEP impact, PrEP access, and the possibility that PrEP works differently for different people were running themes throughout HIVR4P 2018. Conference sessions and presentations looked at the current and potential future impact of the intervention, scale-up options and opportunities and the challenges of building social, political and financial support to make PrEP available for those who could benefit most. Also on the agenda at HIVR4P: PrEP acceptability, mathematical modeling on PrEP targeting, costs and benefits, and a host of presentations on emerging PrEP drugs and delivery options that could increase the impact of PrEP even more in the future. Some of the key PrEP sessions included:
Show me the ring
The themes of user choice and the need for more and better female-controlled prevention options, including options that can protect women without their partner’s knowledge, resonated throughout the conference. Interest was high in the status of the dapivirine ring, as well as in new rings and other female-controlled products in development. Updates on vaginal and rectal microbicides also filled conference rooms in Madrid, with delegates anxious to learn the latest on these long-sought-after forms of prevention. Some key sessions here included:
Give me prevention that lasts
Continuing with the theme of choice in prevention, those seeking news on systemic prevention approaches encountered an expanding universe of data on long-acting PrEP at HIVR4P, including the first tail-phase data on long-acting injectable cabotegravir in females. Also on the programme: new data on product acceptability, new delivery approaches and potential new PrEP agents. Key sessions this week included:
The future of prevention research
If a single sentiment permeated this third biennial HIVR4P meeting, it may have been the sense of excitement at the richness of the prevention pipeline, and the variety of new prevention approaches and products in development. Presentations on new prevention drugs and delivery systems -- including inserts, implantables, gels, biodegradable polymers, refillable reservoirs, osmotic pumps and more -- drew crowds here in Madrid. So did discussions about the opportunities and obstacles created by the increasing number of prevention options available and in development. Among these: the challenges of evolving trial design, the need to understand user preference and evaluate health system capacity, managing product introduction and, of course, maintaining financial and political support for biomedical HIV prevention. Future-focused sessions at the conference included:
To view the complete sessions or to review the data presented, please visit the HIVR4P webcasts page and rapporteurs reports.