Asia Pacific AIDS & Co-infections Conference 2019 HIV

A report back on Pedro Cahn's session - Novel treatment strategies

Pedro Cahn presented on what treatments were used by low and middle income countries (LMIC) and what they could look forward to in the future. The WHO recommendation for these countries is the use of TDF + 3TC + DTG as first line, except for women of child-bearing age where EFV was the preferred third agent. EFV and PI based regimens are now second/third line treatments. As not INSTIs are available in these countries, he also went through the currently available INSTIs. The new NNRTI was also discussed as well as other pipeline treatments (injectables, implants, monoclonal antibodies)

A report back on Siroat Jittjang's session - HIV testing? The answer is YES stupid!

This session focused on the willingness to pay and acceptability of self-testing in Thailand.

Mr. Jittjang gave 2 presentations about his Thai study on self-testing. They looked at assisted and unassisted self-testing, depending on patient preference. The majority of participants chose to have assisted testing, where it was done in front of a tester using the oraquick oral HIV test kit by MSM and transgender women. It was very well accepted by both groups (>80%) and most preferred the assisted self testing. 34- 38% were first time testers. One of the negatives were the number of participants who did not link to follow up services with either a reactive or irregular test result. The acceptable pricing for these tests were between USD8-9.50.

A report back on Denise Hsu's, James McMahon's and Eugene Kroon's session - Progress in HIV Cure/Elimination​

Denise Hsu introduced the topic with how the HIV reservoir can be measured in a number of ways including single copy assay showing the majority of individuals on ART with undetectable viral load on conventional assays will unsurprisingly retain detectable VL on single copy assay- the median level being 3.1 copies/ml. This most likely represents virus production from integrated provirus in reservoirs such as LN and the CNS as ART intensification does not reduce the number.

A report back on Donn Colby's session Starting PrEP During Acute HIV Infection: What is the Risk for Antiretroviral Drug Resistance?

Donn Colby talked about the people who were inadvertently prescribed PrEP during acute HIV infection. The cohort of patients he examined were mainly MSM and male, with a median age of 32 years. Fortunately, only a small proportion of those who were prescribed PrEP through the Thai Red Cross Anonymous Clinic were later found to have acute HIV infection (1 in 350). The majority were diagnosed using qualitative HIV RNA, while the remainder were diagnosed by reactive HIV serology at the 1-month visit.

A report back on Rena Janamnuaysook's session Demographic characteristics and risk behaviors of transgender women using free versus fee-based pre-exposure prophylaxis (PrEP) services in Bangkok, Thailand.

This was one of no less than three different sessions presented by Rena Janamnuaysook, a transgender woman (TGW) from Thailand.The study presented that a subsidized low cost ($30) PrEP was not a barrier to uptake of PrEP amongst TGW unable to access either limited free PrEP provision or full cost PrEP, and could be a mechanism for upscaling the program in Thailand.