Meeting report: IAS 2017
Stichting HIV Monitoring (SHM) contributed data and expertise to a number of projects presented at IAS 2017, including a presentation by one of our researchers, Ard van Sighem. In a session entitled “Hitting the first 90 target: Lessons from population-based surveys”, Ard presented work using an HIV estimation tool developed on behalf of the European Centre for Disease Prevention & Control (ECDC). In collaboration with researchers from the ECDC HIV/AIDS Surveillance and Dublin Declaration Networks, Ard used the ECDC tool and data from the 31 EU/EEA countries to estimate the number of undiagnosed cases of HIV per European sub-region, as defined by the United Nations. The results showed that there are around 120,000 people living with undiagnosed HIV in Europe, the majority of whom live in southern and western Europe. Moreover, although the median time to diagnosis is lowest in northern Europe, the rate of new infections is highest in this region.
Ard also presented a poster at IAS 2017: “From HIV infection to HIV suppression: improvements in the time to reach successive stages in the HIV care continuum in the Netherlands”. Together with researchers from SHM, the Netherland National Institute for Public Health and the Environment (RIVM), Isala hospital in Zwolle and the OLVG hospital in Amsterdam, and using data from SHM’s ATHENA national observational cohort, Ard found that the time between acquiring HIV and achieving viral suppression had decreased in the Netherlands, but continued to be dominated by the duration of undiagnosed HIV infection, which could be further reduced through earlier diagnosis of HIV.
A third study to which Ard contributed and that included SHM data was presented in a poster entitled “International trends in new HIV diagnoses among men who have sex with men in North America, Western Europe and Australia 2000-2014”. This poster showed that although there were different trends in new HIV diagnoses among high-income countries, a stable or decreasing trend was seen in half the countries. However, the proportion of new HIV diagnoses among young men who have sex with men (MSM) showed increasing trends in all countries.
Another SHM researcher, Sonia Boender, presented a poster at IAS 2017, with the title “Initiation of cART: a nationwide overview of variation between HIV treatment centres in the Netherlands”. This poster was based on work carried out together with Colette Smit (SHM) that explored the variation in combination antiretroviral therapy (cART) initiation between the 26 HIV treatment centres in the Netherlands. Using data from SHM’s ATHENA cohort for the years 2012-2015, the study found that the proportion of people initiating cART within 6 months had increased over this period. However, people receiving care at a small treatment centre were less likely to start cART within 6 months than those at a large centre.
During a session on comorbidities, Maartje Dijkstra (Public Health Service (GGD) Amsterdam) shared her findings from work on data from the AGEhIV study, to which SHM contributes. Maartje reported that, among MSM aged ≥ 45 years old, being HIV-1 infected was independently associated with decreased erectile function. Moreover, exposure to lopinavir appeared to be an independent risk factor for decreased erectile function.
There were also two presentations at IAS 2017 from the HIV Transmission and Elimination in Amsterdam (H-TEAM) initiative, in which SHM is one of the partner organisations. Prof. Maria Prins (GGD Amsterdam/Academic Medical Centre Amsterdam) gave a presentation entitled “Closing the gaps: lessons learned in Amsterdam’s success in reaching 90-90-90” during the symposium session on the Fast Track Cities initiative (“Fast-Track Cities: Ending AIDS in High HIV Burden Cities and Municipalities by 2030”). Prof. Prins outlined the Amsterdam approach to reducing the number of new HIV infections in the city through a combination of efforts including a PrEP implementation study for MSM and transgender people and various campaigns to increase awareness and achieve earlier diagnosis among key populations. She ended her talk by highlighting some of the lessons that have been learnt through the H-TEAM initiative, such as the importance of collaboration with all stakeholders, including political leaders and the community.
The second H-TEAM presentation was given by Hanne Zimmerman (GGD Amsterdam), who aimed to gain insight into why MSM choose for either daily or event-driven PrEP, and why they subsequently choose to switch or stop completely. In her talk, entitled “Pre-exposure prophylaxis (PrEP) among men who have sex with men in the Netherlands: motives to choose for, switch to, or stop with daily or event-driven PrEP”, Hanne showed that, among PrEP users in the H-TEAM’s AmPrEP study, reasons for selecting either daily or event-driven PrEP and for switching or stopping varied greatly and were based on issues such as adherence expectations and experiences and anticipated and experienced physical or sexual impact. She concluded that her findings underscore the importance of offering a choice that fits changing personal risk and adherence strategies among PrEP users.
Finally, there were a number of oral and poster presentations of work from other collaborations in which SHM is involved, including D:A:D, COBRA and RDI, covering topics such as the rate of cardiovascular disease and chronic kidney disease, ageing, and the use of artificial intelligence to predict the response to treatment.
Click here for a complete overview of all IAS presentations in which SHM was involved.