I recently had the fortune of attending the annual event of the Canadian Aboriginal AIDS Network (CAAN), combining their annual meeting, caucus of Aboriginal people living with HIV/AIDS (APHA Caucus), skills-building conference and “Wise Practices,” the research conference of CAAN’s Aboriginal HIV & AIDS Community-Based Research Collaborative Centre. The event brought together Indigenous people from across Canada involved in the response to HIV and hepatitis C. Although I attend most years, these gatherings never cease to enthrall and move me.
By Tim Rogers and Sean Hosein
Vancouver is in the limelight again. This year’s International AIDS Society (IAS) Conference may have marked a watershed moment in our HIV response, with some similarity to the 1996 Vancouver AIDS conference when highly active antiretroviral therapy (HAART) hit the world stage.
In response to mounting evidence of the prevention benefits of pre-exposure prophylaxis (PrEP) use by HIV-negative gay and bisexual men, a discussion recently emerged on social media about the perceived exclusion of trans men1 who have sex with men from PrEP research studies.
In fact, trans men participate in many HIV prevention research studies, whether or not they are identified as trans when results are reported. Some do not identify as trans, but rather as men of trans experience or transitioned men, and are happy to check the “male” box without qualification. Other studies have explicitly included trans men and allowed them to self-identify. Regardless, some were upset that when results were reported, PrEP effectiveness among trans men was not addressed. In response, a number of well-intentioned non-trans men voiced their support for greater inclusion of trans men in biomedical and other HIV prevention research. While these statements are a testament to the progress gay and bisexual men’s communities are making in embracing men of trans experience, I feel compelled to offer a reality check about the inclusion of trans men in HIV prevention research.
By Bob Leahy
Recent developments in prevention are pointing to worrying gaps in the community-based approach to HIV prevention in Canada.
Perhaps we have been used to having only a single prevention technology on our books for so long – think condoms – that our ducks are not always in a row when new ones like PrEP come along. Thus potholes in our response become apparent – and none leap in to fix them.
After a series of somewhat inconclusive PrEP trials, whose results were marred by adherence issues, the results of more stringent trials like the PROUD and IPERGAY studies are in, and they are good. So good, in fact, that it would now be foolish not to put PrEP right at the front of the shelf that features ways to stay HIV-negative.
By Zak Knowles
For those of us who work in HIV and Hep C prevention, the advent of new prevention approaches has made us increasingly dependent on evidence for making informed decisions about the best strategies to use with a particular client or community.