{"id":1967,"date":"2020-12-01T10:46:44","date_gmt":"2020-12-01T10:46:44","guid":{"rendered":"http:\/\/blogs.cardiff.ac.uk\/centre-for-trials-research\/?p=1967"},"modified":"2022-04-13T13:59:09","modified_gmt":"2022-04-13T13:59:09","slug":"world-aids-day-2020-bringing-an-end-to-hiv","status":"publish","type":"post","link":"https:\/\/blogs.cardiff.ac.uk\/centre-for-trials-research\/world-aids-day-2020-bringing-an-end-to-hiv\/","title":{"rendered":"World AIDS Day 2020: Bringing an End to HIV"},"content":{"rendered":"\n
Background<\/h2>\n\n\n\n
On\u00a0December\u00a01st\u00a0every\u00a0year we show our support for World AIDS Day. An opportunity for worldwide unity in the fight against HIV. It allows each of us\u00a0and\u00a0our\u00a0organisations to\u00a0show support for those living with HIV and commemorate those who have died from an AIDS-related illness. Globally, there are an estimated 36.7 million people who have HIV\u00a0and more than 35 million people have died of HIV\/AIDS, making it one of the most destructive pandemics in history.<\/p>\n\n\n\n
Major advances: PEP and PrEP<\/h2>\n\n\n\n
Today, major\u00a0advances have been\u00a0made in HIV treatment along with effective prevention measures beyond simply using condoms.\u00a0We now have access to both PEP (post exposure prophylaxis) and PrEP (pre-exposure prophylaxis)\u00a0which prevent the virus taking hold when exposed.\u00a0As researchers,\u00a0we\u00a0understand so much\u00a0more about the developments in HIV.\u00a0Yet this has not translated to the public.\u00a0People do not know the facts about how to protect themselves and others. With\u00a0stigma and discrimination remaining\u00a0a reality for many\u00a0people living with HIV. Each year\u00a0in Wales over 100 people are diagnosed with HIV, a number far higher than it should be.\u00a0<\/p>\n\n\n\n
Research in Wales<\/h2>\n\n\n\n
Thanks to the interest of the Centre\u2019s Director, Prof Kerry Hood, we have developed a program of research centred on HIV prevention.\u00a0In partnership with Public Health Wales, two areas were identified which required researching for Wales. First was the concern around adherence to PrEP, the second was the impact on other sexually transmitted infections if there was a reduction in condom usage.\u00a0\u00a0<\/p>\n\n\n\n
Research fellowship<\/h2>\n\n\n\n
In relation to adherence, Dr David Gillespie is currently undergoing a research fellowship (funded by\u00a0Health and Care Research Wales) investigating how individuals accessing PrEP in Wales are using it, how their use corresponds to their sexual behaviour (as this is the primary route of HIV transmission), and whether there are any processes that influence\u00a0sub-optimal use of PrEP. He\u00a0recently completed an intensive longitudinal study, using electronic medicine caps to measure PrEP use and weekly electronic surveys to measure sexual behaviour. <\/p>\n\n\n\n
Along with a\u00a0qualitative study where participants were interviewed about their experiences of using\u00a0PrEP. He hopes to use data from these studies, as well as a comprehensive review of relevant literature around adherence to PrEP and other similar preventative medicines, to develop a prototype intervention to improve how PrEP is used. Throughout\u00a0his fellowship, Dave works\u00a0closely with four sexual health clinics in Wales (based in\u00a0Aneurin\u00a0Bevan UHB, Cardiff and Vale UHB,\u00a0Betsi\u00a0Cadwaladr\u00a0UHB, and Swansea Bay UHB), a group of mentors with a wide range of expertise, and a stakeholder group comprising experts in PrEP use, PrEP prescribing, sexual health advocacy, and policy.\u00a0<\/p>\n\n\n\n
PhD studentship<\/h2>\n\n\n\n<\/figure>\n\n\n\n
To address the potential negative behavioural impacts of PrEP, Kerry and Dave developed a PhD studentship\u00a0(funded by the Knowledge Exchange Skills Scholarship), to which I was the\u00a0successful applicant. My research aims to understand the relationship between PrEP, sexually transmitted infections and antibiotic resistance in Wales. To explore this relationship I will analyse Public Health Wales\u2019\u00a0sexual health and antibiotic resistance data from pre and post\u00a0PrEP\u2019s\u00a0introduction to identify any\u00a0potential changes. Currently I am\u00a0conducting\u00a0interviews to explore the knowledge and concerns of gay and bisexual men about\u00a0PrEP and its relation to sexually transmitted infections and antibiotic resistance. <\/p>\n\n\n\n
In response to the Coronavirus pandemic\u00a0as work was\u00a0I developed a rapid electronic survey study which examined sexual activity during the UK\u2019s\u00a0lockdown period. This data\u00a0provided a snapshot of behaviour during this time which will be used to explain some of the findings from the interviews and analysis\u00a0fo\u00a0Public Health Wales data.\u00a0I intend to triangulate the findings from the quantitative and qualitative work and develop a causal model of the relationship\u00a0between the variables.\u00a0<\/p>\n\n\n\n
Fast Track Cities<\/h2>\n\n\n\n
From\u00a0mine and Dave\u2019s work the Centre\u2019s research on HIV prevention has expanded and we have recently paired with the organisation Fast Track Cities (FTC) alongside Public Health Wales to help them achieve the UNAIDS 90\/90\/90 targets: 90% of all people living with HIV diagnosed, 90% of all people diagnosed with HIV being on treatment, 90% of all people on treatment having undetectable,\u00a0untransmissible\u00a0viral load.
Kerry acts as a stakeholder within the FTC group and works with the team to identify the particular issues and needs faced by Cardiff. Due to the Covid-19 pandemic, it resulted in FTC being unable to perform their community consultation and so an alternative was required. I, Kerry and Dave aided in delivering a project which explored how the public viewed the sexual health services in Cardiff and the Vale. Other projects have also developed including an intercalated project for one of Cardiff\u2019s medical students which will examine HIV\u00a0related stigma. Molly\u00a0Timlin\u00a0will conduct a systematic review of interventions that target HIV self-stigma and from the findings explore how these interventions could be applied in Wales.\u00a0<\/p>\n\n\n\n
The future<\/h2>\n\n\n\n
From this you can see the Centre for Trials Research has numerous projects currently examining the prevention of HIV.\u00a0We\u00a0are working hard to improve knowledge and help bring an end to HIV transmission in Wales.\u00a0World AIDS Day\u00a0highlights the importance of our work\u00a0, and it reminds the public and government that HIV has not gone away \u2013 there is still a vital need to\u00a0raise money, increase awareness and\u00a0fight\u00a0prejudice.\u00a0<\/p>\n\n\n\n
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