End HIV 901 – Memphis Flyer

Community Outreach Coordinator Stresses Importance of Collaboration In Reducing New HIV Infections to Zero

A collaborative effort is required to reduce Shelby County’s new HIV infection rates to zero by 2030, said representatives from End HIV 901. “The Ending the HIV Epidemic: A Plan For America (EHE)” consists of four strategies that touch on the areas of diagnosis, treatment, prevention, and response, and is a “whole-of-society” initiative coordinated by the U.S. Department of Health and Human Services. The U.S. Department of Health and Human Services identified Shelby County as a “priority county” in 2020 in its effort to end the HIV epidemic by 2030.

Elizabeth Propst, community outreach coordinator of EHE and the department of infectious diseases at St. Jude Children’s Research Hospital. explained that not only is this a “living document,” but it is a community document as well. The Flyer spoke with Propst about how the plan was developed, stakeholder engagement, and implementation of the vision.

Memphis Flyer: How was the EHE plan developed?

Elizabeth Propst: The Connect To Protect, also known as C2P, is a community coalition here in Memphis. The manager and director at the time, Dr. [Aditya] Gaur, saw potential, and it started with that. I believe that broke down from the national announcement declaring that this is a particular topic that needs to be addressed, because new infections are occurring each day and they’re significantly increasing even with knowing how the community has advanced with education. Connect To Protect was the identified coalition to create this plan in 2019, and it carried into 2020. Stakeholders from across the community came together and identified hard-hit areas that impact Memphis in particular, and when it comes to HIV infections. The plan was solidified in December 2020.

What are some things that are specific to Memphis when it comes to implementing this vision?

The biggest vision is being in the Bible belt. The HIV community is very stigmatized. A lot of misconceptions out there, really starting with what barriers we can bridge with focusing on the faith-based community as well the stigma piece.

Even outside of the faith-based community, when it comes to stigma, the education piece isn’t there. So that brings you into education with youth and adolescents. It’s kind of a trickle effect, where it does continuously impact different areas. And then you go into medical professionals who are involved with patients in the HIV community. Looking at the appearance, if patients are taking their medication or not. If they’re not taking medication, what’s going on with that?

Do you think there has been any growth and progress in dispelling myths about transmission? What are some areas that still need growth ?

I definitely think that the community has made some progress, but there’s a lot more work to do, and honestly that comes from being out in the community and getting into spaces and areas where people who don’t know what they need to know, when it comes to HIV. That’s just being out and attending health fairs or just different spaces of different community events that may be going on.

Earlier in the year, I spoke with someone from The Haven, and we talked a lot about how people in underserved communities are a little hesitant to get tested and receive information. How do you all approach education about HIV and awareness campaigns within those underserved communities?

I can’t speak for everybody, but for me specifically, the more that I observe the different settings that I sit in, the more you definitely want to cater to that specific setting. For example, I have two events that I am doing this weekend, and one of them is with a church affiliate, and the other one is with a youth affiliate. The conversations that I have with individuals at the church event may change depending on the population and the nature of the people who are in attendance. Honestly just learning your crowd, and as well as kind of knowing what is most appropriate and what is most effective to catching an individual’s eye.

Was there anything that we didn’t cover that you wanted to give insight into that you think our readers may benefit from?

As far as the community action plan for End HIV 901, the community advisory board is comprised of different stakeholders in the community and different advocates who are essentially nominated as community champions if you will to oversee this community action plan, so this is a community document. The document will be three-years old at the end of the year, but being that we are an ever-evolving community, this document needs to be continuously reviewed. Therefore, that is something that the community advisory board does oversee – a part of this work. Especially within the start of this year, they’ve had an influx of presentations coming in from our EHE community partners who are out there doing the frontline work. You had mentioned The Haven, that’s definitely one of those community partners that we do work with. We are nearing the end to where we are going to be digging our heels deep in the ground and moving forward to update this plan.

In order to help the city of Memphis to reduce HIV infections to 90 percent or more by 2030, doctors are urging HIV negative people to participate in clinical trials for prevention research.

The two major areas of research and development regarding the HIV virus deals with both those living with the virus, and those who test negative, said Doctor Aditya Gaur, director of clinical research in the department of infectious disease at St. Jude’s Children Research Hospital. However when it comes to prevention efforts, those who are usually approached are those who are not living with the virus.

Gaur works with St. Jude’s “Connect 2 Protect” program, which helps to promote outreach and awareness regarding the HIV epidemic in the Mid-South, while also “addressing youth barriers to preventing exposure, testing, obtaining medical care, and moving to adult care.”

“Research is always about taking information to an individual, and letting them make a decision based on the information you provided,” said Gaur, adding that there seems to be a sense of altruism when it comes to youth participation in clinical research trials.

Gaur used Memphis’ contributions to the HPTN 083 trials to emphasize the importance of youth participation. According to the HIV Prevention Trials Network, HPTN 083 “is the first study to compare the efficacy of CAB LA to daily oral TDF/FTC for HIV PrEP.” Gaur added that these trials are credited for an injectable option for HIV prevention. The injection can be taken once every two months, and is an alternative for daily oral medication.

“We had the opportunity to open HPTN 083 in Memphis, and take the study to HIV negative youth in our city and our county,” said Gaur. “The response we received was very, very heartening.”

The coalition enrolled 93 youth in the study, and over many years, combined with more than 4,000 individuals around the world, helped with the approval of the prevention agent.

“That’s a significant number of youth that are interested. That tells us that youth in our community were interested, and they took part in the study,” said Gaur said.

While youth may participate in hopes of benefiting themselves and others, there are other reasons such as incentives and compensation. “It may be that some individuals may join for compensation, but it doesn’t make them any good or bad for a trial. Someone can have altruism and also have a need for money. We have learned to not characterize individuals into just black and white boxes,” said Gaur.

While Gaur expressed the overwhelming response of participants for the HPTN 083 trials, he explained that participation for Purpose 2 Clinical trials have not been as successful.

He said that PURPOSE 2 “will test whether an investigational PrEP (pre-exposure prophylaxis) medicine, lenacapavir, helps reduce the chance of getting HIV through sex.” These trials seek cisgender men, transgender women, transgender men, and gender non-binary individuals who have sex with partners assigned male at birth for research.

Gaur said that one of the most exciting aspects of these trials is that it looks at an agent that is given “subcutaneously” once every six months. He said that the easier and less frequently that patients have to take medicine, the more beneficial it is to many.

“We are always trying to understand what it is. Is the trial too complicated? Are we getting it effectively to you? Always looking at how can we better get out the word so that people can get more information,” Gaur explained. He stressed the concerted efforts of not just community partners, but individuals as well, in order to end the HIV epidemic.