Fast-Track Cities 2023 Announcement

IAPAC, CITY OF AMSTERDAM ANNOUNCE FAST-TRACK CITIES 2023 CONFERENCE

Amsterdam, NETHERLANDS (January 27, 2023) – The International Association of Providers of AIDS Care (IAPAC) and the City of Amsterdam held a joint event today, along with public health authorities and local community representatives, to officially announce the Fast-Track Cities 2023 conference will be held September 25-27, 2023, in Amsterdam, Netherlands.

Launched on World AIDS Day 2014 with 26 initial cities signing the Paris Declaration on Fast-Track Cities, the Fast-Track Cities network today counts more than 500 cities worldwide committed to achieving Sustainable Development Goal (SDG) 3.3 of ending the HIV and tuberculosis (TB) epidemics, and the World Health Organization (WHO) goals of eliminating HBV and HCV, by 2030. The City of Amsterdam was among the first 26 cities to join the Fast-Track Cities network in 2014 and is one of three Dutch Fast-Track Cities along with Rotterdam and Utrecht. In 2022, the City of Amsterdam was also recognized with an IAPAC “Circle of Excellence Award” in recognition of the work advanced by the H-Team (HIV Transmission Elimination Amsterdam), whose aim is to get to zero new HIV infections in Amsterdam by 2026.

The Fast-Track Cities 2023 conference will provide a space for interactive dialogue and facilitate the collaborative development of innovative approaches to ending HIV and TB, as well as eliminating HBV and HCV. The conference will feature a distinguished faculty from across the Fast-Track Cities network, convened under the theme, “Integration and Inclusion for Impact,” reflecting the importance of an integrated approach to urban HIV, TB, and viral hepatitis responses that prioritizes inclusivity in health and social care. The topic of the conference’s high-level panel will be “Inclusivity as Driver: Issues, Challenges, and Opportunities in Implementing SDG 11.”

“To reach the goal of zero new HIV infections in 2026 does not mean that we will be ‘done’ with HIV. We have to keep considering the possibility of new HIV infections. The only way to achieve this goal is that pre-exposure prophylaxis (PrEP) will be easily accessible for everyone who is at risk,” said Ms. Shula Rijxman, Amsterdam’s Deputy Mayor whose administrative portfolio includes public health, disease prevention, care, and social development. “Also, there are still 6,000 people living with HIV in Amsterdam. Until HIV is curable, this is still a group of Amsterdam citizens who need to have access to appropriate care and that we stand for.”

“Given Amsterdam’s exemplary HIV response and the commitment of a broad range of stakeholders in this city with a deep grounding in community engagement and leadership, I am honored to formally announce that we will convene the Fast-Track Cities 2023 conference in Amsterdam,” said Dr. José M. Zuniga, President/CEO of IAPAC and the Fast-Track Cities Institute. “In convening the full network of Fast-Track Cities in one of our ‘Circle of Excellence’ cities, we aim to highlight the network’s progress but also strategize around cross-cutting challenges to ending urban HIV and TB epidemics and eliminating viral hepatitis by 2030.” Click here to read his remarks at the announcement event.

The conference will offer an opportunity for dialogue and cooperation between elected officials, public health department officials, clinical and service providers, urban health experts, and civil society advocates from current and prospective Fast-Track Cities. This year’s conference will be the fourth in-person gathering of the global Fast-Track Cities network. The Fast-Track Cities 2022 was hosted in Sevilla, Spain, and attracted more than 550 in-person and 1,800 online attendees.

The Fast-Track Cities 2023 conference is organized by IAPAC, in partnership with the Joint United Nations Programme on HIV/AIDS (UNAIDS), Stop TB Partnership, World Hepatitis Alliance, and Fast-Track Cities Institute. The conference is made possible through corporate sponsorships from Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare. Other pending corporate sponsorships will be announced shortly.

For information about the conference and/or to register online, visit:

https://www.iapac.org/conferences/fast-track-cities-2023/

To access the Fast-Track Cities 2022 conference summary report, visit:

https://www.iapac.org/fast-track-cities-2022-summary-conference-report/

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About Fast-Track Cities
Fast-Track Cities is a global partnership between more than 500 cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. The partnership’s aim is to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. Launched on World AIDS Day 2014, the partnership also advances efforts to end tuberculosis (TB) epidemics and eliminate viral hepatitis (HBV and HCV) in urban settings by 2030. For more information about the Fast-Track Cities initiative, please visit: https://www.fast-trackcities.org

About the International Association of Providers of AIDS Care
Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis (TB), as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About the Fast-Track Cities Institute
The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

Sevilla Declaration on the Centrality of Affected Communities in Urban HIV Responses Unveiled at Fast-Track Cities 2022 Conference

11 OCTOBER 2022 (Sevilla, Spain) – At a Fast-Track Cities 2022 conference reception held this evening at the Royal Alcazar Palace, several Mayors and a Deputy Governor in attendance were joined virtually by peers from across the Fast-Track Cities network to sign their names to a declaration aimed at defining and facilitating the placement of affected communities at the center or urban HIV responses.

The Mayors of Blantyre (Wild Ndipo), Kingston (Delroy Williams), Libreville (Issa Malam Salatou), Quezon City (Ma. Josefina Belmonte), and Sevilla (Antonio Muñoz Martínez) signed the Sevilla Declaration on the Centrality of Affected Communities in Urban HIV Responses (Sevilla Declaration) along with Johannesburg Mayor (Dada Morero), New York City Mayor Eric Adams, and other Mayors who participated via video or virtually.
The Deputy Governor of the Bangkok Metropolitan Administration (Dr. Tavida Kamolvej) also affixed her signature to the declaration during the Sevilla ceremony, and a representative from GGD Amsterdam signed on behalf of that city’s Mayor (Femke Halsema). Multiple county and provincial officials from Fast-Track Cities in other countries also signed the declaration via video or virtually.
Moreover, Mayors and representatives from an additional 22 Fast-Track Cities in Spain signed the declaration. Of note, the reception’s signing ceremony was witnessed by Carolina Darias, Minister of Health of Spain, in whose country more than 150 cities have joined the Fast-Track Cities network, with Sevilla having been the first Spanish city to sign the Paris Declaration on Fast-Track Cities Ending the HIV Epidemic in 2015.

According to Dr. José M. Zuniga, President/CEO of the International Association of Providers of AIDS Care and the Fast-Track Cities Institute, the Sevilla Declaration will supplement the Paris Declaration on Fast-Track Cities, which more than 400 cities and municipalities worldwide have signed since the network’s launch in 2014, thus joining the Fast-Track Cities network. The new declaration includes 10 commitments Fast-Track Cities are asked to make that range from safeguarding the dignity and rights of communities affected by HIV to meeting the United Nations goals for community-led HIV responses.

“An amorphous and overly malleable term such as ‘placing people at the center’ of the HIV response has little effect if it can be interpreted in a million different ways or worse actioned as mere tokenism that disenfranchises those whose voice at the table and leadership are critically needed,” said Dr. Zuniga. “The 10 commitments that Fast-Track Cities are making in signing the Sevilla Declaration reflect an important step forward in clearly defining, operationalizing, and facilitating what we mean by ‘placing people at the center’ of urban HIV responses at a time when it is most critical to do so.”

The Sevilla Declaration was shaped by organizations representing people living with HIV, including the Global Network of People Living with HIV (GNP+), as well as through regional listening sessions involving local communities of people living with HIV across the Fast-Track Cities network. Also providing input were the four core partners of the Fast-Track Cities initiative: IAPAC, the Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Human Settlements Programme (UN-Habitat), and the City of Paris.

“The Sevilla Declaration provides structure for communities of people living with HIV to more formally play a leadership role in HIV responses at city and municipal levels,” said Sbongile Nkosi, Co-Executive Director of GNP+, which formally endorsed the declaration at the Fast-Track Cities 2022 conference. “We talk a lot about ‘placing people at the center of the HIV response,’ but the Sevilla Declaration does more by articulating commitments local governments and institutions must make to create the space for and empower people living with HIV and their community-based organizations to lead urban HIV responses.”

In its Global AIDS Strategy, 2021-2026, UNAIDS emphasizes the critical nature of community engagement and leadership to regain momentum against HIV that was lost during the COVID-19 pandemic. Through its advocacy on community engagement, UNAIDS has consistently stressed that the call for “nothing for us without us” must be made more than just a slogan.

“In line with the Global AIDS Strategy and the Sevilla Declaration, empowering and integrating community engagement is the cornerstone to ending AIDS and having people at the center of the response, said UNAIDS Deputy Executive Director for Programme, Eamonn Murphy.

Click here to access the Sevilla Declaration.

NOTE: The Fast-Track Cities 2022 conference reception was hosted by the Ayuntamiento de Sevilla, International Association of Providers of AIDS Care (IAPAC), Fast-Track Cities Institute, and Fast-Track Sevilla, with support from Gilead Sciences.

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About Fast-Track Cities

Fast-Track Cities is a global partnership between more than 450 cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. The partnership’s aim is to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. Launched on World AIDS Day 2014, the partnership also advances efforts to end tuberculosis (TB) epidemics and eliminate viral hepatitis (HBV and HCV) in urban settings by 2030.

About IAPAC

Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About the Fast-Track Cities Institute

The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

About GNP+

The Global Network of People Living with HIV (GNP+) is a network for people living with HIV, run by people living with HIV. GNP+ engages with and supports national and regional networks of people living with HIV to ensures that its global work is grounded in local experiences and priorities. The meaningful involvement of people living with HIV is at the heart of all GNP+ does. Using the power of evidence-based advocacy, GNP+ also challenges governments and global leaders to improve access to quality HIV prevention, treatment, care, and support services. For more information about GNP+, please visit: https://gnpplus.net/

About UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. For information about UNAIDS, please visit: https://unaids.org/

Six Cities and a Ukrainian Community-Based Organization Recognized at Fast-Track Cities 2022 Conference

11 OCTOBER 2022 (Sevilla, Spain) – At a Fast-Track Cities 2022 conference reception held this evening at the Royal Alcazar Palace, six Fast-Track Cities and 100% Life, a Ukrainian community-based organization, received 2022 “Circle of Excellence Awards” and the “Community Leadership Award,” respectively, in recognition of their political, public health, and community leadership.

Earlier this year, the International Association of Providers of AIDS Care (IAPAC) and Fast-Track Cities Institute (FTCI), in collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS), launched a nomination process to identify cities from six geographic regions whose work exemplifies the Fast-Track Cities mission. Both IAPAC and UNAIDS are core partners of the Fast-Track Cities initiative, which was launched in 2014 and today comprises more than 400 cities engaged in ending their urban HIV epidemics by 2030. The six cities selected to receive the 2022 “Circle of Excellence Awards” include:

Asia-Pacific: Quezon City, Philippines
Europe: Amsterdam, Netherlands
Latin America/Caribbean: Kingston, Jamaica
North America: New York City, NY, USA
Southern/Eastern Africa: Johannesburg, South Africa
Western/Central Africa: Lagos State, Nigeria

The Mayors of Quezon City (Ms. Ma. Josefina Belmonte), Kingston (Mr. Delroy Williams), and New York City (Mr. Eric Adams) accepted their cities’ 2022 “Circle of Excellence” awards in-person (Mayors Belmonte and William) and via video (Mayor Adams). Public health department officials accepted awards on behalf of Amsterdam, Johannesburg, and Lagos State.

100% Life was recognized both for its efforts during the ongoing war in Ukraine, as well as that of other community-based organizations in that country who have advanced humanitarian and public health efforts on behalf of Ukrainians living with and affected by HIV. Ms. Valeria Rachynska, who is Human Rights, Gender, and Community Development Director at 100% Life, accepted the 2022 “Community Leadership Award” on behalf of her organization and partner organizations across Ukraine.

“Political, public health, and community leadership are at the heart of the Fast-Track Cities movement and are integral to averting AIDS-related deaths, stemming new HIV infections, and eliminating HIV-related stigma,” said Dr. José M. Zuniga, President/CEO of IAPAC and FTCI, which launched the two awards at the Fast-Track Cities 2021 conference. “Congratulations to 100% Life and the six cities honored for their exemplary leadership. May they serve as an inspiration for other community-based organizations and cities as they respond to their urban HIV epidemics with bold leadership.”

“Among the lessons that we have learned in tackling HIV is the need for bold political leadership, global solidarity, ensuring communities are at the center of the response, and a commitment to human rights. This has been true for COVID-19 and will be true for other pandemics to come,” said Winnie Byanyima, Executive Director of UNAIDS. “Ending inequalities is the most effective way to ensure that we are more prepared for the next pandemic. We look to city leadership to do this.”

In 2021, the “Circle of Excellence Awards” recognized five Fast-Track Cities: Bangkok, Thailand; London, England, UK; Nairobi City County, Kenya; San Francisco, CA, USA; and São Paulo, Brazil. The 2021 “Community Leadership Award” recognized GAT, a community-based organization providing health and social services to people living with and affected by HIV in Portugal.

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About Fast-Track Cities

About IAPAC

About the Fast-Track Cities Institute

About UNAIDS

IAPAC Mpox Guidance

Last updated July 25, 2023

On July 24, HHS updated its Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV with an extesive secion on mpox which cover epidemioogy, prevention, clinicla presention, treatment, management of treatment failure, and special considerations for people with HIV

https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/mpox-monkeypox?view=full

The update also includes information on Chagas disease under the same link

Last updated May 19, 2023

FOR IMMEDIATE RELEASE
May 18, 2023

Contact: HHS Press Office
202-690-6343
media@hhs.gov

Fact Sheet: HHS Provides Resources on Ways Communities Can Stay Protected from Mpox in Advance of Summer Months:

Last Summer, the United States faced an unprecedented outbreak of mpox with limited resources. The White House and the U.S. Department of Health and Human Services (HHS) launched an urgent, whole of government response to address the outbreak, which resulted in the deployment of tests, vaccines, and investigational treatments nationwide through HHS’ Administration for Strategic Preparedness and Response (ASPR).

Working in lock step with the LGBTQI+ community, this response resulted in significant declines in cases and the end of the mpox Public Health Emergency on January 31, 2023. As a result, today, the average daily case rate in the United States is 1 or fewer – over a 99% decline in daily case counts since the outbreak’s peak in August 2022.

As we head into the Summer, the Biden-Harris Administration is focused on increasing vaccine uptake to mitigate the risks of mpox and keep communities safe.

The United States stands in a strong position to prevent the expansion of this outbreak as we head into Spring and Summer 2023.

For months, the Biden-Harris Administration has been working closely with jurisdictions and partners to monitor trends, increase vaccine uptake, and improve vaccination rates in communities over-represented in the outbreak to keep them safe.

Since the earliest days of the mpox outbreak, we have not taken our foot off the gas in the fight against mpox and providing resources, education, and outreach to increase equitable access to vaccination, testing, and investigational treatments in communities that could benefit.

The mpox outbreak continues to be a public health priority for HHS and the Administration. For months, both have maintained outreach and education efforts and increased outreach in late winter 2022 and early Spring 2023 to motivate actions to prevent expansion of the current outbreak as festival and event seasons approach. Collectively, the Administration’s efforts aim to expand vaccination for individuals at risk and make testing more convenient for health care providers and patients across the country.

The Biden-Harris Administration remains committed to working with urgency to detect more cases, protect those at risk, and respond rapidly to new cases. As we head into the summer months, here’s important information and resources:

What We Know About the Virus:

Mpox is a disease that can cause flu-like symptoms and a rash. Based on currently available data, the vast majority of mpox cases in this outbreak have been associated with close skin-to-skin contact associated with sex between men.

Chicago has recently reported a new cluster of mpox cases after nearly three months with almost no mpox cases reported. Some of the cases are in people who have been vaccinated for mpox, and all are mild. The Centers for Disease Control and Prevention (CDC) is aware of these new cases and is working closely with Howard Brown Health, the Chicago Department of Health, and the local community to investigate these new cases and limit the size of this cluster.

How to Keep Yourself Safe:

Make sure that you receive two doses of the mpox vaccine if you are considered to be at-risk for mpox. If you only got one shot, it’s never too late to get the second dose.

If you are at risk for mpox but haven’t received your two-dose vaccine yet, temporarily changing some parts of your sex life might reduce the risk of exposure to the virus. Maintain those changes between your first and second shots of the vaccine since it takes two weeks after the second shot to achieve the highest protection. Knowing how mpox is transmitted allows you to make informed decisions about your sex life to further reduce your risk of exposure.

Seek health care and get tested if you have a rash, even if you have been previously vaccinated or had the infection. For more information on where to find testing, vaccines, or treatment, visit CDC’s mpox website.

What We Are Doing to Prevent Outbreaks:

Our recommendation ahead of the summer months is – “Get Healthy and Ready for Summer 2023” – by including mpox vaccination as part of a package of sexual health services that includes HIV and STI testing, treatment, and prevention.

A new mpox outbreak’s chances increase when fewer people are fully vaccinated. We encourage gay, men who have sex with men, and bisexual and transgender people who may be at risk for mpox exposure to get vaccinated or get their second dose if not fully vaccinated. It’s also important to remember that it is never too late to get the second dose. For information on where to find an mpox vaccine site near you, visit CDC’s mpox vaccine locator.

The mpox outbreak continues to be a public health priority for HHS and the Administration, and we will continue working to increase vaccine uptake to keep the outbreak under control.

Ensuring local health departments have the tools and resources they need to combat mpox and protect communities. The CDC, HHS, and White House are closely working with state, tribal, local, territorial public health departments, and other community partners to distribute vaccines where they are needed most.

For more information on the Administration’s equity-related outreach to communities nationwide, visit CDC’s mpox resources page.

Sharing data available on current mpox cases. Anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has mpox is at risk. Take steps to prevent getting mpox. If you have any symptoms of mpox, talk to a health care provider.

For the latest information on current outbreak cases and data, visit CDC’s mpox Page.
For the latest mpox digital resources – including posters, cards, stickers, and event organizer letters – visit CDC’s mpox Digital Resources Page.
For the latest mpox communication toolkits – including toolkits specific to large gatherings, workplaces, and education programs – visit CDC’s mpox Community, Work & School Toolkits page.

Working with members of the LGBTQI+ community to prepare for summer Pride events. The White House and HHS have continued to engage with an extensive list of organizations and advocates. Early Spring 2023 outreach to prepare for festival season, beyond the routine weekly meetings used to inform public health leaders about mpox, has included the following organizations:

InterPride
CenterLink
Center for Black Equity
NMAC
ASTHO
APHL
NAACHO
ANAC
CSTE
BHOC
Grindr
AIDS United
NGLCC
GLMA
GMHC
NASTAD
NCSD
Health HIV
BCHC
LGBTQ Primary Care Alliance
The Center for Black Health Equity
Healthcare for the Homeless
HUD, HRSA, CDC, and SAMSHA grantees
The National Latinix Conference
Members of the House and Ballroom Community
The White House Mpox Equity Workshop
Multiple LGBTQ focused event organizers
HIVMA

Updated May 16

Potential Risk for New Mpox Cases

Distributed via the CDC Health Alert Network
May 15, 2023, 9:00 AM ET
CDCHAN-00490

Summary
In the United States, cases of mpox (formerly monkeypox) have declined since peaking in August 2022, but the outbreak is not over. The Centers for Disease Control and Prevention (CDC) continues to receive reports of cases that reflect ongoing community transmission in the United States and internationally. This week, CDC and local partners are investigating a cluster of mpox cases in the Chicago area. From April 17 to May 5, 2023, a total of 12 confirmed and one probable case of mpox were reported to the Chicago Department of Public Health. All cases were among symptomatic men. None of the patients have been hospitalized. Nine (69%) of 13 cases were among men who had received 2 JYNNEOS vaccine doses. Confirmed cases were in 9 (69%) non-Hispanic White men, 2 (15%) non-Hispanic Black men, and 2 (15%) Asian men. The median age was 34 years (range 24–46 years). Travel history was available for 9 cases; 4 recently traveled (New York City, New Orleans, and Mexico).

Although vaccine-induced immunity is not complete, vaccination continues to be one of the most important prevention measures. CDC expects new cases among previously vaccinated people to occur, but people who have completed their two-dose JYNNEOS vaccine series may experience less severe symptoms than those who have not.

Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events. The purpose of this Health Alert Network (HAN) Health Update is to inform clinicians and public health agencies about the potential for new clusters or outbreaks of mpox cases and to provide resources on clinical evaluation, treatment, vaccination, and testing.

Background
A global outbreak of mpox began in May 2022. Previous outbreaks in places where mpox is not endemic were mostly related to international travel; however, this outbreak spread rapidly across much of the world through person-to-person contact, disproportionately affecting gay and bisexual men, other men who have sex with men (MSM), and transgender people. Most patients with mpox have mild disease, although some, particularly those with advanced or untreated HIV infection, may experience more severe outcomes.

As of May 10, a total of 30,395 cases have been reported in the United States. This outbreak had a peak of about 460 cases per day in August 2022, and gradually declined, likely because of a combination of temporary changes in sexual behavior, vaccination, and infection-induced immunity[1,2]. However, CDC continues to receive reports of new cases and clusters in the United States and internationally.

Although approximately 1.2 million JYNNEOS mpox vaccine doses have been administered in the United States since the beginning of the outbreak, only 23% of the estimated population at risk for mpox has been fully vaccinated. Vaccine coverage varies widely among jurisdictions. The projected risk of a resurgent mpox outbreak is greater than 35% in most jurisdictions in the United States without additional vaccination or adapting sexual behavior to prevent the spread of mpox [3]. Resurgent outbreaks in these communities could be as large or larger than in 2022.

To help prevent a renewed outbreak during the spring and summer months, CDC is urging clinicians to be on alert for new cases of mpox and to encourage vaccination for people at risk. If mpox is suspected, test even if the patient was previously vaccinated or had mpox. Clinicians should also refamiliarize themselves with mpox symptoms, specimen collection, laboratory testing procedures, and treatment options.

Recommendations for Clinicians Evaluating and Treating Patients
Conduct a thorough patient history to assess possible mpox exposures or epidemiologic risk factors. Mpox is usually transmitted through close, sustained physical contact and has been almost exclusively associated with sexual contact in the current global outbreak. It is important to take a detailed sexual history for any patient with suspected mpox.

Perform a complete physical examination, including a thorough skin and mucosal (e.g., oral, genital, anal) examination. Doing so can detect lesions of which the patient may be unaware.

Consider mpox when determining the cause of a diffuse or localized rash, including in patients who were previously infected with mpox or vaccinated against mpox. Differential diagnoses include herpes simplex virus (HSV) infection, syphilis, herpes zoster (shingles), disseminated varicella-zoster virus infection (chickenpox), molluscum contagiosum, scabies, lymphogranuloma venereum, allergic skin rashes, and drug eruptions. Specimens should be obtained from lesions (including those inside the mouth, anus, or vagina), if accessible, and tested for mpox and other sexually transmitted infections (STI), including HIV, as indicated. The diagnosis of an STI does not exclude mpox, as a concurrent infection may be present.

Patients with mpox benefit from supportive care and pain control. Mpox can commonly cause severe pain and can affect anatomic sites, including the anus, genitals, and oropharynx, which can lead to other complications. Assess pain in all patients with mpox virus infection and recognize that substantial pain may exist from mucosal lesions not evident on physical exam. Topical and systemic strategies should be used to manage pain. Pain management strategies should be tailored to the needs and context of an individual patient.

Tecovirimat is considered first-line among options that have not been approved by the U.S. Food and Drug Administration to treat eligible patients with mpox. If a clinician intends to prescribe oral tecovirimat, consider seeking access through enrollment in the AIDS Clinical Trials Group (ACTG) Study of Tecovirimat for Human Monkeypox Virus (STOMP) so that the trial can determine efficacy of this drug. This trial includes a placebo-controlled, randomized arm, and an open-label option for individuals with severe disease or those who decline randomization. Remote enrollment is available. For patients not eligible for the STOMP trial or who decline to participate, stockpiled oral tecovirimat is available upon request for mpox patients who meet treatment eligibility (e.g., have severe disease or are at increased risk for severe disease) under CDC’s Expanded Access Investigational New Drug (IND) protocol. More information about evaluating and treating patients can be found on the CDC mpox Clinical Guidance web pages.

Clinicians should notify their state or local health departments of any suspected or confirmed mpox cases (via 24-hour Epi On Call contact list).

Recommendations for Vaccinating Patients
JYNNEOS vaccine can be given as post-exposure prophylaxis (PEP) both to people with known or presumed exposure to the mpox virus. Vaccine can also be given to people with certain risk factors and recent experiences that may make them more likely to have been exposed to mpox. As PEP, vaccine should be given as soon as possible, ideally within 4 days of exposure; however, administration 4 to 14 days after exposure may still provide some protection against mpox. People who are vaccinated should continue to avoid close, skin-to-skin contact with someone who has mpox. JYNNEOS involves 2 vaccine doses given 28 days apart; peak immunity is expected 14 days after the second dose [4].

Previous studies have suggested that JYNNEOS vaccination is protective against mpox. When combined with other prevention measures, vaccination prior to exposure and PEP vaccination strategies might help control outbreaks by reducing transmission of the mpox virus, preventing disease, or reducing disease severity and hospitalization. Duration of immunity after one or two doses of JYNNEOS is unknown.

Currently, CDC does not recommend routine immunization against mpox for the general public. Mpox vaccination should be offered to people with high potential for exposure to mpox:

People who had known or suspected exposure to someone with mpox.
People who had a sex partner in the past 2 weeks who was diagnosed with mpox.
Gay, bisexual, and other MSM, and transgender or nonbinary people (including adolescents who fall into any of these categories) who, in the past 6 months, have had
- A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, gonorrhea, syphilis).
- More than one sex partner.
People who have had any of the following in the past 6 months
- Sex at a commercial sex venue.
- Sex in association with a large public event in a geographic area where mpox transmission is occurring.
- Sex in exchange for money or other items.
People who are sex partners of people with the above risks.
People who anticipate experiencing any of the above scenarios.
People with HIV infection or other causes of immunosuppression who have had recent or anticipate potential mpox exposure.
People who work in settings where they may be exposed to mpox.
- People who work with orthopoxviruses in a laboratory.

Extensive risk assessment should not be conducted in people who request vaccination to avoid the barriers created by the stigma experienced by many who could benefit from vaccination. People in the community at risk (e.g., gay, bisexual, or other MSM; transgender or nonbinary people) asking for vaccination is adequate attestation to individual risk of mpox exposure. People who previously received only one JYNNEOS vaccine dose should receive a second dose as soon as possible.

For More Information

References

Endo, A. et al. Heavy-tailed sexual contact networks and monkeypox epidemiology in the global outbreak. Science. 2022 Oct 7; 378 (6615):90-94. https://doi.org/10.1126/science.add4507
Clay, P.A., et al. Modelling the impact of vaccination and behavior change on mpox transmission in Washington D.C. medRxiv (Preprint), 2023 Feb 14. Available at: https://doi.org/10.1101/2023.02.10.23285772
CDC. Risk assessment of mpox resurgence and vaccination considerations. 2023 Apr 4. Available at: https://www.cdc.gov/poxvirus/mpox/response/2022/risk-assessment-of-resurgence.html
Rao, A., et al. Use of JYNNEOS (Smallpox and Monkeypox Vaccine, Live, Nonreplicating) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:734-742. https://dx.doi.org/10.15585/mmwr.mm7122e1

Updated May 12, 2023

French officials recently posted an update on an Mpox cluster in the Center-Val de Loire region, with 17 cases reported since the first of the year, including 14 since March 1, 2023. All occurred in men who have sex with men who had several partners but did not attend any common events.

Five of the patients had received two Mpox vaccine doses in 2022. Also, five had received one smallpox dose during childhood, plus one dose in 2022.

Given the high proportion of vaccinated people in the cluster, 59%, Public Health France and its regional partners investigated the development, finding that the proportion of vaccinated cases is higher than the 25% observed at the national level between October 2022 and February 2023.

“It is appropriate to await the results of real-life efficacy studies which will allow better interpretation of these data. To date, there is little perspective on the efficacy of 3rd generation vaccines against Mpox infection,” Public Health France said in its statement.

In other Mpox developments, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) European regional office yesterday posted a joint update on Mpox, which reported 28 new cases from 7 countries since the last update 4 weeks ago. Sixteen of the cases are part of the French cluster. Six were from Spain. Other countries reporting cases are Portugal, the Netherlands, Switzerland, Greece, and Malta.

https://www.cidrap.umn.edu/mpox/recent-french-mpox-cluster-includes-fully-vaccinated-patients

In the Unites States, the Chicago Department of Public Health released a health alert on May 9, 2023, with the following details:

From April 17 to May 5, 2023, there were 12 confirmed and 1 probable case of Mpox reported, all among symptomatic men, at least 2 PLHIV
9 of 13 cases (69%) were among men who were fully vaccinated for Mpox; cases with previous vaccine had mild disease, 1 proctitis
CDC has stated they have not identified clusters in other communities outside of Chicago at this time

Update February 28, 2023

MPOX at CROI 2023 – 7 minute read

MPOX IN PEOPLE LIVING WITH HIV AND CD4 COUNTS <350 CELLS/MM3: A

GLOBAL CASE SERIES

Conclusion: In our case series in PLWH with MPOX, severe systemic

complications and deaths occurred most commonly in persons with CD4 < 100

cells/mm3 and viraemia.

IMPACT OF VACCINATION ON MPOX INCIDENCE IN MSM ON PrEP IN THE

ANRS 174 DOXYVAC TRIAL

Conclusion: In France, MVA-BN vaccination in summer 2022 conferred

high-level protection against mpox infection in highly-at-risk MSM on PrEP.

In this study population, sexual behavior change did not seem to play a role in

reduction of mpox incidence.

HOUSEHOLD TRANSMISSION OF MPOX TO CHILDREN AND ADOLESCENTS

Conclusion: Among children with household contact to an adult with MPOX

in California, only 14% developed symptoms consistent with MPOX, and less

than 5% ultimately tested positive. The secondary attack rate may have been

underestimated because one-third of symptomatic children were not tested.

While the risk of household transmission is low, pediatric household contacts

should be offered post-exposure prophylaxis to prevent MPOX spread.

LONGITUDINAL ASSESSMENT OF VIRAL SHEDDING AMONG PATIENTS WITH

MPOX IN TORONTO, CANADA

Conclusion: Mpox virus genetic material may remain detectable in multiple

anatomic compartments for up to 8 weeks after symptom onset. Correlation

with infectivity requires further study.

MPOX DNA CLEARANCE IN SEMEN OVER SIX MONTHS FOLLOW-UP

Conclusion: These preliminary findings from this cohort of individuals

highlight that viral DNA clearance in seminal fluid samples from people

diagnosed with mpox infection was mostly observed within 2 weeks since first

positive test. These findings suggest that semen testing and prolonged use of

condoms after mpox infection may be necessary.

NEUTRALIZING AND T CELL RESPONSE AGAINST MPOX VIRUS AFTER

MVA-BN VACCINE

Conclusion: The first/single dose of MVA-BN triggers a humoral and cellular

response with nAbs response greater in primed vs. non-primed participants

independently of age. No evidence that HiSXV effect on nAbs response to

MVA-BN differed by HIV status. (Primed=historically small pix vaccinated)

COMPARISON OF SUBCUTANEOUS VERSUS INTRADERMAL ROUTE OF

ADMINISTRATION OF MVA VACCINE

Conclusion: MVA-BN was generally well tolerated; S-AEFIs were reported more

frequently by ID vaccine recipients as well as LSI-AEFI, apart from more frequent

local pain after SC. A larger increase in immunological markers was observed

with ID vs. SC administration, particularly for IgG and nAb. ID route proved to be

safe and immunogenic.

HUMORAL AND CELLULAR IMMUNE RESPONSE AFTER 3 MONTHS FROM

MPOX VIRUS INFECTION

Conclusion: Analysis of immune response after 3 months from MPXV infection

showed detectable IgG and nAb and increased CM, EM, and MVA-specific

responding T-cells, regardless of HIV infection, suggesting the possible

expansion of a protective memory/effector T-cells phenotype and the

persistence of immune protection.

IMMUNE RESPONSES AND VIRAL DYNAMICS AFTER MPOX INFECTION IN THE

2022 OUTBREAK

Conclusion: In our cohort, PWH with CD4+ >450/μL had a similar clinical

presentation of Mpox to HIVneg individuals. Magnitude of humoral immune

responses at the time of diagnosis was associated with a milder presentation

and a shorter and faster viral clearance of Mpox DNA in skin lesions. These

results may inform isolation strategies

NOVEL SEROASSAYS DETECT MPOX-SPECIFIC AND VACCINE-INDUCED

ORTHOPOXVIRUS IMMUNITY

Conclusion: We developed and validated the first mpox-specific seroassay

which uses the complete B21R peptide, which can distinguish recent infection

from vaccination, which in turn was associated with a robust E8L antibody

response. Collectively, our assays provide tools for conducting vaccine response

and immunosurveillance studies to longitudinally detect immunity to MPXV,

determine the true prevalence of MPXV infection and identify asymptomatic

community spread.

CLINICAL PREDICTORS OF MPOX SEVERITY IN AN ITALIAN MULTICENTER

COHORT (MPOX-ICONA)

Conclusion: We found that pts presenting with fever, facial/anal lesions, and

concurrent STIs may develop more severe Mpox. Moreover, higher VL in URT

during the first week after symptoms onset was associated with severe disease.

Our findings may serve to guide management of pts with Mpox in terms of need

for hospitalization and drug therapy. Finally, our study claims an urgent need

to assess whether the persistence of MPXV in biological samples after clinical

recovery may lead to a status of persistent infectivity.

SEVERE MPOX AMONG PEOPLE LIVING WITH HIV RECEIVING TECOVIRIMAT

IN NEW YORK CITY

Conclusion: This group of PWH with advanced HIV had severe mpox

manifestations and poor response to tecovirimat. Early and extended

tecovirimat with coadministration of other mpox treatments in the setting of

limited options is important to try to improve outcomes. Findings of severe

disease and high mortality highlight the urgency of mitigating deep social

inequities and high-quality research to optimize care in this group of PWH.

MANAGEMENT OF MPOX IN PWH ATTENDING A SEXUAL HEALTH

DEPARTMENT IN LONDON, UK

Conclusion: Despite low hospitalization rates in PWH with MPOX, medical

complications and STI rates requiring further management are significantly

high. Further comparative analysis with people without HIV and PWH with

severe immunodepression are needed to define risk factors for hospitalization

and clinical complications.

MOSAIC CLADE 2B MPOX COHORT STUDY: CLINICAL CHARACTERISATION

AND OUTCOMES

Conclusion: MOSAIC is an international study describing characteristics and

outcomes of Clade 2b Mpox; it does not support direct comparison between

tecovirimat-treated and non-treated patients. Lesions and symptoms resolved

within 28 days in most uncomplicated cases with supportive treatment without

hospitalisation. A higher proportion of patients presented with complications at

baseline in the tecovirimat-treated group. There was also a lower proportion of

patients in this group whose lesions had resolved with no serious complications

at D28.

DEVELOPMENT AND PILOT OF AN MPOX SEVERITY SCORING SYSTEM

(MPOX-SSS)

Conclusion: Our pilot MPOX-SSS was able to produce a severity score

retrospectively from 86% of charts, demonstrated good discrimination with

statistically higher scores in groups expected to have more severe disease, and

was able to distinguish change over time for individual patients that correlated

with clinical illness. We propose this tool be assessed for utility in clinical

trials of mpox treatment, in prospective observational cohort studies, and in

comparisons of illness caused by different mpox clades.

CLINICAL PRESENTATION OF MPOX IN PEOPLE WITH AND WITHOUT HIV

Conclusion: In this cohort of mpox cases there was a high prevalence of

well-controlled HIV co-infection, but we find no evidence that PLWH experience

more severe mpox.. Whilst there are a higher proportion of hospitalisations, this

is not statistically significant and is likely to be impacted by additional caution

shown by clinicians in making decisions around mpox care in these patients. All

other outcomes analysed indicate that mpox infections are of similar severity in

people with and without HIV, providing reassurance for patients and clinicians

providing future care for patients with mpox and HIV co-infection.

MPOX AMONG MSM IN THE NETHERLANDS PRIOR TO MAY 2022, A

RETROSPECTIVE STUDY

Conclusion: The first mpox cases in the Netherlands coincided with the

first cases reported in the United Kingdom, Spain and Portugal. We found no

evidence of widespread hMPXV transmission in Dutch sexual networks of MSM

prior to May 2022. Likely, the hMPXV outbreak expanded across Europe within

a short period in the spring of 2022 in an international highly intertwined

network of sexually active MSM.

CHANGES IN SEXUAL BEHAVIORS DUE TO MPOX: A CROSS-SECTIONAL

STUDY OF SGM IN ILLINOIS

Conclusion: SGM YYA in Illinois overwhelmingly reported reducing sexual

contact due to the mpox outbreak. Vaccinated individuals were more likely to

report sexual activity and a greater number of prophylactic activities. Thus, sexpositive

and harm reduction messaging strategies are likely to be more effective

than abstinence-only prevention, which may further stigmatize marginalized

groups.

STIGMA RELATED TO HUMAN MPOX VIRUS AMONG MSM IN THE US, AUGUST

2022

Conclusion: There was low overall prevalence of mpox-related stigma among

MSM in August 2022. These data suggest that messages developed by CDC and

others about mpox and how to protect oneself from mpox infection did not lead

to widespread stigma for this sample of MSM in the US.

HIGH LEVEL OF MPOX KNOWLEDGE AND STIGMA AMONG LGBTQIA+

COMMUNITIES IN BRAZIL

Conclusion: Our results show high rates of mpox knowledge in the LGBTQIA+

communities. Expand access to gender competent care is critical to avoid

underdiagnosis and fight stigma and discrimination.

CHARACTERISTICS AND DISPARITIES AMONG HOSPITALIZED PERSONS WITH

MPOX IN CALIFORNIA

Conclusion: Among persons with mpox and HIV, more hospitalized cases had

uncontrolled HIV and lived in communities with fewer opportunities to lead

healthy lives. Among persons with mpox and without HIV, more that were

hospitalized had diabetes or exfoliative skin disorders. Vaccination and rapid

access to testing and treatment should be prioritized in these groups.

MPOX VIRUS INFECTION IS MORE SEVERE IN PATIENTS WITH

UNCONTROLLED HIV INFECTION

Conclusion: PLWH, considered as a whole, are not at a greater risk of MPXV

severe disease. However, those with uncontrolled HIV infection, due to lack of

effective ART, develop more severe outcomes. Efforts should be done to increase

HIV testing and to ensure linkage to HIV care services. In this setting, ART must

be immediately started.

IMPACT OF HIV INFECTION ON MPOX-RELATED HOSPITALIZATIONS IN

BRAZIL

Conclusion: Our findings suggest an association between worse outcomes

in the HIV care continuum and mpox-related hospitalizations. Advanced

immunosuppression (CD4< 200) contributed to more severe clinical

presentations and death. Public health strategies to mitigate HIV late

presentation and the negative impact of the COVID-19 pandemic to the HIV care

continuum are urgently needed.

CHARACTERISTICS OF THE 2022 MPOX OUTBREAK IN A SOUTHEASTERN US

CITY

Conclusion: Clinical presentation of mpox in Atlanta was similar to other

reports; however, our cohort had a higher burden of HIV co-infection. Severe

mpox disease was observed at higher frequency in individuals with uncontrolled

HIV, indicating an urgent need to better understand the pathogenesis of

HIV-mpox interactions and to develop better prevention and treatment options

for PWH.

CLINICAL OUTCOMES AMONG IN- AND OUTPATIENTS WITH MPOX IN AN

URBAN HEALTH SYSTEM

Conclusion: In this multi-hospital system, a significant proportion of mpox

patients required hospitalization. Immunosuppression and HIV-1 viremia was

associated with hospitalization for mpox. Achieving viral suppression and mpox

immunization should be prioritized among those at risk.

HIV CARE AND PREVENTION CHARACTERISTICS AMONG PERSONS WITH

MPOX AND HIV, TEXAS 2022

Conclusion: Prevalence of HIV infection among persons with mpox was high,

similar to other findings. The majority of persons with mpox and HIV infection

were diagnosed with HIV more than 5 years ago and had HIV laboratory data

signifying utilization of HIV care services in the past year. The disproportionate

impact of mpox on those with HIV infection reinforces the importance of

offering HIV screening testing to persons seeking care for mpox and focusing

public health efforts on linkage or re-linkage to HIV care services as needed.

MPOX OUTBREAK IN PLWHA AND PrEP USERS IN A BRAZILIAN STI CENTER:

DIFFERENT CHALLENGES

Conclusion: The Mpox outbreak in Brazil curbed in September, possibly as a

result of the strong mobilization of the LGBTQIA+ community. The vast majority

of our study participants were PLWHA and PrEP users. PLWA in our study

presented more frequently with extragenital involvement than PrEP users,

possibly due to a weakened immune response of PLWHA to contain the spread to

distant areas. In low-incoming countries with limited diagnostic resources, the

development of an epidemiological and clinical screening prioritizing testing in

MSM, young ,with fever, adenomegaly and genital lesions, could be a strategy

to be implemented.

MPOX IN THE CONTEXT OF POPULATION-LEVEL HIV TREATMENT AND HIV

PrEP PROGRAMS IN BC

Conclusion: A high proportion of mpox cases in BC were prescribed HIV PrEP,

consistent with overlapping risk behaviour and eligibility criteria for HIV PrEP

with mpox transmission and vaccine eligibility. A smaller proportion of the more

heterogeneous HIV Tx clients was similarly affected by mpox. The decline in

mpox cases suggests a potential impact of mpox vaccine uptake and/or altered

client behaviour. Cases of concurrent diagnosis of HIV and mpox emphasize the

importance of screening for sexually transmitted infections, including HIV, in

persons being evaluated for mpox.

CHARACTERISTICS OF PATIENTS HOSPITALIZED WITH MPOX DURING THE

2022 US OUTBREAK

Conclusion: Mpox infection in the current U.S. outbreak has been associated

with severe morbidity and mortality, particularly among persons with AIDS. The

disproportionate burden of severe mpox among persons of color and persons

experiencing homelessness echoes inequities seen in the continuum of care

for PWH. Providers should test sexually active patients with suspected mpox

infection for HIV and other sexually-transmitted infections as indicated at the

time of mpox testing. Engaging all PWH in care remains a critical public health

priority, with additional efforts in HIV outreach and care retention needed to

reduce the population at risk for severe mpox.

EQUITY FOCUSED EVALUATION OF MPOX CARE METRICS IN KING COUNTY,

Conclusion: Public Health and healthcare organizations rapidly scaled-up

mpox testing and treatment over the course of the 5-month epidemic allowing

for most patients to receive TPOXX without significant racial disparities. Testing

and treatment was largely dependent on a single sexual health clinic and

university-affiliated sites.

DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF MPOX WITHIN A NEW

YORK CITY HEALTH SYSTEM

Conclusion: In a diverse cohort of mpox patients, treatment with tecovirimat

was well tolerated and associated with minimal adverse effects. The majority

of hospitalizations occurred in patients with underlying immunocompromising

conditions.

MPOX INFECTION IN WOMEN: A CASE SERIES FROM BRAZIL

Conclusion: We describe different epidemiological, behavior and clinical

profiles of mpox among women and men. The milder mpox clinical presentation

in women can be related to their lower HIV prevalence compared to men. Health

services must provide a comprehensive clinical and epidemiological assessment

that accounts for gender diversity to address the knowledge gaps regarding the

impact of mpox on both cisgender and transgender women.

Update February 17 2023

Fourth meeting of the WHO International Health Regulations Emergency Committee on mpox

The Emergency Committee acknowledged the progress made in the global response to the multi-country outbreak of mpox and the further decline in the number of reported cases since the last meeting. The Committee observed that a few countries continued to see a sustained incidence of illness; the Committee is also of the view that underreported detection and under-reporting of confirmed cases of illness in other regions is likely. Therefore, the Committee considered various options to sustain attention and resources to control the outbreak and advised maintaining the Public Health Emergency of International Concern (PHEIC), while beginning to consider plans to integrate mpox prevention, preparedness and response within national surveillance and control programmes, including for HIV and other sexually transmissible infections.The WHO European Region reported that as of 3 February, 43 countries and territories have not detected any new cases in the past three months. While 18 countries and territories continue to report recent local human-to-human transmission, case numbers have decreased significantly. Future risks of outbreaks relate to the ongoing importation, forthcoming mass gatherings, potential reduced vaccination and surveillance, limited access to testing and behaviour change/. To tackle this, the Region is working towards a five-year plan to achieve and sustain the elimination of mpox in all Member States through engagement with affected communities and integrating intervention into the sexual health programs, to be discussed at the Regional Committee in autumn 2023.The Region of the Americas reported a stable number of cases in the last six weeks, with 200-250 cases per week, and 4% of cases occurring in women. In addition, while the vaccine supply is limited, seven countries have started vaccination. Risk communication and community engagement interventions are being delivered through HIV community-based networks.The Committee reconvened in a closed meeting to examine the questions in relation to whether the event continues to constitute a PHEIC, and if so, to consider the proposed Temporary Recommendations, drafted by the WHO Secretariat in accordance with IHR provisions. The Secretariat provided a presentation on the legal provisions under the IHR in relation to the determination of a PHEIC, and the issuance of Temporary Recommendations.

Updated January 31

HIV.gov convened a meeting of federal HIV communications leadership to start the new year off with the critical message that integrating mpox messaging into our ongoing communications is foundational to our HIV response for 2023. While we recognize the important work that has been done to dramatically decrease new mpox cases, we cannot take our foot off the pedal, as there is still critical work needed to increase and routinize mpox vaccinations.

We were fortunate to hear about mpox in the context of HIV and the importance of an equity-centered response from White House and other U.S. Government leaders. Demetre C. Daskalakis, MD, MPH, Director, CDC Division of HIV/AIDS Prevention and Deputy Coordinator, White House National Mpox Response noted that mpox continues to be a public health issue that disproportionately impacts people with HIV, and data suggest that approximately 40% of people diagnosed with mpox in the United States also have HIV. He also highlighted important action steps (see below) and resource videos to move us forward.

Beginning the meeting, Kaye Hayes, MPA, Deputy Assistant Secretary for Infectious Disease and Director of the Office of Infectious Disease and HIV/AIDS Policy, emphasized the Biden-Harris Administration’s focus on the importance of equity in the mpox response to ensure that no communities are left behind. She also highlighted the intentionality of the work surrounding mpox, including hearing directly from populations most likely to be affected by mpox but least likely to be vaccinated to better understand what is working and what needs to be improved in our response.

Decline in Mpox Cases

During the meeting, Dr. Daskalakis noted that in the U.S., there has been around a 99% reduction in the number of daily mpox cases since the peak of the mpox outbreak in summer 2022. He attributed this to 1) effective communications to gay, bisexual, and other men who have sex with men, as well as transgender individuals and other gender-diverse individuals; 2) the mpox vaccine; and 3) swift response from the LGBTQI+ community.

Syndemics and Mpox

Dr. Daskalakis also discussed mpox in the context of syndemics, noting that mpox infection does not occur in isolation. The September 2022 CDC Morbidity and Mortality Weekly Report showed that HIV or recent sexually transmitted infections (STIs) are common among people with mpox. Dr. Daskalakis thus stressed the importance of continuing to ensure equitable access to mpox screening, prevention, and treatment, including both prioritizing people with HIV and STIs for mpox vaccination and offering HIV and STI screening for people evaluated for mpox. He also emphasized the need to encourage those who haven’t received their second vaccinations to do so.

“We cannot take mpox in isolation,” he asserted. “We need to put it in the context of the interacting epidemics and the interacting social determinants of health that make mpox worse, or that propel mpox transmission.”

The Way-Forward

Dr. Daskalakis discussed navigating the future of the domestic response to mpox. As of the time of the meeting, there were 1,152,073 U.S. mpox vaccines administered. To get to zero mpox cases, he noted we must focus on communications to increase mpox vaccinations and magnify our communications for mpox vaccine administration. [Note: imagery promoting this blog will include this statement]. He also encouraged increased engagement with partners via social media, as well as official government websites, such as HIV.gov.

Harold Phillips, Director, The White House Office of National AIDS Policy, offered a closing message to attendees. He noted that the mpox response was “a true demonstration of when we use and follow the data and the science and we center the approach with equity, we CAN make a difference.”

Stay up to date on mpox and view the CDC’s Mpox Vaccine Equity Toolkit and their Cases and Data page. Also watch and share HIV.gov’s mpox videos featuring Dr. Daskalakis answering 14 top mpox questions.

Updated January 23

Today, the CDC team updated resources related to mpox. These may be found below

New and Updated CDC Resources:

MMWR: Epidemiology of Human Mpox — Worldwide, 2018–2021 NEW

Strategies for Talking with Patients about Vaccinations for Mpox UPDATED

Autopsy and Handling of Human Remains of Patients with Mpox UPDATED

What’s New & Updated UPDATED

Additional Funding Resources:

Mpox Guidance for CDC Grant Recipients

Mpox Considerations for Sexual Health Services (Dear Colleague Letters)

HRSA: Use of Ryan White HIV/AIDS Program Funds for Mpox

HUD’s HOPWA (Housing Opportunities for Persons with AIDS)

SAMHSA: Dear Colleague Letter on Using SAMHSA Grant Resources for Mpox-related Activities

Recently Updated—In Case You Missed It:

MMWR: Mpox Cases Among Cisgender Women and Pregnant Persons — United States, May 11–November 7, 2022

Data and Analytics:

2022 U.S. Mpox Outbreak UPDATED

U.S. Map & Case Count UPDATED

U.S. Mpox Case Trends Reported to CDC UPDATED

Global Map & Case Count UPDATED

Mpox Cases by Age and Gender, Race/Ethnicity, and Symptoms UPDATED

Mpox Vaccine Administration U.S. Map UPDATED

Demographics of Patients Receiving TPOXX for Treatment of Mpox UPDATED

Mpox Technical Reports

Additional CDC Resources:

CDC’s Mpox Internet Site

MMWR Mpox Reports

Health Alert Network (HAN)—Severe Manifestations of Mpox

Mpox Vaccine Confidence Insights Report

Mpox Vaccine Equity Pilot Program

Science Brief: Detection and Transmission of Mpox Virus

Clinician FAQs

Mpox Vaccination Program Provider Agreement

Clinician Outreach and Communication Activity (COCA) Call

Clinical Considerations for Treatment and Prophylaxis of Mpox Virus Infection in People with HIV

Additional Intradermal Administration Sites: JYNNEOS Vaccine

Video: How to Administer Intradermal Vaccine in Forearm, Deltoid, and Scapula

Videos on mpox recommendations and updates from CDC leadership and partners

Completing a Death Certificate in the Setting of Mpox

V-safe after Vaccination Health Checker for Mpox Vaccine

V-safe Print Materials

Mpox Toolkit for Correctional and Detention Facilities

Safer Sex, Social Gatherings, and Mpox

Strategies for Talking with Patients about Vaccinations for Mpox

CDC’s Vaccine Equity Efforts in the Peach State- The Atlanta Black Pride Story

Stories from the Mpox Response

CDC-INFO On Demand – Publications

Print Resources

Additional Partner Resources:

Mpox Vaccine Locator (mpoxvaxmap.org)

CDC/IDSA Clinician Call: Updates & Emerging Issues on COVID-19 and Mpox

ASPR: JYNNEOS Mpox Vaccine Distribution by Jurisdiction

ASPR: Operational Planning Guide

Clinicaltrials.gov: STOMP

Study of Tecovirimat for Human Mpox Virus (STOMP)

FDA: Emergency Use Authorization Fact Sheet

HHS amends PREP Act declaration increasing workforce authorized to administer mpox vaccines

HHS: Public Readiness and Emergency Preparedness (PREP) Act Coverage for Mpox

HHS: Statement From HHS Secretary Becerra on mpox

HHS: U.S. Government Mpox Research Summary

HIV.gov: Addressing Mpox Holistically

HIV.gov: Mpox and People with HIV Videos

NIH: U.S. Clinical Trial Evaluating Antiviral for Mpox Begins

PREP Act Coverage Frequently Asked Questions for Mpox

SAMHSA: Anxiety and Stress Related to Mpox

The White House: A Comprehensive Summary of Federally-Funded Mpox Research Projects

The White House: Mpox Press Briefing (9/28/2022)

WHO: Clinical Management and Infection Prevention and Control of Mpox

WHO: Community Engagement

WHO: WHO recommends new name for monkeypox disease

Published in MMRW today

HIV and Sexually Transmitted Infections Among Persons with Monkeypox — Eight U.S. Jurisdictions, May 17–July 22, 2022

Summary

What is already known about this topic?

In the current global monkeypox outbreak, HIV infection and sexually transmitted infections (STIs) are highly prevalent among persons with monkeypox.

What is added by this report?

Among 1,969 persons with monkeypox in eight U.S. jurisdictions, 38% had HIV infection, and 41% had an STI in the preceding year. Among persons with monkeypox, hospitalization was more common among persons with HIV infection than persons without HIV infection.

What are the implications for public health practice?

It is important to leverage systems for delivering HIV and STI care and prevention and prioritize persons with HIV infection and STIs for vaccination. Screening for HIV and other STIs and other preventive care should be considered for persons evaluated for monkeypox, with HIV care and HIV preexposure prophylaxis offered to eligible persons.

Monkeypox and HIV

CDC doesn’t know if having HIV increases the likelihood of getting monkeypox. Monkeypox can spread to anyone through prolonged, close, personal, often skin-to-skin contact, as well as through contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox, or contact with respiratory secretions, through kissing and other face-to-face contact.

CDC continues to monitor monkeypox among people with HIV. During the current monkeypox outbreak, there does not appear to be more severe monkeypox illness in people who have HIV and are virally suppressed (having less than 200 copies of HIV per milliliter of blood). In fact, the World Health Organization (WHO) monkeypox guidance states, “People living with HIV on antiretroviral therapy with suppressed viral load are not considered to be immunosuppressed.” However, people with HIV who are not virally suppressed may be at increased risk for severe illness and death from monkeypox.

Currently there is no treatment approved specifically for monkeypox. However, medicine (antivirals) developed for use in patients with smallpox may help treat people with monkeypox.

At this time, CDC doesn’t have enough data to know whether people who have HIV and are virally suppressed might benefit from taking medicine if they get monkeypox.

Because patients with a weakened immune system may have more severe monkeypox illness, healthcare providers might consider using antiviral medicines (e.g., tecovirimat) or Vaccinia Immune Globulin for these patients. This could include people newly diagnosed with HIV or people with HIV who are not virally suppressed. See: Treatment Information for Healthcare Professionals.

At this time, vaccination is recommended for people with exposures to a probable or confirmed case with monkeypox, for example people who have had close physical contact with someone diagnosed with monkeypox. Vaccination may also be offered to people who had a presumed exposure, such as men who have sex with men who have had multiple sexual partners during the past 14 days in a jurisdiction with known monkeypox activity.

There are currently two licensed vaccines in the United States to prevent smallpox – JYNNEOS and ACAM2000. These smallpox vaccines may provide protection against monkeypox because smallpox and monkeypox are very similar viruses. Only JYNNEOS is FDA approved for the prevention of monkeypox in people 18 and older.

The JYNNEOS vaccine has been studied in people with HIV who are virally suppressed, and they do not have more frequent or severe side effects from the vaccine than people who did not have HIV. The JYNNEOS vaccine seems to be well tolerated, with the most common side effects being injection site pain, redness, swelling and itching. Some recipients also reported muscle pain, headache, fatigue, nausea, and chills. More data are needed to know if this vaccine is tolerated by people newly diagnosed with HIV or by people with HIV who are not virally suppressed. Clinicians should weigh the benefits of vaccination with the unknown risk of an adverse event for a person if their HIV is not virally suppressed.

ACAM2000 has been shown to have more frequent and severe side effects, especially for people with weakened immune systems or who are pregnant, have a heart condition, or skin conditions like eczema, psoriasis, or dermatitis. ACAM2000 is not recommended for people with HIV, even if they are virally suppressed, due to this increased risk of severe side effects.

Data is limited, but most HIV treatment can be safely given with monkeypox treatment and smallpox vaccines. People with HIV should inform their healthcare provider of all their medications to help determine if any interactions exist.

No, HIV pre-exposure prophylaxis (PrEP) is still effective and should be continued as prescribed.

People with HIV should follow the same recommendations as everyone else to protect themselves from monkeypox.

Avoid direct contact with rashes, sores, or scabs on a person with monkeypox, including during intimate contact such as sex. We believe this is currently the most common way that monkeypox is spreading in the U.S.
Avoid contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
Avoid contact with respiratory secretions, through kissing and other face-to-face contact from a person with monkeypox.

New Study Documents the Frequent Detection of Monkeypox Virus DNA in Saliva, Semen, and other Clinical Samples

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.28.2200503

Updated June 30, 2022

This week, the administration released an new fact sheet on Monkey pox. Key is the rollout of a national strategy for smallpox vaccination against monkeypox for people at risk. This follows a decision by Quebec Province to do the same with that province and Montreal being the epicenters of the current outbreak in North America

https://www.whitehouse.gov/briefing-room/statements-releases/2022/06/28/fact-sheet-biden-harris-administrations-monkeypox-outbreak-response/

As part of the monkeypox outbreak response, the Biden-Harris Administration is launching a national strategy to provide vaccines for monkeypox for individuals at higher risk of exposure. The strategy aims to mitigate the spread of the virus in communities where transmission has been the highest and with populations most at risk. This plan distributes the two-dose JYNNEOS vaccine, which the Food and Drug Administration (FDA) approved for protection against smallpox and monkeypox in individuals 18 years and older determined to be at high risk for smallpox or monkeypox infection. States will be offered an equitable allotment based on cases and proportion of the population at risk for severe disease from monkeypox, and the federal government will partner with state, local, and territorial governments in deploying the vaccines.

The goal of the initial phase of the strategy is to slow the spread of the disease. HHS will immediately allocate 56,000 vaccine doses currently in the Strategic National Stockpile to states and territories across the country, prioritizing jurisdictions with the highest number of cases and population at risk. To date, vaccines have been provided only to those who have a confirmed monkeypox exposure. With these doses, CDC is recommending that vaccines be provided to individuals with confirmed monkeypox exposures and presumed exposures. This includes those who had close physical contact with someone diagnosed with monkeypox, those who know their sexual partner was diagnosed with monkeypox, and men who have sex with men who have recently had multiple sex partners in a venue where there was known to be monkeypox or in an area where monkeypox is spreading.

In the coming weeks, HHS expects to receive an additional 240,000 vaccines, which will be made available to a broader population of individuals at risk. HHS will hold another 60,000 vaccines in reserve.

HHS expects more than 750,000 doses to be made available over the summer. An additional 500,000 doses will undergo completion, inspection, and release throughout the fall, totaling 1.6 million doses available this year.

First Case Report of Monkeypox in a Person Living with HIV

An HIV-positive man in his 30s taking Abacavir, Lamivudine and Dolutegravir and with a CD4 + T-cell count above 700 cells/mm³ (normal range 410–1,545 cells/mm³) and HIV viral load < 100 copies/mL, visited a primary care doctor after his return from Europe to Melbourne, Australia. He reported onset of a genital rash 8 days earlier. The rash had started 5 days after he reported unprotected sex with four casual male partners in Europe. The initial symptoms were painless white pustules on the penis that became painful and pruritic. He reported that he developed a fever and malaise 3 days after the first appearance of the penile rash and over the subsequent 5 days, the rash disseminated to his trunk, then more sparingly to the face and limbs while the genital lesions crusted over.

Swabs taken from deroofed skin lesions on the hand, calf and trunk in addition to combined nose throat swabs on the day of hospital admission, were all positive for monkeypox virus using previously described conventional [2] and in-house RT-PCR assays for orthopox and monkeypox viruses. Whole genome sequencing performed as described in the Supplementary material of DNA derived from the skin lesions resulted in the complete recovery of the entire monkeypox genome (MPXV-VIDRL01, Genbank_ID ON631963) with phylogenetic analysis revealing clustering with other monkeypox virus sequences from the May 2022 outbreak in Europe and the United States.

Rapid communication Home Euro surveillance Volume 27, Issue 22, 02/Jun/2022 Monkeypox infection presenting as genital rash, Australia Yael Hammerschlag et al

The World Health Organization (WHO) reported in its May 30, 2022, update that it had received reports of 257 confirmed monkeypox cases and approximately 120 suspected cases in 23 countries where the virus is not endemic as of May 26, 2022. In the United States, the Centers for Disease Control and Prevention (CDC) has reported 12 cases in eight states as of May 27, 2022. No deaths have been reported in nonendemic countries. The WHO classifies the global public health risk level posed by monkeypox as moderate.

Background

Monkeypox was first detected in 1958 in laboratory monkeys.¹ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo.² Since then, monkeypox has been reported in humans in other central and western African countries, with occasional cases reported outside of Africa.¹

Global Outbreak

In May 2022, more than 120 confirmed or suspected cases of monkeypox have been reported in at least 11 non-African (endemic) countries, including Australia, Belgium, Canada, England, France, Germany, Israel, Italy, Netherlands, Portugal, Spain, Sweden, and Switzerland.²

Historical Context

In 2003, the first monkeypox outbreak outside of Africa was in the United States, when 70 cases in humans were reported, linked to contact with infected pet prairie dogs, which had been housed with Gambian pouched rats imported into the United States from Ghana.³ Monkeypox was reported in travelers from Nigeria to the United States in July 2021 and November 2021.³

2022 US and Global Outbreak

On May 20, 2022, the US Centers for Disease Control and Prevention (CDC) issued an alert urging doctors and state health departments to be vigilant for cases of monkeypox, following confirmation of cases in the US.^{4, 5} Federal officials say they expect to identify additional infections in the coming days. According to the CDC, it is not clear how people in the cluster outbreaks so far were exposed to the monkeypox virus but cases include people who self-identify as men who have sex with men.⁶ Public health officials have issued similar alerts in Australia, Belgium, Canada, England, France, Germany, Israel, Italy, Netherlands, Portugal, Spain, Sweden, and Switzerland.

Monkeypox virus is known to spread through close contact with the lesions, bodily fluids and respiratory droplets of infected people or animals or materials contaminated with the virus. Human transmission is thought to occur primarily through respiratory droplets. Investigations are ongoing that the virus may be spreading by sexual contact, following outbreaks of monkeypox in Europe related to two parties in Spain and Belgium, attended primarily by gay men. Although many cases have been reported among men who have sex with men (MSM), and bisexual men, spread may be occurring because the virus was introduced into the community and it has continued to spread there, both by sexual and social contact.

Key Facts about Monkeypox³

Monkeypox is caused by monkeypox virus.
Monkeypox typically presents clinically with fever, rash, and swollen lymph nodes and may lead to a range of medical complications.⁷
The incubation period is usually 7-14 days but can range from 5-21 days.
Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur and the fatality ratio has been around 3-6%.
Monkeypox is transmitted to humans through close contact with an infected person (skin lesions, body fluids, respiratory droplets and contaminated materials such as bedding) or animal, or with material contaminated with the virus.
The clinical presentation of monkeypox resembles that of smallpox but is less contagious than smallpox and causes less severe illness.
Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. A vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019.
An antiviral agent (tecovirimat) that was developed for smallpox was licensed by the European Medical Association (EMA) for monkeypox in 2022 based on data in animal and human studies. Tecovirimat is not yet widely available.

Summary of CDC Recommendations for Clinicians⁶

If clinicians identify patients with a rash that could be consistent with monkeypox, especially those with a recent travel history to areas reporting monkeypox cases, monkeypox should be considered as a possible diagnosis.
The rash associated with monkeypox involves vesicles or pustules that are deep-seated, firm or hard, and well-circumscribed
Presenting symptoms typically include fever, chills, the distinctive rash, or new lymphadenopathy; however, onset of perianal or genital lesions in the absence of subjective fever has been reported.
Information on infection prevention and control in healthcare settings is provided on the CDC website’s Infection Control page.⁸
Clinicians in the United States should consult their state health department or CDC through the CDC Emergency Operations Center (770) 488-7100 as soon as monkeypox is suspected.
Clinicians outside of the United States consult their relevant subnational and national public health authorities for guidance and epidemiological surveillance purposes.

What At-Risk Individuals Should Do⁶

The CDC advises people who may have symptoms of monkeypox should contact their healthcare provider. This includes anyone who:

Traveled to central or west African countries, parts of Europe where monkeypox cases have been reported
Reports contact with a person with confirmed or suspected monkeypox

The World Health Organization (WHO) notes that available evidence suggests that those who are most at risk are those who have had close physical contact with someone with monkeypox, and that risk is not limited to men who have sex with men.

Notes

[1] Monkeypox goes global: why scientists are on alert Max Kozlov Nature News May 20 2022

[2] CDC Monkeypox https://www.cdc.gov/poxvirus/monkeypox/index.html Last updated May 20 2022

[3] Monkeypox World Health Organization May 19,2022 https://www.who.int/news-room/fact-sheets/detail/monkeypox

[4] CDC tells doctors to be on alert for monkeypox as global cases rise Washington Post https://www.washingtonpost.com/health/2022/05/20/cdc-monkeypox-alert/

[5] Monkeypox in the United States CDC https://www.cdc.gov/poxvirus/monkeypox/outbreak/us-outbreaks.html

[6] 2022 United States Monkeypox Case https://www.cdc.gov/poxvirus/monkeypox/outbreak/current.html

[7] Signs and Symptoms CDC https://www.cdc.gov/poxvirus/monkeypox/symptoms.html

[8] Precautions to Prevent Monkeypox Transmission https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-hospital.html

IAPAC and City of Sevilla Announce Fast-Track Cities 2022

IAPAC AND CITY OF SEVILLA ANNOUNCE FAST-TRACK CITIES 2022

Sevilla, Spain (April 7, 2022) – The International Association of Providers of AIDS Care (IAPAC), the City Council of Sevilla, and civil society representatives held a joint press conference today to officially announce the Fast-Track Cities 2022 conference, which will take place October 11-13, 2022, in Sevilla. Under the theme of “Leading Together,” the conference will reflect the intersection of solidarity and leadership in public health as the framework of the Fast-Track Cities movement.

The Fast-Track Cities network was launched on World AIDS Day 2014 with the signing of the Paris Declaration on Fast-Track Cities by 26 cities around the world. Today, the Fast-Track Cities network has more than 390 cities globally committed to the goals of ending the HIV and tuberculosis (TB) epidemics and eliminating HBV and HCV by 2030. There are more than 15 Fast-Track Cities in Spain, of which Sevilla was the first to join the global network in 2015.

The Fast-Track Cities 2022 conference will provide space for interactive dialogue and facilitate the collaborative development of innovative approaches to ending HIV and TB, as well as eliminating viral hepatitis. The conference aims to foster exchange and cooperation between government leaders, public health officials, clinical service providers, urban health experts, and civil society representatives from current and future Fast-Track Cities.

The topic of the conference’s high-level panel will focus on realizing migrants’ right to health, a key population for which greater efforts are needed in optimizing access to and use of health services related to HIV, TB, viral hepatitis, and other diseases.

“Given the leadership of the multiple public health actors that are driving Sevilla’s response to HIV, the theme ‘Leading Together’ is ideal for the Fast-Track Cities 2022 conference that we will hold in your city,” said Dr. José M. Zúñiga, President/CEO of IAPAC and the Fast-Track Cities Institute. “By convening the entire Fast-Track Cities network, we intend to publicize their successes, but also strategize around the cross-cutting challenges we encounter to accelerate the responses to HIV, TB, and viral hepatitis, especially as we regain momentum lost during the COVID-19 pandemic.”

“The City of Sevilla has positioned itself as an international benchmark in the efforts to end HIV/AIDS thanks to close collaboration between the City Council, other administrations, and associations,” said Mr. Antonio Muñoz Martínez, Mayor of Sevilla. “In October 2015, we were the first Spanish city to adhere to the Fast-Track Cities strategy, and since 2018 we have implemented a work plan that is yielding results and meeting the objectives that we had set for ourselves. The celebration in Sevilla of the Fast-Track Cities 2022 conference is an opportunity that should serve to reinforce our commitment as a city and launch a clear and forceful message of international scope so that ending HIV remains a priority on political and institutional agendas.”

The Fast-Track Cities 2022 conference is organized by IAPAC, in collaboration with the Joint United Nations Program on HIV/AIDS (UNAIDS), the Stop TB Alliance, the World Hepatitis Alliance, as well as the Fast-Track Institute. The conference is made possible through corporate sponsorship and grants from AbbVie, Gilead Sciences, Merck Sharp & Dohme, and ViiV Healthcare.

For conference information and/or to register online, visit: https://www.iapac.org/conferences/fast-track-cities-2022/

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About Fast-Track Cities

Fast-Track Cities is a global partnership between more than 390 cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. The partnership’s aim is to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. Launched on World AIDS Day 2014, the partnership also advances efforts to end tuberculosis (TB) epidemics and eliminate viral hepatitis (HBV and HCV) in urban settings by 2030. For more information about the Fast-Track Cities initiative, please visit: https://www.fast-trackcities.org

About the International Association of Providers of AIDS Care

About the Fast-Track Cities Institute

The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

European Fast-Track Cities Mayors Declare Support for Ukraine

European Fast-Track Cities Mayors

Declare Support for Ukraine

IAPAC (April 4, 2022) – Mayors from across Europe signed a Fast-Track Cities Mayors’ Declaration of Support for Ukrainian People Affected by HIV, TB, and Viral Hepatitis. As of today, 31 Mayors have signed the Mayors’ Declaration, expressing their solidarity with Ukraine’s four Fast-Track Cities and condemning “the violence the Russian Federation is inflicting upon the Ukrainian people, which runs afoul of our shared commitment to the rights outlined in the Universal Declaration of Human Rights.”

In addition, the Mayors cited their concerns regarding disruptions in HIV and other essential health services caused by the war in Ukraine. They noted that “[the] humanitarian crisis in Ukraine has defined an unprecedented need for global solidarity, both for those who remain in the country and for millions of Ukrainians who are seeking refuge abroad. This need includes the provision of medical and social services to a growing number of refugees, among them people at risk for and those living with HIV, TB, and viral hepatitis.” The Mayors concluded their declaration by pledging their “commitment to transform this declaration of support into concrete actions on behalf of our respective Fast-Track Cities and in the spirit of solidarity.

In announcing the release of the Mayors’ Declaration, Dr. José M. Zuniga, President/CEO of IAPAC and the Fast-Track Cities Institute, said that “exercising political leadership requires taking a stance when the human rights to life, liberty, and security of person are violated, as they clearly are during the unprovoked war on Ukraine. I applaud the European Fast-Track Cities Mayors who signed the Mayors’ Declaration of Support for Ukrainian People Affected by HIV, TB, and Viral Hepatitis for taking a stance and expressing their solidarity with the Ukrainian people during this humanitarian crisis, among them people living with and affected by HIV, TB, and viral hepatitis.”

Click here to read the Mayors’ Declaration.

#WeStandWithUkraine and HIV-Affected Ukrainians

An interview with IAPAC’s President/CEO, Dr. José M. Zuniga

Over the past four weeks, Ukraine has become the focal point of international attention as it pushes back on Russian military aggression while enduring the hardships that war inflicts on combatants and civilians. In the images depicting the effects of military assaults, it is difficult to differentiate the people who are feeling the impact of an unprovoked war. Nonetheless, among them are Ukrainians living with HIV and people who are vulnerable to HIV acquisition based on social determinants of health. Dr. José M. Zuniga, President/CEO of the International Association of Providers of AIDS Care (IAPAC) and the Fast-Track Cities Institute (FTCI), reflects upon the humanitarian crisis and efforts to show solidarity with the people of Ukraine.

What are your thoughts about the humanitarian crisis precipitated by the Russian Federation’s military assault on Ukraine?

Without wading too deep into an evolving geopolitical situation, suffice it to say that IAPAC and FTCI condemn violence perpetrated against any people, including when it is the result of military aggression. Such violence runs counter to the Universal Declaration of Human Rights and other human rights instruments, including the European Convention on Human Rights, of which the Russian Federation and Ukraine are both parties. If we have learned anything from history, it is that civilians bear the brunt of suffering caused by military conflict, and sadly we are now witnessing through news reports a surge of attacks on civilian facilities, including hospitals, and an escalating civilian death toll.

What impact is the military campaign having on Ukrainians living with and affected by HIV?

There are an estimated 250,000 people living with HIV in Ukraine. Thanks to the efforts of local, national, regional, and international partners, among them IAPAC and FTCI, the HIV response in Ukraine has grown ever more robust and contributed to improvements across the HIV care continuum. Prior to the start of the current hostilities in Ukraine, there was still much work to do to close HIV testing and treatment gaps, but there was clearly forward momentum to further accelerate the HIV response across the five Fast-Track Cities in Ukraine. In Kyiv, which was the first city in Ukraine to join the Fast-Track Cities network, we saw a double-digit percentage point increase in the number of people living with HIV on antiretroviral therapy – from 44% in 2015 to 81% in 2020. On the HIV prevention front, we had seen progress in scaling up pre-exposure prophylaxis (PrEP). Additionally, efforts to address the psychosocial and harm reduction needs of people who inject drugs were in a state of continuous improvement, serving as a model to replicate beyond Ukraine’s borders. And, notably, the HIV community, working in partnership with political and public health leaders, was demonstrating the power of multi-stakeholder collaboration to address HIV and intersectional stigma in a way that contributed to bolstering respect for all people living with and affected by HIV, including LGBTQ+ people, people who inject drugs, and others vulnerable by virtue of their social status. This remarkable progress achieved in Ukraine over several years is now jeopardized by unavoidable HIV and other health service disruptions and the displacement of millions of people both within Ukraine and to bordering countries. I am also deeply concerned about the mental health and socioeconomic crises that all Ukrainians will endure for the foreseeable future. Finally, it is worth noting that the COVID-19 pandemic is not over and adds one more layer of complexity on the health needs of Ukrainians in general, including those affected by HIV.

What has been learned to date from the public health response in Ukraine and about the importance of networks of affected communities in disaster situations?

Projecting public health needs is key. For example, prior to the escalation of military hostilities, the Ukrainian public health system provided a month’s supply of antiretroviral therapy (ART) to the estimated 156,000 people living with HIV. Additionally, health facilities and people who inject drugs were provided a one-month supply of opioid substitution therapy (OST). Supply chains are now disrupted, and we are hearing about stock outs in heavily bombarded regions, but at a minimum, neither ART nor OST were immediately disrupted. Moreover, we have witnessed how formal and informal networks of people affected by HIV – in Ukraine and surrounding countries – have mobilized to support each other through these difficult times. We, IAPAC and FTCI, are in contact with these networks as we aim to offer our assistance to community groups, clinicians, and public health clinics. What we have learned over the past few weeks also reinforces what we observed throughout the COVID-19 pandemic: there is an important role that city governments must play in equal partnership with national governments when faced with natural or human-made disasters. The current situation has additionally revealed some inherent weaknesses in the health system, not exclusive to Ukraine, that require public health preparedness at the city level on par with the pandemic preparedness planning that many Fast-Track Cities are now engaged in based on lessons learned from the COVID-19 pandemic. Bottom line, though, as with the response to the colliding COVID-19 and HIV epidemics around the world, an important take-away from the first few weeks of this military conflict is the powerful nature of community engagement. Community is once again on the front lines, filling in the gaps, and worthy of our support today, tomorrow, and into the future, as an integral part of the global public health architecture.

What are IAPAC and FTCI doing to respond to the needs of Ukrainians living with and affected by HIV? Both those in-country and those seeking refuge in other countries?

In addition to communicating our solidarity with the people of Ukraine, IAPAC and FTCI are engaged in efforts to convey a broader range of solidarity from IAPAC’s 30,000 clinician-members and the global network of more than 380 Fast-Track Cities. We cannot be ambiguous in that expression, not when so many lives have been turned upside down and the number of war casualties, including deaths, continues to rise. But our solidarity in words is not sufficient. We are partnered with like-minded donors and institutions in multiple countries to secure medical commodities, including antiretroviral and other medications. We are supporting calls for individual and corporate donations to aid community-based organizations in Ukraine, as well as Poland, Romania, and other countries that are giving refuge to millions of fleeing Ukrainians, among them people living with HIV. And, as a medical association, IAPAC is equally focused on the needs of displaced clinicians and other healthcare professionals as their needs, on a personal level, are as acute as those of any other refugee. This is an all-hands-on-deck moment for us all and we are proud to be part of a coordinated effort aimed at translating words into action.

What can individuals do to stand in solidarity with and assist Ukrainians living with and affected by HIV?

I encourage individuals to advocate a peaceful resolution to the current military conflict in Ukraine. Contact your elected officials. Make your voices heard through social media. #WeStandWithUkraine should be going mega-viral daily. Global solidarity is crucial. I can tell you from personal interactions with Ukrainian friends and colleagues that these expressions of solidarity from everyday people mean to them as much as those coming from political leaders (as important as political statements are to present a united front against war in Ukraine). But actions can speak louder than words. If individuals have the means, there are vehicles through which to donate to humanitarian relief efforts, including a Fast-Track Cities Solidarity Fund aimed at assisting Ukrainian people living with and affected by HIV and those institutions on-the-ground that are willing and capable to weave a safety net for those made vulnerable by war.

What is your hope for the future of Ukraine and its communities affected by HIV?

My hope for Ukraine is that it will maintain its rightful place among the nation-states of the world, in peaceful co-existence with its regional neighbors. I pray for a speedy end to the military aggression that is affecting the entirety of Ukrainian society, but also its bordering countries, including those providing sanctuary to millions of refugees. As a veteran of a foreign war, and to quote someone else’s words, “I hate war as only a soldier who has lived it can.” As a human being, my heart embraces the people of Ukraine and I hope that they may soon resume their lives realizing their human rights to life, liberty, and security of person. And, as a public health practitioner, I hope that we can work shoulder-to-shoulder with communities, clinicians, public health, and political partners to rebuild and fortify the HIV response in Ukraine. At the appropriate moment, when hostilities cease, we can and must regain momentum in our collective efforts to stem new HIV infections, avert AIDS-related deaths, and improve the quality of life for Ukrainian communities affected by HIV.

The International Association of Providers of AIDS Care (IAPAC) represents more than 30,000 clinicians and allied healthcare professionals worldwide and serves as the Secretariat for the Fast-Track Cities Institute (FTCI). The FTCI offers technical support to a growing network of currently 380-plus cities and municipalities striving to end their urban HIV, tuberculosis, and viral hepatitis epidemics by 2030.

IAPAC Announces Fast-Track Cities Progress on World AIDS Day and Initiative’s 7th Anniversary

Several Cities Sign PARIS DECLARATION ON FAST-TRACK CITIES
Fast-Track Cities Report Updated 90-90-90 Targets Data
Data Dashboards Launched for Several Fast-Track Cities
IAPAC Releases HIV Policy Brief on 90-90-90 Best Practices

WASHINGTON, DC (December 1, 2021) – As the world marks the 34^th World AIDS Day, the International Association of Providers of AIDS Care (IAPAC) today announced progress across the Fast-Track Cities network on the 7^th anniversary since the network’s launch on World AIDS Day 2014. In addition to IAPAC, the network’s three other core partners include the Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Human Settlement Programme (UN-Habitat), and the City of Paris.

On and around World AIDS Day 2021, a dozen new cities joined the Fast-Track Cities network, bringing the total to more than 380 cities worldwide whose mayors or provincial governors have signed the Paris Declaration on Fast-Track Cities. The network’s new members include cities such as Harare (Zimbabwe), Perth (Australia), Pittsburgh (USA), and Luxembourg (Luxembourg). In total, 64 existing Fast-Track Cities also reported updated 90-90-90 data on World AIDS Day 2021 regarding the percentage of people living with HIV (PLHIV) who know their status (1^st 90 target), percentage of PLHIV who know their HIV status and are on antiretroviral therapy (ART; 2^nd 90 target), and percentage of PLHIV on ART who achieve viral suppression, meaning the virus is undetectable and therefore cannot be sexually transmitted (3^rd 90 target). Of the 64 cities, 19 reported 90-90-90 data for the first time since joining the network. Of the 47 cities that had previously reported data, 45 cited improvements in one or more of the 90 targets since the year in which they reported baseline data. Moreover, Blantyre (Malawi), Florence (Italy), and Nairobi City-County (Kenya) reported they had surpassed the targets (90-92-90, 95-97-97, and 93-99-94, respectively).

“Whether measured by the continued geographic expansion of the Fast-Track Cities network or continued momentum to attain and surpass the 90-90-90 targets, we have witnessed over the past seven years the power of sustained multistakeholder engagement in urban HIV responses that place communities at the center of the progress made in ending their HIV epidemics,” said Dr. José M. Zuniga, President/CEO of IAPAC and its Fast-Track Cities Institute. “We are proud of the agility and resilience shown by more than 380 cities that are committed to acting locally to realize the goal of ending AIDS as a public health threat by 2030, even in the midst of the COVID-19 pandemic.”

IAPAC is assisting Fast-Track Cities to transition their data reporting from the 90-90-90 targets around which the initiative initially focused to more ambitious 95-95-95-95 targets in the new UNAIDS Global AIDS Strategy (2021-2026). These targets translate into 95% of PLHIV knowing their status, 95% percent of those who know their status taking ART, and 95% of those on ART achieving viral suppression. These three updated targets are augmented with a fourth new target of 95% of at-risk individuals using combination HIV prevention, including pre-exposure prophylaxis (PrEP). These data will be visualized on data dashboards on which Fast-Track Cities report their data annually. On World AIDS Day 2021, IAPAC launched three new data dashboards for the cities of Austin/Travis County, TX (USA), Durham/Durham County, NC (USA), and Las Vegas/Clark County/Nevada (USA).

In parallel, IAPAC released “Best Practices for Attaining and Surpassing 90-90-90 from Select Fast-Track Cities,” the first in a series of HIV policy briefs that will document best practices in relation to policies, programs, and strategies that are successfully closing gaps across HIV prevention and treatment continua. The brief released today focuses on five Fast-Track Cities – Bangkok (Thailand), Lagos State (Nigeria), London (UK), San Francisco (USA), and São Paulo (Brazil) – with best practices related to attainment of 90-90-90 targets as well as addressing stigma and improving quality of life for an aging cohort of PLHIV. The policy brief was made possible through support from Gilead Sciences.

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About Fast-Track Cities
Fast-Track Cities is a global partnership between more than 380 cities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. The partnership’s aim is to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. Launched on World AIDS Day 2014, the partnership also advances efforts to end tuberculosis (TB) epidemics and eliminate viral hepatitis (HBV and HCV) in urban settings by 2030. For more information about the Fast-Track Cities initiative, please visit: https://www.fast-trackcities.org

About the International Association of Providers of AIDS Care
Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About the Fast-Track Cities Institute
The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

IAPAC Hosting 16th Annual Conference Focused on Optimizing HIV Prevention and Treatment Adherence

Orlando, Florida (November 7, 2021) – The International Association of Providers of AIDS Care (IAPAC) will host its 16th annual conference of HIV prevention and treatment adherence (Adherence 2021) over the next three at days the Loews Portofino Bay Hotel in Orlando, Florida. With almost 200 in-person attendees expected in a conference venue in strict compliance with social distancing and current health regulations, and almost 1,000 participants expected online, the hybrid format of the conference will enable IAPAC to include more participants in this annual event during the COVID-19 pandemic.

The Adherence 2021 conference will focus on state-of-the-science evidence, best practices, and the real-world implementation of behavioral, clinical, structural, and other interventions to maximize the therapeutic and preventative effects of antiretroviral agents. The conference will also provide a forum for discussion and presentation of implementation science focused on closing evidence-to-practice gaps across the HIV prevention and care continua, as well as community engagement in planning, implementing, and monitoring HIV responses in affected communities.

“Although hosted in hybrid format, Adherence 2021 is no less robust than past conferences. We are featuring measures taken to mitigate the disruptive effects of COVID-19 on HIV responses, but also exploring innovations in the prevention and treatment of HIV, including long-acting antiretrovirals,” said IAPAC President/CEO Dr. José M. Zuniga. “Ultimately, we are convening to ensure that we optimize HIV care and treatment continua with the aim of ending AIDS as a public health threat by 2030.”

Conference highlights will include a Keynote Address from Dr. Meg Doherty, Director of Global HIV, Hepatitis, and Sexually Transmitted Infections (STI) Programs at the World Health Organization (WHO). She is joining a conference faculty that includes clinicians, behavioral scientists, policy makers, and community representatives from around the globe.

The Adherence 2021 conference is taking place two weeks after the IAPAC-hosted Fast-Track Cities 2021 conference held October 20-22, 2021, in Lisbon, Portugal, also in a hybrid format. That conference drew more than 400 in-person participants and over 1,800 participants online. According to Dr. Zuniga, the number of participants for both hybrid conferences attests to the appeal of this format, since invited speakers and participants can join in conference activities even if they are not able to travel to the venue.

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About the International Association of Providers of AIDS Care

IAPAC Welcomes Biden Administration’s Intent to Nominate Dr. John Nkengasong to serve as U.S. Global AIDS Coordinator

Statement by Dr. José M. Zuniga

President/CEO, IAPAC and Fast-Track Cities Institute Washington, DC, USA • 23 September 2021

The International Association of Providers of AIDS Care (IAPAC) and the Fast-Track Cities Institute welcome news of the Biden Administration’s intent to nominate Dr. John Nkengasong, founding Director of the Africa Centres for Disease Control and Prevention (CDC), to serve as the new U.S. Global AIDS Coordinator and lead the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

Throughout his career, Dr. Nkengasong has exemplified an unwavering commitment to science and to addressing public health challenges in a manner that recognizes persistent health and social inequities. He also has exhibited requisite traits needed to fulfill the role of U.S. Global AIDS Coordinator, including accountability, commitment, engagement, and tenacity – all of which are needed if we are to regain forward momentum toward ending the global HIV pandemic. For these reasons, IAPAC and the Fast-Track Cities Institute will unreservedly support Dr. Nkengasong’s nomination and confirmation, while also calling on the African Union to appoint a worthy successor to take the reins of the Africa CDC at this critical juncture.

These are challenging times during which the COVID-19 pandemic has disrupted the global HIV response. If we are to realize the promise of the Global AIDS Strategy (2021-2026), we will need to leverage PEPFAR’s ability to deploy U.S. government funding and work through strategic partnerships to save millions of lives. This ability can also serve as a powerful adjunct to national, regional, and international efforts to scale-up COVID-19 vaccination efforts so that vaccine equity can also be realized for every person in every country.

With a bold, qualified, and passionate leader at the helm of the U.S. global AIDS response, we have every reason to hope that progress can be made across our responses to the HIV and COVID-19 pandemics, notably in countries and municipalities where the pace of progress is lagging.

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About the IAPAC and the Fast-Track Cities Institute
With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV, tuberculosis (TB), and viral hepatitis by 2030. IAPAC is also the core technical partner of the Fast-Track Cities initiative and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC and our global activities, please visit: https://www.iapac.org/

IAPAC Releases “LGBTI+ Health Equity: A Global Report of 50 Fast-Track Cities” Confirms Glaring Inequities across LGBTI+ Communities

275 key informants from 50 cities participated in the first study allowing comparison of LGBTI+ health equity across four regions – Africa, the Americas, Asia-Pacific, and Europe.
Study outcomes exposed health inequities and numerous other challenges facing LGBTI+ populations, including discrimination in criminal justice systems.
Report concludes with recommendations for local and national governments, providers of care and health systems, community-based organizations, and international actors.

COPENHAGEN, Denmark (August 18, 2021) – Results from IAPAC’s groundbreaking study, LGBTI+ Health Equity: A Report of 50 Fast-Track Cities, were announced today during Copenhagen 2021 (WorldPride). The research, which gathered data from four geographic regions, focused on urban LGBTI+ health equity through surveys of 275 key informants who work closely with LGBTI+ populations in 50 cities.

Among the study’s revelations was the fact that no region came close to perfect on LGBTI+ health equity indicators, including quality of life, access to care, or nondiscrimination. Moreover, the average global quality of life score for LGBTI+ communities across the 50 cities was 3.2 on a scale of 1 (poor) to 5 (excellent). In terms of access to care, globally, HIV-related services scored a 3.8 on a scale of 1 to 5, but mental healthcare scored just 2.8 and gender-affirming care scored 2.7.

“We cannot adequately address HIV and other health conditions without including LGBTI+ populations, and we cannot adequately serve LGBTI+ populations unless we understand the diversity and complexity of these communities and their needs,” said Dr. José M. Zuniga, President/CEO of IAPAC and the Fast-Track Cities Institute, and the study’s senior investigator. “Those of us working in the field of health and in any other topic area relevant to LGBTI+ health equity must recommit ourselves to working holistically to end the disparities these communities face.”

The report also revealed the clear lack of disaggregated data on LGBTI+ individuals, particularly populations beyond sexual minority men. And, while the research showed a marked resilience among LGBTI+ communities in each of the cities studied, the underlying stigma, discrimination, and lack of visibility that perpetuate health and other inequities remain largely the same around the world.

LGBTI+ Health Equity: A Report of 50 Fast-Track Cities was made possible by a grant from ViiV Healthcare. To download the report: https://bit.ly/3iU5mwn.

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About the International Association of Providers of AIDS Care

IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV, tuberculosis, and viral hepatitis by 2030. IAPAC is also a core technical partner of the Fast-Track Cities initiative and the Secretariat for its Fast-Track Cities Institute (https://www.ftcinstitute.org/). For more information about IAPAC and our global activities, please visit: https://www.iapac.org/

IAPAC Mourns the Passing of Rabbi Allen I. Freehling

IAPAC Mourns the Passing of Rabbi Allen I. Freehling

Statement by Dr. José M. Zuniga
President/CEO and Trustee At-Large
International Association of Providers of AIDS Care
7 January 2021 • Washington, DC, USA

“It is with the most profound sorrow that I convey news that our beloved Rabbi Allen I. Freehling, first Chair Emeritus of the International Association of Providers of AIDS Care (IAPAC), passed away peacefully at his Los Angeles home last night in the company of his wife, Mrs. Lori Freehling. Rabbi Freehling was the founding Chair of the IAPAC Board of Trustees, after its re-birth in 1995, and served in that role until retiring in 2014.

On behalf of the IAPAC Board of Trustees, staff, and members, I have conveyed to Mrs. Freehling our association’s sincere condolences and thanked her for supporting Rabbi Freehling over his more than two decades of service to IAPAC. We also extend our deepest sympathies to his two surviving children, six grandchildren, and four great-grandchildren.

I cannot overstate how much Rabbi Freehling’s caring and thoughtful leadership meant to IAPAC and, personally, to me. Suffice it to say that he personified the definition of a ‘mensch.’ His honor and integrity were invaluable assets to IAPAC and our senior leadership in our continuous efforts to curb new HIV infections, avert AIDS-related deaths, and eliminate stigma and discrimination perpetrated against people living with and affected by HIV.

In that latter vein, Rabbi Freehling kept IAPAC pointed towards a ‘North Star’ that focused on the universal principles of human rights and respect for the dignity of every person. He exemplified this commitment to social justice throughout 30 years as a Senior Rabbi, but also in his civic roles, including as former Executive Director of the City of Los Angeles Human Relations Commission.

I invite all of our colleagues, friends, and allies to join us in honoring Rabbi Freehling’s memory.”

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About the International Association of Providers of AIDS Care

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV, tuberculosis (TB), and viral hepatitis by 2030. IAPAC is also the core technical partner of the Fast-Track Cities initiative and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC and our global activities, please visit: https://www.iapac.org/

15-Year Anniversary: Adherence 2020 Goes Virtual

In a keynote address delivered to Adherence 2020 Virtual conference delegates, the Deputy Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Dr. Shannon Hader called upon global health leaders to implement a universal test-and-connect approach to reach the dual goals of curbing new HIV transmissions and stopping AIDS-related deaths by 2030.

“It takes a lot of leadership commitment to make it happen,” said Dr. Hader in an address that reviewed new research about how to encourage communities to adopt the universal test-and-connect approach. Dr. Hader added that the experience of the COVID-19 pandemic has made the concept of community-wide HIV testing more widely understood and accepted among the general public.

Dr. Hader’s remarks followed an introduction by Dr. José M. Zuniga, President/CEO of the International Association of Providers of AIDS Care (IAPAC), which hosted the Adherence 2020 Virtual conference (15th International Conference on HIV Treatment and Prevention Adherence) on November 2-3, 2020.

“The optimization of healthcare delivery is critical to securing lasting progress in the global effort to end the HIV epidemic. Any disruption in access to antiretroviral medications, regardless of cause, can have serious consequences for anyone living with HIV,” said Dr. Zuniga. “Universal HIV test-and-connect approaches are vitally important to reach and surpass the global 90-90-90 targets within the context of COVID-19-related HIV service disruptions.”

The two-day live-streamed conference featured plenaries, panel discussions, and oral/poster abstract presentations across five tracks: Adherence, Combination HIV Prevention, Continuum of Care, Community Engagement, and Implementation Science.

For the first time in its 15-year history, the Adherence 2020 Virtual conference was held online to accommodate the ongoing public health restrictions related to COVID-19. The global COVID-19 pandemic was one of the key topics at the conference, as these restrictions have in some areas impacted access to and utilization of HIV services by people living with and affected by HIV.

Dr. Hader noted that although the genesis of the universal test-and-connect approach began even before World Health Organization (WHO) adopted it as a recommendation in 2015, the experience of the COVID-19 pandemic has brought renewed focus on this approach and how it can be applied to other public health threats beyond HIV. Dr. Hader emphasized that a community-wide approach need not be uniform, and that the approach can be applied to defined populations within communities, but noted that the key to making these interventions effective ultimately requires support from a variety of stakeholders. Dr. Hader added that 2021 will be a “special year” for UNAIDS, as the United Nations’ dedicated agency focused on HIV defines service delivery and other targets for 2025 and how to get “back on track” for the 2030 goals.

Dr. Carol Ngunu spoke on an HIV pre-exposure prophylaxis (PrEP) panel from her experience at the Nairobi City-County Health Services in Kenya. Dr. Ngunu reflected on the persistent challenge of social stigma and how travel restrictions due to the COVID-19 epidemic in Nairobi City-County created an additional barrier, which caused a significant drop in the numbers of people reaching health clinics that offer HIV services, including PrEP. She recommended increasing the number of service delivery points, with the goal of creating “one-stop-shops” where people can access comprehensive healthcare services, ideally co-located with pharmacies, thereby reducing the time and distance between people and the services they need.

“One of the biggest barriers is stigma,” said Dr. Latesha Elopre who is an Assistant Professor of Infectious Diseases at the University of Alabama at Birmingham in the United States. Dr. Elopre discussed a particular form of stigma, known as “PrEP stigma,” in which some people mistakenly believe that a person has HIV if they are taking PrEP medication. She also identified prohibitive cost, lack of insurance, frequency of visits, and transportation as additional barriers to comprehensive biomedical preventative care.

Elizabeth Foote, who works as a Clinical Services Manager at the Sussex Community NHS Foundation Trust in the United Kingdom, opened a panel discussion about HIV treatment adherence with a presentation about “intentional non-adherence” to antiretroviral therapy. Clinicians have been working to understand this phenomenon, and the reasons why people might decide to stop taking their antiretroviral medications. While mental conditions are an important initial consideration for clinicians, said Foote, it is equally important to avoid language that creates a paternalistic dynamic between patient and health care provider. The key is to “maintain engagement” regardless of whether or not someone is adhering to their medication.

William Matovu spoke from his experience with the “U=U” public education campaign through the Love to Love Organization, which is based in Kampala, Uganda, and how the hopeful message of “treatment as prevention” can motivate people living with HIV to remain adherent to their antiretroviral medications. Matovu added that it is important to prevent “HIV colonialism” from leading to the assumption that people living with HIV in developing world countries cannot understand the science of HIV.

Dr. Asa Radix, Senior Director of Research and Education at Callen-Lorde Community Health Center and an Associate Clinical Professor of Medicine at New York University in New York City, NY, USA, addressed a community engagement-themed panel discussion about the value of community-led research that recognizes the full spectrum of HIV stakeholders at the local, national, and global levels. Dr. Radix highlighted in particular that transgender individuals remain under-represented in research studies, which can lead to unintended consequences, such as not being aware of potential contraindications for people who are also taking hormone therapy.

Presenter PowerPoint presentations are available on the Adherence 2020 Virtual archive page, and presentation and panel discussion videos from the conference are available on IAPAC’s YouTube channel.

COVID-19 Disruptions in HIV Services Highlighted During 90-90-90 Targets Update

COVID-19-Related Disruptions in HIV Services

Highlighted during 90-90-90 Targets Update

WASHINGTON, DC, USA (July 1, 2020) – Representatives from the US President’s Emergency Plan for AIDS Relief (PEPFAR), Joint United Nations Programme on HIV/AIDS (UNAIDS), World Health Organization (WHO), and International Association of Providers of AIDS Care (IAPAC) expressed concern today about COVID-19-related disruptions in the continuity of HIV services. They spoke during a session at the sixth annual 90-90-90 Targets Update, which IAPAC co-hosted with UNAIDS and the International Treatment Preparedness Coalition (ITPC) on June 30-July 1, 2020, as an AIDS 2020 Virtual pre-conference. The session was entitled, “Lost Time: Recovering from COVID-19’s Impact on the Global HIV Response.”

IAPAC President/CEO Dr. José M. Zuniga presented data from a survey of more than 500 clinicians treating people living with HIV (PLHIV). In addition to quantifying that 53% of respondents are managing patients with SARS-CoV-2 infection, the survey revealed COVID-19-related disruptions in access to HIV services, including antibody testing (35%), antiretroviral therapy (ART) initiation (29%), and pre-exposure prophylaxis (PrEP) initiation (31%). Similarly, Dr. Meg Doherty, Director of the WHO’s Department of Global HIV, Hepatitis, and STI Programs, cited data from a survey of 99 countries reporting partial or complete disruptions across 25 different health services, including continuation of established ART (32%), tuberculosis case detection and treatment (42%), and treatment of mental health disorders (61%).

“Any disruption to HIV and health services can turn a local crisis into a humanitarian catastrophe, which we are all trying to avoid,” said Dr. Zuniga. “The global HIV community is focused on leveraging innovation, facilitating community engagement, and prioritizing human rights to mitigate potential harm to people living with and affected by HIV. Sustained access to quality health services is vital to ending the HIV and COVID-19 pandemics.”

Differentiated service delivery, multi-month drug dispensing, and telemedicine platforms were among the innovations cited by Dr. Angeli Achrekar, Principal Deputy US Global AIDS Coordinator, during a presentation about PEPFAR’s efforts to maintain the continuity of HIV services in more than 50 countries. In addition to echoing the need for innovation in the context of COVID-19, Dr. Shannon Hader, UNAIDS’s Deputy Executive Director, Programs, stressed the importance of applying lessons from the global HIV response, notably protecting human rights and facilitating community engagement, including by utilizing community organizations as essential service providers.

The 90-90-90 Targets Update, which was made possible through support from Gilead Sciences and ViiV Healthcare, also featured seven other sessions, including separate sessions focused on national and municipal progress towards achieving the UNAIDS 90-90-90 targets. Launched in 2014, the programmatic targets call for 90% of PLHIV to know their status, 90% of PLHIV who know their status to access ART, and 90% of PLHIV on ART to achieve viral suppression.

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About the International Association of Providers of AIDS Care (IAPAC)

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030.

IAPAC Retrofits Fast-Track Cities Dashboards to Visualize COVID-19 Data and Resources

IAPAC Retrofits Fast-Track Cities Dashboards to Visualize COVID-19 Data and Resources

WASHINGTON, DC, USA (April 20, 2020) – The International Association of Providers of AIDS Care (IAPAC), in partnership with Dure Technologies and the Fast-Track Cities Institute, is retrofitting its Fast-Track City dashboards to visualize confirmed COVID-19 case, death, and recovery data alongside existing municipal-level HIV data the dashboards have visualized since 2015. In addition to the COVID-19 data, the retrofitted dashboards will map COVID-19-related services and illustrate COVID-19 data trends.

The first two retrofitted Fast-Track City dashboards launched today are for the cities of London and New York City. Additional retrofitted dashboards will be launched later this week, available via the Fast-Track Cities Global Web Portal. Following are links to the London and New York City dashboards:

London: http://www.fast-trackcities.org/cities/london-covid
New York City: http://www.fast-trackcities.org/cities/new-york-covid

“The COVID-19 pandemic is disrupting health systems in urban centers and its impact can be measured in lives endangered and too many lives tragically lost,” said IAPAC President/CEO Dr. José M. Zuniga, who is Chair of the Fast-Track Cities Institute. “By retrofitting city dashboards, we remain true to a central tenet of the Fast-Track Cities initiative: data-driven action. Visualizing a city’s COVID-19 data reinforces local public health measures to mitigate new SARS-CoV-2 infections. Mapping COVID-19-related services is also public service to complement efforts by local health departments to communicate critical public health resources and other information.”

“We are proud to partner with IAPAC and the Fast-Track Cities Institute to leverage Fast-Track Cities dashboards to serve the public good at a time of suffering caused by the burgeoning COVID-19 pandemic,” said Vipin Yadav, CEO of Dure Technologies, the Fast-Track Cities initiative’s IT partner. “While we hope local COVID-19 epidemics subside in the near future, we believe cutting-edge technology is key to advancing public health initiatives. We are prepared to continue delivering this public service to Fast-Track Cities for the foreseeable future.”

COVID-19 and HIV, TB, and Viral Hepatitis Education

While there are not enough data today to determine whether people living with HIV are at increased risk of SARS-CoV-2 infection, people who have underlying conditions, including infectious diseases, are at greater potential risk of severe complications from COVID-19. Moreover, preliminary results of an IAPAC survey of HIV-treating clinicians indicate disruptions in prevention, care, treatment, and psychosocial services being delivered to people living with and at-risk for HIV. The Fast-Track Cities initiative, through IAPAC, is coordinating a series of educational webinars to educate clinicians and allied healthcare providers in Fast-Track Cities about evidence-based recommendations for managing COVID-19 for people living with HIV, tuberculosis (TB), and/or viral hepatitis.

Following the postponement of its planned Adherence 2020 conference in June 2020 due to COVID-19-related restrictive measures, IAPAC will also host a virtual Adherence 2020 pre-conference from 12-5 pm ET, May 6, 2020, focused on the “Continuity of HIV Care in the Presence of COVID-19.” Moderated by Dr. Zuniga with welcome remarks by Dr. Shannon Hader, Deputy Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), the pre-conference will feature from clinician and community experts. To register online or for more information about the pre-conference, visit: https://www.iapac.org/conferences/adherence-2020-virtual-pre-conference/

Additionally, IAPAC is maintaining a repository of regularly updated evidence-based COVID-19 resources and recommendations, which can be accessed on the IAPAC website at: https://www.iapac.org/hiv-covid-19/

Fast-Track City Dashboards

Since 2015, IAPAC has developed city dashboards through support from multiple grantors, including the AIDS Healthcare Foundation, MAC AIDS Fund, Merck & Co., President’s Emergency Plan for AIDS Relief (PEPFAR), US Agency for International Development (USAID), and ViiV Healthcare.

About Fast-Track Cities

Fast-Track Cities is a network of more than 300 cities and municipalities striving to their end urban HIV, TB, and viral hepatitis epidemics by 2030.

About the International Association of Providers of AIDS Care

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030. IAPAC is also a core technical partner of the Fast-Track Cities initiative and serves as the Secretariat for the Fast-Track Cities Institute.

IAPAC Announces Fast-Track Cities Implementation Science Fund

IAPAC Announces Fast-Track Cities Implementation Science Fund

ViiV Healthcare and Gilead Sciences Support Fund with Combined $750,000 Contribution to Support Implementation Science Studies in Fast-Track Cities

WASHINGTON, DC, USA (April 28, 2020) – The International Association of Providers of AIDS Care (IAPAC) announced the launch of a Fast-Track Cities Implementation Science Fund today to support clinical and community researchers to conduct studies aimed at identifying optimally effective interventions, policies, and strategies that enhance urban HIV responses. The first round of study grants will be supported by a combined $750,000 investment by ViiV Healthcare and Gilead Sciences, which will be managed by IAPAC in coordination with an international Expert Advisory Committee.

In making the announcement, IAPAC President/CEO Dr. José M. Zuniga noted that the rational allocation of limited human and financial resources requires new insights to guide clinical, public health, and financial decision-making among Fast-Track Cities in pursuit of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets.

He indicated the scientific field in which these types of questions are best asked and answered is implementation science, which aims to investigate barriers to the effective implementation of evidence-based interventions for public health impact and to test new approaches to implementing these interventions.

“IAPAC is proud to launch the Fast-Track Cities Implementation Science Fund, with initial support from ViiV Healthcare and Gilead Sciences, as a vehicle to inform local decision-makers to implement interventions, policies, and strategies that can improve HIV prevention and treatment outcomes within urban HIV responses,” said Dr. Zuniga. “The funded studies will examine implementation gaps relevant to optimizing HIV care and prevention continua, without which Fast-Track Cities cannot attain and exceed the UNAIDS 90-90-90 targets on a trajectory towards getting to zero new HIV infections and zero AIDS-related deaths.”

“The incredible progress made in treating and preventing HIV over the past 30 years has saved millions of lives and provided us with the tools needed to end the epidemic. However, without the effective implementation of HIV health services that take into account real-world challenges to ensure all individuals are tested, treated and cared for, our best efforts to end the epidemic will not be successful. ViiV Healthcare is proud to support IAPAC as part of our pioneering commitment to implementation science to bridge the gaps between HIV research and clinical practice,” said Dr. Maggie Czarnogorski, Director of Implementation Science at ViiV Healthcare.

“Gilead is pleased to support IAPAC with the launch of a Fast-Track Cities Implementation Science Fund. We know that it takes more than medicines to address the challenges of HIV/AIDS and are committed to supporting implementation science. The resources will address critical gaps, disparities and stigma to help identify the best interventions for Fast-Track Cities to attain and exceed the UNAIDS 90-90-90 targets,” said Mr. Korab Zuka, Vice President of Public Affairs at Gilead Sciences.

The Fast-Track Cities Implementation Science Fund will prioritize the following gaps for study: 1) finding and testing HIV unawares; 2) improving linkage to HIV prevention, care, and support services; 3) promoting the prompt initiation of and adherence to antiretroviral therapy; 4) maximizing retention and long-term engagement in HIV care; 5) improving health-related quality of life and quality of care; 6) addressing disparities in access to/utilization of HIV prevention and care services; 7) optimizing care for unique populations, including children, adolescents and elderly people living with HIV; 8) eliminating stigma and discrimination, notably within health settings; and 9) accelerating uptake of innovative policies and programs, as well as new diagnostics, medicines, and technologies.

The Fast-Track Cities Implementation Science Fund’s international Expert Advisory Committee is comprised of implementation science experts and community researchers. They are tasked with establishing study criteria, reviewing/approving study proposals, and analyzing/translating study results for dissemination across the Fast-Track Cities network. The Expert Advisory Committee is expected to approve Letter of Interest (LOI) guidance that will be made available to interested applicants at www.iapac.org in early May 2020.

About Fast-Track Cities
Fast-Track Cities is a network of more than 300 cities and municipalities striving to their end urban HIV, TB, and viral hepatitis epidemics by 2030.

About the International Association of Providers of AIDS Care
With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030. IAPAC is also a core technical partner of the Fast-Track Cities initiative.

IAPAC, UN-Habitat Partner to End Urban HIV, TB, HCV Epidemics

IAPAC, UN-Habitat Partner to End Urban HIV, TB, HCV Epidemics

Memorandum of Understanding Signed at 10^th World Urban Forum

ABU DHABI, United Arab Emirates (February 12, 2020) – The International Association of Providers of AIDS Care (IAPAC) and the United Nations Programme on Human Settlements (UN-Habitat) announced a new partnership today to strengthen the efforts of Fast-Track Cities to end their urban HIV, tuberculosis (TB), and viral hepatitis epidemics within the context of Sustainable Development Goal 11 (to make cities and human settlements inclusive, safe, resilient, and sustainable). Today’s announcement coincided with the signing of a Memorandum of Understanding (MoU) between IAPAC and UN-Habitat at the 10^thWorld Urban Forum.

“Addressing the need for people to live in cities that are inclusive, safe, resilient, and sustainable is essential to ending the HIV, TB, and viral epidemics.” said Dr. José M. Zuniga, IAPAC President/CEO, who signed the MoU today alongside Mr. Victor Kisob, Deputy Executive Director of UN-Habitat. “Through this partnership with UN-Habitat we embark on a ‘Decade of Action’ to make the Sustainable Development Goals a reality within the context of the Paris Declaration on Fast-Track Cities and the New Urban Agenda.”

By signing the MoU, IAPAC and UN-Habitat agree to engage in joint advocacy and best practice-sharing among Fast-Track Cities regarding the health-related priorities in the New Urban Agenda, which was adopted at the UN Conference on Housing and Sustainable Urban Development (Habitat III) in Quito, Ecuador, in 2016, and endorsed by the UN General Assembly that same year. The New Urban Agenda outlines global principles, policies, and standards required to achieve sustainable urban development. The IAPAC and UN-Habitat partnership will also prioritize the collection and dissemination of programmatic and other data to enhance public health interventions.

“Thriving cities must be healthy cities and this collaboration with IAPAC brings on board experts from the two agencies to address a core issue of getting cities on that last mile towards ending their HIV epidemics. Cities must have the knowledge, technology, data, and funding that can ensure that no one and no community is left behind,” said Mr. Victor Kisob.

The 10^th World Urban Forum is convened by UN-Habitat to promote sustainable urban development. This year’s forum theme is “Cities of Opportunities: Connecting Culture and Innovation.”

About the International Association of Providers of AIDS Care

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030.

About UN-Habitat

UN-Habitat is the United Nations programme working towards a better urban future. Its mission is to promote socially and environmentally sustainable and inclusive human settlements development and the achievement of adequate shelter for all.

About Fast-Track Cities

Fast-Track Cities is a network of more than 300 cities and municipalities striving to their end urban HIV, TB, and viral hepatitis epidemics by 2030.

NYC and Geneva Surpass UNAIDS 90-90-90 HIV Targets

NYC and Geneva Surpass UNAIDS 90-90-90 HIV Targets
Fast-Track Cities Release New HIV Testing and Treatment Data

Washington, DC, USA (December 2, 2019) – Health officials in New York City, NY, USA, and the Canton of Geneva, Switzerland, announced today that these two cities have surpassed the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets. The Paris Declaration on Fast-Track Cities calls for attaining and surpassing the targets, which translate into 90% of people living with HIV (PLHIV) knowing their status, 90% of PLHIV who know their status accessing antiretroviral therapy (ART), and 90% of PLHIV on ART achieving viral suppression.

New York City, which became a Fast-Track City in 2016, is the first Fast-Track City in the United States to surpass the 90-90-90 targets by attaining 93-90-92. By attaining 90-96-93, the Canton of Geneva becomes the fifth European municipality to reach this important milestone, joining the cities of Amsterdam, Netherlands; Brighton, UK; London, UK; and Manchester, UK. The Canton of Geneva was among the 26 initial cities and municipalities to join the Fast-Track Cities network in 2014.

“The attainment of these global programmatic targets by New York City and the Canton of Geneva marks a momentous milestone on any Fast-Track City’s journey towards ending its HIV epidemic,” said IAPAC President/CEO Dr. José M. Zuniga. “We congratulate the political and public health leaders, clinicians and services providers, and community members who have made these achievements possible. We also encourage their ongoing efforts to get to zero new HIV infections, zero AIDS-related deaths, and zero stigma by 2030.”

As a core partner of the Fast-Track Cities initiative, IAPAC today launched new interactive data dashboards made possible through support from the US Agency for International Development (USAID) and ViiV Healthcare. The dashboards illustrate baseline 90-90-90 data for eight Fast-Track Cities:

Fast-Track City (2018 data)	Know Status	On ART	Virally Suppressed
Columbia, SC, USA	84%	N/A*	85%
Fulton County (Atlanta), GA, USA	84%	87%	82%
Jefferson County (Birmingham), AL, USA	84%	76%	83%
Kampala, Uganda	59%	98%	93%
Lagos, Nigeria	66%	99%	84%
Washington, DC, USA	87%	78%	85%
Windhoek, Namibia	85%	89%	73%
Yaoundé, Cameroon	74%	87%	N/A*

*N/A: Data are not currently generated

“Fast-Track Cities can only accelerate their HIV responses to achieve the 90-90-90 targets if they know their local epidemics – notably the gaps across the HIV care continuum,” said Dr. Zuniga. “That is why data-driven, equity-based HIV responses are at the heart of ending urban HIV epidemics by 2030, and a priority for technical assistance to Fast-Track Cities.”

These eight municipalities whose data dashboards were launched today are among a total of 42 Fast-Track Cities that are reporting new or updated 90-90-90 data this year. Several of these cities and municipalities have reported significant progress since the year they reported their baseline data, including:

Bangkok, Thailand, which went from 79-57-79 (2016) to 92-78-76 (2018);
Kyiv, Ukraine, which went from 51-44-85 (2015) to 73-73-96 (2018); and
Nairobi County, Kenya, which went from 77-96-55 (2016) to 79-99-92 (2018).

“The progress made in Bangkok, Kyiv, and Nairobi County is a testament to prioritizing programs and resources towards leaving no woman, man, or child behind, which includes addressing health inequalities,” said Dr. Zuniga. “Kyiv’s progress, for example, demonstrates that even in a city resisting strong epidemiological headwinds faced by other cities in Eastern Europe, our calculus for success – political commitment, public health innovation, and the meaningful engagement of affected communities – is working.”

Following is a full list of cities and municipalities that have reported new or updated 90-90-90 data during 2019:

NORTH AMERICA

Atlanta (Fulton County), GA, USA (2018): 84-87-82
Austin, TX, USA (2016): 100-80-72
Columbia, SC, USA (2018): 84-N/A*-75
Denver, CO, USA (2018): 87-N/A*-90
Birmingham (Jefferson County), AL, USA (2018): 84-76-83
Minneapolis, MN, USA (2017): 88-72-88
New Orleans, LA, USA (2018): 87-75-89
New York City, NY, USA (2018): 93-90-92
Phoenix, AZ, USA (2017): 87-58-99
Providence, RI, USA (2017): 91-79-91
San Antonio (Bexar County), TX, USA (2018): 81-72-87
San Francisco, CA, USA (2017): 94-79-94
Washington, DC, USA (2018): 87-78-85

LATIN AMERICA/CARIBBEAN

Kingston/St. Andrew, Jamaica (2018): 93-53-66
Salvador de Bahia, Brazil (2017): 58-78-91
São Paulo, Brazil (2018): 87-72-95

SUB-SAHARAN AFRICA

Dar es Salaam, Tanzania (2018): 77-98-N/A*
eThekwini, South Africa (2018): 91-77-93
Johannesburg, South Africa (April-June 2019): 86-65-85
Kampala, Uganda (2018): 59-98-93
Kigali, Rwanda (2018): 91-94-89
Kinshasa, Democratic Republic of the Congo (2018): 74-56-54
Lagos, Nigeria (2018): 66-99-84
Lubumbashi, Democratic Republic of the Congo (2018): 65-92-23
Nairobi County, Kenya (2018): 79-99-92
Windhoek, Namibia (2018): 85-89-73
Yaoundé, Cameroon (2018): 74-87-N/A*

ASIA-PACIFIC

Almaty, Kazakhstan (2018): 84-80-70
Bangkok, Thailand (2018): 92-78-76
Taipei, Taiwan (2018): 80-92-96
Quezon City, Philippines (2018): 76-66-17

WESTERN, CENTRAL, EASTERN EUROPE

Amsterdam, Netherlands (2018): 95-94-96
Berlin, Germany (2018): 89-93-95
Brighton, UK (2017): 93-99-99
Canton of Geneva, Switzerland (2017): 90-96-93
Kyiv, Ukraine (2018): 73-73-96
London, UK (2018): 95-98-97
Manchester, UK (2017): 91-97-94
Milan, Italy (2017): N/A*-96-90
Odesa, Ukraine (2018): 70-56-92
Paris, France (2018): 88-96-94
Seville, Spain (2018): 85-98-95

*N/A: Data are not currently generated

Fast-Track Cities data are maintained and updated online at http://fast-trackcities.org.

About Fast-Track Cities

Fast-Track Cities is a global partnership between almost 300 cities and municipalities, the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. The partnership’s aim is to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. The initiative was launched on World AIDS Day 2014 in Paris.

About the International Association of Providers of AIDS Care (IAPAC)

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030. Please visit www.iapac.org for more information about IAPAC’s activities.

IAPAC Welcomes Winnie Byanyima as New UNAIDS Executive Director

IAPAC Welcomes Winnie Byanyima as New UNAIDS Executive Director

Statement by Dr. José M. Zuniga
President/Chief Executive Officer, IAPAC
August 14, 2019 – Washington, DC, USA

On behalf of the International Association of Providers of AIDS Care (IAPAC), I welcome UN Secretary-General António Gutteres’ appointment of Winnie Byanyima to serve as the next Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). We call on her to leverage our forward momentum and work with and through UNAIDS’ many partners to expand upon local, national, and regional HIV responses for the benefit of every person living with and affected by HIV.

We are at a pivotal juncture in the global effort to stem the tide of new HIV infections and end AIDS-related deaths. The benefits of so much progress have not been shared universally, leaving significant numbers of people without access to life-saving treatment that can also prevent HIV transmission. All of us have a duty to ensure that no one is left behind in the global HIV response. We must sustain political commitment, avoid complacency, eliminate persistent HIV-related stigma, and maintain investments in data-driven and equity-based interventions. Ms. Byanyima enters her new role with a proven record of leadership on the global level and a fresh perspective that will serve UNAIDS well as we prepare to enter the fifth and hopefully final decade of the HIV epidemic.

We stand ready to strengthen our longstanding partnership with UNAIDS, including our 5-year collaboration with a growing network of more than 300 Fast-Track Cities that are working in solidarity to end their urban HIV epidemics. We also pledge to support Ms. Byanyima and the superb team of advocates and technicians that make up the global UNAIDS family, because our collective successes will save lives and ultimately lead to the end of the HIV epidemic.

# # #

With more than 30,000 members globally, IAPAC is the largest association of clinicians and allied health professionals working to end AIDS as a public health threat by 2030. For more information about IAPAC and our global activities, visit: https://www.iapac.org/

Four Irish Cities Join Fast-Track Cities to Form Fast-Track Ireland

Four Irish Cities Join Fast-Track Cities to Form “Fast-Track Ireland”

Ireland joins HIV initiative — Prime Minister Leo Varadkar met with the *Paris Declaration* signatories in Dublin

June 14, 2019 — Irish Prime Minister Leo Varadkar applauded the cities of Cork, Dublin, Galway, and Limerick for signing the Paris Declaration on Fast-Track Cities today in a country-wide effort to address the HIV epidemic. Ireland’s Minister for Health Simon Harris and Minister for Health Promotion Catherine Byrne attended a signing ceremony in Dublin, along with IAPAC President/CEO Dr. José M. Zuniga, HSE National Director of Health and Wellbeing Dr. Stephanie O’Keefe, and officials and community representatives from each city.

“The Government wants to reduce the number of people who contract HIV,” said Irish Prime Minister Leo Varadkar. “We want to make it easier for people to get tested and know their status, as people who know their status get treated and are far less likely to pass it on. I am really pleased that Ireland is joining forces with other cities and partners around the world in this global initiative to fight HIV. Collaborating in this way will help us to identify and share best practices.”

More than 300 municipalities have now joined the Fast-Track Cities network in pursuit of international programmatic targets related to HIV testing, treatment, and prevention. The network promotes collaboration between local elected officials, community organizations, clinical and service providers, and people living with HIV to optimize HIV prevention and care continua by using data-driven strategies to ensure no one is left behind in urban and national HIV responses.

“IAPAC welcomes the Irish cities of Cork, Dublin, Galway, and Limerick to the Fast-Track Cities network, and we applaud the political commitment made by their Mayors, in partnership with affected communities, to work towards ending their local HIV epidemics,” said Dr. Zuniga. “We also applaud the Department of Health’s investment towards Fast-Track Ireland activities – an investment that is ‘wind in the sails’ for ambitious plans to scale-up HIV testing, linkage to preventative and therapeutic care, and eliminate the barrier that AIDS-related stigma continues to represent almost four decades into the global HIV epidemic.”

The Government of Ireland announced that it will also allocate an additional €450,000 in funding for HIV testing, treatment, prevention programs. These four Irish cities will work together along with Healthy Ireland and the Healthy City and Counties program to reach the targets that have been set by the Fast-Track Cities initiative. The Paris Declaration on Fast-Track Cities was launched on World AIDS Day in 2014 with IAPAC, the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris as the core partners.

“Sexual health is one of our key priorities under Healthy Ireland and reducing the number of new HIV diagnoses in Ireland is a priority focus for me,” said Ireland’s Health Minister Simon Harris. The new funding also includes support for increased access to preventative PrEP medication and a public awareness campaign about the negative impacts of HIV-related stigma.

Representatives of community organizations in each of the four cities also signed the Paris Declaration today, including HIV Ireland (Dublin), AIDS West (Galway), GOSHH (Limerick), and Sexual Health Centre Cork. Each of these community partners are promoting HIV testing as part of their efforts to respond to Ireland’s HIV epidemic.

IAPAC, CITY OF AMSTERDAM ANNOUNCE FAST-TRACK CITIES 2023 CONFERENCE

Last updated July 25, 2023

Last updated May 19, 2023

Fact Sheet: HHS Provides Resources on Ways Communities Can Stay Protected from Mpox in Advance of Summer Months:

Updated May 16

Potential Risk for New Mpox Cases

Updated May 12, 2023

Update February 28, 2023

Update February 17 2023

Fourth meeting of the WHO International Health Regulations Emergency Committee on mpox

Updated January 31

Decline in Mpox Cases

Syndemics and Mpox

The Way-Forward

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Monkeypox and HIV

New Study Documents the Frequent Detection of Monkeypox Virus DNA in Saliva, Semen, and other Clinical Samples

IAPAC AND CITY OF SEVILLA ANNOUNCE FAST-TRACK CITIES 2022

European Fast-Track Cities Mayors

Declare Support for Ukraine

An interview with IAPAC’s President/CEO, Dr. José M. Zuniga

What are your thoughts about the humanitarian crisis precipitated by the Russian Federation’s military assault on Ukraine?

What has been learned to date from the public health response in Ukraine and about the importance of networks of affected communities in disaster situations?

What are IAPAC and FTCI doing to respond to the needs of Ukrainians living with and affected by HIV? Both those in-country and those seeking refuge in other countries?

What can individuals do to stand in solidarity with and assist Ukrainians living with and affected by HIV?

What is your hope for the future of Ukraine and its communities affected by HIV?

IAPAC Announces Fast-Track Cities Progress on World AIDS Day and Initiative’s 7th Anniversary

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