December 1, 2016
Dear MTN Friends and Family,
As 2016 draws to a close, I would like to share some updates on our work to develop new strategies for prevention of HIV in men and women, and to share with you some changes in MTN leadership.
Today, on World AIDS Day, the New England Journal of Medicine has published the results of both ASPIRE and The Ring Study, along with a commentary written by Adaora Adimora. As she notes, there is still much to be done in order to realize our dream of safe and effective HIV prevention for women everywhere.
We know that the dapivirine ring can offer women protection – provided that it is used consistently. With our open-label study, HOPE, now activated, we have been encouraged that women are enthusiastic about the opportunity to use the dapivirine ring. Both HOPE and the International Partnership for Microbicide’s open-label study, DREAM, will help us understand whether they will use the ring with higher adherence in the context of knowing that it can be effective with regular and consistent use and that there is no placebo.
But what about younger women? In both ASPIRE and the Ring Study, participants between 18 and 21 years of age were more likely to remove the ring, which may explain why they had no or limited protection from HIV. We have been working hard to prepare for the launch of a new study, MTN-034 (REACH), which will evaluate in an open-label crossover design both the ring and oral PrEP in young women ages 16-21. Four sites will be conducting REACH in South Africa, Zimbabwe and Kenya (Please welcome to our MTN family the Kisumu Clinical Research Site!) and we anticipate a Q3 2017 start. We also have plans to expand our portfolio of studies of the ring in lactating and pregnant women. One theme we have heard consistently in our discussions with young women is their desire for a single product that could provide contraception and HIV protection. To that end, our first study of a multipurpose ring containing both dapivirine and levonorgestrel is set to launch early next year.
As many of you know, Ian McGowan elected to step down as an MTN principal investigator to be with his husband, Ross Cranston, in Spain, where they have both relocated. I wanted to take this opportunity to thank him for his leadership and service to the MTN in helping to oversee both the day-to-day operations as well as a robust scientific agenda. Indeed, Ian has shared in these responsibilities from the very beginning, when we were first funded and established as a clinical trials network in 2006. While we wish him well, this is not good bye. Ian remains very much a part of the MTN family as director of the rectal microbicide research program, with two studies of dapivirine gel poised to begin in the coming months and two additional protocols with new product concepts currently in development. We remain fully committed to developing new options for men and women, whether they be rectal inserts or ARV-containing lubes.
Leading the MTN is a big job, and so it gives me great pleasure to formally announce that Jared Baeten, professor and vice-chair of global health at the University of Washington, is now MTN co-PI, effective today. Jared has played a pivotal role in making and advancing some of the field’s most important contributions, particularly with respect to oral PrEP and reproductive health. And we owe much of the success of the ASPIRE study to Jared, who as protocol chair was the team’s most avid cheerleader. Jared will remain HOPE protocol chair, with co-chairs Thesla Palanee-Phillips and Nyaradzo Mgodi also overseeing the study.
This year was also a sad one, with the death of our dear friend and colleague Ward Cates, who led the MTN work at FHI 360 from day one of the network. That said, we are pleased to announce Kristine Torjesen’s new role as MTN Leadership and Operations Center PI for FHI 360, and Lisa Levy as MTN associate director at FHI 360.
I hope many of you will join us at our MTN Annual Meeting March 20-22 in Washington DC. As a network, we can be proud of the progress we have made together and be excited about our path ahead. Each of us plays an important role, and while we may differ in more ways than one, we will continue to work with a singular purpose until December 1 no longer signifies World AIDS Day but merely another day in an AIDS-free world. I hope that you will continue to stand with us as we work toward that goal.
Sharon Hillier, Ph.D.