Latest news with #JenniferHo
Scoop
17-06-2025
- Health
- Scoop
To Be Or Not To Be? Daily Oral Versus Long-Acting Injectable Medicines For HIV Prevention
Scientific research has gifted us with a range of evidence-based options to protect ourselves from getting infected with HIV. In 2012, US FDA had first approved Pre-Exposure Prophylaxis (PrEP) daily oral medicines for HIV prevention. More recently, long-acting injectable options of PrEP are also approved. We at CNS listened to the experts on both of these PrEP options so that we can make an informed choice. A lively debate was organised at the recently concluded 10th Asia Pacific AIDS and Co-Infections Conference (APACC 2025) in Tokyo, Japan, on "Should Long-Acting Injectables (LAIs) Replace Oral Antiretrovirals for Biomedical HIV Prevention in the Asia-Pacific Region?" Also, 13th International AIDS Society Conference on HIV Science (IAS 2025) and 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases (POC25) will open soon. Arguments in favour of long-acting injectable PrEP dwelt upon the current dismally low use of oral PrEP in the Asia Pacific Region - as of end 2023, around 204,000 individuals were actively using PrEP - just 2% of the 8.2 million target set for 2025. Also a significant number of individuals discontinue PrEP within a relatively short period of time after initiation. For example, in Thailand, a programme serving over half of all PrEP users, saw 47% of clients discontinuing within 12 months, according to the Institute of HIV Research and Innovation (IHRI). "I don't fear the side effects. I fear the side eyes" Varied reasons were put forward by debater Jennifer Ho, a global health advocate from Thailand, included "Oral PrEP is not reaching those most at risk. Transgender women navigating stigma in clinics, sex workers who cannot safely carry pills; men who have sex with men and young men hiding their PrEP from family; persons who use drugs facing criminalisation - all of these find it difficult to take daily oral PrEP. Pill shaming keeps people from starting or leads them to quietly stop, because of 'I don't fear the side effects. I fear the side eyes.' On the other hand, long-acting injectables remove structural and behavioural barriers and can reach people outside formal systems. We need prevention tools that meet people's needs. Prevention works when it does not depend upon disclosure, disability or perfect routine. Oral PrEP stigmatises life because you have to take a pill daily. Long-acting injectables are discreet, there is no daily pill to remember, there is no need to hide. Long-acting injectables are a prevention strategy that is realistic, respectful and responsive." Dr Nagalingeswaran Kumarasamy, a well known infectious disease expert from India gave a doctor's perspective on the necessity of long-acting injectable PrEP. He serves as Chief and Director of Infectious Diseases Medical Centre at Voluntary Health Services Hospital in Chennai, India. He is also the Secretary General of AIDS Society of India (ASI) - a nationwide network of medical experts and researchers on HIV, co-infections and co-morbidities. Dr Kumarasamy said that daily PrEP pill is not a suitable or desirable prevention strategy for everyone. We need more options as well as expanded access or use by key populations (people who are at a heightened risk of HIV). Long-acting PrEP will likely be a very cost-effective improvement over standard PrEP but may require novel financing mechanisms that bring short-term fiscal planning efforts into closer alignment with longer-term societal objectives. Cost effectiveness is different from cost of sale. Long-acting injectables will be cost effective in the long run. It is too much to expect daily adherence from people who are not sick. Also studies have found that long-acting injectables like cabotagravir and lenacapavir to be superior to oral PrEP. It is not about 'either/or' but expanding options for HIV prevention While conceding that long-acting injectable PrEP is promising, Danvic Rosadiño, Co-Chair, WHO Guidelines Development Group on Long-acting Injectable Cabotegravir for HIV Prevention, firmly argued that replacing oral PrEP is premature, impractical and inequitable. Danvic heads programmes and innovations at LoveYourself in the Philippines. "It is not a question of 'either', 'or'. It is about expanding options, and not eliminating them. In a socially, economically and politically diverse region like the Asia Pacific, this will risk undermining progress. The three core reasons why oral PrEP should not be replaced is cost, convenience and confidence," he said. "Long-acting injectable PrEP is far more expensive than generic oral PrEP. How many governments of this region will be able to afford long-acting injectables? If we replace oral PrEP, we will be leaving the most vulnerable behind. We have been able to roll out PrEP in a very de-medicalised manner. We have built our systems which allow oral PrEP to be accessed in community clinics, in mobile clinics, in peer outreach facilities. It is easy, discreet and empowering, especially for those avoiding judgmental or stigmatising healthcare settings. However long-acting injectables might bring us to clinical dependence, and many of our clients do not feel welcome in clinical facilities. We set up communities for giving oral PrEP because the mainstream system was not built for us. It excluded and stigmatised the community. We have created alternate spaces where people could feel safe, respected and seen not just as patients but as people. If we shift HIV prevention back to clinical systems, we risk destroying those safe spaces. Long-acting injectables might require clients to go back to those places which they actively avoided. Granted that long-acting injectables are very promising, replacing oral PrEP with them would create barriers and not bridges. We must protect choice. Different people need different things-some will prefer pills, some will prefer injectables. Let us invest in building a system where these options co-exist and where everyone- no matter where they live - can access HIV prevention that works for them," said Danvic. Do not forget stigma, inequity and costs Dr Rayner Kay Jin Tan, an Assistant Professor at the Saw Swee Hock School of Public Health, National University of Singapore, supported Danvic. He opined that 'Stigma, inequity and costs are very important considerations when we think about PrEP and other HIV prevention products. Keeping these things in mind, we should not replace oral PrEP with long-acting injectables. Oral PrEP has been de-medicalised to a large extent and distribution is community driven, thus bringing access to communities. And the cost of long-acting injectables is still not known. No generic manufacturer has given any idea of what it would cost. And most of the HIV infections are in countries that will not be able to meet the high cost of long-acting injectables. Except for Australia, no other countries in the Asia-Pacific have approved any long-acting injectable PrEP. However, both sides agreed that not everyone needs the same prevention options, but everyone deserves what works best for them. Speed, scale, implementation, and equity must be at the core of translating exciting scientific tools into public health impact. Give real choices to people to choose from full range of HIV combination prevention options It is now for the readers to decide which premise do they support- long-acting injectables or daily oral PrEP -till science develops more exciting HIV prevention tools. And above all, expanding the range of prevention options to protect ourselves from HIV should always remain the mainstay - and trusting people to have real choices if all combination prevention options are offered to them. Oral PrEP or pre-exposure prophylaxis is an HIV medicine taken daily by HIV negative individuals that reduces their risk of acquiring HIV through sex by about 99% and from injection drug use by at least 74%. PrEP should be used with condoms when possible. There are newer approved PrEP options that also protect us against few STIs, like Doxy PrEP (which provides reasonable protection against getting infected with STIs like syphilis, chlamydia, and gonorrhoea). Know more about long-acting injectable PrEP Since 2022, one of the long-acting injectable PrEP has a medicine called cabotegravir which has shown high efficacy in protecting us from HIV. It involves injections administered intramuscularly, with the first two injections given four weeks apart, followed thereafter by an injection every 8 weeks. Studies have shown it to be safe and superior to daily oral PrEP (which uses medicines like tenofovir and emtricitabine) for HIV prevention among cisgender women, cisgender men who have sex with men, and transgender women who have sex with men. It offers a promising alternative to daily oral PrEP, particularly for individuals who may face challenges with adherence to daily medication. It was recommended by the WHO in 2022 as an additional HIV prevention option for people at substantial risk of HIV infection. However, its current high cost of US$ 22,000 per year per user jeopardises its potential for public health benefits. In July 2022, its manufacturer ViiV Healthcare announced a voluntary license with the Medicines Patent Pool, allowing 90 countries to buy generic versions of cabotegravir for HIV prevention. The cost of generic version is expected to be potentially around US$ 16-34 per person per year. However, generic versions will not be out before 2027. Long-acting Lenacapavir Long-acting lenacapavir PrEP given as a subcutaneous injection once every 6 months, has been found to be highly effective. In 2024, two landmark clinical studies- PURPOSE 1 and PURPOSE 2- showed it to be 100% efficacious in preventing HIV among cisgender women and 96% efficacious among men who have sex with men, transgender and gender non-binary individuals, and was found superior to oral PrEP. It is currently priced at US$ 42,250 per year per person in the US, but is expected to become much more affordable to around US$ 200-300 per year per person with the introduction of generic versions, that are expected to be available by 2027. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights).
Japan Today
18-05-2025
- General
- Japan Today
How Asian American became a racial grouping – and why many with Asian roots don't identify with the term these days
By Jennifer Ho For the first time, in 1990, May was officially designated as a month honoring Asian American and Pacific Islander heritage. Though the current U.S. administration recently withdrew federal recognition, the month continues to be celebrated by a wide array of people from diverse cultural backgrounds. People from the Pacific Islands have their own distinct histories and issues, delineated in part by a specific geography. Yet when we refer to the even broader category of Asian Americans, a concept with a deep yet often unknown history, who exactly are we referring to? There are nearly 25 million people of Asian descent who live in the United States, but the term Asian American remains shrouded by cultural misunderstanding and contested as a term among Asians themselves. As a professor of Asian American studies, I believe it is important to understand how the label came into being. A long history of Asian people in America The arrival of people from Asia to the U.S. long predates the country's founding in 1776. After visits to modern-day America that began in the late 16th century, Filipino sailors formed – as early as 1763 – what is believed to be the first Asian settlement in St. Malo, Louisiana. But it wasn't until the 1849 California Gold Rush that Asian immigration to the U.S. – from China – began on a mass scale. That was bolstered in the 1860s by Chinese laborers recruited to build the western portion of the Transcontinental Railroad. Starting toward the end of the 19th century, Japanese immigration steadily picked up, so that by 1910 the U.S. Census records a similar number for both communities – just over 70,000. Likewise, a small number of South Asian immigrants began arriving in the early 1900s. An exclusionary backlash Yet after coming to the U.S. in search of economic and political opportunities, Asian laborers in America were met by a surge of white nativist hostility and violence. That reaction was codified in civil society groups and government laws, such as the Chinese Exclusion Act in 1882. By 1924, federal law had expanded into a virtual ban on all Asian immigration, and through the first half of the 20th century, a multitude of anti-Asian laws targeted areas including naturalization, marriage and housing, among others. From the start, people from Asian countries in the U.S. were generally identified broadly with identifiers such as 'Oriental,' a common term at the time mostly for those from China, Japan and Korea. As more Asians came to the U.S, other terms were used to denigrate and demean these new immigrants, whose physical appearance, language and cultural norms were distinctly different from their Euro-American neighbors. 'Asian American' and the birth of a movement The desire to claim America was one of the drivers for activists in the 1960s to create the concept of Asian American that we know today. The movement began in the charged political context of anti-Vietnam War protests and the Civil Rights Movement for Black equality. Students of Asian heritage at San Francisco State University and the University of California, Berkeley were organizing for the establishment of ethnic studies classes, specifically those that centered on the histories of Asians in the U.S. Rejecting the term 'oriental' as too limiting and exotic, since oriental literally means 'from the East,' the student activists wanted a term of empowerment that would include the Filipino, Chinese, Korean and Japanese students at the heart of this organizing. Graduate students Emma Gee and Yuji Ichioka came up with 'Asian American' as a way to bring activists under one radical organizing umbrella, forming the Asian American Political Alliance in 1968. A contested term Today, the Asian American label has moved beyond its activist roots. The term might literally refer to anyone who traces their lineage from the whole of the Asian continent. This could include people from South Asian countries such as India, Pakistan or Sri Lanka to parts of West Asia like Syria, Lebanon or Iran. Yet not all people who identify as Asian actually use the words Asian American, since it is a term that flattens ethnic specificity and lumps together people with as disparate of backgrounds as Hmong or Bangladeshi, for example. A 2023 Pew Research Center survey of self-identified Asian adults living in the U.S. revealed that only 16% of people polled said they identified as 'Asian American,' with a majority – 52% – preferring ethnic Asian labels, either alone or in tandem with 'American.' Moreover, unlike the student activists who worked together through their shared Asian American identity, the majority of people of Asian descent living in the U.S. came after the 1965 Immigration Act was passed, which ended all prior anti-Asian immigration laws. This, combined with a subsequent wave of Asian immigration from parts of Asia not represented in the past – including Vietnam, Taiwan and Pakistan – means that most Asian Americans alive today are either immigrants or one generation removed from immigrants. As a largely immigrant and recently Americanized group, many Asians therefore may not relate to the struggles of an earlier history of Asians in the U.S. That may contribute to why many don't connect with the term 'Asian American.' Korean immigrants, for instance, may not see their history connected with third-generation Japanese Americans, particularly when considering their homelands have been in conflict for decades. For some, Asian American is too broad a term to capture the complexity of Asian-heritage Americans. Indeed, Asian Americans come from over 30 countries with different languages, diverse cultures, and histories that have often been in conflict with other Asian nations. Within such a broad grouping as 'Asian American,' a wide range of political, socioeconomic, religious and other differences emerge that greatly complicate this racial label. Even though the term remains contested, many Asians still see value in the concept. Much like the activists who first created the label in the 1960s, many believe it signifies a sense of solidarity and community among people who – despite their many differences – have been treated like outsiders to the American experience, regardless of how American their roots are. Jennifer Ho is Professor of Asian American Studies, University of Colorado Boulder. The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts. External Link © The Conversation
South China Morning Post
02-03-2025
- Entertainment
- South China Morning Post
Your perfect week: what to do in Hong Kong, March 2-8
Drink this Alibi – Wine Dine Be Social Alibi head mixologist Jennifer Ho (left) and digital marketing agency co-founder Carman Lee will be behind the bar on March 8. Photo: Alibi The bar at Cordis Hong Kong is marking International Women's Day with a series of guest shifts on March 8, featuring women from all walks of life. Using gin from woman-owned local distillery Two Moons, the line-up features a flight attendant, the founder of a women's entrepreneurship community, a spirits ambassador and bartenders, with 50 per cent of the proceeds from drink sales going to the YWCA. Advertisement Level 5, Cordis Hong Kong, 555 Shanghai Street, Mong Kok Try this Francophonie Festival French-Cantonese comic book artist Kei Lam will be among the exhibitors at the Francophonie Festival. Photo: Francophonie Festival The French language is celebrated in full at this year's Francophonie Festival, taking place from today to March 29. Featuring contributions from the French, Swiss, Belgian and Canadian communities, the programme brings together exhibitions, film screenings and panel discussions in French, English and Cantonese. A food fair, board games festival, football competition and comic book showcase are on the cards, too. For more details, visit Do this Le Petit Chef Le Petit Chef melds 3D projection mapping with a five-course meal. Photo: Le Petit Chef Combining 3D visual mapping with whimsical animations and a five-course menu, Le Petit Chef has arrived at Grand Hyatt Hong Kong. With 14 sessions taking place each week from Tuesday to Sunday, the show invites diners to follow the titular chef on his quest for the finest ingredients, which are transformed into dishes such as bouillabaisse, lobster en papillote and steak au poivre. Reservations are essential and can be made at Upper Level, Grand Hyatt Steakhouse, Grand Hyatt Hong Kong, 1 Harbour Road, Wan Chai See this LIV Golf Abraham Ancer on his way to victory in last year's Hong Kong LIV golf tournament. Photo: Dickson Lee
