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A unique in vivo electrical pulse generator to improve membrane permeability for drugs and simultaneously facilitate self-powered nano devices for nano drug delivery systems (NDDS) was identified. The use of an unsupported biological catalyst component of the power supply was aimed at the NDDS instead of a conventional membrane electrode assembly (MEA). Self-powered carriers of drugs and prodrugs with improved controlled release capability to target areas using substrate available in biological matrices such as glucose in blood is envisaged. The experimental application implemented prototype designed chambers allowing the entry of premixed precursors and low ohm resistance due the absence of diffusion layers and optimised open circuit voltage (OCV). This would also minimise poisoning and rupturing of the proton exchange membrane (PEM). The model uses the isothermal experimental design (37°C) parameter and the glucose is partly oxidised prior to entry and mostly oxidised at the surface of the proton exchange membrane (PEM). The experimental model used a residence time instead of the usual flow rate. The power was notably high for short periods due to the absence of carbon supported diffusion layers. The findings included low levels of glucose and glucose oxidase (GOx) are needed for OCV optimisation. ; We wish to acknowledge the financial assistance of the National Research Foundation (NRF) and the Stellenbosch University support staff; Institute of Solid State Physics, University of Latvia as the Center of Excellence has received funding from the European Union's Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART²

AbstractIntroductionRandomized clinical trials have demonstrated the efficacy of antiretroviral pre‐exposure prophylaxis (PrEP) in preventing HIV acquisition among men who have sex with men (MSM). However, limited research has examined initiation and adherence to PrEP among Black MSM (BMSM) in the United States (US) who are disproportionately represented among newly HIV infected and late to care individuals. This research reports on the HIV Prevention Trials Network 073 (HPTN 073) study aimed to examine PrEP initiation, utilization and adherence among Black MSM utilizing the theoretically principled, culturally informed and client‐centered care coordination (C4) model.MethodsThe HPTN 073 study enrolled and followed 226 HIV‐uninfected Black MSM in three US cities (Los Angeles, CA; Washington DC; and Chapel Hill, NC) from February 2013 through September 2015. Study participants were offered once daily oral emtricitabine/tenofovir (FTC/TDF) PrEP combined with C4 and followed up for 52 weeks. Participants received HIV testing, risk reduction education and clinical monitoring.ResultsOf the 226 men enrolled, 178 participants initiated PrEP (79%), and of these 64% demonstrated PrEP utilization at week 26 (mid‐point of the study) based on pharmacokinetic testing. Condomless anal sex with an HIV‐infected or unknown status casual male partner was statistically significantly associated with a greater likelihood of PrEP initiation (adjusted odds ratio (OR) 4.4, 95% confidence interval (CI) 1.7, 11.7). Greater age (≥25 vs. <25, OR 2.95, 95% CI 1.37 –6.37), perception of having enough money (OR 3.6, 95% CI 1.7 to 7.7) and knowledge of male partner taking PrEP before sex (OR 2.22, 95% CI 1.03 to 4.79) were statistically significantly associated with increased likelihood of PrEP adherence at week 26. Annualized HIV incidence was 2.9 (95% CI 1.2 to 7.9) among those who initiated PrEP, compared to 7.7 (95% CI 2.5 to 24.1) among those who did not initiate PrEP (p = 0.18).ConclusionsResults suggest a high level of PrEP initiation among at‐risk Black MSM, a group historically characterized as hard to reach. The data support the importance of addressing contextual factors that affect PrEP initiation and adherence, and of additional research on the ultimate benefit of PrEP in HIV prevention among Black MSM.

AbstractIntroductionMen who have sex with men (MSM) and transgender women (TGW) in sub‐Saharan Africa (SSA) are profoundly affected by HIV with high HIV prevalence and incidence. This population also faces strong social stigma and legal barriers, potentially impeding participation in research. To date, few multi‐country longitudinal HIV research studies with MSM/TGW have been conducted in SSA. Primary objective of the HIV Prevention Trials Network (HPTN) 075 study was to assess feasibility of recruiting and retaining a multinational prospective cohort of MSM/TGW in SSA for HIV prevention research.MethodsHPTN 075, conducted from 2015 to 2017, was designed to enroll 400 MSM/TGW at four sites in SSA (100 per site: Kisumu, Kenya; Blantyre, Malawi; Cape Town, South Africa; and Soweto, South Africa). The number of HIV‐positive persons was capped at 20 per site; HIV‐positive persons already in care were excluded from participation. The one‐year study included five biobehavioural assessments. Community‐based input and risk mitigation protocols were included in study design and conduct.ResultsOf 624 persons screened, 401 were enrolled. One in five participants was classified as transgender. Main reasons for ineligibility included: (a) being HIV positive after the cap was reached (29.6%); (b) not reporting anal intercourse with a man in the preceding three months (20.6%); and (c) being HIV positive and already in care (17.5%). Five (1.2%) participants died during the study (unrelated to study participation). 92.9% of the eligible participants (368/396) completed the final study visit and 86.1% participated in all visits. The main, overlapping reasons for early termination included being (a) unable to adhere to the visit schedule, predominantly because of relocation (46.4%), and (b) unable to contact the participant (32.1%). Participants reported strong motivation to participate and few participation barriers. Four participants reported social harms (loss of confidentiality and sexual harassment by study staff) that were successfully addressed.ConclusionsHPTN 075 successfully enrolled a multinational sample of MSM/TGW in SSA in a prospective HIV prevention research study with a high retention rate and few documented social harms. This supports the feasibility of conducting large‐scale research trials in this population to address its urgent, unmet HIV prevention needs.