HIV Specialist - March 2021 - 5

USPSTF Members Release Statement on Addressing Systemic Racism
IN A REMARKABLE
EDITORIAL, Addressing
Systemic Racism Through
Clinical Preventive Service
Recommendations From
the US Preventive Services
Task Force, published in
JAMA, the members of the
U.S. Prevention Services Task Force (USPSTF)
observed that health services offering lifesaving
benefits are " not equitably available to Black,
Indigenous, and Hispanic/Latino people. " The
USPSTF is a volunteer body of prevention
and medical experts responsible for making
evidence-based recommendations regarding
clinical preventive services such as screenings,
counseling services and preventive medications.
The committee assigns a letter grade (A-D) to
these services. Under the Affordable Care Act
services with a recommendation of A or B must
be covered without cost sharing. For example,
the USPSTF gave an A recommendation that
people with high risk of HIV acquisition be
offered Pre-Exposure Prophylaxis (PrEP).
In the editorial, the USPSTF committed to

H

" identify when systemic racism contributes
to health inequities and to include evidencebased strategies that will reverse the negative
effects of systemic racism on preventable
disease. " They further committed to taking
the specific actions:
■	 Consider race primarily as a social and not
a biological construct and use consistent
terminology throughout recommendation
statements to reflect this view.
■	 Promote racial and ethnic diversity in addition to gender, geographic and disciplinary
diversity in membership and leadership of
the USPSTF and foster a culture of diversity
and inclusivity as an enduring value of the
USPSTF. This will be assessed annually prior
to soliciting nominations for new members
and internally assigning leadership roles.
■	 Commission a review of the evidence, including an environmental scan and interviews
with clinicians, researchers, community leaders, policy experts, other guideline developers
and patients from groups that are disproportionately affected to summarize the evidence
on how systemic racism undermines the

benefits of evidence-based clinical preventive
services and causes preventable deaths. This
will be completed by June 2021.
■	 Iteratively, update USPSTF methods to
integrate the best evidence and consistently address evidence gaps for Black,
Indigenous, and Hispanic/Latino populations. This includes measures to identify and
track strategies to demonstrate progress
in addressing health inequities regarding
clinical preventive services.
■	 Use a consistent and transparent approach
to communicate gaps in the evidence
related to systemic racism in preventive care
in Recommendation Statements and the
USPSTF's annual report to Congress. This
includes an ongoing assessment of how the
effects of systemic racism on the quality of
the evidence and receipt of clinical preventive services perpetuate health inequities.
■	 Collaborate with other guideline-making
bodies, professional societies, policy makers, and patient advocacy organizations on
efforts to reduce the influence of systemic
racism on health.

HIV research yields potential drug target

UMANS POSSESS a formidable multi-layered defense
system that protects us against viral infections. Better
understanding of these defenses and the tricks that
viruses use to evade them could open novel avenues for treating
viral infections and possibly other diseases.
For example, a human protein called SAMHD1 impedes replication
of HIV and other viruses by depleting deoxynucleotides - building
blocks needed for the replication of the viral genome. It has long
remained a mystery whether and how this protein is activated in
response to infection.
Now researchers from UT Health San Antonio have discovered that
SAMHD1 recognizes a unique molecular pattern in nucleic acids. This
pattern, called " phosphorothioation, " may act as a signal for action.
It's like a sentinel atop a palace wall who sees an invading horde in the
distance and calls the troops to battle stations.
Understanding the mechanism of SAMHD1 activation could be a
step forward in the fight against HIV/AIDS.
" If we are able to increase SAMHD1 activity using a specific drug,
that could potentially have anti-HIV activity, " said Corey H. Yu, PhD,

postdoctoral fellow in the laboratory of Dmitri Ivanov, PhD, at UT
Health San Antonio.
Today's antivirals target the viral proteins. If, in addition, therapies
could unleash the power of our existing immune defenses on the virus
to help eliminate it from the body, that could be a game-changer.
" It's a different way to look at antiviral drugs, " Dr. Yu said. " We want
to know if we can try to target a protein to hopefully boost its activity
against HIV. "
Dr. Yu is first author of the study findings published Feb. 2 by the
journal Nature Communications. The National Institutes of Health
funded the research.
Nucleic acid binding by SAMHD1 contributes to the antiretroviral
activity and is enhanced by the GpsN modification.
Corey H. Yu, Akash Bhattacharya, Mirjana Persaud, Alexander B.
Taylor, Zhonghua Wang, Angel Bulnes-Ramos, Joella Xu, Anastasia
Selyutina, Alicia Martinez-Lopez, Kristin Cano, Borries Demeler, Baek
Kim, Stephen C. Hardies, Felipe Diaz-Griffero and Dmitri N. Ivanov.
First published: Feb. 2, 2021, Nature Communications.
https://doi.org/10.1038/s41467-021-21023-8

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https://www.doi.org/10.1038/s41467-021-21023-8 http://WWW.AAHIVM.ORG

HIV Specialist - March 2021

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