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HOPER study HIV Original Pharmaceutical E-reputation Research June 5 th , 2014

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HOPER est une étude qui traite la présence du VIH dans le monde digital. Au cours de 2014, plus de 19 000 documents issus du web et des réseaux sociaux ont été collectés par les outils de LexisNexis Business Informations Solutions. Ils ont ensuite été analysées par ses équipes d'analystes, spécialisés dans le domaine "Life Sciences". The HOPER report was carried out after collecting more than 19 000 documents throughout the month of March 2014. Then, they were analysed by LexisNexis BIS' Life Sciences analysts.

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HOPER studyHIV Original Pharmaceutical

E-reputation Research

June 5th, 2014

HOPER2

Preface

For our fourth edition, Doctors 2.0 & You will again provide a forum for a well-informed discussion amongst all stakeholders: patients, professionals, industry, public sector about the  use of Social Media, Mobile Applications, Serious Games, Connected Objects. This information is presented through real-life examples in prevention and disease conditions.

To complement the program, each year, Doctors 2.0 & You chooses to-gether with LexisNexis Business Information Solutions, a theme to study, based on the strategic importance of the area in healthcare. The resulting report is a key element  of the partnership between Doctors 2.0 & You and LexisNexis Business  Information Solutions.

After diabetes in 2013 with the ISMOR or Insulin Social Media Original Research, we have turned together to HIV, with   HOPER,    “HIV ORIGINAL PHARMACEUTICAL E-REPUTATION RESEARCH”.  HIV has been one of the most active areas in healthcare on the web, from the early days to now. We  felt that participants would benefit from a look at the kind of hard data that LexisNexis Business Information Solutions can produce regarding the activity of HIV digitally, patient profiles, information about drugs….

The results of the HOPER report are indeed rich and demonstrate the diversity and quantity of  information available from user-generated sources. The importance of this should not be under-estimated. HOPER will provide many avenues for improved collaboration amongst healthcare stakeholders.

We sincerely thank the team for their hard work in putting the study together and look forward to the conversations we will all engage in together.

 

Denise Silber,Founder Doctors 2.0 & You

Basil Strategies

HOPER

Introduction

Hoper is the first study on social media networking & HIV in 2014. The Hoper study col-lected and analyzed more than 19,000 web documents over more than 1,400 French web sources during March 2014, including about 80 sources specialized in virology and infectiology.

Hoper outlines the French HIV digital ecosystem and provides insights about its stakeholders: • Highlights on the key online channels, stakeholders and topics visible over the period,• Focus on 3 major HIV e-patient profiles,• Visibility and e-pharmacovigilance trends for 3 leading HIV drugs,• Comparison of US and French digital/social/mobile initiatives of 3 pharmaceutical laboratories, in this therapeutic area.

The outcomes of the study can help pharmaceutical laboratories to identify where in the French HIV digital ecosystem there are opportunities and room for improving visibility, reputation and digitalness of their brands and products and better reaching their target audiences through relevant online touchpoints.

The Hoper report does not aim to be an exhaustive study but rather it is an analysis of the type of discussions taking place at a particular time to provide high-level insights into the public debate around HIV in the web and the social media. For responses on specific questions in this area, please contact us and we will be very pleased to help.

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HOPERHIV Original Pharmaceutical E-reputation Research June 5th, 2014

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HOPER

HOPER

1. HIV IN DIGITAL LANDSCAPE

A/ HIV: overall visibility on internet, trends and buzzesB/ Twitter, forums, websites, press… Where is the media coverage?C/ Focus on TwitterD/ Focus on forums

2. E-PATIENTS’ PROFILS AND DISCUSSIONS

A/ Experienced patients providing adviceB/ Long-term patients trying a drug regimen reductionC/ Unexperienced patientsD/ Most discussed topics

3. STAKEHOLDERS PRESENCE

A/ Associations’ commitmentB/ Personalities’ mobilizationC/ Institutions’ roles and activitiesD/ Laboratories’ share of visibility

4. E-PHARMACOVIGILANCE: BENCHMARK OF 3 ANTIVIRAL DRUGS

5. DIGITAL INITIATIVES IN FRANCE & USA

A/ Comparison of digital initiatives between France and USA for three laboratoriesB/ USA: Branded websites and unbranded digital initiativesC/ FRANCE: Unbrandred websites and digital initiatives

68910

11121314

16171819

20

5

23

2425

HIV>98% 1 %

O,5%

1. HIV IN DIGITAL LANDSCAPE

A - HIV: overall visibility on internet, trends and buzzesAmong 19,000 web documents collected in March 2014:

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HOPER - HIV Original Pharmaceutical E-reputation Research

>98%The therapeutic area (HIV, sero-positivity, AIDS, etc) is the most discussed topic with several hun-dreds of new documents per day, rep-resenting more than 98% of the vol-ume of documents over the month.

1%CROI 2014 - (Conference on Retroviruses

and Opportunistic Infections) only rep-resents 1% of the volume of documents.

The conference was mostly covered in the online press, on blogs, forums

and Twitter, at the beginning of March.

0,5%3 HIV drugs - Presista, Isentress

and Atripla - and their active prin-ciples represent 0,5% of documents.

Their visibility is limited to forums where patients share their experience with HIV drugs and specialized websites.

HIV>98% 1 %

O,5%

HIV>98% 1 %

O,5%

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1

2

3

4

5

0 200400

600800

1,000

1,200

1st march

5 march

10 march

15march

20march

25march

30march

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HOPER - HIV Original Pharmaceutical E-reputation Research

1 . Oscars: Matthew McConaughey and Jared Leto received Academic Awards for their perfor-mances in the film Dallas Buyers Club . Several tweets have also passed on Jared Leto’s speech and its support to the whole HIV community.

2. Second baby born with HIV cured. This re-mission is explained by starting HIV treatment just few hours after the child’s birth.

3. Tweets related to the evening launch of Sidaction 2014 with the intervention of Line Renaud and the participation of Jean-Luc Romero.

4. Tested in female monkeys, a new vaginal gel could protect women against HIV even if applied hours after sex.

5. Persistent buzz related to HIV transmission between women.

6. Tweets related to#Sidaction campaign 2014.

BUZZ OVER TIME (March 2014)

Facebook - 4 docs

Blogs - 55 docs

NationalPress - 161 docs

Websites - 459 docs

Forums - 1,108 docs

Twitter - 17,236 docs91%

HOPER - HIV Original Pharmaceutical E-reputation Research

Twitter and forums are the main online agoras where public conversations related

to HIV take place (more than 91% of the 19,000 documents) !

TWITTER is much more represented than the other types of sources. However, a huge amount of off-topic” tweets (up to 80%) mention AIDS/HIV in a “humorous” or even disparaging way.

Besides, AIDS associations are very active on Twitter and some pieces of news related to

HIV have also been widely retweeted (for example Oscars to Dallas Buyers Club’s actors, etc).

• FORUMS play a key role in the French HIV digital landscape. A few forums specifically focused on HIV, such as Seronet Forum

and Sidaweb Forum, are “THE” online places where French patients share their experience and disease management tips. Lively conver-

sations take place there on forums. Some of these patients have been active members for years.

• WEBSITES include web portals dedicated to HIV (Seronet, Aides, etc), health-dedicated sources (covering current news on HIV therapies, HIV prevention, HIV epi-

demiology, etc) and general information sources (either covering current news on HIV or quoting HIV in various contexts, for example health challenges in Africa).

• The visibility of Aids/HIV in the NATIONAL PRESS is mostly a matter of occasional “scoops”: Oscars to Dallas Buyers Club’s actors, therapeutic innovations (anti-HIV gels), controversies (drug consumption rooms, etc).

• A few BLOGS such as « Le blog des séropositifs en colère » or « Le blog de JL Romero » are rather active.

B - Twitter, Forums, websites, press… Where is the media coverage?

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HOPER - HIV Original Pharmaceutical E-reputation Research

Ranking of these accountsby numberof followers(04/29/14)

Top 10 Twitter accountsaccording to number of tweets related to HIV over the month of March 2014

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60 tweets50 tweets40 tweets30 tweets20 tweets10 tweets

Elus contre le SIDA - 1,493 fol.

Jean LucRomero21,927 followers SidaInfoService - 2,277 fol.

COCQSIDA - 410 fol.

Essai VRI - 110 fol.

Directeur des soins - 3,204 fol.

AssociationAIDES99,141 followers

Recherch0ns6,645 followers

Séropositif libéré - 15 fol.

Elus contre le SIDA

Jean-Luc Romero

Association AIDES

Recherch0ns

SidaInfoService

Mutuelle Info

COCQSIDA

ESSAIVRI

Directeur des soins

Séropositif libéré

• Aids activist and elected representative @JeanLucRomero and his association @ElusContreSida with nearly 30 % of the tweets have been very active, sup-porting a petition asking for non-discriminatory funeral services.

• Through the dedicated account @essai_VRI, the Vaccine Research Institute announced the recruitment of 100 volunteers to test a new HIV vaccine.

• Association accounts (@assoAIDES, @SidaInfoService) tweeted/retweeted news related to HIV (surveys, CROI’s and research highlights, prevention and test initiatives, political actions, etc).

• Other accounts like @recherch0ns, @mutuellesinfo and @DirecteurdesSoins mainly passed on information picked up in the press or on health-dedicated websites.

C - Focus on Twitter

Doctissimo Forum (416 messages)Others - (75 messages)

Atoute - Forum - (20 messages)

Forum gay - (26 messages)

Boursorama - Forum - (34 messages)

Au féminin - Forum - (39 messages)

Forum Santé Médecine - (53 messages)

Hépatite - Forum - (61 messages)

Forum Jeuxvideocom - (66 messages)

Sida Web - (101 messages)

Seronet - Forum(170 messages)

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HOPER - HIV Original Pharmaceutical E-reputation Research

• Doctissimo is far the major French source of reference where nets users seek advice after a “risky behavior”. Testing/diagnosis and prevention are the most discussed topics. 40 % of the mes-sages come from this forum. Similar discussions occur on forums like Forum Santé Médecine, Forum Au Féminin (with a predominance of female net users) and Forum AToute.

• HIV diagnosed patients rather express themselves on Seronet and Sida Web forums. The impact of the disease and/or the therapy on their daily life is the most discussed topic.

• Most messages from Forum JeuxVidéo quote HIV/aids in a “humorous” or disparaging way.

Top 10 forums according to number of messages related to HIV over the month of March 2014

General health forums, HIV/hepatitis forums, LGBT forums, youngster forums and feminine forums are the most represented types, with strong specificities regarding HIV conversation content.

D - Focus on forums

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2. E-PATIENTS’ PROFILES AND DISCUSSIONS

A - “EXPERIENCED PATIENT PROVIDING ONLINE ADVICE ABOUT HIV”Men or women, typically 35 or more years-old, with a long experience

with HIV, with a controlled disease, giving advices to younger people and other net-users regarding unsafe sex practices and the importance to get tested for HIV.

• Aware of policies and practices established by hospitals or other healthcare professionals to manage either new patients or older ones who need a readjustment of their prescription medicines.

• In general, a cultivated person, belongs to higher social categories, with advanced medical knowledge. Fights prejudices associated to gender identity, ethnic origins or sexual orientation.

• Able to put things into perspective and calm other net-users’ anxiety by providing factual data. Easily accessible, especially to newly diagnosed patients and appreciated by net-users for his/her patience and ability to explain complex data, and for a wider open-mindedness than healthcare professionals.

• Participates every day in online discussion threads and provides recommendations to other net users, but remains humble and respectful of the healthcare professionals.

• Shares links to online content, sometimes corporate links.

« Un test de dépistage du VIH donne officiellement une sérologie définitive à partir de quarante-deux jours après la dernière prise de risque. » 04/03/2014http://forum.doctissimo.fr/doctissimo/infections-sexuellement-transmissibles/test-vih-sujet_166267_1.htm#68726966_61

« 1) Une séroconversion tardive, c’est une séroconversion qui intervient après quatre semaines, tu es loin de ça. 2) Cela veut dire plein de choses. Les miens sont enflés quand je suis patraque, quand j’angoisse, quand j’ai de la fièvre, quand j’ai une infection, quand je ne sais pas... C’est à un médecin de répondre à cette question. 3) Il ne fait que dire ce que tout le monde devrait savoir

et que tu sais aussi mais que tu es incapable de rationaliser. » 06/03/2014http://forum.doctissimo.fr/doctissimo/infections-sexuellement-transmissibles/peur-extrem-sujet_165557_1.htm#68837590_11

HOPER - HIV Original Pharmaceutical E-reputation Research

« N’importe quoi ! Sans paniquer, il est concerné par le fait qu’il a pris un risque. On ne se base pas sur la sérologie d’autrui pour en déduire sa propre sérologie. Tu fais quoi de la fenêtre sérologique ? De plus, ils ont tous les deux pris des risques. Ils doivent se faire dépister tous les deux. On fait les

choses correctement ou on ne les fait pas car ça ne sert à rien. » 13/03/2014http://forum.doctissimo.fr/doctissimo/sida/preservatif-casse-acte-sujet_165932_1.htm#69585414_58

«  Tous les jours sur ce topic, on trouve des gens qui somatisent. Tu es le gagnant du jour.  » 03/03/2014http://forum.doctissimo.fr/doctissimo/sida/stress-somatisation-sujet_165906_1.htm#68741841_127

« Appelle Sida info service, qui te dira s’il y a des précédents de contaminations de ce type ( je n’en ai jamais entendu parler). C’est un accident du travail.. Que t’a dit la personne qui t’a soigné ?  » 02/03/2014 http://forum.doctissimo.fr/doctissimo/sida/risque-sujet_165904_1.htm#68741869_142

B - “LONG-TERM PATIENT TRYING A DRUG REGIMENREDUCTION”Patient with an extensive experience in HIV drugs, interested in reducing his/her therapeutics in order to avoid adverse events or simply to detoxify his/her organism.

• Frequently deals with the resistance of physicians, relatives, friends or other patients for which reducing the treatment is not a good way to manage the disease, especially when it is well controlled.

• Has generally good blood test results, a good immunity and has frequently an undetectable viral load.

• Decides to reduce his/her treatment because of positive testimonies from other patients posted on forums or blogs. Several of them mention the « ICCARRE method », which consists in reducing the dos-age after a strong initial treatment.

• Sometimes, this method is first tried during travels, holidays or week-ends and a number of patients notice that this break does not change their blood test results, so they do not inform their physicians about it. When the patient reiterates this break or decides to lastingly reduce the treatment, then the physician is informed. This method is applied in different ways: by taking the drugs only a few days a week or by reducing the daily dosage.

« Seulement maintenant, après 3 ans de Truvada-Isentress, non seulement je ne dors toujours pas, ou le sommeil n’est pas réparateur, mais les lypodystrophies sont devenues insupportables, j’enfle de l’abdomen et des seins, une horreur, tout ce que je mettais avant me boudine :-( Le bilan

est nickel 1300 CD4, charge virale toujours indétectable et c’est le problème: ma toubib ne tient compte que de ça! Donc, pour ma consult de Mars, vu que j’ai tout essayé, je vais lui mettre le marché en main: soit on essaie un allègement type 3/7, soit j’arrête tout! Ca fait 10 ans que je gobe bien tout ce que l’on me donne, je suis super observante, mais je connais mon corps: au bout de 3 ans de la même combinaison, les résultats sont toujours ok, mais moi, plus du tout! » 02/03/2014 http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68342151_1

HOPER - HIV Original Pharmaceutical E-reputation Research

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« Après une année de TRI je suis passé, avec l’accord de mon médecin à 6jours/7. ET c’est génial! Mon toubib me dit que tout le monde est largement en surdosage... Bon on verra si on passe en 5/7 bientôt. Déjà un jour de moins ça soulage psychologiquement et le corps bien sûr! Je prends

Eviplera. » 02/03/2014http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68342151_1

«  Soledad j’ai d’abord commencé de 7/7 à 5/7 de moi-même car je suis sous ATRIPLA depuis si longtemps avec des résultats identiques depuis tant d’années (avec les 3 molécules qui le composent)! Que j’ai pensé que je ne courrais aucun danger... Les labos n’ont jamais fait la différence pour la

posologie entre un enfant (ou ado), une femme de 40 Kg (environ) et un homme de 80 Kg comme moi!!! Je me suis dit qu’ils avaient du un peut forcer sur les dosages, histoires d’avoir des résultats immédiats sans se préoccuper des effets secondaires! » 03/03/2014 http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68342151_1

« Vous oubliez souvent de nous dire si vous pratiquez un allègement de traitement avec ou sans assentiment et/ou contrôle médical. Je vous rappelle que nous ne sommes pas médecins et que pour ma part mes 2 dernières infectiologues sont contre un traitement a la demande. D’après

elles c’est trop risque et a terme ça augmente les résistances et ça fait repartir la charge virale. C’est parfois indiqué à certains patients qui ont 20 ans de tri derrière eux pour soulager un moment mais pas tout le temps leur corps mais AVEC accord et contrôle d’un médecin. » 04/03/2014http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68342151_1

C - “UNEXPERIENCED PATIENT RECENTLY DIAGNOSED”Patient recently diagnosed, with a poor experience with HIV. Feeling lost, confused, facing a difficult situation, needing help regarding the disease, the treatment.

• In the case of a primary infection, has to deal with several drugs simultaneously.

• Often searches the Internet for information on drug treatments and the evolution of the disease.

• Feels insecure and uncomfortable with the treating physician.

• Generally afraid of various aspects: blood test results (especially CD4 value), viral load, adverse events associated with the drugs that will have to be taken.

• Feels depressed, ashamed and guilty in the first days after diagnosis, almost to the point of wanting to die.

• Shocked and barely able to « understand » and « absorb » explanations provided by healthcare professionals.

• Needs time to accept the new condition and the useful advice provided by other patients.

HOPER - HIV Original Pharmaceutical E-reputation Research

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« Mon médecin généraliste qui est aussi infectiologue m’a sorti que tant que je n’aurai pas fini la pré-infection, je resterai sur ce que j’ai. Génial on discute bien mdr.... Heu... Bon ok à la limite je comprends. Mais en juin quand ce sera terminé, je serais toujours à 3 prises et je n’en veux

qu’une! Je suis comme tout le monde, ça me gonfle d’avaler des cachetons surtout que j’ai la dose mais moins importante qu’avant. » 01/03/2014http://www.seronet.info/billet_forum/un-prise-par-jour-66145#68323689_3

« Pour ma part j’ai commencé un traitement avec une PCP, des T4 à 24 et une CV très élevée. Allergique au Bactrim, je suis à ce sirop bien connu, qui est lui une vrai contrainte, surtout en dé-placement ou en sortie au restau. Pour le reste, mes prises de cachet ne sont que peu de chose

et pourtant ! Avec une MAC identifiée en mars, je suis sortie de l’hosto avec le matin 3 ARV (1 Truvada, 1 Isentress) et un traitement antibiotique anti MAC (10 cachets ou gélules) + 1 pour le diabète, 1 pour l’hypertension, 1 pour le fer. Le soir, 1 pour la MAC, 1 Isentress, 1 pour le Fer, 1 pour le diabète et 1 piqure d’anticoagulant pour une embolie. Sans oublier ce sirop matin et soir. Je me trouvais heureux de n’avoir rien le midi ! » 05/03/2014http://www.seronet.info/billet_forum/un-prise-par-jour-66145#68323689_3

« Toujours est-il que malgré tout ce que j’ai pu lire de positif sur cette maladie, je suis très affecté, car ce qu’on ne connait pas nous terrifie... Je pleure beaucoup, malgré le soutien que je peux recevoir de mes amies et de mon partenaire. Je m’en veux tellement de lui avoir imposé cette

situation. Il a décidé d’affronter cette épreuve avec moi, je lui en serai éternellement reconnaissant. » 07/03/2014http://www.seronet.info/billet_blog/juste-diagnostique

« Je l ai vu hier et j’avoue être encore sonnée.. donc il m a donné plusieurs infos mais c’est encore confus.. » 05/03/2014http://forum.doctissimo.fr/doctissimo/sida/doute-fiabilite-depistage-sujet_165872_1.htm#68855832_16

HOPER - HIV Original Pharmaceutical E-reputation Research

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Prevention

Impact on daily life

Screening test diagnosis

Efficiency

Immunity viral load

Coinfection comorbidity

Adverse events

Drug interactions

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D - Most discussed topics about HIV

The most discussed topics, by the number of documents:

• PREVENTION is the most recurrent topic in HIV digital landscape with 30% of documents. - on websites and in the press, prevention was mainly evoked in the context of the upcoming Sidaction campaign (scheduled at the beginning of April) and along with several buzzes focused on means of prevention of HIV transmission (start of clinical trials on a vaginal ring that might protect from infec-tion, debate on drug consumption rooms, etc)

- on forums the message is more straightforward i.e. “use a condom if you don’t know the serological profile of your partner”

- Twitter users either pass on prevention initiatives or spread information on new prevention methods or advances on HIV-vaccine research.

• IMPACT ON DAILY LIFE topic with 25% of documents mentions contamination by HIV in a sexual context. Difficulties to announce seropositivity to loved ones or to accept a HIV+ diagnosis are also often discussed on forums.

• SCREENING/DIAGNOSIS is also a very visible topic with 13% of documents as epidemiologic data were published and tweeted: victims of aids on the rise in Japan, HIV contamination of drug users in Sen-egal, young women more contaminated than men in France, etc.

• DRUG EFFICACY was strongly fueled by the media coverage of various news highlighting the efficacy of antiretroviral drugs in the context of the CROI 2014 conference: start of clinical trials on a vaginal ring containing tenofovir, case of HIV+ newborn “cured” by a tritherapy, results of the Partner Study.

• IMMUNITY/VIRAL LOAD corresponds to news on development of an HIV-vaccine and the cover-age of the CROI 2014 conference; results from a US National Institute of Health study on gene-editing offering new hope in controlling the virus without drugs was also picked up by the French press and on Twitter.

Prevention, impact of HIV on daily life, and screening/diagnosis of the disease are the 3 most discussed topics.

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Manual coding (sample of 1,500 documents)

3. STAKEHOLDERS PRESENCE

A - Associations’ commitment: Sidaction and AIDES are the most mentioned and also very active online

SIDACTIONThe 20th edition of SIDACTION, in April, was already widely covered on social media and other online media in March . It was an opportunity for several media to communicate about prevention and past breakthough discoveries in the area of HIV.

AIDES• Frequently communicates on the prevalence of HIV in France or other countries and on prevention / diagnosis actions taken throughout the country. Aides announced the launch of new clinical trials and the publication of major results. • Recently Aides strengthened its partnership with the Archives Nationales in order to preserve the archives of the association.• Aides faces (like Act Up) a restructuring plan due to a lack of funding.• Aides was also mentioned in articles on the condemnation of a HIV+ man accused of having inten-tionally infected its wife.• Others cited with fewer documents: Médecins Du Monde, Médecin Sans Frontière, Act-up, CRIPS, Tinder, SidaSOS, Coalition Plus, Inter-LGBT

HOPER - HIV Original Pharmaceutical E-reputation Research

Personalities775 docs

Associations1,030 docs

Institutions424 docs

Labs82 docs

12 3 4

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Associations, personalities and institutions are leading the discussions around HIV on the web and social media. The pharma labs are far behind.

Sidaction(298 documents)

Aides (194 docs.)LGBT (87 docs.)

Sida InfoService (84 docs.)

AssociationsAfrique(76 docs.)

Others(291 docs.)

Jean-Luc Romero(185 documents)

Jared Leto (145 docs.)

Elus locauxcontre le sida (109 docs.)

MatthewMcConaughey(108 docs.)

MarisolTouraine(67 docs.)

Others(161 docs.)

InspectionGénéraledes AffairesSociales(106 documents)

AgenceNationale deRecherchesur le Sida(99 docs.)

Inserm (55 docs.)

Conseilnationaldu sida(51 docs.)

Others(112 docs.)

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B- Personalities’ mobilization: JL Romero and his association of local politiciansmobilized against AIDS and serodiscrimination

JEAN-LUC ROMEROJean-Luc Romero is a French politician who was among the first to reveal its seropositivity. He is also president and founder of the ELCS Association (« Elus Locaux Contre le Sida / Locally Elected politi-cians Against AIDS), president of CRIPS IDF and member of the National Council of AIDS. He is involved in prevention campaigns, especially in Paris, and more generally in the fight against homophobia and serophobia in daily life.

ELCSELCS association is fighting for equal access to freedom of movement regardless of HIV status, for non-discriminatory funeral services, for free condoms, for improving risk reduction measures and for allowing homosexual people to donate blood.

J. LETOM. McCONAUGHEYVery high visibility for Jared Leto and Mattew McConaughey during the Oscars Event with the awards received for their performance in « Dallas Buyers Club » movie.

MARISOL TOURAINEFrench Health Minister Marisol Touraine did not specifically communicate about HIV, but she was challenged on social media to take a clear position in favor of non-discriminatory funeral services.

OTHERSOthers cited in fewer documents: Anne Hidalgo, Laurent Fabius, Line Renaud, Elton John, Pierre Bergé, Jean-Louis Touraine, Emmanuelle Cosse.

HOPER - HIV Original Pharmaceutical E-reputation Research

Sidaction(298 documents)

Aides (194 docs.)LGBT (87 docs.)

Sida InfoService (84 docs.)

AssociationsAfrique(76 docs.)

Others(291 docs.)

Jean-Luc Romero(185 documents)

Jared Leto (145 docs.)

Elus locauxcontre le sida (109 docs.)

MatthewMcConaughey(108 docs.)

MarisolTouraine(67 docs.)

Others(161 docs.)

InspectionGénéraledes AffairesSociales(106 documents)

AgenceNationale deRecherchesur le Sida(99 docs.)

Inserm (55 docs.)

Conseilnationaldu sida(51 docs.)

Others(112 docs.)

Sidaction(298 documents)

Aides (194 docs.)LGBT (87 docs.)

Sida InfoService (84 docs.)

AssociationsAfrique(76 docs.)

Others(291 docs.)

Jean-Luc Romero(185 documents)

Jared Leto (145 docs.)

Elus locauxcontre le sida (109 docs.)

MatthewMcConaughey(108 docs.)

MarisolTouraine(67 docs.)

Others(161 docs.)

InspectionGénéraledes AffairesSociales(106 documents)

AgenceNationale deRecherchesur le Sida(99 docs.)

Inserm (55 docs.)

Conseilnationaldu sida(51 docs.)

Others(112 docs.)

C- Institutions’ roles and activities: national institutions more visible than international ones, IGAS and ANRS at the forefront

IGASThe IGAS (General Inspectorate of Social Affairs) and the Aids National council both recom-mended to remove the discriminatory prohibition related to HIV positive status for funeral services. Their position was widely covered on Twitter.

ANRSThe ANRS (National Agency for Research on Aids) is mainly mentioned in the context of clinical trials (prime-boost vaccine trial, functional remission observed in ANRS-Optiprim trial involving recently diagnosed patients, early treatment in newborns, etc.).

INSERMAccording to the INSERM, drug injection rooms could help reducing HIV transmission. The INSERM also launched a survey to understand how HIV can impact the daily life of women.

OTHERSOthers cited in fewer documents: Onusida, Centers for Disease Control and Prevention, Corevih, National Academy of Pharmacy, Unesco.

Sidaction(298 documents)

Aides (194 docs.)LGBT (87 docs.)

Sida InfoService (84 docs.)

AssociationsAfrique(76 docs.)

Others(291 docs.)

Jean-Luc Romero(185 documents)

Jared Leto (145 docs.)

Elus locauxcontre le sida (109 docs.)

MatthewMcConaughey(108 docs.)

MarisolTouraine(67 docs.)

Others(161 docs.)

InspectionGénéraledes AffairesSociales(106 documents)

AgenceNationale deRecherchesur le Sida(99 docs.)

Inserm (55 docs.)

Conseilnationaldu sida(51 docs.)

Others(112 docs.)

HOPER - HIV Original Pharmaceutical E-reputation Research

18

D- Labs’ share of visibility: GlaxoSmithKline, Gilead and Merck on the podium

GSK• Promising preven-tive results published regarding monthly in-jection of long-lasting GSK744 in macaque monkeys; a clinical trial in humans will be launched soon.

• LATTE Study: a combina-tion of GSK744 and rilpi-virine shows an efficiency similar to that of a standard tri-therapy for long-lasting viral sup-pression.

GILEAD• In France, withdrawal of a batch of Viread due to potential rubber residues. • Market launch of Stribild, the first once-daily 4 drug combotreatment for HIV in a single tablet.

MERCK• Clinical trial results evaluating experimental drug in HIV/HCV coinfected patients.• Development of MK-1439, an investigational nucleoside, potentially interesting in the context of resistance to other nucleosides as efficient as Sustiva and with a higher tolerance.

HOPER - HIV Original Pharmaceutical E-reputation Research

19

GSK, Gilead and Merck are by far the three most visible phar-maceutical companies men-tioned in relation to HIV. Their visibility is essen-tially linked to preclini-cal or clinical trials (a consequence of communications around the CROI congress).

GSK(18 documents)

Gilead(17 documents)Merck

(13 documents)

BMS(9 documents)

Janssen(6 documents)

Roche(5 documents)

Theradiag(5 documents)

AbbVie(4 documents)

ViiV(3 documents)

Boehringer(2 documents)

Number of documents published between03/01/2014 and 03/31/2014, excluding Boursorama

HOPER - HIV Original Pharmaceutical E-reputation Research

4. E-PHARMACOVIGILANCE: BENCHMARK OF 3 ANTIVIRAL DRUGS

A - Potential cases of e-pharmacovigilance:Prezista*, Isentress* and Atripla*Prezista and Isentress are twice as visible online as Atripla. The 3 drugs display similar high proportions for potential online pharmacovigilance cases.

For the three medicines, about 1/3 of messages correspond to potential e-pharmacovigilance cases (33% for Prezista, 29% for Isentress, 37% for Atripla) – a proportion much higher than in other therapeutic areas such as diabetes or level 1 analgesia where potential PV cases are typically in the range 5 to 10% of messages.

Almost all these potential e-pharmacovigilance cases were identified on Seronet discussion forum.

A total of 24 potentialonline PV cases forthe three drugs

20

30docs

PREZISTA

28docs

ISENTRESS

!42

%

25%

33%

ATRIPLA• Lower bone density of babieswhose mothers took Tenofovir• Dizzyness• Psychological side-effects • Drug regimen reduction cases

ISENTRESS• Excessive tiredness /exhaustion sleep disorders• Hyperthyroidy• Lipodystrophy• Thinness• Headaches

PREZISTA• Sleep disorders, anxiety,weird dreams • Difficulties concentrating• Lipodystrophy• Tiredness

PHARMACOVIGILANCEMESSAGES

16docs

ATRIPLA

30docs

PREZISTA

28docs

ISENTRESS

!42

%

25%

33%

ATRIPLA• Lower bone density of babieswhose mothers took Tenofovir• Dizzyness• Psychological side-effects • Drug regimen reduction cases

ISENTRESS• Excessive tiredness /exhaustion sleep disorders• Hyperthyroidy• Lipodystrophy• Thinness• Headaches

PREZISTA• Sleep disorders, anxiety,weird dreams • Difficulties concentrating• Lipodystrophy• Tiredness

PHARMACOVIGILANCEMESSAGES

16docs

ATRIPLA

*3 different types of drugs selected : a protease inhibitor (Prezista), a reverse transcriptase inhibitor (Atripla) and an integrase inhibitor (Isentress)

21

B - Potential online Phamacovigilance cases: selection of patients comments

ATRIPLA« Parce que Atripla chez un nombre non négligeable de pa-tients à provoqué des effets secondaires psy importants et parfois graves. » 24/03/2014h t t p : / / w w w . s e r o n e t . i n f o / b i l l e t _ f o r u m / s t r i b i l d - v s - e v i -plera-66460#70351649_2

«  L‘utilisation du Tenofovir pendant la grossesse chez une femme vih+ entraine une perte de masse osseuse chez le nouveau né #CROI2014 » 05/03/2014https://twitter.com/jdflaysakier/statuses/441246411976630272

« Après avoir parcouru de nombreux forums et témoignages sur la toile cela fait plus de 6 mois que je suis passé à 4 jours sur 7 (en accord avec mon médecin). Je suis sous ATRIPLA et aucune baisse de T4 ni augmentation de la CV depuis. Cela fait plus d’une boite de cachetons en moins par trimes-tre !!! » 01/03/2014http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68342151_1

ISENTRESS«  Seulement maintenant, après 3 ans de Truvada-Isentress, non seulement je ne dors toujours pas, ou le sommeil n’est pas réparateur, mais les lypodistrophies sont devenues insupportables, j’enfle de l’abdomen et des seins, une horreur, tout ce que je mettais avant me boudinne:-( » 02/03/2014 http://www.seronet.info/sondage/au-cours-des-12-derniers-mois-jai-deja-pratique-lallegement-de-mon-traitement-arv-65652#68418952_1

« Isentress + Kivexa m’a t’il dit. Argument essentiel : C’est THE traitement quand les autres ont causé des effets secondaires un peu gênants au quotidien et au bureau.... Eh bien, euh…Comment vous dire ?!!!  Faut déjà VIVRE je serais tenté de dire LOL...depuis je n’ai plus la moindre énergie ! Pour écrire ces lignes, je suis appuyé contre un mur pour ne pas m’écrouler, j’ai bu des litres de café pour ne pas m’endormir debout quand je fais pipi...soit entre 45 sec et 1mn30... » 21/03/2014http://www.seronet.info/billet_forum/effets-secondaires-65826#70049541_3

« Depuis plusieurs années je suis sous Viread Celsentri et Isentress, je n’ai plus de mauvaises répartitions des  graisses mais je suis maigre, surtout des jambes, je ressemble à un sloogy » 11/03/2014http://www.seronet.info/billet_forum/mauvaise-repartition-des-graisses-dans-le-corps-65857#69189446_4

HOPER - HIV Original Pharmaceutical E-reputation Research

PREZISTA « Avec Prezista , je rencontre des troubles du sommeil : réveil toutes les 2 heures avec angoisses et rêves anormaux. Du coup, j’ai l’impression que mon sommeil n’est pas réparateur alors qu’avant je dormais très bien. Pouvez-vous m’indiquer si vous avez eu cet effet secondaire en prenant ce médicament et au bout de combien de temps cela a passé? » 23/03/2014http://www.seronet.info/billet_forum/prezista-effets-secondaires-66503#70221344_5

«  Pour ma part, j‘étais justement sous Norvir Truvada et Prezista depuis qqes années...et j’ai moi aus-si le bidon+visage/bras/jambes emacies...je viens de passer aujourd’hui sous evilprepamachintruc «  22/03/2014 http://www.seronet.info/billet_forum/syndrome-du-gros-ventre-63454#70093809_6

« J’ai évoqué, il y a environ quinze jours, lors de mon entretien avec mon spécialiste ce genre de pertes de mémoire et, selon lui, ça n’a rien à avoir avec le VIH ni avec le traitement, mais, plutôt avec un déborde-ment d’idées, de pensées,…. ; Bref, un esprit trop vif ! » 21/03/2014http://www.seronet.info/billet_forum/effets-secondaires-65826#70049541_4

2022

HOPER - HIV Original Pharmaceutical E-reputation Research

5. DIGITAL INITIATIVES IN FRANCE & USA

A - Comparison of digital initiatives between France and USA for three laboratories

• Janssen uses a wider range of channels than its competitors and innovates with photo sharing on Tumblr (USA) or a serious game (France). Janssen is also the only lab of the three to post video content on Youtube and to engage in conversation on Facebook.

• Due to weaker regulatory constraints, satellite websites are more numerous in the USA, where the 3 HIV drugs studied each have a dedi-cated website.

• With the exception of BMS in France, each laboratory proposes at least one free smartphone application related to HIV in each of the 2 countries.

• No official Twitter account focused on HIV was identified for any of these 3 laboratories.

23

Janssen more digitally active and innovative than Merck and BMS both in France and in the USA

USA France

Satelitewebsites

Apple Storewebsites

GooglePlay apps

Seriousgames

Twitter Facebook Youtube Tumblr

2 1 00 0 0 0 0 1 00 0 0 11 10 0

Total

4BMS

Satelitewebsites

Apple Storewebsites

GooglePlay apps

Seriousgames

Twitter Facebook Youtube Tumblr

2 0 10 0 0 0 0 0 2 10 0 11 0

Total

7Merck

Satelitewebsites

Apple Storewebsites

GooglePlay apps

Seriousgames

Twitter Facebook Youtube Tumblr

3 1 10 0 0 0 0 0 0 01 1 11 1 1 1

Total

10

Janssen / J&J

USA

B - Branded websites andunbranded digital initiativesonly Janssen is active in the social media space

• Branded initiatives are limited to «  classical  » websites where multilingual content is sometimes available (English and Spanish versions of Atripla and Prezista websites).

• Janssen is the most active lab, visible with 3 types of initiatives (website, social media, mobile apps but not serious games).

• Sharing visual content is one of the ways chosen to interact with net users (Merck’s ’I Design’, Janssen’s ’Positively together’).

• The ’Positively together’ Tumblr platform of Janssen is a world premiere in pharma industry.

• Strong involvement of BMS towards HIV positive women (the « SHE » initiative is also active in France – see next page).

HOPER - HIV Original Pharmaceutical E-reputation Research

24

Drug-specific digital service(branded)

HIV-specific digital service (unbranded)

I DESIGNBMSSHE

JanssenVIROLOGY

PORTAL

JanssenPOSITIVELYTOGETHER

MYHEALTH

MATTERS

BMSTHE HIV

GUIDE

JanssenHIV

Seriousgames

Mobilesapplications

Socialmedia and

networks

Websites ISENTRESSBMS

ATRIPLAJanssen

PREZISTA

Drug-specific digital service(branded)

HIV-specific digital service (unbranded)

BMSSHE

JanssenVIROLOGY

PORTAL

JanssenFacebookVIH-SIDA

Seriousgames

Mobilesapplications

Socialmedia and

networks

Websites

JanssenYoutube

VIHservices

Merck

Merck

Merck

MerckMON

JOURNALPOSITIF

JanssenDIETETIQUE

et VIH

JanssenVIHdeo

game

HOPER - HIV Original Pharmaceutical E-reputation Research

FRANCE

C- Unbranded websites anddigital initiativesJanssen stands out with the most diverse initiatives

• Absence of drug-specific branded initiatives due to French regulatory constraints.

• Janssen is the most active laboratory, visible with 4 types of initiatives (websites, social media, mo-bile apps, serious game) and launching initiatives in collaboration with associations (e.g. VIHdeo game launched ahead of Sidaction 2014). Providing services to patients in addition to providing a medicine seems key for the laboratory (e.g. providing nutritional advice).

• BMS and Merck are visible on fewer channels (respectively SHE website and ‘mon journal positif’ free app).

25

Drug-specific digital service(branded)

HIV-specific digital service (unbranded)

I DESIGNBMSSHE

JanssenVIROLOGY

PORTAL

JanssenPOSITIVELYTOGETHER

MYHEALTH

MATTERS

BMSTHE HIV

GUIDE

JanssenHIV

Seriousgames

Mobilesapplications

Socialmedia and

networks

Websites ISENTRESSBMS

ATRIPLAJanssen

PREZISTA

Drug-specific digital service(branded)

HIV-specific digital service (unbranded)

BMSSHE

JanssenVIROLOGY

PORTAL

JanssenFacebookVIH-SIDA

Seriousgames

Mobilesapplications

Socialmedia and

networks

Websites

JanssenYoutube

VIHservices

Merck

Merck

Merck

MerckMON

JOURNALPOSITIF

JanssenDIETETIQUE

et VIH

JanssenVIHdeo

game

Study Methodology

HOPER

HIV Original Pharmaceutical E-reputation Report was carried out after col-lecting and analyzing discussions (19,000 documents) throughout the month of March over 1,400 French web sources, including about 80 sources specialized in virology and infectiology.

After an automatic download based on queries, the documents were sorted and analyzed by LexisNexis Business Information Solutions Life Sciences analysts.

The team have integrated over 10 years of work in France and Europe into the study, combined with specialists expertise in web 2.0 and eHealth. The team has been trained to pharmacovigilance methodology.

About LexisNexis Business Information SolutionsLexisNexis Business Information Solutions, is a subsidiary of the international communication group Reed Elsevier and a specialist of online information for professionals. Our customers are companies belonging to the CAC 40 and SBF 120 for which we regularly conduct e-reputation and market insight studies. Over the years LexisNexis BIS specialized in pharmaceutical and healthcare, working for the most important laboratories in France. Our added value: a kit of powerful, analytical tools tailored to the web and social media, together with a team of multi-lingual analysts, experts in ehealth.

Spelling mistakes have not been proofed from original authoring in social media (blogs, forums, ...)

26

Photos: istockphoto.com / D

R - Design by Alexandre de Saint-Jouan alex@

saintjouan.com/ Acetone.fr

Further information : +33 1 71 72 48 49 http://bis.lexisnexis.fr/contact_us.html