The Three Zeros of Eliminating HIV / AIDS: Global Science and Policy

The Three Zeros of Eliminating HIV / AIDS: Global Science and Policy

Friday, May 17, 2013

The New York Academy of Sciences

The UNAIDS "three zeros" strategy urges that we take a global approach in our efforts toward zero new HIV infections, zero AIDS-related deaths and zero discrimination, and provides a clear vision for future HIV / AIDS research and policy. This one-day symposium will present view points from a range of key opinion leaders discussing their approach to improve communication and collaboration on a global scale. Updates from research leaders will tackle capacity-building for HIV prevention, care, and treatment: controlling the spread of HIV, including reducing mother to child transmission, PEPFAR and other international programs, addressing public health concerns, reducing transmission via international human trafficking, treatment as prevention, microbicides, and local and international vaccine trial updates. A case study will cover current approaches to tackling HIV in inner-city communities, and a panel of international advocacy experts will tackle the path towards zero discrimination.

Reception to follow.

Registration Pricing

Member$30
Student/Postdoc Member$15
Nonmember (Academia)$65
Nonmember (Corporate)$85
Nonmember (Non-profit)$65
Nonmember (Student / Postdoc / Resident / Fellow)$45


The Microbiology & Infectious Diseases Discussion Group is proudly supported by




Mission Partner support for the Frontiers of Science program provided by Pfizer

Agenda

* Presentation titles and times are subject to change.


Friday, May 17, 2013

8:00 AM

Registration and Continental Breakfast

8:30 AM

Welcome and Opening Remarks:
Jennifer Henry, PhD, The New York Academy of Sciences
Bill Snow, Global HIV Vaccine Enterprise

Session I. Overview: Improving Communication and Collaboration

8:45 AM

Approaches to Improving Communication and Collaboration – the NIH Perspective
Mary Marovich, MD, National Institute of Allergy and Infectious Diseases, NIH

9:25 AM

Improving Communication and Collaboration – the UNAIDS Perspective
Luiz Loures, MD, MPH, UNAIDS

10:05 AM

Case Study: Using Tools We Have to Drive the Epidemic to Zero
Robert R. Redfield, MD, University of Maryland School of Medicine

10:35 AM

Coffee Break

Session II. Towards Zero New HIV Infections and Zero AIDS-Related Deaths

11:00 AM

Antiretroviral Treatment for the Prevention of HIV Transmission
Myron S. Cohen, MD, The University of North Carolina at Chapel Hill

11:30 AM

Next-Generation, Soluble, Cleaved HIV-1 Env Trimers for Vaccine and Structural Studies
John P. Moore, PhD, Weill Cornell Medical College

12:00 PM

HVTN 505: Clinical Trial Results
Magdalena Sobieszczyk, MD, MPH, Columbia University Medical Center

12:40 PM

Vaccine Update: Africa and Thailand
Nelson L. Michael, MD, PhD, Walter Reed Army Institute of Research

1:10 PM

Lunch Break

2:15 PM

Implementing Treatment as Prevention – The Key to an AIDS & HIV-free Generation
Julio Montaner, MD, BC Centre for Excellence in HIV / AIDS

2:45 PM

Violence, Trafficking and HIV Transmission: a Public Health Perspective
Michele R. Decker, ScD, MPH, Johns Hopkins Bloomberg School of Public Health

3:15 PM

When Gender and Conflict Collide: The Role of Sexual Violence and other Human Rights
Violations in Conflict on HIV Transmission

Annie Sparrow, MD, MPH, Mt Sinai Global Health

Session III. Translating Science into Action

3:45 PM

Panel Discussion, Moderated by Jerome Kim, MD, Walter Reed Army Institute of Research
Chris Collins, amfAR, The Foundation for AIDS Research
Tim Horn, Treatment Action Group
Rick King, PhD, International Aids Vaccine Initiative (IAVI)
Daniel Tietz, RN, JD, AIDS Community Research Initiative of America (ACRIA)
Mitchell Warren, AIDS Vaccine Advocacy Coalition (AVAC)
Jane Waterman, International Aids Vaccine Initiative (IAVI)

4:30 PM

Networking Reception

5:30 PM

Close

Speakers

Organizers

Jerome Kim, MD

Walter Reed Army Institute of Research

Jerome H. Kim, MD, is currently Principal Deputy and Chief, Laboratory of Molecular Virology and Pathogenesis at MHRP. He also serves as the Project Manager for the HIV Vaccines and Advanced Concepts Evaluation Project Management Offices, U.S. Army Medical Materiel Development Activity, Fort Detrick, MD. Dr. Kim, a Colonel in the United States Army Medical Corps, started his military career in the Air Force, assigned to the Department of Retroviral Research, WRAIR. After a brief exodus, he entered Army service in 2000 in the Department of HIV Vaccine Research, Division of Retrovirology, WRAIR. Prior to serving as the Principal Deputy, MHRP, Dr. Kim was the Chief, Department of Retrovirology, U.S. Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand (2004-2008). He has also been the Chief, Biomedical Research Service, Tripler Army Medical Center (2002-2004) and Assistant Chief, Department of HIV Vaccine Development, MHRP (2000-2002). He has been deployed to Afghanistan in support of Operation Enduring Freedom. Dr. Kim’s research interests include HIV molecular epidemiology, host genetics, and HIV vaccine development. He serves as a reviewer for scientific journals and has served on consultations for the World Health Organization and the Global HIV/AIDS Vaccine Enterprise. Dr. Kim is an Associate Professor of Medicine at the Uniformed Services University of the Health Sciences and is a Clinical Associate Professor of Medicine at the John A. Burns School of Medicine, University of Hawaii. He is a Fellow of the American College of Physicians and a Fellow of the Infectious Diseases Society of America. Military honors include the Army Commendation Medal with one oak-leaf cluster (OLC), the Air Force/Army Meritorious Service Medal with 4 OLC, the “A” designator and the Order of Military Medical Merit. Dr. Kim graduated Phi Beta Kappa with highest honors in Biology and high honors in History from the University of Hawaii, Manoa in 1980, where he won the Library Prize for Pacific Islands Area Research and the Arthur Lyman Dean Prize in the Humanities. He graduated from the Yale University School of Medicine in 1984. Dr. Kim completed his training in Internal Medicine (1987) and fellowship in Infectious Diseases (1990) at Duke University Medical Center and was elected into Alpha Omega Alpha while at Duke.

Yegor Voronin, PhD

Global HIV Vaccine Enterprise

Yegor Voronin, PhD, is a Senior Science Officer at the Secretariat of the Global HIV Vaccine Enterprise, an alliance of organizations dedicated to accelerating the development of preventive HIV vaccines. He oversees the Timely Topics in HIV Vaccines program, which brings experts together to identify and address the most pressing strategic needs of HIV vaccine research and development. Dr. Voronin has spent nearly 15 years in HIV research. He began his work in Dr. Vinay Pathak’s laboratory at West Virginia University and at the National Cancer Institute in Frederick, MD studying the molecular details of the reverse transcription process. He then moved on to the Fred Hutchinson Cancer Research Center in Seattle where he studied population genetics and mechanisms of evolution of HIV in the laboratories of Drs. Michael Emerman and Julie Overbaugh. Dr. Voronin holds a master’s degree in Molecular Biology from the Novosibirsk State University in Russia and a PhD in Biochemistry from the West Virginia University.

Jennifer Henry, PhD

The New York Academy of Sciences

Speakers

Myron S. Cohen, MD

The University of North Carolina at Chapel Hill

Myron S. Cohen is the J. Herbert Bate Distinguished Professor of Medicine, Microbiology and Immunology and Public Health at the University of North Carolina at Chapel Hill. Dr. Cohen received his BS degree from the University of Illinois, Champaign-Urbana and an MD degree from Rush Medical College. He completed Internal Medicine Training at the University of Michigan, and an Infectious Disease Fellowship at Yale University. Dr. Cohen is an elected member of the Institute of Medicine. He is a Fellow of the American College of Physicians and the Infectious Disease Society of America, and a member of the American Society of Clinical Investigation and the American Association of Physicians. Dr. Cohen serves as the Director of the UNC Division of Infectious Disease and the UNC Institute for Global Health and Infectious Disease, and Associate Vice Chancellor for Global Health. Dr. Cohen serves as Co-PI of the NIH HIV Prevention Trials Network (HPTN). Dr. Cohen received the Distinguished Alumnus Award from Rush Medical College in 2000. He received the Thomas Parran Award (2005) for lifetime achievement in STD research from the American Sexually Transmitted Diseases Association. In 2008 Dr. Cohen received the O. Max Gardner Award, the highest honor in the University of North Carolina 16 campus system. Dr. Cohen been recognized for more than a decade as one of America’s “Top Doctors” and “Best Doctors”. Dr. Cohen’s research work focuses on the transmission and prevention of transmission of HIV. Dr. Cohen helped to develop laboratory methods to measure HIV in genital secretions, as well as methods to detect the best antiviral agents to reduce replication of HIV in these compartments. For this work Dr. Cohen has received 30 years of continuous funding from the National Institutes of Health, including an NIH MERIT Award. Dr. Cohen is the architect and Principal Investigator of the multinational HPTN 052 trial, which demonstrated that antiretroviral treatment prevents the sexual transmission of HIV-1. This work was recognized by Science Magazine as the “Breakthrough of the Year” in 2011. Dr. Cohen is the author of more than 500 publications. He has written extensively about the prevention of HIV infection. Much of Dr. Cohen’s research has been conducted in resource constrained countries, especially in Malawi and in the People’s Republic of China.

For more information contact Lisa Chensvold, Director of Communications, UNC Institute for Global Health and Infectious Diseases: globalhealth.unc.edu.

Michele R. Decker, ScD, MPH

Johns Hopkins Bloomberg School of Public Health

Michele R. Decker, ScD, MPH, is an Assistant Professor in the Department of Population, Family and Reproductive Health, at the Johns Hopkins Bloomberg School of Public Health where she also directs the Women’s Health program of the Center for Public Health and Human Rights. A social epidemiologist by training, her research focuses on gender based violence, i.e., sexual assault, intimate partner violence, and sex trafficking, and their implications for HIV and other aspects of sexual and reproductive health. Much of this research focuses on marginalized populations including urban women, adolescents and those involved in transactional sex or sex work. She is currently involved in developing and testing clinic-based intervention efforts to mitigate the health consequences of violence, as well as primary mixed-methods research to understand the mechanisms by which violence influences sexual health and HIV risk. She works domestically as well as internationally in South/Southeast Asia and Eastern Europe/Central Asia. She has contributed to over 75 peer reviewed articles on these topics as well as consultations with the World Health Organization, UNFPA and the World Bank.

Luiz Loures, MD, MPH

UNAIDS

Dr Luiz Loures, Deputy Executive Director of Programme of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Assistant Secretary-General of the United Nations

Dr Luiz Loures joined UNAIDS in 1996 and was appointed Deputy Executive Director of Programme and Assistant Secretary-General of the United Nations in January 2013. He leads UNAIDS’ efforts in leveraging critical support to countries to meet 2015 global AIDS targets and establish a sustainable response to AIDS. Dr Loures is a medical doctor with nearly 30 years of experience in the AIDS response. His engagement ranges from providing medical care to people living with HIV in the early days of the epidemic, to his dynamic involvement in global policy framework development. Born, raised and educated in Brazil, Dr Loures completed his medical studies at the Federal University of Minas Gerais, specializing in critical care. He holds an MPH degree from the University of California at Berkeley.

Mary A. Marovich, MD

National Institute of Allergy and Infectious Diseases, NIH

Dr. Mary Anne Marovich joins NIAID’s Division of AIDS as the new director of the Vaccine Research Program, where she will lead the development and coordination of clinical and preclinical research on HIV vaccines. Marovich comes to NIH from the U.S. Military HIV Research Program, where she served as chief of vaccine research and development since 2005. In that position, she led, directed and developed a global HIV vaccine research program. Additionally, Marovich worked as the clinic director for MHRP’s Rockville Vaccine Assessment Center where she lead and directed multiple early-stage HIV and non-HIV vaccine clinical trials. Further, she served as chair of the Walter Reed Army Institute of Research Institutional Review Board. Marovich earned bachelor’s degrees in biochemistry and chemistry at Illinois State University and a medical degree at Loyola University of Chicago-Maywood. In 1993, she completed a residency in internal medicine and clinical infectious disease training at the University of Colorado and earned a diploma in tropical medicine and hygiene from the Royal College of Physicians and Surgeons, London School of Tropical Medicine and Hygiene. Marovich worked in NIAID’s Laboratory of Parasitic Diseases as a clinical fellow from 1995-1998 and as a clinical associate from 1998-99 while she completed her infectious disease fellowship. An associate professor of medicine with the Uniformed Services University’s Department of Medicine, Marovich has won several honors for academic and teaching excellence. Additionally, she serves on a number of technical panels and as a scientific journal reviewer. She is a member of the American Association of Immunology, the American Society of Tropical Medicine and a Fellow of the American College of Physicians.

Nelson L. Michael, MD, PhD

Walter Reed Army Institute of Research

Nelson L. Michael, MD, PhD is the Director of the U.S. Military HIV Research Program (MHRP) at the Walter Reed Army Institute of Research, an international HIV vaccine research program that successfully integrates HIV/AIDS prevention, care and treatment. Dr. Michael’s career has focused on developing an effective HIV vaccine to protect U.S. and Allied Armed Services and reduce the global impact of the disease. MHRP’s international research program has seven research centers in the U.S., Africa and Asia, where it conducts HIV discovery research, cohort studies, vaccine trials and therapeutic investigation. Dr. Michael guided MHRP through the completion of the RV144 HIV vaccine study in Thailand, which provided the world’s first demonstration that a preventive HIV vaccine was possible and subsequently elucidated correlates of risk of infection and sieve effects. More recently, Dr. Michael helped lead a study on a new vaccine regimen that partially protected monkeys from HIV-like infection. This research also identified factors associated with HIV prevention and control, and identified new HIV vaccine candidates to test in human clinical trials for both prevention and therapeutic applications.

Julio Montaner, MD

BC Centre for Excellence in HIV / AIDS

Dr. Julio Montaner is originally from Buenos Aires, Argentina. He is currently Professor and Head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia (UBC). He is also the UBC and St. Paul’s Hospital Foundation Chair in AIDS Research, as well as the Director of the BC Centre for Excellence in HIV/AIDS. He was the President of the International AIDS Society from 2008-2010. He played a key role in establishing the efficacy of NNRTI based highly active antiretroviral therapy (HAART) and more recently, played a key role in establishing the efficacy of HAART treatment as prevention with financial support of the BC Ministry of Health, an Avant Garde Award from the National Institute on Drug Abuse in the US, as well as the Canadian Institute for Health Research. Dr. Montaner has authored over 550 scientific publications on HIV/AIDS. His current research interests include HAART as prevention, optimal use of HAART, salvage therapy, new antiretrovirals, as well as hard to reach populations, treatment as prevention of viral hepatitis and addiction management, including harm reduction strategies. In 2008, he was inducted into the Royal Society of Canada. In 2010, he received an Honorary Doctor of Science from Simon Fraser University, the Prix Galien, the Order of BC, as well as the Albert Einstein World Science Award. In 2012, he was the recipient of the Grand Decoration of Honor for Services to Austria, the Hope is a Vaccine Award from the Global Alliance to Immunize against AIDS, and The Queen Elizabeth II Diamond Jubilee Medal for his contributions to the field of HIV/AIDS.

John P. Moore, PhD

Weill Cornell Medical College

He is a tenured Professor of Microbiology and Immunology at Weill Cornell Medical College in New York. He received his BA, MA, MPhil and PhD degrees from Cambridge University, UK.  From 1982 to 1992, he worked there, at the University of Glasgow, and the Chester Beatty Laboratories, London. He moved to the USA in 1992, joining the Medical College in 2000. He was an Elizabeth Glaser Scientist of the Pediatric AIDS Foundation and has held an Unrestricted Grant for Infectious Disease Research from the Bristol-Myers Squibb Foundation. He holds a Merit Award from NIAID. He is an Editorial Board member for several journals, and has served on study sections and committees for NIH and charities. He directs projects on HIV-1 entry into cells and how to inhibit it with specific drug candidates and antibodies; designing envelope glycoprotein trimers for neutralizing antibody induction and structural studies; and understanding HIV-1 resistance under selection by CCR5 inhibitors.

Robert R. Redfield, MD

University of Maryland School of Medicine

Dr. Robert R. Redfield has been actively engaged in clinical research and clinical care of chronic human viral infections and infectious diseases, especially HIV, for more than 30 years. Dr. Redfield is a graduate of Georgetown University School of Medicine and completed his internal medicine and infectious diseases training at Walter Reed Army Medical Center and Walter Army Institute of Research. He served as the founding director of the Department of Retroviral Research within the Military’s HIV Research Program and retired after 20 years of service in the US Army Medical Corp when he co-founded the University of Maryland’s Institute of Human Virology. He is currently a Professor of Medicine, Professor of Microbiology and Immunology, and serves as the IHV Associate Director and Director of the Division of Clinical Care and Research, as well as the Chief of Infectious Diseases within the University of Maryland School of Medicine. Dr. Redfield made several important early contributions to our understanding of HIV, to include the demonstration of the importance of heterosexual transmission and the development of the Walter Reed staging system for HIV infection. His dominant area of research interest is focused the development of novel biological approaches to the treatment of chronic viral pathogens with a particular focus on targeting host cell pathways and host directed immunity for their therapeutic potential. Presently, Dr. Redfield oversees an extensive clinical program providing HIV care and treatment to more than 5,000 patients in the Baltimore/Washington DC community. He also leads extensive USG funded global care and treatment, and post-graduate medical education programs, which are currently active in 5 African and 2 Caribbean countries.

Bill Snow

Global HIV Vaccine Enterprise

Mr. William (Bill) Snow is a Director of the Global HIV Vaccine Enterprise, an alliance of organizations dedicated to accelerating the development of preventive HIV vaccines. Bill oversees a Secretariat who helps to facilitate coordination, collaboration, knowledge sharing and resource optimization in the HIV vaccine field. Bill has a long and distinguished history in the HIV vaccine field, advising on and advocating for funding, legislation and a wide variety of activities to help accelerate development of a safe, effective and affordable AIDS vaccine for more than 20 years. He is a co-founder and long-time Board member of AVAC: Global Advocacy for HIV Prevention, and was a member of the Coordinating Committee and Board of the Enterprise when it received its initial funding in 2005. Bill was instrumental in establishing national, local and global community-advisory boards at the NIH clinical trial networks AVEG, HIVNET and HVTN and today sits on the NIAID AIDS Vaccine Research Subcommittee, the NIH Vaccine Research Center Scientific Advisory Working Group and has at times served in the leadership groups of every HIV vaccine clinical trials group to date.

Magdalena Sobieszczyk, MD, MPH

Columbia University Medical Center

Dr. Magdalena Sobieszczyk is an Assistant Professor of Clinical Medicine in the Infectious Diseases Division at the Columbia University College of Physicians and Surgeons. She is an investigator in the National Institutes of Health sponsored HIV Vaccine Trials Network (HVTN), a multicenter organization whose mission is to develop an effective preventive HIV vaccine, and an investigator in the AIDS Clinical Trials Group. She is the Associate Director of the NYC HIV Vaccine Unit and her research focuses on developing, testing, and implementing biomedical strategies to prevent HIV. She has been involved in development and implementation of several national and international HIV vaccine protocols including serving as the co-chair of HVTN 505, a phase 2b protocol evaluating the efficacy and safety of VRC’s DNA prime/rAd5 boost vaccine regimen. Dr. Sobieszczyk is also the protocol chair of HVTN 802, a longitudinal observational study to evaluate the virologic, immunologic, and clinical course of HIV infection in persons who participated in advanced phase HIV vaccine trials. Dr. Sobieszczyk completed her Internal Medicine residency and fellowship in Infectious Diseases at Columbia University College of Physicians and Surgeons and holds an MPH degree from the Mailman School of Public Health.

Annie Sparrow, MD, MPH

Mount Sinai Global Health

Dr. Annie Sparrow, MD, MRCP, FRACP, MPH is Assistant Professor and Deputy Director of the Human Rights Program in the Department of Global Health, teaching human rights and humanitarian aid in complex emergencies. An Australian, Dr. Sparrow spent her first ten postgraduate years practicing pediatric intensive care in London and her native Perth. She began focusing more on public health after a brief stint in Afghanistan under Taliban control. She served as a lead public advocate for refugees detained in punitive conditions in Australia and worked in remote Aboriginal communities before obtaining a Masters in Public Health at Harvard. She then joined Human Rights Watch, focusing on HIV and sexual violence in conflict and working mainly in Sudan and Chad. On one trip to Darfur, she gave displaced children crayons and paper, which they used to draw pictures about the atrocities they had witnessed and escaped. These pictures became the much-acclaimed “Darfur Drawings” exhibit that traveled widely and was used by the International Criminal Court as evidence of systematic war crimes by the Sudanese government. Most recently, Dr. Sparrow spent several years based in Nairobi working in various complex humanitarian emergencies (Sudan, Timor Leste, Somalia, Zimbabwe) for the Emergency Response Team of Catholic Relief Services and a further year as director of UNICEF’s malaria program in Somalia for the Global Fund against Aids, Tuberculosis and Malaria.

Panelists

Chris Collins

amfAR, The Foundation for AIDS Research

Chris Collins is Vice President and Director of Public Policy at amfAR, the Foundation for AIDS Research, where he leads the organization’s policy analysis and advocacy efforts. Collins also oversees amfAR’s GMT Initiative, a global grantmaking program. Before joining amfAR, Collins was a policy and communications consultant for numerous domestic and global health organizations. In 2007 he authored Improving Outcomes: Blueprint for a National AIDS Plan for the United States, which helped catalyze the movement for the first comprehensive U.S. National HIV/AIDS Strategy. He then helped organize advocacy for development and design of the Strategy. As a consultant to the Bill & Melinda Gates Foundation, Collins coordinated the work of the Global HIV Prevention Working Group. He also oversaw production of the Missing the Target report series on international AIDS service scale-up, produced by the International Treatment Preparedness Coalition (ITPC). Collins is a co-founder of the AIDS Vaccine Advocacy Coalition (AVAC), served as its executive director for two years, and remains on its board. As Appropriations Associate for Rep. Nancy Pelosi in the late 1990s, Collins developed the first Congressional legislation designed to provide incentives for the development and delivery of vaccines against AIDS, malaria, and TB. He is the author of dozens of publications on health policy. Collins holds a Master’s Degree in Public Policy from the Kennedy School of Government at Harvard University.

Tim Horn

Treatment Action Group

Tim Horn is the HIV Project Director at the Treatment Action Group (TAG), a New York-based independent research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS. He is the former Editor-in-Chief of AIDSmeds.com, an educational portal for people living with HIV/AIDS, and Executive Editor of The PRN Notebook, a quarterly journal for HIV-treating clinicians. He has also worked for the Foundation for AIDS Research (amfAR), the AIDS Treatment Data Network and the PWA Health Group. He has been living with HIV since 1992.

Rick King, PhD

International AIDS Vaccine Initiative (IAVI)

Rick King is the Vice President of Vaccine Design, overseeing a comprehensive AIDS vaccine discovery program that includes an AIDS Vaccine Design & Development Laboratory in Brooklyn, the Neutralizing Antibody Center at the Scripps Research Institute in La Jolla, California and a New Translational Research laboratory in Delhi India. King received his PhD in Biochemistry from Johns Hopkins University and conducted postdoctoral research at the National Cancer Institute’s Laboratory of Cellular Molecular Biology where he discovered a molecular abnormality that occurs with certain breast cancers. King has worked as an Associate Professor in the Lombardi Cancer Research Center’s Department of Biochemistry, and as the Senior Vice President of Research at GenVec, Inc. At GenVec, he led the company’s efforts in the identification, selection and advancement of products for cancer, ocular and infectious disease applications, leading to therapeutics currently in clinical trials. King has been the author and recipient of many peer reviewed grants, is an inventor on 12 issued patents, and has published more than 80 peer-reviewed publications.

Daniel Tietz, RN, JD

AIDS Community Research Initiative of America (ACRIA)

Daniel Tietz has served as Executive Director of the AIDS Community Research Initiative of America (ACRIA) since March 2006. In his tenure, Tietz doubled ACRIA’s budget and vastly expanded its research activities, as well as its educational, materials development, and evaluation consulting services. He hasalso ensured that ACRIA is committed to furthering sensible, science-based public policy, and actively advocates for the resources necessary to bring an end to the AIDS epidemic in the U.S. and around the world. With the creation of the ACRIA Center on HIV & Aging, Tietz has guided the organization to become an international leader in research on and responses to the needs of older adults with and at risk for HIV. Following the 2006 release of its groundbreaking Research on Older Adults with HIV (ROAH) study, ACRIA has collaborated with researchers around the world and delivered much-needed HIV prevention, education, and related services to people over age 50, including training and capacity building to HIV and senior services providers across the U.S. and beyond. A registered nurse and lawyer, Tietz previously served as Deputy Executive Director for Operations at the Coalition for the Homeless, Deputy Executive Director for Day Treatment and Residential Services at Housing Works, and Director of Housing Opportunities for Persons With AIDS (HOPWA) at the Postgraduate Center for Mental Health. Earlier in his career, he worked for the Massachusetts Department of Mental Health in a senior staff position for the Deputy Commissioner. In addition, Tietz has long-advocated on behalf of LGBT rights and social justice issues through independent political activity, including campaign management.

Founded in 1991 in response to the slow pace of government and academic research on HIV, the AIDS Community Research Initiative of America brought for the first time an activist, community-based approach to the study of new treatments for HIV and related diseases, such as viral hepatitis. In addition to drug trials and behavioral research, ACRIA also offers a comprehensive HIV health literacy program, including training and capacity building services, materials development, consulting, and program evaluation.

Mitchell Warren

AIDS Vaccine Advocacy Coalition (AVAC)

Mitchell Warren is the Executive Director of AVAC, an international non-governmental organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic. Before this, he was the Senior Director for Vaccine Preparedness at the International AIDS Vaccine Initiative (IAVI) where he directed efforts to increase community understanding and national involvement in AIDS vaccine clinical trials. Warren previously spent four years as Vice President and Director of International Affairs for The Female Health Company (FHC), the manufacturer of the female condom, where directed efforts to design and implement reproductive health programs that integrate the female condom, and he led global advocacy efforts for expanded commitment to female-initiated prevention methods. Warren also spent six years at Population Services International (PSI) designing and implementing social marketing, communications and health promotion activities in Africa, Asia and Europe, including five years running PSI’s project in South Africa. Warren is a member of the Global HIV Prevention Working Group; the board of directors of the Global HIV Vaccine Enterprise; the WHO-UNAIDS HIV Vaccine Advisory Committee; the Office of AIDS Research Advisory Council of the US National Institutes of Health (NIH); and the AIDS Research Advisory Committee of the US NIH’s National Institute of Allergy and Infectious Diseases (NIAID). Warren has degrees in English and History at the University of Wisconsin-Madison and studied health policy at the Johns Hopkins University School of Hygiene and Public Health.

Jane Waterman

International Aids Vaccine Initiative (IAVI)

Jane Waterman guides IAVI’s advocacy, policy, resource mobilization, communications and media relations programs. Jane has a wealth of experience in resource and policy development for HIV and AIDS programs, and technical knowledge of gender and development issues. Jane was previously on the senior management team of the International HIV/AIDS Alliance, a global network of national organizations that provide financial and technical support to community-based organizations in more than 40 countries. As director of external relations at the Alliance, she was responsible for developing and managing its fundraising and communications strategies, maintaining its relationship with corporate, philanthropic and government donors and raising the profile of the organization. Prior to joining the Alliance in 2004, Jane was Head of Resource Mobilization at the International Planned Parenthood Federation. She spent time in sub-Saharan Africa between 1987 and 1993, initially as a VSO volunteer and then with the British Council. She has a Master’s degree in Gender and Development, a Postgraduate Certificate in Education and a Certificate in Fundraising Management. Jane is also a graduate of the United Kingdom Cabinet Office/Henley Business School Top Management Programme.

Sponsors

Grant Support

Supported by educational grants from Gilead Sciences Inc., Janssen Therapeutics, Division of Janssen Products, LP and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

Academy Friend

Sanofi Pasteur

Promotional Partners

AIDS Community Research Initiative of America

British HIV Association (BHIVA)

Fred Hutchinson Cancer Research Center (Vaccine & Infectious Disease Division)

HIV Vaccine Trials Network

Immunization Action Coalition

International AIDS Society

International AIDS Vaccine Initiative


The Microbiology & Infectious Diseases Discussion Group is proudly supported by




Mission Partner support for the Frontiers of Science program provided by Pfizer

Abstracts

Antiretroviral Treatment for the Prevention of HIV Transmission
Myron S. Cohen, MD, The University of North Carolina at Chapel Hill

The transmission of HIV is dictated by the concentration of HIV-1 in relevant fluids (regardless of route of transmission) and the viral genotype and phenotype. People newly infected with HIV-1 (i.e. acute infection) and those with STD co-infections excrete such a large concentration of virus as to be “hyperinfectious”. The transmission of HIV likely occurs in the first few hours after exposure. The transmission of HIV after heterosexual intercourse is generally limited to one or a small number of founder variants which themselves may be “hyperinfectious”, and a slightly larger median number of variants with unprotected anal intercourse or parenteral HIV exposure.  Antiretroviral agent can be used as pre- and post-exposure prophylaxis (PrEP and PEP), or to render a person with HIV infection less contagious.  In a study conducted by the HIV prevention Trials Network (HPTN 052) HIV transmission was reduced by 96% by antiretroviral treatment in combination with counseling and condoms. In addition, people who received earlier treatment had improved health. Ecologic and observational studies suggest that broader, earlier antiviral treatment of HIV may already be reducing incidence in some populations. In Kawuzu Natal South Africa, communities with increased availability of treatment demonstrated a substantial and expected improvement in patient survival and employment, and reduced HIV incidence.  However, maximal benefit of HIV “treatment for prevention”  more broadly will require a program of universal “test and treat”, where many more infected patients are identified, linked to care, and treated very early in disease and for life. Community randomized trials designed to support this approach are underway in Africa.
 

Violence, Trafficking and HIV Transmission: A Public Health Perspective
Michele R. Decker, ScD, MPH, Johns Hopkins Bloomberg School of Public Health

Globally, an estimated one in three women experience physical or sexual violence in their lifetime, often at the hands of an intimate partner. This abuse, and the accompanying power dynamics, constrain women’s agency for sexual negotiation, and leave them vulnerable to coerced condom non-use as well as partners who introduce higher levels of sexual risk. So too, the abrasions that can accompany forced or coerced sex can facilitate transmission. Women in sex work are a core HIV risk population whose elevated HIV burden was recently confirmed. Growing evidence illustrates tremendous violence against women in sex work, including prevalent forced and coerced sex, often unprotected, and at times with multiple sequential partners. Consistent with that found in the general population, physical and sexual abuse have been found to impart significant HIV risk to women in sex work in multiple global settings. Finally, evidence confirms the presence of trafficking as an entry mechanism to the sex industry, one that imparts a trajectory of chronic disempowerment for young women and girls. The lasting HIV vulnerabilities posed by gender-based violence, including early, forced, and coerced entry to sex work, are clear. Further illustrating the public health relevance of addressing gender-based violence is recent evidence that reducing violence against women in sex work can achieve significant gains in terms of incident HIV both among sex workers and in the general adult population.
 

Improving Communication and Collaboration
Luiz Loures, MD, MPH, UNAIDS

The UNAIDS vision of “ zero new HIV infections, zero discrimination and zero AIDS-related deaths” is fast becoming regarded as a goal, possibly with a time frame that is realistic. How does an aspiration convert into reality? There are five elements to this: Focus, Speed, Smart investments, Innovation and Human rights. A combination of these five elements can bring about the end of the AIDS epidemic. The rapid success observed in the AIDS response has been possible because of global solidarity and shared responsibility between governments, communities, people living with HIV, civil society, private sector and the scientific community. Investments in AIDS, from international donors and domestic sources total nearly US$ 17 billion, up from US$500 million just a little over a decade ago. New HIV infections have plummeted, as access to prevention services and treatment increased across the world. And with a record 8 million people on antiretroviral therapy, AIDS deaths have fallen by more than 50% between 2005 and 2011. New developments-political, social and scientific change the AIDS landscape every day and dialogue with implementing partners and communities is key to the make the most of what is available.
 

Approaches to Improving Communication and Collaboration – the NIH Perspective
Mary A. Marovich, MD, National Institute of Allergy and Infectious Diseases, NIH

The magnitude and complexity of the HIV epidemic require collaboration and effective communication strategies to ensure continual progress. The Division of AIDS within the NIAID has taken several approaches to promoting collaborative and interactive investigations. A key approach has been forming “collaboratories” comprising centers or consortia designed to optimize the sharing of resources, information, specimens, cohorts, clinical trial capacity, training tools, and programs. These awards are structured with funding dependent on the demonstration of multidisciplinary collaborative research efforts to accelerate the acquisition of knowledge. Examples will be presented of improved collaboration through such agreements or public-private partnerships. Each example addresses the priority mission of halting the spread of HIV infection by developing a preventive HIV vaccine.
 

Vaccine Update: Africa and Thailand
Nelson L. Michael, MD, PhD, Walter Reed Army Institute of Research

HIV vaccine development has seen much activity over the last 12 months since the Academy held an HIV/AIDS Symposium. Work stemming from the watershed 2009 RV 144 HIV vaccine efficacy trial revealed correlates of risk of infection that are now better understood in terms of testable hypotheses that may elucidate mechanistic associations most notably humoral responses to the V2 loop of the HIV Env protein. Molecular sieve analysis has provided orthogonal support for the importance of V2 specific immune responses in the RV 144 clinical result. These studies are executing in parallel with plans to better understand the immunogenicity of the RV 144 ALVAC-gp120 heterologous prime-boost vaccine regimen through new, scientifically intense phase 2a immunogenicity studies in Thailand and plans for two efficacy studies in southern Africa and Thailand in volunteers at risk for HIV infection via heterosexual and homosexual routes of transmission. The interim analysis of the HVTN 505 phase 2b HIV vaccine efficacy study of a gag-pol-env DNA-Ad5 prime boost regimen in U.S. MSM was recently announced clearly demonstrating futility for acquisition and viremic control causing vaccinations in that study to halt and for volunteers to be unblinded to vaccine versus placebo arm participation. While not statistically meaningful, there were more infections in the vaccine arm of HVTN 505 versus the placebo arm in both per protocol and modified intent to treat populations. Long-term results of a previously halted efficacy study of a related gag-pol-nef Ad5 vector in African heterosexuals recently showed statistically meaningful excess infections in the vaccine arm albeit years after partial vaccination and volunteer unblinding. The impact of these events on very promising pre-clinical and early phase I studies of rare serotype human Ad vectors (i.e. Ad26, Ad35) with MVA and protein subunit components will be discussed. Swift progress on understanding the molecular immunology of the steps involved in coaxing antibody responses from the germ line to elicit potent, broadly cross reactive neutralizing antibodies continues with the hope that this approach can begin early entry into the clinic to distill theory to practice.
 

Implementing Treatment as Prevention - The Key to an AIDS & HIV-free Generation
Julio Montaner, MD, BC Centre for Excellence in HIV / AIDS

While an outright cure or a preventive vaccine for HIV/AIDS remains elusive, remarkable advances in HIV treatment have been achieved. More recently, evidence has accumulated that the viral load suppression achieved by highly active antiretroviral therapy (HAART) has a marked impact on decreasing HIV transmission. As a result, expansion of HAART coverage to all those in medical need has been proposed as a potentially cost-averting strategy to dramatically curb HIV/AIDS morbidity and mortality, as well as HIV transmission. HPTN 052 - a prospective randomized trial - provided definitive and compelling confirmatory evidence of the efficacy of Treatment as Prevention among sero-discordant couples. HPTN 052 showed a 96.3% decrease in the risk of HIV transmission with immediate HAART. Of note, immediate HAART was also associated with a 30% decrease in the combined endpoint of disease progression and death, and an 83% reduction in the incidence of extra-pulmonary tuberculosis. We have derived population level evidence of the impact of Treatment as Prevention in BC, where since the initial roll out of HAART in 1996, there has been a greater than 90% decrease in progression to AIDS and death among HIV infected individuals, and a greater than 70% decrease in new HIV diagnoses per year. The soon to be released 2013 WHO Treatment Guidelines are expected markedly expand HAART eligibility globally. The challenge remains to secure the necessary political will to fully implement the 2013 WHO Treatment Guidelines and thus fully capitalize on the impact of Treatment as Prevention as the means to secure an AIDS & HIV-free generation.
 

Next-Generation, Soluble, Cleaved HIV-1 Env Trimers for Vaccine and Structural Studies
John P. Moore, PhD, Weill Cornell Medical College

One approach to making an HIV-1 vaccine involves the design of recombinant proteins based on the virus’s trimeric envelope glycoprotein (Env) complex, with the goal of inducing broadly neutralizing antibodies (bNAbs). The external, vaccine-relevant regions of the Env complex can be produced as soluble proteins, provided steps are taken to stabilize the normally weak interactions between the gp120 and gp41 subunits of the trimer. In the absence of such modifications, the soluble trimeric Env complex dissociates rapidly into its constituents.  The most commonly used stabilization procedure involves eliminating the natural cleavage site between the gp120 and gp41 components, yielding an “uncleaved gp140”. Our alternative approach is to promote cleavage but introduce other stabilizing changes into the trimer to make what we call SOSIP gp140s. Our most current version is BG505 SOSIP.664 gp140, based on a subtype A pediatric isolate. These trimers are homogenous, highly stable and closely resemble the native Env complexes that are found on viruses, when viewed by electron microscopy. The BG505 SOSIP.664 gp140 trimers express a wide range of bNAb epitopes but very few for irrelevant, non-neutralizing antibodies. The trimers can also be produced efficiently in a range of mammalian cells. Preliminary studies of their immunogenicity in rabbits are yielding encouraging results from the perspective of NAb induction. We have also found that uncleaved gp140s based on BG505 and several other Env sequences form heterogenous, aberrant structures that do not resemble native viral Env spikes, when made under comparable conditions and viewed by electron microscopy. The critical distinction between the SOSIP gp140s and uncleaved gp140s is the cleavage event, which is essential for soluble trimers to remain in a native configuration; the SOSIP mutations stabilize that configuration and allow the native-like trimers to be produced and purified. The implications of these findings for vaccine and structural studies will be discussed.
 

Using Tools We Have to Drive the Epidemic to Zero
Robert R. Redfield, MD, University of Maryland School of Medicine

Enormous progress has been made in the treatment of HIV infection, both in the United States and globally. Recent reports of experts in Africa have confirmed a dramatic reversal of declined life expectancy in Africa, as well as the impact of expanded ARV treatment. Despite the progress in Africa, the US epidemic remains, especially in high prevalence metropolitan areas. Key facts to confront the epidemic are in hand, however effective implementation remains a challenge. Early diagnosis for all HIV infected people, effective linkage to care and retention in care, and effective ARV treatment at both the individual and community levels. The time has come to make effective steps to implement a national priority to bring the US HIV epidemic to a halt.
 

HVTN 505: Clinical Trial Results
Magdalena Sobieszczyk, MD, MPH, Columbia University Medical Center

We will review and discuss the results of HVTN 505, atest-of-concept efficacy trial that evaluated the efficacy and safety of VRC’s DNA prime/rAd5 boost vaccine regimen in men who have sex with men and transgender persons. The National Institute of Allergy and Infectious Diseases (NIAID) recently decided to stop administration of vaccinations and continue following participants in HVTN 505 because an independent data and safety monitoring board (DSMB) found that the vaccine regimen neither reduced HIV acquisition nor decreased post-acquisition viral load.
 

When Gender and Conflict Collide: The Role of Sexual Violence and Other Human Rights Violations in Conflict on HIV Transmission
Annie Sparrow, MD, MPH, Mount Sinai Global Health

We use the phrase ‘the feminization of HIV’ to illustrate the complex interaction between gender inequality and the increased risks of contracting HIV through sexual violence and other harmful practices such as polygamy, child brides, wife inheritance and widow cleansing, to name a few. The HIV epidemic has always been fuelled by discrimination, marginalization and stigmatization, and the fallout on women is reflected in the geography of structural violence - the ongoing discrimination against women in terms of their political, social, cultural and economic rights. When it comes to conflict, there is a collision of structural and functional violence, intensifying the risks to girls and women. The sources of vulnerability - physiological, socio-economic, cultural, and political - are magnified by the widespread human rights violations that are either specific to war, or heightened in conflict and displacement: consider cultural practices such as female genital mutilation together with rape as a weapon of war, child marriage and dowry crimes after livelihoods are denied or lost, the confluence of compensatory or opportunistic assault and ‘women’s work’, transactional sex and food insecurity, trafficking and peace-keeping forces. Adolescent girls are particularly vulnerable, for reasons that combine physiology and culture with sexual predation and weaknesses in international human rights law. An endless cycle of sexual violence and high-risk sexual behavior, with all the attendant risks of exposure to HIV, may follow a girl’s loss of value after rape - the market value of virtue in itself being a reflection of gender inequality and denial of women’s rights.
 

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