HIV 2014: Science, Community and Policy for Key Vulnerable Populations

HIV 2014: Science, Community and Policy for Key Vulnerable Populations

Monday, May 5, 2014

The New York Academy of Sciences

Presented By

 

The UNAIDS' vision calls for a global approach in efforts to achieve zero new HIV infections, zero AIDS-related deaths and zero discrimination, and provides a clear path for future HIV research and policy. Despite progress in treatment scale-up, in searching for a cure, and improved life expectancy for people living with HIV, there remains a need for major breakthroughs in a number of areas. These include capacity-building to scale up access to for HIV prevention, care and treatment; ensuring access to scientific developments for key populations, reducing transmission among vulnerable populations; enhancing the prevention benefits of HIV treatment expansion; microbicides; and development of more efficacious vaccines for prevention or for treatment. To foster collaboration among basic researchers, activists, human rights advocates, affected communities, policy makers and physicians who work on HIV, the New York Academy of Sciences will host HIV 2014: Science, Community and Policy for Key Vulnerable Populations in collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS). The proposed program aims to explore recent innovations, in technologies and programmes, as well as remaining challenges of reaching key populations, including people who inject drugs, sex workers and men who have sex with men. The broad goals of this symposium will be to enhance partnerships between leading international researchers (from academia, government and industry), clinical investigators and public health and policy advocates, to promote the exchange of ideas, results and technologies, and to ensure successful translation of knowledge into improved outcomes for HIV in key vulnerable populations.

*Reception to follow.

This event will also be broadcast as a webinar.

Please note: Transmission of presentations via the webinar is subject to individual consent by the speakers. Therefore, we cannot guarantee that every speaker's presentation will be broadcast in full via the webinar. To access all speakers' presentations in full, we invite you to attend the live event in New York City when possible.

Registration Pricing

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

 

Presented by

  • UNAIDS
  • The New York Academy of Sciences

**Note: The HIV 2014: Science, Community and Policy for Key Vulnerable Populations symposium is cosponsored by the Joint United Nations Programme on HIV/AIDS (UNAIDS). The views expressed in symposium materials or publications, by speakers and moderators, or by any symposium cosponsors do not necessarily reflect the official views or policies of UNAIDS; nor does mention of trade names, commercial practices, or organizations imply endorsement by UNAIDS.


The Microbiology & Infectious Diseases Discussion Group is proudly supported by

  • Pfizer

Agenda

* Presentation titles and times are subject to change.


May 5, 2014

7:30 AM

Registration and Continental Breakfast

Session I. Situation Report

8:00 AM

Welcome Remarks
Jennifer Henry, PhD, The New York Academy of Sciences

8:10 AM

Opening Remarks
Luiz Loures, MD, MPH, UNAIDS, Geneva, Switzerland

8:25 AM

Keynote Address
New Methods, New Estimates for MSM in the World
Chris Beyrer, MD, MPH, Johns Hopkins Bloomberg School of Public Health, Baltimore, PA, USA

8:45 AM

Prevention Technologies for PWID: Overcoming the Obstacles
Daniel Raymond, Harm Reduction Coalition, New York, NY, USA

9:05 AM

Current Challenge and Opportunities in Access for Sex Workers
Anna-Louise Crago, Trudeau Scholar, University of Toronto, Canada

9:25 AM

Linking Human Rights and Science for Key Populations
Joe Amon, PhD, Human Rights Watch, New York, NY, USA

9:45 AM

Discussion

10:00 AM

Networking Coffee Break

Session II. New Prevention Technologies and Approaches

10:30 AM

Scaling Up HIV Programs for Key Populations in South Africa
Fareed Abdullah, MD, South African National AIDS Council, Pretoria, South Africa

10:50 AM

Long-Acting Parenteral Formulation of GSK1265744 Protects Macaques against Repeated Challenges with SHIV
Chasity Andrews, PhD, Aaron Diamond AIDS Research Center, New York, NY, USA

11:10 AM

The SAPPH-IRe Trial – ART for HIV prevention among female sex workers in Zimbabwe
Frances M. Cowan, FRCP FRCPE MSc MD, Centre for Sexual Health and HIV/AIDS Research Zimbabwe

11:30 AM

Can We Treat MSM Early Enough?
Jerome Kim, MD, Walter Reed Army Institute of Research, Bethesda, MD, USA

Session III. New Clinical Frontiers

11:50 AM

HCV Treatment: The Golden Age
Kristen Marks, MD, Weill Cornell Medical College, New York, NY, USA

12:10 PM

HIV and Aging in MSM
Steven G. Deeks, MD, UCSF, San Francisco, CA, USA

12:30 PM

Networking Lunch Break

1:30 PM

The Perfect Storm: HIV, Tuberculosis, and People Who Inject Drugs in Criminal Justice Settings
Frederick L. Altice, MD, Yale School of Medicine, New Haven, CT, USA

1:50 PM

Effective Response to HIV in People Who Inject Drugs in Ukraine: Successful Implementation of Evidence Based Harm Reduction, Policies and Human Rights Principles
Pavlo Smyrnov, MD, MPH, International HIV/AIDS Alliance in Ukraine, Ukraine

Session IV. Interactive Panel Discussion

2:10 PM

Science, Community and Policy – Maximising Intersections and Synergies
Moderator: Peter Godfrey-Fausset, MBBS, DTM&H, FRCP (UK), UNAIDS

Panelists: Mark Harrington, Treatment Action Group
Arne Näveke, PhD, International AIDS Vaccine Initiative
Ani Shakarishvili, MD, UNAIDS
Mitchell Warren, AIDS Vaccine Advocacy Coalition (AVAC)

3:00 PM

Closing Remarks: Call to Action, and Moving On to Melbourne
Chris Beyrer, MD, MPH, Johns Hopkins Bloomberg School of Public Health, Baltimore, PA, USA
Luiz Loures, MD, MPH, UNAIDS, Geneva, Switzerland

Networking Reception

4:00 PM

Close

Speakers

Organizers

Chris Beyrer, MD, MPH

Johns Hopkins Bloomberg School of Public Health, Baltimore, PA, USA

Chris Beyrer MD, MPH, is a professor of Epidemiology, International Health, and Health, Behavior, and Society at the Johns Hopkins University Bloomberg School of Public Health. He is the founding Director of the University’s Center for Public Health and Human Rights. He also serves as Associate Director of the Johns Hopkins Centers for AIDS Research (CFAR) and as Associate Director for the JHU Center for Global Health. He serves as PI of the Johns Hopkins T 32 HIV Training Program in Epidemiology and Prevention Science. Dr. Beyrer is a member of the Scientific Advisory Board of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Co-Chairs the U.S. National Institutes of Health Office of AIDS Research Planning Committee on Epidemiology and Natural History and serves on the Scientific Expert Panel of UNAIDS. In 2012, he became President- Elect of the International AIDS Society, and will serve as President of the IAS, the world’s largest body of HIV professionals, from 2014-16. Prof. Beyrer Co-Chairs the IAS Key Populations Working Group with Prof. Michel Kazatchkine. He is also serving as Co-Chair, with Prof Adeeba Kamarulzaman, of the WHO Consolidated Guidelines for HIV among Key Populations, due for release in 2014.

Prof. Beyrer is the author of more than 200 scientific papers, and author or editor of six books, including War in the Blood: Sex, Politics and AIDS in Southeast Asia, and Public Health and Human Rights: Evidence-Based Approaches. He has guest-edited a number of series and special issues, including a special of The Lancet on HIV and Substance Use in 2010, for The Lancet on MSM and HIV in 2012 and a current series in The Lancet on HIV and Sex Work, due for release at AIDS 2014. He has served as a consultant and adviser to numerous national and international institutions, including the National Institutes of Health, the World Bank, WHO, UNAIDS, the Open Society Foundations, the Walter Reed Army Institute for Research, amfAR The Foundation for AIDS Research, Physicians for Human Rights and Human Rights Watch. Dr. Beyrer received a BA in History from Hobart and Wm. Smith Colleges, his MD from SUNY Downstate in Brooklyn, NY, and completed his residency in Preventive Medicine, public health training, an MPH and a Infectious Diseases Fellowship at Johns Hopkins University in Baltimore. He received an honorary Doctorate (PhD) in Health Sciences from Chiang Mai University in Thailand, in 2012, in recognition of his 20 years of HIV service in Thailand.

Peter Godfrey-Faussett, BA, MBBS, DTM&H, FRCP(UK)

UNAIDS, Geneva, Switzerland

Peter Godfrey-Faussett is a professor at the LSHTM and consultant physician at the Hospital for Tropical Diseases. After training in clinical infectious diseases and molecular genetics, he spent five years leading the Zambian AIDS-related TB (ZAMBART) project, an interdisciplinary collaborative research programme between the LSHTM, Lusaka Urban District Health Management Team and the University of Zambia. Thereafter he spent a year working with the Global Tuberculosis Programme of the World Health Organization, where he was responsible for developing strategies to address the combined epidemic of TB and HIV. Following his return to London he has maintained an interest in global policies around TB and HIV and served as chairman for the Technical Review Panel of the Global Fund against AIDS, Tuberculosis and Malaria. A regular member of WHO expert groups, his research interests remain focused on the impact that the HIV epidemic is having on TB control and on interventions to reduce both diseases.  He is currently seconded full-time to UNAIDS, where he is the Senior Science Adviser with a wide ranging portfolio including HIV cure, ARV-based HIV prevention, HIV vaccines and synergies between the HIV and the non-commnicable disease response.

Ani Shakarishvili, MD

UNAIDS, Washington DC, USA

Dr. Anna (Ani) Shakarishvili currently is Senior Technical Adviser at the UNAIDS Liaison Office in the US. She took up this position in January 2013 when she joined UNAIDS office in Washington DC from her assignment as the UNAIDS Country Director in Ukraine for almost eight years. Prior to joining UNAIDS in 2005, she held a number of senior positions including as the STD Team Lead at the Global AIDS Program, and Coordinator of CDC’s Health Education and Promotion, and STD-HIV research and programs in Eastern Europe and Central Asia at the US Centers for Disease Control and Prevention (CDC) in Atlanta, GA.

Dr. Shakarishvili is a medical doctor with the specialization in reproductive health and endocrinology, and professional training in epidemiology, STDs and HIV public health research and program implementation. She received her clinical and public health trainings in her native country of Georgia, CDC and Emory University School of Medicine in the US.

Yegor Voronin, PhD

Senior Science Officer Global HIV Vaccine Enterprise, New York, NY, USA

Yegor Voronin is a Senior Science Officer at the Global HIV Vaccine Enterprise (the Enterprise). In this role, he is responsible for identifying, developing, and managing science-related initiatives and activities for the Enterprise. In particular, he oversees the Timely Topics in HIV Vaccines initiative. Prior to joining the Enterprise, Dr. Voronin completed his postdoctoral training with Dr. Michael Emerman and Dr. Julie Overbaugh at the Fred Hutchinson Cancer Research Center (FHCRC) in Seattle, Washington, USA. Over the last fifteen years he studied HIV and other retroviruses on a variety of levels, from their potential use as gene therapy vectors at the West Virginia University, to molecular mechanisms of reverse transcription at the National Cancer Institute, to HIV and SIV evolution and population genetics at the FHCRC. 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

Fareed Abdullah, MD

South African National AIDS Council, Pretoria, South Africa

Dr. Fareed Abdullah is Chief Executive Officer of the South African National AIDS Council (SANAC), a position he has held since February 2012. 

Previously, Dr Abdullah was the Africa Unit Director for the Global Fund to Fight AIDS, Tuberculosis and Malaria and served as Director of Technical Support for the International HIV/AIDS Alliance.  From 1994 to 2006, he worked in the Western Cape Provincial Department of Health as Deputy Director-General and Head of the AIDS program.

Dr Abdullah received an honorary doctorate from the University of Cape Town, where he trained as a specialist in public health medicine, for his role in the successful scale-up of a province-wide antiretroviral treatment program.

Frederick Altice, MD

Yale School of Medicine, New Haven, CT, USA

Frederick L. Altice, MD, is a professor of medicine and professor, epidemiology and public health at Yale University in New Haven, Connecticut where he also serves as the director of clinical and community research. He is board-certified in both infectious diseases and addiction medicine.

Dr Altice’s research interests are focused on the interface between infectious diseases, including HIV, tuberculosis, and viral hepatitis, and substance use disorders. Specifically, he is interested in prevention, treatment, and behavioral intervention research activities. As a clinical epidemiologist and intervention researcher, he has created novel programs for the treatment of HIV, viral hepatitis, tuberculosis, and substance use disorders in vulnerable populations, including injection drug users, criminal justice populations, and men who have sex with men. In addition to developing and testing evidence-based interventions to improve adherence, including directly administer antiretroviral therapy among HIV-infected drug users and released prisoners, Dr Altice has been at the forefront of integrating medication-assisted therapies such as methadone, buprenorphine, and extended-release naltrexone into treatments for individuals with HIV, HCV, tuberculosis, and mental illness.

Dr Altice is currently the principal investigator on numerous clinical investigations funded by the National Institutes of Health and several other federal agencies and served as a leading member of the World Health Organization’s Policy Guidelines for Collaborative Tuberculosis and HIV Services for Injecting and Other Drug Users: An Integrated Approach. He is also a member of the International Association of Physicians in AIDS Care’s Guidelines Committee for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons With HIV. Dr Altice is currently leading studies in Ukraine, Russia, Central Asia, Malaysia, Peru, and the United States. In addition to publishing his research in peer-reviewed journals, Dr Altice has authored several significant books and book chapters. He lectures nationally and internationally on the subjects of infectious diseases, addiction medicine and the delivery and organization of healthcare services, including integrated healthcare.

Joe Amon, PhD

Human Rights Watch, New York, NY, USA

Joe Amon is the Director of the Health and Human Rights Division at Human Rights Watch. His work focuses on human rights and the political determinants of health. Since joining Human Rights Watch in 2005, Joe has worked on a wide range of issues including access to medicines; the impact of discrimination on access to prevention and treatment; censorship and the denial of health information; arbitrary detention; and the role of civil society in the response to infectious disease outbreaks and environmental health threats. Between January 2009 and June 2013 he oversaw Human Rights Watch's work on disability rights.

Chasity Andrews, PhD

Aaron Diamond AIDS Research Center, New York, NY, USA

Dr. Chasity Andrews received her PhD from the University of Michigan in Pharmaceutical Sciences in 2010. Her graduate research focused on vaccine adjuvant delivery systems. In particular, she engineered liposomal delivery systems to target antigens and adjuvants to specific subcellular compartments. Following the completion of her graduate studies, Dr. Andrews joined the laboratory of Dr. David Ho at the Aaron Diamond AIDS Research Center, affiliate of The Rockefeller University, as a postdoctoral fellow. In Dr. Ho’s laboratory, her research focuses on the evaluation of long-acting agents, including small molecules and antibodies, for pre-exposure prophylaxis.

Chris Beyrer, MD, MPH

Johns Hopkins Bloomberg School of Public Health, Baltimore, PA, USA

Frances Cowan, FRCP, FRCPE, MSc, MD

Centre for Sexual Health and HIV/AIDS Research Zimbabwe, Zimbabwe

Dr Cowan is a Reader in the Department of Infection and Population Health at University College London. She is a clinical epidemiologist who has been living and working full time in Zimbabwe since 1999. She leads a large portfolio of HIV prevention and sexual and reproductive health research including several clinical trials and impact evaluations of national programs. The group works closely with the Zimbabwe Ministry of Health and Child Care and the National AIDS Council to undertake research to facilitate intervention scale up and inform the evidence base for their HIV prevention and care policies and programming. She oversees implementation of Zimbabwe’s National Sex Work Programme ‘Sisters with a Voice’ now operating in 36 sites across Zimbabwe. Her research group employs around 100 researchers. In 2012, the research group was registered as a not for profit Trust (CeSHHAR Zimbabwe). Dr Cowan is co-chair of HPTN’s Adolescent Science Committee and is co-principal investigator on a number of research capacity strengthening grants with the University of Zimbabwe College of Health Sciences She is also a member of several WHO expert review panels.

Anna-Louise Crago

University of Toronto, Canada

Anna-Louise Crago has been part of the sex workers’ rights movement for close to two decades. She is the former clinical coordinator at Stella, the center by and for sex workers in Montréal and has worked for SWAN, the Sex Workers’ Rights Advocacy Network of Central Eastern Europe and Central Asia since 2006. She is the author of numerous human rights reports including: Our Lives Matter: Sex Workers Unite for Health and Rights: 8 Country Case Studies; Rights Not Rescue: A Report on Female, Male, and Transgender Sex Workers' Human Rights in Botswana, Namibia, and South Africa (with Jayne Arnott); and Arrest the Violence: Human Rights Abuses Against Sex Workers in Central Eastern Europe and Central Asia. Anna-Louise is currently a Trudeau Scholar pursuing a PhD in social and medical anthropology at the University of Toronto where her research focuses on sex workers’ living and working conditions in contexts of armed conflict. She is also one of the guest-editors of the upcoming special issue of the Lancet on HIV and Sex Workers.

Steven Deeks, MD

University of California - San Francisco, CA, USA

Steven G. Deeks, MD, is a Professor of Medicine in Residence at the University of California, San Francisco (UCSF) and a faculty member in the Positive Health Program (AIDS Program) at San Francisco General Hospital. Dr. Deeks has been engaged in HIV research and clinical care since 1993. He is a recognized expert on HIV-associated inflammation. His research has several linked objectives, including: (1) to determine the mechanisms that contribute to persistent inflammation during therapy, (2) to determine association between HIV persistence and inflammation during effective antiretroviral therapy, (3) to characterize the impact of persistent inflammation on end-organ disease and function, and (4) to develop novel therapeutic interventions that reduce chronic inflammation and/or the size of the latent reservoir.

Dr. Deeks has published over 300 peer-review articles, editorials and invited reviews on these and related topics. He has been the recipient of several NIH grants. He is the principle investigator of an NIH-funded international collaboratory aimed at developing therapeutic interventions to cure HIV infection (DARE). He is the co-chair of the “Towards an HIV Cure” International Working Group and a member of the Office of AIDS Research Advisory Council (ORAC). He was elected to the American Society for Clinical Investigation (ASCI). In addition to his clinical and translational investigation, Dr. Deeks maintains a primary care clinic for HIV infected patients, and is a member of the Department on Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents.

Jerome Kim, MD

Walter Reed Army Institute of Research, Bethesda, MD, USA

COL Jerome H. Kim, M.D., is currently Principal Deputy, US Military HIV Research Program (MHRP) and the chief of the Laboratory of Molecular Virology and Pathogenesis, MHRP, at the Walter Reed Army Institute of Research.  MHRP is a multidimensional, international research program encompassing vaccine research and development, HIV prevention research, and clinical research. As the head of the HIV Vaccines Project Office, US Army Medical Materiel Development Activity, he runs the Army's HIV vaccine advanced development program. Dr. Kim’s current research interests include HIV molecular epidemiology, host genetics, and HIV vaccine development. He is a Professor, Department of Medicine, Uniformed Services University of the Health Sciences.

Luiz Loures, MD, MPH

UNAIDS, Geneva, Switzerland

Luiz Loures is the deputy executive director of programme of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and assistant secretary-general of the United Nations. Loures leads UNAIDS efforts to support countries in meeting the 2015 global AIDS targets and establishing a sustainable response to AIDS. Loures is a medical doctor with nearly 30 years of experience in the AIDS response. His work ranges from providing medical care to people living with HIV in the early days of the epidemic to helping to develop a global policy framework. Loures received his MD at the Federal University of Minas Gerais in Brazil, specializing in critical care. He also holds an MPH from the University of California, Berkeley.

Kristen Marks, MD

Weill Cornell Medical College, New York, NY, USA

Kristen Marks, MD, MS, Assistant Professor of Medicine and ID Fellowship Program Director.  Dr. Marks received Internal Medicine residency and Infectious Diseases fellowship training at New York-Presbyterian Hospital (Cornell), where she focused her clinical training and research on HIV and hepatitis virus infections, and she completed Weill Cornell's Master's Degree in Clinical Investigation.  Her current research focuses on improving treatment outcomes in patients with HIV and hepatitis virus co-infections and includes studies of acute HCV as well as new treatment strategies for chronic HCV.  She was the vice chair of an AIDS Clinical Trials Group (ACTG) multi-center study, currently serves on 3 other ACTG hepatitis protocol teams, and is a member of the ACTG Hepatitis Transformative Science Group.  She is co-investigator in the Cornell HIV/AIDS Clinical Trials Unit and Center for Study of Hepatitis C, where she is the site PI for 5 treatment studies and 2 other protocols related to HCV.  She also sits on IDSA, AASLD, and IAS-USA’s joint guidelines panel for “Recommendations for testing, managing and treating hepatitis C”.

Daniel Raymond

Harm Reduction Coalition, New York, NY, USA

Daniel Raymond is the Policy Director of the Harm Reduction Coalition, based in New York City, where he leads national, state and local advocacy efforts to advance strategies addressing the intersection of substance use and health. His current work focuses on hepatitis C, opioid overdose prevention, syringe access and HIV prevention for people who inject drugs, and coverage of harm reduction and addiction treatment and recovery services.

He currently serves on the AASLD/IDSA Hepatitis C Guidance Panel and the FDA Antiviral Drugs Advisory Committee. He is a Steering Committee member and former Chair of the National Viral Hepatitis Roundtable, and a member of the Board of Trustees for the Washington Heights CORNER Project. He has worked in the fields of syringe exchange and harm reduction for over two decades.

Pavlo Smyrnov, MD, MPH

International HIV/AIDS Alliance in Ukraine, Ukraine

Pavlo Smyrnov is Deputy Executive Director of International HIV/AIDS Alliance in Ukraine. He is involved in development and implementation of large HIV/AIDS response program focused on most at risk populations, such as people who inject drugs, commercial sex workers, and men having sex with men funded by Global Fund to Fight AIDS, Tuberculosis and Malaria. He is member of technical writing group for development of country proposal to the Global Fund to Fight HIV, Tuberculosis and Malaria and was also involved in developing of country proposals in Round 1, Round 6 and Round 10 of Global Fund. Pavlo is participating in many research projects in the field of substance use, high-risk behavior, HIV prevention and network epidemiology. He is Ukraine principal investigator for socially-integrated transdisciplinary prevention project TRIP (transmission reduction intervention project) which develops new ways of HIV prevention in the risk networks of recently infected individuals. Pavlo has MPH degree from Boston University School of Public Health, is a senior lecturer and PhD fellow at School of Public Health of the National University of Kyiv-Mohyla Academy. Pavlo is Edmund Muskie Fellow and Returning Scholar of Academic Fellowship Program of Open Society Foundation.

Panelists

Mark Harrington

Treatment Action Group

Mark Harrington joined the seminal AIDS activist group, ACT UP (the AIDS Coalition to Unleash Power) in 1988, five years after receiving his bachelor’s degree from Harvard University. As a member of ACT UP’s Treatment and Data Committee, Mark helped plan and execute ACT UP’s “Seize Control of the FDA” demonstration in 1988 and its “Storm the NIH” demonstration in 1990. The events helped initiate a fundamental shift in regard to how the U.S. Food and Drug Administration (FDA), the U.S. National Institutes of Health (NIH), and other government agencies addressed HIV community health priorities.

Arne Näveke, PhD

International AIDS Vaccine Initiative

Arne Näveke is Executive Director of Advocacy, Policy and Communications for the International AIDS Vaccine Initiative, which he joined in May 2013. Based at IAVI’s headquarters in New York, he oversees global advocacy, policy and communications aimed at ensuring that research and development of a preventive AIDS vaccine remains high on policy agendas.

Previously, Dr. Näveke held executive positions in Communications, Public Affairs, and Policy with GSK Vaccines in Brussels, Sanofi Pasteur MSD in Lyon, and Aventis in Frankfurt, covering most available vaccines and the infectious diseases they help prevent. Among other achievements, he planned and oversaw implementation of the internal and external communications strategies for European launch of the world’s first human papillomavirus (HPV) vaccine Gardasil®. Prior to joining industry, Dr. Näveke was a journalist for scientific and general print and broadcast media. He holds a Ph.D. in biochemistry from the French Alternative Energies and Atomic Energy Commission and the University of Munich, and a Master of Science in chemistry from the University of Hamburg.

Ani Shakarishvili, MD

UNAIDS

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.

Moderator

Peter Godfrey-Faussett, BA, MBBS, DTM&H, FRCP(UK)

UNAIDS, Geneva, Switzerland

Peter Godfrey-Faussett is a professor at the LSHTM and consultant physician at the Hospital for Tropical Diseases. After training in clinical infectious diseases and molecular genetics, he spent five years leading the Zambian AIDS-related TB (ZAMBART) project, an interdisciplinary collaborative research programme between the LSHTM, Lusaka Urban District Health Management Team and the University of Zambia. Thereafter he spent a year working with the Global Tuberculosis Programme of the World Health Organization, where he was responsible for developing strategies to address the combined epidemic of TB and HIV. Following his return to London he has maintained an interest in global policies around TB and HIV and served as chairman for the Technical Review Panel of the Global Fund against AIDS, Tuberculosis and Malaria. A regular member of WHO expert groups, his research interests remain focused on the impact that the HIV epidemic is having on TB control and on interventions to reduce both diseases.  He is currently seconded full-time to UNAIDS, where he is the Senior Science Adviser with a wide ranging portfolio including HIV cure, ARV-based HIV prevention, HIV vaccines and synergies between the HIV and the non-commnicable disease response.

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Treatment Action Group

Presented by

  • UNAIDS
  • The New York Academy of Sciences

**Note: The HIV 2014: Science, Community and Policy for Key Vulnerable Populations symposium is cosponsored by the Joint United Nations Programme on HIV/AIDS (UNAIDS). The views expressed in symposium materials or publications, by speakers and moderators, or by any symposium cosponsors do not necessarily reflect the official views or policies of UNAIDS; nor does mention of trade names, commercial practices, or organizations imply endorsement by UNAIDS.


The Microbiology & Infectious Diseases Discussion Group is proudly supported by

  • Pfizer

Abstracts

Prevention Technologies for PWIDs: Overcoming the Obstacles
Daniel Raymond, Harm Reduction Coalition, New York, NY, USA

Estimates of the global population of people who inject drugs (PWIDs) range from 11 million to 22 million, with roughly 3 million PWIDs living with HIV. Access to critical HIV prevention interventions and coverage of antiretroviral treatment for PWIDs has been uneven and limited to date. Barriers to scaling up effective responses to HIV include intersecting challenges of stigma, legal environments, and policy. The persistence of obstacles jeopardizes the potential uptake of new strategies, including treatment as prevention and pre-exposure prophylaxis, while constraining the impact of established prevention tools including syringe access and opioid substitution treatment. Combination approaches to scaling up prevention for PWIDs require structural approaches to the social, legal and policy contexts informed by meaningful community engagement, participation and mobilization.
 

Advances and Challenges in Access to Prevention, Treatment and Care for Sex Workers
Anna-Louise Crago, Trudeau Scholar, University of Toronto, Toronto, Canada

The past few years have presented both significant advances and challenges in achieving sex workers’ access to prevention, treatment and care for HIV on a global scale. Major obstacles have included: continued widespread human rights abuses fuelled by the predominance of legal and policy frameworks predicated on criminalization, raids and the conflation of sex work and trafficking; the persistence of discrimination as a major barrier to treatment and adequate services; the advent of restrictions on American international aid to sex worker projects (later partially repealed); and a number of transnational initiatives that have exerted huge pressure on international health bodies, human rights organizations and national governments to endorse further repression of sex work and a reversal of support for sex workers’ rights, including their right to health. Despite these barriers, there have been significant improvements. The proportion of spending on prevention services for sex workers has increased globally. The international sex workers’ movement has achieved meaningful partnerships with WHO and UN bodies that have led to the development of groundbreaking policies, tools and guidance. Lastly, a number of landmark local initiatives have shown promising results.
 

Scale up of HIV programmes for Key Populations in South Africa
Fareed Abdullah, FCPHM, South African National AIDS Council

Although key populations have always been regarded as being at high risk of becoming infected with and transmitting HIV infection, prevention and treatment programmes for these communities have been neglected for more than two decades. South Africa has finally turned its attention to the epidemics in key populations. We describe the methods employed to scale up HIV programmes for key populations together with their attendant challenges and discuss the opportunities provided both for testing and implementing new biomedical prevention technologies in these key populations. The challenges include epidemiological, programmatic and financial challenges as well as challenges generated by legal and social obstacles to reaching these neglected populations.
 

Long-Acting Parenteral Formulation of GSK1265744 Protects Macaques against Repeated Challenges with SHIV
Chasity D. Andrews, Aaron Diamond AIDS Research Center, The Rockefeller University, New York, NY, USA

While oral and topical pre-exposure prophylaxis (PrEP) modalities have demonstrated protection against HIV-1 transmission, the modest and variable efficacy results have been largely attributed to lack of adherence to the prescribed regimen. Long-acting (LA) PrEP agents may offer an opportunity to address this deficiency in current approaches to daily PrEP. GSK1265744 (GSK744) is an integrase strand transfer inhibitor and analogue of dolutegravir with physicochemical properties that permit a 200 mg/mL LA injectable nanosuspension formulation. Following a single injection of GSK744 LA in healthy volunteers, a plasma half-life of 21 to 50 days was observed, supporting quarterly dosing in humans. Our studies were performed to evaluate the effectiveness of GSK744 LA as PrEP in a rhesus macaque challenge model. We have demonstrated that GSK744 LA administered monthly starting one week prior to the first virus exposure completely protects macaques from eight intrarectal SHIV exposures.  A follow-up experiment established that plasma concentrations exceeding 3X protein-adjusted levels that would block 90% of infections (PAIC90) in vitro provided 100% protection against infection in the macaque, whereas levels above 1X PAIC90 were ~97% effective. These plasma levels of GSK744 can be readily achieved in man with quarterly 800 mg IM injections. Phase 2 evaluations of GSK744 LA as PrEP initiated in 2014 in anticipation of Phase 3 efficacy trials.
 
Coauthors: William Spreen2, Lee Moss2, Yun Lan Yueh2, Agegnehu Gettie1, Kasi Russell-Lodrigue3, Hiroshi Mohri1, Cecilia Cheng-Mayer1, Zhi Hong2, Martin Markowitz1, David D. Ho1
1Aaron Diamond AIDS Research Center, The Rockefeller University, New York, NY, USA
2GlaxoSmithKline, Research Triangle Park, NC, USA
3Tulane National Primate Research Center, Covington, LA, USA

 

The SAPPH-IRe Trial – ART for HIV prevention among female sex workers in Zimbabwe
Frances M Cowan, MD, MSc, Department of Infection and Population Health, University College London, United Kingdom

Sex workers (SWs) bear the brunt of the HIV epidemic; SWs in Zimbabwe have high HIV prevalence (>50%) but are poorly engaged in prevention and care. Data from Zimbabwe’s National SW Program ‘Sisters’ indicates that HIV sero-incidence is several-fold higher than among the general population. The SAPPH-IRe trial tests a targeted intervention for SW designed to decrease the proportion of all SWs with detectable HIV viral load (VL), by increasing the proportion of HIV infected SW virally suppressed on antiretroviral therapy (ART), and by prevention in HIV negative women. SAPPH-IRE is a matched-pair cluster-randomized trial. The ‘Sisters’ Program will be implemented in 14 trial communities, with seven (one cluster/pair) randomly allocated to the enhanced ‘SAPPH-IRe’ intervention.  SW in trial communities will be surveyed at baseline and at 18-24 months using respondent driven sampling to assess 'population level' effects. Survey data will be complemented by programmatic and process data guided by a ‘theory of change’ to maximise generalizability. The ‘Sisters’ program is supported by peer educators an provides free HIV testing and counselling, referral to government ART services for HIV+, contraception, condoms, STI syndromic management. The SAPPH-IRe intervention will provide the: ‘Sisters’ program supplemented by onsite provision of ART, repeat testing for HIV negatives, offer of PrEP for HIV negative SWs, intensified community mobilization and adherence support. The primary outcome is the proportion of all SW who are infectious (VL>1000 copies/ml). A key secondary outcome is the proportion of HIV infected SWs who are infectious (VL>1000 copies/ml).
 

Can We Treat MSM Early Enough?
Jerome H. Kim, US Military HIV Research Program, Walter Reed Army Institute of Research

The RV254 and RV217 protocols have been used to identify MSM in Thailand during the earliest stages of HIV infection (Fiebig I – III) and are designed to evaluate and initiate cART treatment as quickly as possible.  The study has provided important information about the impact of early treatment on DNA reservoirs; the reconstitution, if not the preservation of gut associated lymphoid tissue; early neurological involvement; and importantly has provided important experience working in these at-risk and sometimes proscribed populations.  We will describe correlative information from a recent non-human primate study, and update our current plans for these cohorts, including treatment interruption, broadly neutralizing monoclonal antibodies and therapeutic vaccination.
 
Coauthors: Jintanat Ananworanich, Nelson L. Michael, Merlin L. Robb, US Military HIV Research Program, Walter Reed Army Institute of Research
 

HCV Treatment: The Golden Age
Kristen Marks, Weill Cornell Medical College, New York, NY

HCV represents an important comorbidity in people living with HIV infection .   Particularly for people who inject drugs (PWID) who are disproportionately co infected with HCV.  Cohort studies have shown HCV to be a leading, if not the leading, cause of non AIDS-related death for HIV-infected persons.     More recently, acute HCV has also emerged as an epidemic in men who have sex with men (MSM).      Historically, treatment has been limited by both efficacy and toxicity, which led typically to deferral of therapy in HIV/HCV coinfected individuals.   Tremendous progress has been made in anti-HCV drug discovery over the past 5-10 years, with multiple classes of antivirals that act directly on the viral life cycle.  We are on the verge of having well tolerated direct acting antiviral combinations that can cure the vast majority of people treated.  However, challenges exist, such as those related to drug-drug interactions, access to treatment, and cost.  Nonetheless, the opportunity to dramatically reduce liver-related morbidity and mortality exists; those in the HIV community, providers, and policy makers must do everything they can to seize it.
 

HIV and Aging in MSM
Steven G. Deeks, University of California, San Francisco

HIV infected adults who are effectively treated with antiretroviral therapy (ART) have an unexplained excess risk for several age-associated complications, including cardiovascular disease, osteopenia, cancer, liver dysfunction, renal dysfunction, and neurocognitive disease. Many of these complications are predicted by immune dysfunction and inflammation, both of which persist during effective ART. Indeed, the immune system during ART shares some similarities with that seen in the very old (“immunosenescence”).  In the context of other risk factors associated with aging that may be more common in the MSM population—particularly social isolation, poverty, substance abuse, and polypharmacy—there are growing concerns that the multimorbidity of HIV disease will lead to early onset of age-associated functional impairments (e.g., frailty). A multidisciplinary research agenda is being assembled to address this growing concern. It is hoped that lessons learned from the study of HIV disease will be informative to the study of aging in other chronic conditions.
 

The Perfect Storm: HIV, Tuberculosis, and People Who Inject Drugs in Criminal Justice Settings
Frederick Altice, MD, Yale School of Medicine, New Haven, CT, USA

There are currently 10 million prisoners with 40-60 million people transitioning through them annually.  Criminal justice settings (CJS) are highly dynamic with unpredictable movement and involve an array of types of settings, including police detention, compulsory drug detention centers, pre-trial detention (jails) and prisons.  Globally, the prevalence of HIV is 5-fold greater and TB is 60-100 fold greater than found in the surrounding communities, primarily due to the shared risk factors for both HIV and TB and for incarceration, including criminalization of drugs and sex workers and trans-institutionalization of individuals with psychiatric and substance use disorders (SUDs), people living with HIV/AIDS (PLWHA) and the homeless.  As such, CJS become “high risk” environmental amplifiers where both HIV and TB are concentrated and subsequently TB is propagated to others due to inadequate screening and treatment, poor circulation and crowding and immunosuppressed PLWHA who are at markedly increased risk for acquiring and developing TB – and therefore transmitting it to others.  Tuberculosis contributes the greatest to prison-related morbidity and mortality. For those who survive, however, nearly all are released to the community, often without adequate continuity of care – especially those with SUDs.  A case study of Malaysian prisoners will be discussed to provide empiric and modeling data that should guide best practices.  In addition, evidence-based practices that have high likelihood for reducing prison-related morbidity and mortality from HIV, TB and HIV/TB coinfection will be discussed, including challenges to their implementation.
 

Effective response to HIV in people who inject drugs in Ukraine: successful implementation of evidence based harm reduction, policies and human rights principles
Pavlo Smyrnov, MPH, International HIV/AIDS Alliance in Ukraine, Kyiv, Ukraine

Every fifth of the estimated 310,000 people who inject drugs (PWID) in Ukraine is HIV-positive. PWID are affected most by HIV and other health and social problems associated with drug use.  From mid-late 1990s, the HIV response among PWID in Ukraine was mainly driven by community organizations (CBOs). Thanks to the international organizations’ and CBOs’ advocacy, resource mobilization and support, major breakthroughs such as policy reforms and implementation of widely scaled comprehensive harm reduction services, including substitution therapy (ST), have become a reality in Ukraine. By the end of 2013, in 330 cities over 200,000 PWID were reached by HIV prevention, HIV testing, and clinical referrals often combined with social and legal support; over 7,000 patients accessed ST through the network of 130 CBOs in cooperation with health, interiors and other institutions. Few innovative approaches such as Peer Driven Intervention allowed reaching out and ensuring access to harm reduction services for most vulnerable subpopulations, such as women, young and stimulant users. To address the challenging issue of the low access of PWID to ART (10% in 2013), in 2013 CBOs started to implement a community-initiated treatment intervention assuring access to ART for HIV-positive PWID. As a result of these efforts, the programs demonstrated real impact documented as a decrease since 2006 in the number of registered HIV cases among PWID, in the proportion of PWID among the total number of registered HIV cases and the HIV prevalence among young PWID decreased from 26% in 2006 to below 4% in 2013.
 

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