HIV Treatments and Prevention Strategies

June 26, 2013

On June 30, HIV researchers, activists, and policymakers will meet in Kuala Lumpur for the IAS 2013 conference to discuss the latest breakthroughs and challenges in combatting this epidemic. At the Mailman School, faculty from across departments are testing new treatments and prevention strategies. Below is a compilation of work that they are doing.

ICAP Reaching MSM with HIV Prevention, Care, and Treatment Services in Rwanda

ICAP is collaborating with the Government of Rwanda on an innovative project for men who have sex with men (MSM) to increase access to quality, MSM-friendly HIV prevention, care, and treatment services in the capital, Kigali.

Three pilot clinics have seen a significant increase in the number of MSM accessing services; over 140 MSM were reached with prevention messages and 120 MSM accessed HIV testing at the three clinics.

Researchers Make Advances in Quest for AIDS Vaccine

Researchers in the Center for the Aids Programme of Research in South Africa under its director and Mailman School professor of Epidemiology, Dr. Salim Abdool Karim, conducted a study showing a vulnerability that allows the human body to kill most strains of HIV. Dr. Abdool Karim and team discovered unique changes in the virus in two women that enabled them to produce broadly neutralizing antibodies, killing up to 88% of HIV types.

Study Findings Shed Light on Timing Co-Treatment of HIV and TB

Findings from the Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPit) study by Drs. Salim and Quarraisha Abdool Karim investigated how to time treatment for individuals infected with tuberculosis (TB) and HIV in sub-Saharan Africa. The study found that individuals with a low T-cell count were better off if they began ART within the first four weeks of TB treatment, resulting in a two-thirds decline in the death rate.

Public Health Creativity in Action at ICAP Program in Kenya

In a region in Kenya where ICAP is a lead partner in battling HIV, transmission of the virus from pregnant women to their babies has been cut from 30% to less than 5%. The team is also applying other tactics to prevent transmission of the virus in “discordant couples” that is slowing the rate of new infections.

Seek, Test, Treat and Retain Community HIV Prevention Project in San Juan, PR

Dr. Lisa Metsch, Stephen Smith Professor and Chair of Sociomedical Sciences, is co-principal investigator with Dr. Jorge L. Santana-Bagur of the University of Puerto on a five-year grant to implement a community-level approach for increasing access to HIV care and retention for drug users in San Juan, Puerto Rico. The study will bring new insights on a particularly difficult subpopulation to link to and retain in care—HIV-infected drug users.

Project RETAIN: An Efficacy Trial Testing an Integrated Model of Substance Use Treatment, Mental Health, and HIV Primary Care Services for HIV-Positive Drug Users

Dr. Lisa Metsch and Dr. Carlos del Rio of Emory University are testing if a “Retention Clinic” that provides onsite evidence-based substance use and patient navigation services to HIV-positive crack cocaine users in an HIV primary care setting will improve the HIV-care outcomes of HIV-infected crack cocaine users.

Expanding HIV Testing to Dental Care Settings

Oral HIV rapid testing in the dental setting is increasingly recognized as an opportunity to identify and refer individuals at risk for HIV infection. Dr. Lisa Metsch and colleagues conducted a nationally-representative survey of general dentists across the U.S. regarding barriers and facilitators to offering oral HIV rapid testing chairside, examining dentists’ knowledge, attitudes, beliefs, and willingness for offering routine HIV rapid testing in the dental care setting.

Rapid HIV Testing With or Without Risk-Reduction Counseling in Drug Treatment

A study by Dr. Lisa Metsch and Dr. Grant Colfax (formerly of the San Francisco Health Department) of HIV-negative adults who reported no past-year HIV testing found that participants randomized to on-site rapid testing were significantly more likely to complete an HIV test compared with participants randomized to an off-site referral arm.

HIV Trial for Improving Engagement in Care among NYC Recently Diagnosed HIV-Positive MSM

Promoting Action towards Health (PATH) is an intervention for newly HIV-diagnosed MSM that incorporates health enhancement and positive prevention strategies. Integrated into HIV care settings, PATH has the potential to significantly increase engagement in care and adherence to HIV treatment and reduce sexual risk. Dr. Patrick Wilson, associate professor of Sociomedical Sciences, is co-investigator.

Role of State Regulations in HIV Testing in Nation’s Opioid Treatment Programs

A study led by Dr. Thomas D’Aunno identifies the extent to which clients in a national sample of opioid treatment programs received HIV testing and examines the relationships between state laws for informed consent and pretest counseling, and rates of HIV testing among these clients. The results showed the need to increase HIV testing and also underscore the beneficial possibilities of dropping pretest counseling as a requirement and using the opt-out approach to informed consent for HIV testing. Other research by Dr. D’Aunno analyses HIV prevention efforts, HIV testing and counseling in U.S. outpatient substance abuse treatment units.

African American Churches and AIDS Prevention

Robert E. Fullilove, EdD, clinical professor of Sociomedical Sciences, is working with faith-based initiatives aimed at increasing the involvement of African-American churches in AIDS prevention and service activities with a particular emphasis on New York State.