IAS news
SPRING 2014
Nobody Left Behind
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Welcome to Durban and to AIDS 2016
from the 2013 IAS Governing
Council Retreat
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16 The
for the IAS HIV
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from CROI 2014, the Conference on
Retroviruses and Opportunistic Infections
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11 CIPHER
lays foundations
paediatrics priority
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IAS 2013 Evaluation Report
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IAS 2015 planning is underway
12 News
14 Report
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IAS Towards an HIV Cure Community Workshop
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Focusing on Key Affected Populations:
“Nobody Left Behind”
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Message from the President and the
Acting Executive Director
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AIDS 2014 Programme steps up the pace
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Sex Workers’ Freedom Festival, Kolkata, India. Photo © APNSW / Dale Kongmont.
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8 The IAS launches a new campaign focusing
on Key Affected Populations.
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For more information about the IAS visit www.iasociety.org
IAS talks with Andrew Grulich, IAS Governing
Council Member in Asia and the Pacific Islands
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Evaluation and feedback on the work we do are
very important to us. The Evaluation Report of
the 7th IAS Conference on HIV Pathogenesis,
Treatment, and Prevention (IAS 2013) is now
available online and shows that IAS 2013 was
yet another successful conference. While we are
enormously gratified by this positive feedback, we
know well that we could not achieve these results
without our partners and our members.
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We are also happy to share great news about
CIPHER, our paediatric initiative, which has
recently received a second generous grant of
£500,000 from ViiV Healthcare to strengthen
and extend our activities in paediatric HIV.
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MEMBERSHIP
This month we are launching an exciting new
project, the Nobody Left Behind campaign, aimed
at mobilizing key stakeholders and public opinion
to promote and protect the rights of Key Affected
Populations. The campaign will run in conjunction
with the publication of a White Paper on access
to treatment for KAPs which will be launched at
the AIDS 2014 conference in Melbourne.
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In addition, we decided that the focus in 2014 will
be on three key priorities. One is Key Affected
Populations (KAPs), comprising men who have
sex with men, sex workers, people who inject
drugs and transgender people. The other two are
paediatric HIV and HIV Cure.
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Photo: © IAS A number of colleagues left the IAS secretariat
at the end of 2013 after many years of
committed work and tireless service to the HIV
response. On behalf of the IAS and its members,
I would like to express my gratitude to them
and wish them all the best for the future.
Bernard Kadasia
IAS Acting Executive Director
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Françoise Barré-Sinoussi
IAS President
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At the same time we decided to start looking
at how we can strengthen our involvement in
hepatitis C and other HIV related co-infections.
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I would like to end my message by paying tribute
to Nelson Mandela, one of the greatest leaders of
our times and a champion in the response to HIV,
who passed away last December. His passing was
deeply saddening, but his legacy will last in each
one of us determined to end the HIV epidemic.
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In the second half of 2013 we held a series of
internal and external meetings to analyze the
organization’s position within the HIV sector and
our added value. We discussed about the future
of the IAS, its successes so far but also the
potential challenges lying ahead of us. We also
looked at the synergies between our Research
Promotion and Policy and Advocacy work and
decided to merge the two to improve the
efficiency and effectiveness of what we do.
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Photo: © IAS / Steve Shapiro, Commercialimage.net
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As we all know, in recent
years the landscape of the
HIV epidemic has dramatically
changed demanding a more
targeted and focused response.
As a dynamic, independent
organization, we have to evolve
too, in order to fulfill our values
and objectives and to maximize
our impact.
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Message from the Acting
Executive Director
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Such interest is certainly due to the reputation
of the International AIDS Conference whose
programme will once again demonstrate the
engagement, focus and quality of work that is
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In January, the initiative Towards an HIV Cure,
organized a community training workshop in
Chennai, India. It was rewarding for me to speak
in front of an eager audience made up of young
researchers and members of the HIV positive
community. I believe that information sharing and
community involvement are key to encouraging
new collaborations and research projects. We
are also looking forward with great expectation
to the forthcoming Towards an HIV Cure Symposium
taking place in Melbourne, Australia, 19-20 July 2014.
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We are just a few months away from AIDS 2014
and we can really feel a growing level of enthusiasm
and interest for the conference both at an international
and local level. Melbourne is bursting with energy
and we already have more than 80 events planned
in Australia before and during AIDS 2014.
done in and around the field of HIV. We all know
that the challenges we are facing with HIV and
associated diseases like hepatitis, tuberculosis
and non-AIDS comorbidities, are far from
being overcome. As we get closer to the 2015
Millennium Development Goals, global health
priorities are rapidly changing. The upcoming
AIDS conference will be the place to also
strengthen our mobilization towards the next
global health challenges. Universal access at
an affordable price to the new hepatitis C
treatments will certainly be one of those.
AIDS 2014 will also be the place to voice
strongly against repressive policies that violate
human rights and significantly impede access to
health efforts in key affected populations.
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The IAS secretariat is busy
working on its forthcoming
conferences. The AIDS 2014
Conference Coordinating
Committee is currently finalizing
the conference programme.
At the same time, planning for the
IAS 2015 conference (Vancouver,
Canada, July 2015) and AIDS
2016 (Durban, South Africa,
July 2016) is also moving ahead.
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Message from the President
IAS News Spring 2014
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Messages from the President and the Acting Executive Director
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AIDS 2014 Programme
steps
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The programme will again host bridging sessions to
provide multidisciplinary, multi-perspective dialogues
and to link the three programme components science, community and leadership and accountability.
Confirmed bridging session topics include:
access to hepatitis C testing and treatment, ageing,
multidisciplinary health programming, partnerships
in the HIV Response, LGBTI rights and transitioning
from paediatric to adolescent care.
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From Delhi, Professor Lewin
travelled to Pune where she met
with Ramesh Paranjape, director
of the National AIDS Research
Institute, before taking part in a
session on HIV Cure at the HIV
Congress in Mumbai.
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Experienced abstract writers are invited to register
their interest in volunteering for the next round
of Abstract Mentoring, for the 8th IAS Conference
on HIV Pathogenesis, Treatment and Prevention
(IAS 2015), which will take place on 19–22 July 2015,
by sending an email stating their full name and
email address to: [email protected]
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Brent Allan, Community Programme Committee
Co-Chair, is looking forward to meeting colleagues in
Melbourne to “work together to create sessions that
explore recent scientific advances, best practices and
shared challenges that touch all regions and around
the world, creating a programme that shapes and
drives the response for the next few years.”
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This year the Abstract Mentor Programme
recruited 109 volunteer mentors who provided
expert feedback on 405 abstracts. More than
300 researchers from around the world made use
of this unique service to develop their abstract
writing skills. The programme aims to provide equal
opportunities for researchers who are less experienced
abstract submitters or who live in resource-limited
settings, to present their findings at the conference.
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Local Co-Chair Professor Sharon
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Lewin took AIDS
2014 on the
road to India in March. At a public
seminar in New Delhi hosted by
UNAIDS and the Government of
Victoria, Australia, Professor Lewin
delivered a lecture titled Towards
an HIV Cure: Dare to Dream? to
some 100 guests. She met with
Government bureaucrats in Delhi.
Prior to the lecture, Professor
Lewin met with some key Indian
media outlets.
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The conference programme will provide a platform
for the latest HIV research and state-of-the-art
programming. Historically, only a small proportion
of submissions (approximately 30%, including poster
exhibition) make it into the final programme of the
conference. Abstracts are now being reviewed and
scored by a team of 1,400 reviewers from 87 nations.
The Programme Committees will gather in April for
an intense three day meeting to build sessions that
will form the core of the AIDS 2014 programme.
AIDS 2014 on the
road in India
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Elly Katabira, IAS Immediate Past President and
AIDS 2012 International Co-Chair is looking forward
to the critical themes addressed at AIDS 2014:
“AIDS 2012 was a celebration of effective advocacy
as people living with HIV were welcomed to the
United States and, after getting an update on the
conference planning, I predict AIDS 2014 will be
a defining moment as well, fomenting discussion
around a comprehensive action plan for the HIV
response post-2015.”
Melbourne Convention and Exhibition Centre (MCEC)
Photo: © MCEC
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Dr. Gita Ramjee, Scientific Programme Committee
Co-Chair, noted that the “bridging sessions are
especially critical because they are an opportunity
for experts from every aspect of the HIV
response to engage and share knowledge and
explore how the linkages and synergies might be
used to create effective partnerships.”
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Echoing Professor Lewin’s thoughts, Professor
Françoise Barré-Sinoussi, IAS President and AIDS
2014 International Co-Chair, said: “it is crucial,
that each of us: scientists, healthcare professionals,
opinion and political leaders, people living with
HIV and their representatives, attend the conference
in Melbourne to demonstrate our determination
and our commitment. It is critical to accelerate
development in science, to progress in access to
health for all and to advance human rights and
social justice.”
These programme developments follow the
announcement in late January of the plenary
speakers (see next page). Plenary speakers
will speak on a specific theme for each day.
Conference Coordinating Committee (CCC)
members chose each speaker based on their
outstanding contribution to the HIV response,
their expertise in a selected topic area and their
ability to reach a wide audience.
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Professor Sharon Lewin, AIDS 2014 Local Co-Chair,
was pleased with the submission figures and said
that, “the submission rates prove there is a strong
commitment to the HIV response despite the travel
distance to Melbourne and the funding restrictions
that many organizations are facing. Given the
significant number of submissions from Asia and
the Pacific Islands, it will be a chance to highlight
the diverse nature of the Asia Pacific region’s HIV
epidemic and the unique responses to it.”
Workshop and Programme Activity working group
members met during the first week of April
to
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select top scoring workshops, sessions, performances,
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installations and networking zone proposals.
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Most of the abstracts submitted fell under
Track D: Social and Political Research, Law, Policy and
Human Rights (33.3%), followed closely by Track
C: Epidemiology and Prevention Research (25.2%).
Regionally, the majority of abstracts are from Asia,
the Pacific Islands and Africa, however the United
States, India, Nigeria, Uganda and Australia are
strongly represented throughout all submissions.
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More than 8,000 abstracts were submitted
during the application period which closed
on 6 February 2014. The most cutting edge
submissions will be used to build the abstract,
workshop, Global Village and Youth components
of the programme.
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As the imminent 20th
International AIDS Conference
(AIDS 2014) programme nears
completion, interest continues
to grow at every level of the
HIV response.
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IAS News Spring 2014
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AIDS 2014 Programme steps up the pace
World AIDS Day 2014 in Melbourne
IAS News Spring 2014
< Continued from previous page
Daily Plenary Sessions
AIDS 2014 Affiliated
Independent Events
MONDAY, 21 JULY:
Where are we now?
PLHIV at the centre of the HIV response
Lydia Mugherera, Uganda
THURSDAY, 24 JULY: Stepping up the
pace: making the long term short term
State of the ART: HIV Cure - where are
we now and where are we going?
Jintanat Ananworanich, Thailand
Stepping up the pace on an HIV Vaccine: what
needs to be done? Antonio Lanzavecchia,
Switzerland
TUESDAY, 22 JULY: What’s holding
us back and how do we move faster?
Stepping up the pace for MSM and
transgender - understanding the science
Beatriz Grinsztejn, Brazil
HIV and the law Michael Kirby, Australia
No one left behind: HIV and tuberculosis
co-infection Diane Havlir, United States
Where are we headed on Ending AIDS in
children Shaffiq Essajee, United States
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in Melbourne
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for Democracy in Myanmar and UNAIDS Global
Advocate for Zero Discrimination and MichelCONFERENCES
Sidibé,
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UNAIDS Executive Director, both in Melbourne to
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participate in World AIDS Day activities. CONFERENCES
Let us know your aspirations for the biggest,
Other World AIDS Day activities included:
global HIV and AIDS conference. What issues are
close to your heart that you would like to see
Paint the Town Red - the AIDS 2014 local secretariat
reflected in the conference?
and friends took to the streets to suppor t the
Melbourne Youth Force and promote the conference
Make your voice heard at AIDS 2014 and join the
as par t of the “Paint the Town Red” initiative in
“Your AIDS 2014” campaign!
Federation Square on Saturday, 30 November.
www.youraids2014.org
Giant “World AIDS Day” letters were installed on
the bridge near the Square to raise awareness
about World AIDS Day in Melbourne.
YOUR AIDS 2014
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World AIDS Day Worldwide - Australia’s only
LGBTI radio station and AIDS 2014 official media
par tner JOY 94.9 hosted a global conversation
streamed over 24 hours live on-air and online
from the Melbourne studios. The event featured
interviews with esteemed scientists, political figures,
policymakers and community representatives from
around the world who joined those in Australia to
have a global conversation about critical issues in
the response to HIV. Video highlights of the day and
podcasts of interviews are available here:
www.worldaidsdayworldwide.org
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What does AIDS 2014
mean to you?
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Sharon Lewin, Aung San Suu Kyi and Michel Sidibé
in Melbourne on World AIDS Day
Photo: © IAS/Andrew Henshaw
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AIDS 2014 Local Co-Chair Sharon Lewin officially
launched the countdown to AIDS 2014 in
Melbourne on World AIDS Day 2013. Lewin joined
Nobel Laureate and human rights activist Aung
San Suu Kyi, Chairperson of the National League
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WHAT DOES IT
MEAN TO YOU?
Let us know your aspirations
for the biggest, global HIV and
AIDS conference. What issues
are close to your heart that you
would like to see reflected in
the conference?
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No one left behind: effective drug policy and
harm reduction Khuat T.H. Oanh, Vietnam
Where are we headed with HIV and
Adolescents L’Orangelis Thomas Negron,
Puerto Rico (community perspective), Susan
Kasedde, UNICEF
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Affiliated Independent Events
applications close
Where are we headed with ART - beyond an
undetectable viral load David Cooper, Australia
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30 June 2014
WEDNESDAY, 23 JULY:
No one left behind
FRIDAY, 25 JULY:
Where are we headed?
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Abstract submissions late
breakers close
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15 May 2014
Better and smarter investments in the
HIV response Mark Dybul,
The Global Fund to Fight AIDS,
Tuberculosis and Malaria
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Registrations late fee
deadline Exhibition
applications close
Stepping up the pace for MSM and
transgender - the community response
Laurindo Garcia, Philippines
Gender inequality and HIV
Jennifer Gatsi-Mallet, Namibia
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2 May 2014
– 24:00 CET
Strengthening health systems and
community Olive Shisana, South Africa
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Key Dates
Stepping up the pace on new prevention
technologies Kenneth Mayer, United States
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Organizations wishing to register an AIDS 2014
Affiliated Independent Event may now apply online.
In the past, such events have included meetings,
forums, cultural events, galas, art exhibits and
performances. The events will address HIV and
AIDS and support the vision of the conference
and its policy of diversity and inclusion.
No one left behind: HIV and Indigenous
populations James Ward, Australia
State of the art epidemiology & access
Salim Abdool Karim, South Africa
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Affiliated Independent Events are external
events happening in or around Melbourne which
complement the official conference programme.
No one left behind: HIV and Sex workers
Daisy Nakato, Uganda
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In addition, it was agreed to follow the recommendation
of the IAS Governing Council Future Conferences
Working Group to widen the scope of the IAS
Conference to include Hepatitis, Tuberculosis and
other HIV-related topics.
The CCC also discussed the role and make-up of the
Community Advisory Group (CAG) which advises
the CCC on community matters and contributes
to the development of the overall conference
programme. It was noted that membership should
be as diverse and equitable as possible with regards
to gender, HIV status, age, ethno-cultural background,
geographic and regional representation.
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It will be nearly 20 years since the 1996 International
AIDS Conference was held in Toronto, Canada
and the CCC reflected on this point, noting that
the conference will be a good opportunity to take
stock of progress to date to overcome the HIV
epidemic. However, the organizers agreed that it
will also be an opportunity to consider new science,
as well as look to the future in terms of challenges
and opportunities. It will be a time to study what
Millennium Development Goals (MDGs) were
achieved and which were missed. In addition, new
guidelines from the WHO will be due, so delegates
can also consider what changes in programme and
treatment protocols may take place post 2015.
The committee also discussed the conference
programme structure. The programme will
include ground-breaking presentations from
top investigators covering the four conference
tracks to be called: Basic Science; Clinical Science;
Prevention Science; and Implementation Science.
In addition, a wide range of dynamic activities,
such as workshops, “meet the expert” sessions
and symposia sessions will provide par ticipants
with opportunities to network, share best
practice and present their studies.
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the surrounding waters of Vancouver.CONFERENCES
In addition,
IAS 2015 CAG:
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the committee agreed that it would be useful
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Three local representatives
(nominated by
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the new
the local par tner UBC)
logo and “One World One Hope”, the painting
by Joe Average presented at AIDS 1996, which
One international representative (nominated
by the civil society par tners for the
became the lasting symbol of that conference.
International AIDS Conference)
Having a similarity between the two will help to
illustrate the journey of the last 20 years in the
One representative from the IAS 2013 CAG
HIV sector. Based on this discussion, the final
The committee discussed nominations for these
logo was developed and is featured here.
positions and invites will be sent out shor tly.
During the meeting, the CCC discussed and
approved the conference objectives (see box) which
will be used to frame the IAS 2015 communications
and promotional activities in the coming months.
In March 2014 the second
Conference Coordinating
Committee (CCC) meeting was
held to continue preparations
for the 8th IAS Conference on
HIV Pathogenesis, Treatment
and Prevention (IAS 2015),
to be held between 19–22
July 2015, in Vancouver, British
Columbia, Canada.
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Conference
Objectives
Focus on the latest HIV science
and its applications for prevention,
treatment and care worldwide
Provide new insights into HIV
vulnerability and determinants of
disease progression
Develop strategic discussions around
the increasing challenges of TB, viral
hepatitis and chronic co-morbidities
Continue to support research
into treatment as prevention, the
search for functional remission/
cure and vaccine
Review implementation research
that addresses barriers to scaling
up and integrating research and
prevention in resource limited and
policy constrained settings
Highlight the situation of HIV in
Canada and in the USA
The committee heard that the city of Vancouver is
more than ready to receive some 6,000 delegates.
Vancouver was significantly renovated to host the
Winter Olympics in 2010. The convention centre
where IAS 2015 will be hosted is state-of-the-art
and has good public transport links to the airport.
The local co-hosts, University of British Columbia
(UBC) Division of AIDS, are already in discussions
with the Mayor of Vancouver and other local
authorities to ensure the city is ready for IAS 2015.
In order to star t promotional activities in full,
the CCC recognized that an official logo was
needed soon in order to brand and promote
the conference. The committee looked at
various logo concepts and concluded that the
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There will be five members for
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logo should reflect the landscape, skyline and
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IAS 2015 planning is underway
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IAS News Spring 2014
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“One World One Hope”, painting for the XI International AIDS Conference (AIDS 1996),Vancouver.
Image reproduced with the permission of the artist. © Joe Average Inc. 2008
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We invite you to find out more by downloading the
full IAS 2013 Evaluation Report, available now at:
ww.iasociety.org/Web/WebContent/File/IAS2013_
Evaluation_Report.pdf
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The leading data collection instrument was an
online survey sent to all individual delegates at the
end of the conference and which attracted
a response rate of 33%.
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In addition to the online delegate survey, individual
interviews with delegates and focus group
discussions were conducted both during and after
the conference. Questions assessed the motivation
to attend the conference, the perceived benefits of
attending the conference, the quality and relevance of
the science presented and how the conference could
be improved. The delegate profile, marketing of the
conference, services provided online and onsite and
the impact of the previous IAS conference (IAS 2011,
held in Rome, Italy), are also reported on.
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In an effort to continuously improve, identify
strengths and weaknesses, measure impact and be
accountable to delegates, non-delegates, donors,
sponsors and other stakeholders the IAS evaluates
each conference. This has now been done for the
7th IAS Conference on HIV Pathogenesis, Treatment
and Prevention (IAS 2013) held in Kuala Lumpur,
Malaysia, from 30 June to 3 July 2013.The conference
attracted 5,167 participants, including 3,609 delegates1
from 132 countries.
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IAS 2013 Evaluation Report
- now available!
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IAS News Spring 2014
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Reference
Audience at the IAS 2013 Monday Plenary Session
Photo: © IAS/Marcus Rose/Workers’ Photos
Editors-in-Chief:
Susan Kippax, PhD (Australia)
Papa Salif Sow, MD, MSc (Senegal)
Mark Wainberg, PhD (Canada)
1.This classification includes regular delegates, student/youth/postdocs, speakers, media representatives and scholarship recipients.
It excludes staff, organizers, volunteers, hostesses, exhibitors,
accompanying persons and faculty (one-day attendees).
Special Issues:
Read the latest supplements published in JIAS:
www.jiasociety.org/index.php/jias/pages/view/special#supplements
The Global Action to reduce HIV stigma and discrimination supplement highlights current
interventions to reduce HIV-related stigma and discrimination and demonstrates how these
interventions have impacted the communities in which they are implemented.
http://www.jiasociety.org/index.php/jias/issue/view/1464
The epidemiology of HIV and prevention needs among men who have sex with men in
Africa supplement features new epidemiological data on the HIV burden among MSM
populations in Africa and addresses the challenges of intersecting stigmas related to HIV
and sexual orientation.
http://www.jiasociety.org/index.php/jias/issue/view/1465
Latest Review
Spending of HIV resources in Asia and Eastern Europe: systematic review reveals the need
to shift funding allocations towards priority populations.
Andrew Craig et al. http://www.jiasociety.org/index.php/jias/article/view/18822
Latest Research Article
Sources of HIV incidence among stable couples in sub-Saharan Africa.
Hiam Chemaitelly et al. http://www.jiasociety.org/index.php/jias/article/view/18765
Did you know? IAS members benefit from 15% reduction of the publication fee in JIAS!
www.jiasociety.org
Follow JIAS on Facebook: www.facebook.com/jiasociety
and Twitter @jiasociety for new articles and news
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I hope all of you will be in Durban to take part in
this event which will have a lasting impact on one
of the most important challenges of South Africa,
Sub-Saharan Africa and the world.
L eadership - South African Ministry of Health
(http://www.health.gov.za/)
S cience - South African Medical Research
Council (www.mrc.ac.za)
Regional
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Durban seaside
Photo: © Durban KwaZulu-Natal Convention Bureau
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S cience - Réseau Africain des Praticiens assurant
la prise en charge medicale des personnes
vivant avec le VIH/SIDA (RESAPSI)
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L eadership - Enda Santé
(www.enda-sante.org)
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ommunity - The AIDS and Rights Alliance
(ARASA) (www.arasa.info)
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2013. The IAS used this opportunity to connect and
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network with African-based partnersCONFERENCES
and members.
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The International Conference on AIDS and
Sexually Transmitted Infections in Africa (ICASA)
is a biennial conference that alternates between
Anglophone and Francophone African countries.
It provides a forum for exchange of experiences
and lessons learned from around the world when
responding to HIV, AIDS, and STIs. This event is the
continent’s largest gathering of HIV/AIDS activists
th
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Cape Town, South Africa from 7-11 December
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reported on at IAS 2013.
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KL to Bangkok, which highlighted the main research
and researchers. The 17 ICASA took place in
IAS at ICASA
IAS activities included: a High Level Panel on HIV and
Drug Use in Thailand; the IAS exhibition booth; the
popular How to write a research manuscript workshop;
a satellite session on Human Rights and the Role
of HIV Professionals; and a Science Update: from
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The participation of these partners is a critical
component in ensuring the success of the conference.
Their responsibilities include the integration of any
local and regional components within the conference,
reaching out to local and regional stakeholders and
building strong support at all levels and with all relevant
structures in the country and region for the conference.
Local
Community - South African National AIDS
Council (http://www.sanac.org.za/)
For the full report, see: www.iasociety.org/Web/
WebContent/File/IAS_at_ICAAP_Oct_2013.pdf
The 11th International Congress on AIDS in Asia and
the Pacific (ICAAP11), held from 18-22 November
2013 welcomed almost 4,000 participants to
Bangkok, Thailand. The IAS made the most of this
important event in the HIV calendar by hosting,
co-organizing and participating in various events.
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I would like to welcome the three African and three
South African organizations which have recently
been chosen to represent community, leadership
and science pillars on the Conference Coordinating
Committee (CCC), the highest governing body for
the International AIDS Conference.
Regional Conferences
IAS at ICAAP11
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The biennial International AIDS Conference truly is
the premier gathering for those working in the field
of HIV, as well as policymakers, people living with HIV
and others committed to the global response to
HIV and AIDS. AIDS 2016 will provide a tremendous
opportunity to show how much progress South Africa,
a country profoundly impacted by the HIV epidemic,
has made in implementing and funding evidence-based
prevention and treatment interventions.
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I am so proud that Durban,
South Africa was chosen to
host the 21st International AIDS
Conference (AIDS 2016) from
17 to 22 July 2016.
Welcome back to Durban!
These organizations join the international partners
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– International AIDS Society
(IAS), the Joint United
Nations Programme on HIV/AIDS (UNAIDS),
the Global Network of People Living with HIV
(GNP+), the International Community of Women
living with HIV/AIDS (ICW), the International
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Council of AIDS Service Organizations (ICASO), CONFE
the Positive Women’s Network - South Africa and CONF
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The Global Forum on MSM & HIV (MSMGF).
This is the second time that Durban will be hosting
the International AIDS Conference, having hosted the
XIII International AIDS Conference in 2000 under
the theme Breaking the Silence.That conference was
the first to take place in a developing country and
enormously helped to change the structure and nature
of the AIDS conferences. I look forward to working
with many scientists to enable researchers to showcase
the progress that Africa has made in managing the HIV
and AIDS epidemics. With its large epidemic, South
Africa offers an opportunity for conducting research
the results of which may benefit other countries.
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By Professor Olive Shisana, AIDS
2016 Local Co-Chair
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Welcome back to Durban!
Professor Olive Shisana, AIDS 2016 Local Co-Chair
Photo: © IAS
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IAS News Spring 2014
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Events
included: an IAS/UCT Colloquium on Scoping
the Next Era Of HIV Social Science In Africa: Who, What,
How?; a consultation with stakeholders on national
AIDS programmes Effectiveness and Efficiency (E2);
the IAS Exhibition booth; satellite sessions on What
Kind of Problem is a Pill: Social Science Responds to
the ART Scale-Up in Africa and Closing the gap of
Antiretroviral Treatment coverage in Africa. The IAS also
put together a High-level panel on HIV, Drug Policy
and Public Health in Africa, ran workshops on How
to write a conference abstract (in French and English)
and How to write a research manuscript, as well as
a session on AIDS 2014 - How to get involved.
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For the full report see:
www.iasociety.org/Web/WebContent/File/IAS_
at_ICASA_Report_2013.pdf
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IAS News Spring 2014
ADV
ADVOCACY POLICY
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Men who have sex with men, sex workers,
transgender people, and people who inject drugs,
are the Key Affected Populations (KAPs) most
burdened by the HIV epidemic.
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Yet for all of that, it has NOT been an intervention
that has been universal in its achievements.
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The rollout of antiretroviral therapy to those most
in need over the past 20 years has been one of the
most significant global health interventions of this
and the past century.
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POLICY
This is, for all of us who work in the sector, good
news. Excellent news.
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Globally, the annual number of
new HIV infections continues to
fall – between 2001 and 2012 in
26 countries – a reduction of more
than 50% and encouragingly, the
drop was even more pronounced
among children. More people than
ever are now receiving life-saving
antiretroviral therapy, contributing
to steady declines in the number
of AIDS-related deaths and
further strengthening efforts to
prevent new infections.1
ADVOCACY
wealth distribution6. This is a public health disaster
Sex workers, when pregnant and HIV positive, are
and if not urgently addressed, will make it exceedingly
regularly denied “Prevention of Mother-to-Child
Transmission” (PMTCT) services since they are
difficult to beat HIV and end AIDS in the foreseeable
seen as unworthy of care. Men with anorectal
future in some parts of the world.
sexually transmitted infections in countries where
Progress in reaching the 2015 Millennium
homosexuality is illegal are not only denied care and
Development Goal targets and realizing the
treatment, but may be harassed and referred to the
UNAIDS’ “zero vision” very much depends on
police. Criminalization and illegality or inaccessibility
ensuring equitable access to comprehensive
ADVOCACY
of sterile injecting equipment make HIV prevention
HIV services by overcoming stigma and
and treatment among people who inject drugs
discrimination, eliminating
harmful laws that
particularly difficult in many countries. Transphobic
ADVOCACY
criminalize KAPs and removing barriers to
discrimination, victimization, and lack of social
accessing on the ground HIV services.
support are consistently associated with attempted
suicide, substance use, dropping out of school and
Led by co-chairs Dr. Chris Beyrer, the
unprotected sex among transgender youth.2
President-Elect of the IAS and Professor Michel
Kazatchkine, the UN Secretary General Special
The data collected thus far is patchy but still
Envoy on HIV/AIDS in Eastern Europe and
informative and shocking: in an extensive review
Central Asia, the IAS Advisory Group on Key
of data representing 99,878 female sex workers in
Affected Populations will guide IAS advocacy
50 countries, sex workers were 13.5 times more
likely to be living with HIV than other women of
on the elimination of stigma and discrimination
reproductive age.3 Surveillance data in low- and
of KAPs, promote policy and legal reforms to
middle-income countries found that men who
ensure universal access to HIV services for
have sex with men are 19.3 times more likely to
KAPs and finally, raise KAPs issues at the most
be living with HIV than the general population.4
influential international forums, culminating in
A systematic review and meta-analysis that
the Nobody Left Behind campaign.
assessed HIV infection burdens in transgender
The Nobody Left Behind campaign aims to
women in 15 countries5 shows that this population
mobilize key stakeholders to acknowledge and
is 48.8 times more likely to be living with HIV than
address the challenges faced by KAPs in accessing
the general population of reproductive age. While
comprehensive HIV services. Its launch will officially
opioid substitution therapy (OST) is recognized
coincide with the presentation of both the HIV
around the world as part of the comprehensive
Human Rights Code of Conduct for HIV Professionals
package of an evidence-based approach to HIV
and the White Paper: Maximizing the treatment and
prevention, 2010 data revealed that OST coverage
prevention benefits of ART for Key Affected Populations
for the treatment and care for people who inject
at the 20th International AIDS Conference (AIDS
drugs has only reached 6–12% on a global scale,
2014), to be held in Melbourne in July 2014.
with a wide gap between regions depending on
POLICY
ADVOCACY
By Manoj Kurian, IAS Senior
Manager, Policy and Advocacy
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ADVOCACY
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Nobody Left Behind
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OLICY
Nobody Left Behind
Y
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March at AIDS 2008, Mexico City
Photo: © IAS/Mondaphoto
IAS News Spring 2014
Nobody Left Behind
Chris Beyrer, M.D, MPH
IAS President-Elect
Dr. Chris Beyer is Co-Principal Investigator of the newly
funded Johns Hopkins Center for AIDS Research
(CFAR) and also serves as Associate Director of the
Johns Hopkins Center for Global Health.
He has extensive experience in conducting
international collaborative research and training
programs in HIV/AIDS and other infectious
disease epidemiology, infectious disease prevention
research, HIV vaccine preparedness, health and
migration and health and human rights.
Dr. Beyrer served as Field Director of the
Thai PAVE and HIVNET studies from 1992–1996,
based in Chiang Mai, northern Thailand, and has
done extensive research in the epidemiology of
HIV in Thailand, Burma, China, India, South Africa,
Malawi, Tanzania, Russia and Kazakhstan.
He authored the 1998 book “War in the Blood:
Sex Politics and AIDS in Southeast Asia”,
co-edited the 2008 book “Public Health and
Human Rights: Evidence-Based Approaches”
and co-authored the 2011 book “The Global
Epidemics of HIV among MSM in Low- and
Middle-Income Countries for the World Bank”.
Chris Beyrer, M.D, MPH
IAS President-Elect
He currently serves on the Scientific Advisory
Board for the U.S. PEPFAR Program, where he
co-chairs the working group on key populations.
Professor Michel
Kazatchkine, M.D.
Professor Michel Kazatchkine has spent the last 30
years fighting AIDS as a leading physician, researcher,
administrator, advocate, policy maker and diplomat.
UN Secretary-General’s
Special Envoy on HIV/
AIDS in Eastern Europe
and Central Asia
He attended medical school in Paris and has
completed post-doctoral fellowships at St. Mary’s
Hospital in London and Harvard Medical School.
He is Professor of Immunology at Université
René Descar tes in Paris and has authored or
co-authored over 500 ar ticles focusing on
autoimmunity, immuno-intervention and HIV/AIDS.
Professor Kazatchkine has played key roles in
various organizations, serving as Director of the
national Agency for Research on AIDS (ANRS)
in France (1998–2005), Chair of the WHO
Strategic and Technical Committee on HIV/AIDS
(2004–2007), Member of the WHO Scientific
and Technical Advisory Group on Tuberculosis
(2004–2007) and first Chair of the Global Fund
Technical Review Panel.
From 2005 to 2007, he served as French
Ambassador on HIV/AIDS, Board Member and
Vice-Chair of the Global Fund to fight AIDS,
Tuberculosis and Malaria (2005–2007).
Professor Michel Kazatchkine, M.D.
UN Secretary-General’s Special Envoy on HIV/AIDS in
Eastern Europe and Central Asia
In 2007, he was elected Executive Director of the
Global Fund, a position in which he served until
March 2012.
Members of the IAS
Advisory Group on Key
Affected Populations
Chris Beyrer (Co-Chair)
Michel Kazatchkine (Co-Chair)
Elliot Ross Albers - International
Network of People who Use Drugs
(INPUD), United Kingom
Stefan Baral - Johns Hopkins University,
USA
Mauro Cabral - Global Action for
Transgender Equality, Argentina
Carlos Cáceres - Universidad Peruana
Cayetano Heredia, Peru
Daouda Diouf - ENDA Tiers Monde,
Senegal
JoAnne Keatley - Centre of Excellence
for Transgender Health, University of
California, San Francisco, USA
Nina Kerimi - Turkmenistan
Noah Methney - The Global Forum on
MSM and HIV (MSMGF), USA
Nadia Rafif - The Global Forum on
MSM and HIV (MSMGF), Morocco
Kate Shannon - B.C. Centre for
Excellence in HIV/AIDS, Canada
In July 2012, Professor Kazatchkine was appointed
as the UN Secretary-General’s Special Envoy
on HIV/AIDS in Eastern Europe and Central Asia.
In this position, he focuses on building high-level
political support for national and regional responses
to the HIV epidemic and advocates for improved
access to prevention, treatment and care for the
populations most in need.
He is also a Senior Fellow with the Global
Health Program of the Graduate Institute for
International and Development Studies in
Geneva, a member of the Global Commission on
Drug Policy and serves as Chair of the Board of
the Robert Carr Civil Society Networks Fund.
References
1. http://www.unaids.org/en/media/unaids/contentassets/
documents/epidemiology/2013/gr2013/UNAIDS_Global_
Report_2013_en.pdf
3. Baral,S., Beyrer, C., Muessig, K., Poteat, T., Wirtz, A., Decker,
M., Sherman, S and Kerrigan, D. (2012). The Lancet Infectious
Diseases - Vol. 12, Issue 7, Pages 538-549
2. Lombardi E, Wilchins R, Priesing D, Malouf D. Gender
violence: Transgender experiences with violence and
discrimination. Journal of Homosexuality. 2001;42(1):89-101
4. Baral S et al. (2007) “Elevated risk for HIV infection among
men who have sex with men in low- and middle-income
countries 2000-2006 a systematic review”. PLoS Medicine,
4(12): e339
5. Baral, S., Poteat, S., Stromdahl, S,Wirtz, A, Guadamuz,T and Beyrer,
C (2013) “Worldwide burden of HIV in transgender
women: a systematic review and meta-analysis”; The
Lancet. 13:214-22
6. IHRA, “The Global State of Harm Reduction, Towards An
Integrated Response, Opioid Substitution Therapy”, 2012, p.19,
http://www.ihra.net/files/2012/07/24/GlobalState2012_Web.pdf
9
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IAS Towards an HIV Cure community workshop Chennai, 30 January 2014
IAS News Spring 2014
IAS Towards an HIV Cure Community
Workshop Chennai, 30 January 2014
Beyond the mission to accelerate
and facilitate international research
for a potential HIV cure, the
IAS Towards an HIV Cure Global
Scientific Initiative is strongly
determined to ensure that the
broader HIV community is involved
and engaged in this process.
With this in mind, the Towards an HIV Cure initiative
organized a community training workshop on the
topic of HIV cure in Chennai, India, in conjunction
with the HIV Science 2014 Symposium on HIV and
Infectious Diseases, organized by YRG Care.
The workshop aimed to provide the basic elements
to understand the challenges and obstacles for an
HIV cure, but also the encouraging recent results and
the current research directions.The workshop was
attended by almost 100 participants, approximately
half of whom were young and mid-career
researchers and clinicians and the other half were
members of the local and regional community and
members of HIV+ networks.
and highlighted in particular the ways in which
community members can be engaged and involved
in the initiative. Dr. Ross also presented the plans
for the 2014 Towards an HIV Cure Symposium, to be
held in Melbourne, Australia, on 19–20 July 2014.
A community representative, who wished to
remain anonymous to avoid the difficult stigma
still surrounding HIV-positive people in India, gave
a touching and brave speech on his own personal
perspective as a man living with HIV in Chennai.
Although he realizes that a cure for HIV is unlikely
to be a reality for himself, he is hopeful that research
will advance to ensure that future generations will
be able to benefit from a cure for HIV, allowing
patients to safely interrupt antiretroviral therapy
and, importantly, be freed from the stigma and
discrimination that still surrounds HIV in so many
parts of the world.
Dr. Jack Whitescarver, of the NIH Office of AIDS
Research and Dr. Suniti Solomon, Director of YRG
Care, co-chaired the workshop and facilitated the
discussion. Professor Françoise Barré-Sinoussi, IAS
President and co-chair of the IAS Towards an HIV Cure
initiative gave the welcoming statement by explaining
why an HIV cure is being pursued and the initial
results that provide some encouragement, all while
stressing that a cure for HIV is not yet available and
will not be immediately.
The satellite workshop continued with two
presentations by Dr. Diana Finzi, of the NIAID-NIH,
and Dr. Asier Saez-Cirion of the Institut Pasteur.
Dr. Finzi provided a very clear background of the
basic mechanisms of HIV latency explaining why it is
so difficult to target HIV reservoirs. Dr. Finzi went
on to highlight the encouraging recent results that
provide hope that an HIV cure may be possible
one day. These recent studies included the report of
the Berlin patient, the only person known to have
completely eliminated HIV from his body, the recent
case of the Mississippi baby, who was treated very
early after birth) and is now suppressing viral load
even in the absence of antiretroviral therapy. Dr. Finzi
also provided balance to her presentation by reminding
the audience of the recent case of the two Boston
patients, who were initially thought to be in remission
of HIV, but who have unfortunately seen their
virus return.
Dr. Anna Laura Ross, Towards an HIV Cure Strategy
and Science Manager, discussed the organization
of the initiative, the ongoing events and activities
Dr. Asier Saez-Cirion gave a stimulating talk on the
opportunities of early antiretroviral therapy (ART)
in limiting the size and breadth of HIV reservoirs.
In particular, Dr. Saez-Cirion presented the ANRS
Visconti cohort of 14 patients who were treated in
acute HIV infection phase and, following prolonged
and continued ART, subsequently interrupted
their therapy and were still able to control viral
replication. Although HIV is still present in these
individuals, they are now able to control the virus
without having to take daily drugs.
Dr. Whitescarver and Professor Solomon chaired the
final discussion, which gave rise to a lively interaction
between the researchers and the members of HIV+
networks. The community members were eager to
understand in detail the current context of HIV cure
research and several expressed their wish to engage
further and be part of the IAS HIV cure initiative.
While in Chennai, the IAS staff were able to visit the
YRG Care Clinic and Laboratory, where Professor
Françoise Barré-Sinoussi inaugurated the “HIV Cure
Research Laboratory” on 30 January 2014.
In conclusion, the IAS Towards an HIV Cure Community
training workshop was successfully attended and
gave rise to a lively and interactive discussion.
The IAS hopes to repeat this positive experience
with additional community workshops elsewhere
around the world.
towards an
cure
people focused
science driven
Audience at the Towards an HIV Cure workshop in Chennai, India
Photo: © IAS/Graphick Stills
IAS News Spring 2014
CIPHER lays foundation for the IAS HIV paediatrics priority
11
Successful Collaborative Initiative
for Paediatric HIV Education and Research (CIPHER) lays foundation
for the IAS HIV paediatrics priority
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On 27 November 2013, the International
AIDS Society-Industry Liaison Forum
(IAS-ILF) held the first of a series of
thematic roundtables. On this occasion,
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participants from 13 antiretroviral (ARV)
manufacturers and 12 international
organizations were convened to identify
ways to allow more engagement of industry
with different stakeholders in addressing
challenges specific to paediatric ARVs (e.g.,
formulations, regulatory approval and
market fragmentation). The roundtable,
“Paediatric antiretrovirals: The barriers
to and solutions for improved access
to optimal drugs in resource-limited
settings”, highlighted industry’s willingness
to address issues related to paediatric ARV
development and production.The meeting
report is available online here.
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Laying the foundation for this, a comprehensive
research agenda in paediatric HIV was developed
in collaboration with key stakeholders and experts:
Evidence for Action: A Needs Assessment of HIV
Research Priorities for Paediatric Populations
CIPHER started promoting this agenda through
a core programme of activities.
Thematic Roundtable Series
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In 2012-2013, CIPHER focused on two main
goals; the first was promoting and investing in
targeted research to address priority questions to
optimize service delivery and clinical management
of infants, children and adolescents in RLS.
The second goal was convening stakeholders
and establishing collaboration mechanisms to
strengthen communication, knowledge transfer
and exchange among paediatric HIV cohorts.
These activities have been received with much
enthusiasm and support and CIPHER would like
to thank the many paediatric HIV experts and
stakeholders who have contributed their time and
insight to help make the first two years of the initiative
a success. With an additional commitment from
ViiV Healthcare for USD 800,000 in 2014, the IAS
will continue the CIPHER core programme, while
leveraging this funding to diversify the sponsor base
for its paediatric priority and extend its activities in
paediatric HIV to areas such as advocacy and
implementation of programmes for scale-up of care
and services.
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The Collaborative Initiative for Paediatric HIV
Education and Research (CIPHER) was launched
in 2012 with the support of a generous twoyear unrestricted educational grant of USD 2.4
million from ViiV Healthcare. Positioned as the
flagship paediatric HIV research initiative of the
IAS, CIPHER built on significant work undertaken
by the IAS-Industry Liaison Forum (IAS-ILF) in
promoting and accelerating HIV research relevant
to women and children in resource-limited
settings (RLS). CIPHER is guided by paediatric
experts convened by the IAS.
Online paediatric HIV cohort database:
On World AIDS Day 2013, CIPHER launched
an online, searchable paediatric HIV cohort
database with an interactive map and complete
cohort profiles to act as a forum and tool for
researchers, funders and policy makers. The aim is
for paediatric cohorts worldwide to register and
A special issue in the Journal of the International
AIDS Society (JIAS), Perinatally HIV-infected
Adolescents, was also produced. CIPHER will
sponsor another Special Issue of JIAS in 2014.
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Moreover, despite the concerted global scale-up
of PMTCT and ART in children, the paediatric
population remains understudied in comparison
with adults. It is widely recognized that there is
insufficient data in key areas and increased efforts
in bridging these knowledge gaps are needed to
support evidence-based policies for paediatric
populations.
CIPHER Cohort Collaboration:
CIPHER convened a Paediatric HIV Cohort
Investigator Consultation in May 2013, in Venice,
Italy, with the major paediatric HIV cohorts
worldwide. Notably, this meeting resulted in
agreement by the cohorts present to collaborate
on data-sharing projects to address two
identified research gaps: (1) the time first line
treatments work for children before failing, and
(2) adolescent epidemiology and transition to
adult care. CIPHER provided a grant of USD
500,000 to the three data centres that will be
handling the data collection and analysis for
the collaboration. This is the first collaboration
to include such a broad range of participating
paediatric cohorts.
contribute to the database. Currently, this online
resource provides centralized information and
contact details on paediatric cohorts, including
data on overall numbers enrolled disaggregated
by age, sex and route of transmission. Under
development is an epidemiology tool function
showing the current number of subjects enrolled
in the cohorts. This forum will continue to
expand with new ideas in 2014.
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In addition, as the HIV epidemic matures and
more children receive treatment, there is an
increasing population of perinatally-HIV infected
adolescents, facing the challenges of chronic
health complications combined with coming of
age while living with HIV.
A competitive grant programme: In 2013 the
CIPHER Grant Programme awarded USD 1
million to seven early-stage investigators for
targeted research to optimize paediatric HIV
care and treatment in RLS. The programme was
designed to attract early-stage investigators to
paediatric HIV research in order to cultivate a
new generation of scientists dedicated to the field
and foster innovative ideas and evidence-based
approaches and interventions.
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Much progress has been made in
scaling up Prevention of Motherto-Child Transmission (PMTCT)
and delivery of antiretroviral
therapy (ART) to children,
however the paediatric population
remains significantly disadvantaged
with respect to access to
treatment, with only 34% of
eligible children receiving ART
compared to adults at 65%.
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Two monkey studies demonstrated the potential
of a monthly injected HIV integrase inhibitor in
protecting against vaginal acquisition of HIV.7,8 One
study involved six macaques who received three
intramuscular injections of long-acting GSK1265744
(GSK744LA) four weeks apart at a dose that
yielded plasma concentrations similar to those in
humans receiving 400-mg injections.7 Six monkeys
got placebo shots. All macaques given GSK744LA
remained negative for HIV RNA and DNA through
22 vaginal challenges with simian HIV (SHIV),
RESEARCH
RESEARCH
RESEARCH
Fast-evolving PrEP
strategies
RESEARCH
A study of 22 macaques measured SIV RNA and
DNA in plasma, cells and tissue after intravenous
exposure to SIVmac239.3 Two monkeys were
treated with four-drug ART before peak viral
replication, two were treated at or near peak
replication and 18 began ART in early chronic
infection. Thirty-two weeks after infection, SIV
DNA in PBMCs averaged 2.5 log (about 300
copies/mL) per 100 million cells in the first group,
Research reported in 2013 raised hopes that
reduced-intensity hematopoietic stem cell
transplantation could banish replicating HIV and
allow ART suspension in adults who underwent
this risky procedure because of life-threatening
lymphoma.4 But at CROI 2014, Boston researchers
reported HIV rebounds in blood three and eight
months after, ART stopped in these two men.5
Before treatment suspension, one man had HIV
DNA detectable at a level below one copy in
short-lived terminally differentiated T-cell subsets
and no HIV DNA in any other subset. The second
man had no detectable HIV DNA in any T-cell
subset. The Boston team surmised that “long-lived
tissue reservoirs inaccessible to sampling may have
contributed to viral persistence” in these men.
The single apparent sterilizing HIV cure in an adult
involved a man who – unlike the Boston patients
– underwent pre-transplant obliteration of bone
marrow cells and received a stem-cell transplant
from a donor carrying the HIV-resistant CCR5
delta 32 mutation.6
In another study eight macaques received the same
RESEARCH
intramuscular dose of GSK744LA four weeks apart
and four macaques remained untreated.8 All four
untreated monkeys became infected after a single
vaginal SHIV challenge. Six of the eight GSK744LAtreated animals remained HIV-free through 24 weeks,
after vaginal challenges at weeks One, five, and seven.
The two GSK744LA-treated monkeys that became
infected did so three and seven weeks after the last
SHIV challenge.These monkeys had been pre-treated
with two 30-mg doses of DepoProvera to thin
the cervicovaginal epithelium. HPTN 077 will test
injected GSK744LA as PrEP in women and men.
RESEARCH
Clinicians in California began treating an infant in
the first day of life after confirming HIV RNA in
blood and cerebrospinal fluid and HIV DNA in
cells.2 Nine months after birth, this child remains
on ART, has no detectable HIV DNA in resting
CD4 cells and has no recoverable infectious
virus. Persaud and colleagues do not use the
word “cure” to describe these cases, preferring
“seroreversion” or “viral remission.” An imminent
trial of ART in infants with confirmed HIV
infection in the first 48 hours of life will rigorously
test this strategy.
RESEARCH RESEARCH
RESEARCH
RESEARCH
The Mississippi baby began ART soon after birth,
attained an undetectable viral load in plasma,
then stopped treatment when her mother
dropped out of care.1 When the baby returned
to care, no HIV could be found in blood despite
ART suspension. Now 41 months old, this
baby has not received ART for 23 months, has
only trace amounts of HIV DNA in peripheral
blood mononuclear cells (PBMCs) and has no
detectable replication-competent virus or
HIV-specific immune responses.2
RESEARC
RESEARCH
RESEARCH
Who can clear HIV?
RESEARCH
RESEARCH
Other research presented at CROI 2014 supported
the concept that very early ART may limit HIV invasion
of viral reservoirs, but a report on two Boston stemcell transplant patients suggested that this approach to
a functional cure will be more difficult. Four research
teams offered new data on current and possible future
pre-exposure prophylaxis (PrEP) strategies, while a
large European study confirmed the extremely low
risk of sexual HIV transmission from someone with an
undetectable viral load.
RESEARCH
up to 12 weeks after the last GSK744LA dose. RESEARCH
All six control animals became infected.
RESEARCH
RESEARCH
One year after reporting the
case of the Mississippi baby,1
Deborah Persaud and colleagues
detailed a second case of an
HIV-infected newborn treated with
combination antiretroviral therapy
(ART) soon after birth, who
appears to have cleared HIV from
blood and resting CD4 cells.2
3.5 log (about 3,000 copies/mL) in the second
group and 4.4 log (about 25,000 copies/mL) in
the third group. These researchers proposed that
delaying ART for as little as three days in the
“hyperacute” phase of infection can result in
10- to 100-fold higher SIV levels in tissue
reservoirs after treatment begins.
RESEAR
RESEARC
RESEARC
RESEARCH
RESEARCH
news from CROI 2014, the Conference on Retroviruses
and Opportunistic Infections
RE
CH
RESEARCH
RE
H
RESEARCH
ESEARCH
Preventing, clearing and
controlling HIV:
By Mark Mascolini
EARCH
IAS News Spring 2014
RESEARCH
RESEARCH
Preventing, clearing and controlling HIV: news from CROI 2014
RESEARCH
12
RESEARC
Antiretroviral-infused vaginal rings offer an
alternative to injected or oral PrEP. A double-blind
placebo-controlled trial randomized 48 HIV-negative
women to a ring containing the non-nucleoside
dapivirine plus the CCR5 antagonist maraviroc,
dapivirine alone, maraviroc alone, or placebo for
28 days.9 Dapivirine (but not always maraviroc)
could be detected in blood, vaginal fluid and
cervical tissue at different sampling times. Lab
studies showed that the dapivirine/maraviroc ring
or the dapivirine-only ring protected cervical tissue
from HIV challenge and dapivirine levels correlated
positively with protection against HIV. A phase
three trial of the dapivirine ring is underway.
The only agent currently licensed for PrEP is
co-formulated oral tenofovir/emtricitabine (TDF/
FTC), based partly on results of the Partners PrEP
trial, which randomized African men and women
to TDF/FTC, TDF alone, or placebo.10 A follow-up
repor t at CROI 2014 tracked study par ticipants
who continued solo TDF or TDF/FTC and initial
placebo participants randomized to start TDF or
TDF/FTC.11 In this phase of the trial HIV incidence
measured 0.7 per 100 person-years in the TDF arm
and 0.5 per 100 in the TDF/FTC arm, an insignificant
difference. In comparison, HIV incidence in the
original placebo arm measured 2.0 per 100.
Key findings from CROI 2014
A second baby treated with ART soon after birth appears to have cleared HIV DNA from resting
CD4 cells (although this baby currently remains on ART)
Delaying ART for only 3 days during acute infection may result in 10- to 100-fold higher HIV levels
in tissue reservoirs, a monkey study suggested
A long-acting injected HIV integrase inhibitor largely blocked vaginal acquisition of virus in two
macaque studies. A trial in humans will begin soon
A study of 1,110 HIV-discordant heterosexual and gay couples detected no HIV transmissions
within any couple when the positive partner had a viral load below 200 copies/mL during periods
when the couples did not use condoms
Arrival of ART in rural Uganda led to a 35% lower risk of one member in an HIV-negative couple
acquiring HIV
IAS News Spring 2014
ART thwarts transmission,
prolongs survival
HPTN 052, a four-continent randomized trial,
found that immediate ART cut HIV transmission
risk 96% in 1763 HIV-discordant heterosexual
couples compared with delayed ART.12 At CROI
2014, the observational PARTNER study found
that HIV-positive par tners in 1,110 heterosexual
and gay European couples never transmitted
HIV to their par tner when they had a viral load
below 200 copies/mL, even though they did not
use condoms during the observation period.13
HIV transmission risk within study couples
during periods when the positive partner had
an HIV load below 200 copies/mL and the
couples did not use condoms was 0 for any
sex act, 0 for anal sex, 0 for vaginal sex by men,
0 for receptive vaginal sex with ejaculation,
0 for inser tive anal intercourse by men who
have sex with men (MSM), 0 for receptive anal
intercourse without ejaculation by MSM and
0 for receptive anal sex with ejaculation by
MSM. Because years of follow-up differed for
each of these sex acts, so did 95% confidence
intervals (CI). The widest confidence interval
(0 to four) involved receptive anal intercourse
with ejaculation among MSM. The PARTNER
team cautioned that “uncer tainty over the upper
limit of risk remains” and will be addressed in
the 2014-2017 PARTNER 2 study.
Preventing, clearing and controlling HIV: news from CROI 2014
A study of almost 100,000 adults living in a rural
area of KwaZulu-Natal province, South Africa,
found that ART scale-up led to a much larger
gain in life expectancy among women than men,
apparently because many fewer HIV-positive men
sought HIV care.15 From 2000 through 2011,
the study tracked deaths in 52,964 women and
45,688 men, including 3,729 HIV-related deaths in
women and 3,500 in men. Adult life expectancy
soared during the study period by about seven
years in HIV-positive men and ten years in HIVpositive women. But the gap in life expectancy
between HIV-positive women and men doubled
from about four years in 2004, when ART scale-up
began, to nearly nince years in 2011. In 2011,
40% of women who died of HIV infection never
sought HIV care, compared with 70% of men.
Statistical analysis determined that HIV-positive
women who needed ART had more than
a doubled chance of starting than men (adjusted
odds ratio 2.4, 95% CI 1.4 to 4.3) and this difference
between women and men did not vary substantially
by pregnancy status. The researchers speculated
that the difference between women and men
starting ART may reflect a bias among the primarily
female nurses who initiate ART or cultural factors
that make it less acceptable for men than women
to seek care.
Arrival of ART in rural Rakai, Uganda coincided
with lower introduction of HIV into 4,570 initially
concordant HIV-negative heterosexual couples.14
During annual study visits from 1997 through
2011, a partner in 135 couples became infected
with HIV. Self-reporting sex outside the couple
raised chances of new HIV infection in the
couple 4.6 times. In the period after ART became
available in Rakai, in 2004, new HIV infection in
a previously negative couple became 35% less
likely (adjusted hazard ratio 0.65, 95% CI 0.43
to 0.98), mostly because of a 46% lower risk in
men (adjusted hazard ratio 0.54, 95% CI 0.35 to
0.83). The Rakai investigators noted that medical
circumcision among non-Muslim men also
contributed to their lower HIV acquisition risk.
Deborah Persaud at the IAS 2013 conference
Photo: © IAS/Marcus Rose/Workers’ Photos
References
1. Persaud D, Gay H, Ziemniak C, et al. Absence of detectable
HIV-1 viremia after treatment cessation in an infant. New
England Journal of Medicine, 2013, 369:1828-1835.
6. Hütter G, Nowak D, Mossner M, et al. Long-term control of
HIV by CCR5 delta32/delta32 stem-cell transplantation. New
England Journal of Medicine, 2009, 360:692-698.
2. Persaud D, Deveikis A, Gay H, et al. Very early combination
antiretroviral therapy in perinatal HIV infection: two case
studies. Conference on Retroviruses and Opportunistic
Infections. 3-6 March 2014. Boston. Abstract 75LB.
7. Radzio J, Spreen W,Yueh YL, et al. Monthly GSK744
long-acting injections protect macaques against repeated
vaginal SHIV exposures. Conference on Retroviruses and
Opportunistic Infections. 3-6 March 2014. Boston.
Abstract 40LB.
3. Okoye AA, Rohankhedkar M, Reyes M, et al. Early treatment
in acute SIV infection limits the size and distribution of the
viral reservoir. Conference on Retroviruses and Opportunistic
Infections. 3-6 March 2014. Abstract 136LB.
4. Henrich T, Hanhauser E, Sirignano M, et al. In depth
investigation of peripheral and gut HIV-1 reservoirs, HIVspecific cellular immunity, and host microchimerism following
allogeneic hematopoetic stem cell transplantation. 7th IAS
Conference on HIV Pathogenesis, Treatment and Prevention.
30 June-3 July 2013. Kuala Lumpur. Abstract WELBA05.
5. Henrich TJ, Hanhauser E, Sirignano MN, et al. HIV-1 rebound
following allogeneic stem cell transplantation and treatment
interruption. Conference on Retroviruses and Opportunistic
Infections. 3-6 March 2014. Boston. Abstract 144LB.
8. Andrews CD, Spreen WR,Yueh YL, et al. GSK1265744
long-acting protects macaques against repeated high-dose
intravaginal challenges. Conference on Retroviruses and
Opportunistic Infections. 3-6 March 2014. Boston.
Abstract 941LB.
9. Chen BA, Panther L, Hoesley C, et al. Safety and
pharmacokinetics/pharmacodynamics of dapivirine and
maraviroc vaginal rings. Conference on Retroviruses and
Opportunistic Infections. 3-6 March 2014. Boston. Abstract 41.
10. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral
prophylaxis for HIV prevention in heterosexual men and
women. New England Journal of Medicine, 2012, 367:399-410.
11. Baeten J, Donnell D, Ndase P, et al. Single-agent TDF versus
combination FTC/TDF PrEP among heterosexual men and
women. Conference on Retroviruses and Opportunistic
Infections. 3-6 March 2014. Boston. Abstract 43.
12. Cohen MS, Chen YQ, McCauley M, et al. Prevention of
HIV-1 infection with early antiretroviral therapy. New England
Journal of Medicine, 2011, 365:493-505.
13. Rodger A, Bruun T, Cambiano V, et al. HIV transmission
risk through condomless sex if HIV+ partner on suppressive
ART: PARTNER study. Conference on Retroviruses and
Opportunistic Infections. 3-6 March 2014. Boston.
Abstract 153LB.
14. Grabowski MK, Lessler J, Nalugoda F, et al. Introduction of
HIV into stable heterosexual couples in Rakai, Uganda before
and after ART. Conference on Retroviruses and Opportunistic
Infections. 3-6 March 2014. Boston. Abstract 146.
15. Barnighausen T, Herbst AJ, Tanser F, et al. Unequal benefits
from ART: a growing male disadvantage in life expectancy
in rural South Africa. Conference on Retroviruses and
Opportunistic Infections. 3-6 March 2014. Boston. Abstract 150.
13
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The IAS GC also spent time discussing a proposal
that had been developed by the International
AIDS Society-Industry Liaison Forum (IAS-ILF)
Advisory Group, to improve opportunities to
strengthen collaborative, mutually beneficial
relationships between industry, the IAS and other
stakeholders and consequently broaden the
scope and impact beyond the current IAS-ILF.
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During the retreat,
the IAS GC selected Paris as
the host city for the 9th IAS Conference on HIV
Pathogenesis, Treatment and Prevention (IAS 2017)
and agreed on a shortlist of potential host cities
for the 22nd International AIDS Conference (AIDS
2018). They also discussed plans and progress for
the upcoming 20th International AIDS Conference
(AIDS 2014) in Melbourne. This conference will
have a number of new virtual features in addition
to the conference app, e.g. a YouTube channel,
and an online support wall. The IAS GC Working
Group on Conferences - which has been assigned
to think creatively about future conferences –
reported back from its previous discussions.
The working group will liaise closely with the
newly formed group that will be looking at HIV
and co-morbidities, to explore possibilities to
widen the scope of the IAS Conference on
HIV Pathogenesis, Treatment and Prevention
to include hepatitis C, tuberculosis and other
non-HIV-specific topics.
The IAS Governing Council in Paris for the annual retreat
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The New ILF
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Efficiency and Effectiveness in National AIDS
Programmes (E2) will remain a priority until the
end of July 2014. Other previous IAS Policy and
Advocacy Priorities - Treatment as Prevention
(TasP), HIV and Human Rights and Social and
Political Research - will be incorporated across the
main priorities, with the work of Advisory Groups
and Working Groups included in the overall
strategy of the new department. A new working
group of IAS GC members was also formed to
further investigate how the IAS could work more
with Hepatitis C and other co-morbidities.
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Paediatric HIV
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During the three days of the retreat, the IAS GC
had the opportunity to discuss the IAS Policy and
Advocacy Priorities from previous years. Taking
into consideration the existing and potential
synergies between IAS Policy and Advocacy and
Key Affected Populations (KAPs)
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It was decided that the priorities of the IAS-ILF will
be the same as the IAS priorities for Advocacy and
Research Promotion, providing a space for industry
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stakeholders to participate in
and contribute to IAS programmes. The IAS-ILF
Advisory Group will continue working on the
concept and an implementation plan during the
first half of 2014.
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IAS Advocacy and
Research Promotion
Priorities
Towards an HIV Cure
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The IAS GC members met at the Institut
Pasteur where they looked at the IAS’s recent
successes and challenges, discussed about the
future of the IAS and the strategic direction of
the organization and talked about upcoming
IAS-convened conferences. The agenda also
included key discussions about priorities in
Advocacy and Research Promotion for the
coming year, as well as discussions and approvals
of the IAS’s 2014 budget, along with the budgets
for upcoming conferences.
IAS Research Promotion, it was decided to merge
the two into a joint IAS Advocacy and Research
Promotion Department, with the following main
priorities for 2014:
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IAS President, Professor
Françoise Barré-Sinoussi,
convened the 10th Annual IAS
Governing Council (GC) Retreat
in her home town of Paris,
France on 4–6 December 2013.
IAS News Spring 2014
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Report from the 2013 IAS
Governing Council Retreat
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Repor t from the 2013 IAS Governing Council Retreat
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Repor t from the 2013 IAS Governing Council Retreat
IAS News Spring 2014
Governance and
Membership
After discussions with the IAS Governance
and Membership Subcommittee and the IAS
Executive Committee, the IAS GC decided to
increase the IAS membership fees as of 1 January
2014. The fees for IAS members in high-income
countries had remained at the same level since
2006 and the membership fees in middle/lowincome countries had not been increased since
the early days of the IAS.
Relation Building and
Resource Development
The fundraising strategies and funding targets
for 2014 were carefully examined by the
IAS GC during the retreat. The Fundraising
Depar tment will work closely with both the
Advocacy and Research Promotion, IAS and
the New ILF and Conference depar tments to
deliver strong business plans to raise funds for
2014 and beyond.
Professor Barré-Sinoussi thanked the IAS GC
members for their strong contributions during
the meetings and acknowledged the hard work
done by all IAS staff present at the retreat and
those in Geneva. She also thanked Anton Pozniak
for his work as IAS Treasurer and Chris Beyrer,
who will be taking over the presidency of the
IAS on 25 July 2014, at the closing ceremony of
AIDS 2014 in Melbourne.
Chris Beyrer, IAS President-Elect, and Françoise Barré-Sinoussi, IAS President
© IAS
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IAS News Spring 2014
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The IAS Talkss With Andrew Grulich
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The IAS talks with Andrew Grulich
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IAS Governing Council Member in Asia and the Pacific Islands MEMBERSHIP
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As a public health scientist working in HIV, my current
work focuses on two areas of critical relevance to the
current moment in the HIV epidemic. Firstly, I work
on HIV prevention in homosexual men. My group’s
work in this area covers the spectrum of biomedical
and behavioural prevention, including work on the
efficacy of treatment as prevention for prevention
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As a GC member, I believe it is my role to bring
the concerns of individual members and of my
region, to the attention of the IAS GC and thus to
influence the IAS’s strategic directions.
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Q: P
rofessor Grulich, how do you see your role
as an IAS Governing Council (GC) member
in Asia and the Pacific Islands and how does
the focus of your current work influence your
work on the IAS GC?
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of HIV transmission by anal sex; a pre-exposure
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prophylaxis demonstration
project; the roll-out of
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rapid and home-based
HIV
testing
and
the
manner
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in which HIV risk behaviour intersects with each of
these biomedical technologies. My second research
area is on HIV-related cancer, an important cause
of morbidity in people living long term with HIV.
We are investigating the design of potential future
anal cancer screening projects in homosexual men.
Homosexual men are greatly over-represented
in the HIV epidemic globally and this is particularly
the case in the extremely diverse epidemics driven
by key populations in the Asia-Pacific region.
Andrew Grulich, MBBS, PhD, is a Public
Health Physician and Head of the HIV
Epidemiology and Prevention Program
at the Kirby Institute, UNSW, in Sydney,
Australia, where he leads a group
of researchers who investigate the
transmission and prevention of HIV
and sexually transmissible infections,
predominantly in homosexual men.
Professor Grulich has more than 20 years’ experience
working at high levels in the public health response
to HIV. In addition to his scientific role, he was
President of the Australasian Society for HIV Medicine
in 2001–2003 and was Chair of the New South
Wales Health Department’s committee overseeing
HIV prevention in 2001–13. Prof. Grulich has been
a member of the Australian Health Minister’s advisory
committee on HIV since 2000 and was a member of
the board of the AIDS Council of New South Wales in
1997–2000. In 2012, he chaired state and federal
expert technical advisory groups which were tasked
with providing evidence-based strategic advice on
how Australia should implement an HIV prevention
revolution. Prof. Grulich has also authored more than
300 peer reviewed articles.
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Q: W
hat do you think the impact of holding the
20th International AIDS Conference (AIDS
2014) in Melbourne will be on Australia and
on the Asia-Pacific region?
Bringing the world’s largest HIV conference to
Australia has already energized the HIV response in
Australia. Despite Australia’s success in controlling
the epidemic, in recent years there have been very
substantial increases in HIV transmission and a degree
of complacency has crept in. Hosting AIDS 2014 in
Australia has galvanized our response. Within the
last year we have approved rapid HIV tests for use
in clinical and community-based settings, commenced
trials of home-based testing for HIV and made
government-subsidised HIV therapies available
regardless of CD4 count. State and Federal
governments have committed to highly ambitious
new goals of reductions in HIV transmissions.
Regionally, the conference will highlight the increasing
epidemics driven by Key Affected Populations as
well as extraordinarily diverse epidemics across Asia
and the Pacific and shine a light on the need for
increased financing of the response.
Q: What can the IAS do to improve work with
the regions?
Being based in Geneva, the IAS can feel like a far flung
organization to many people working in the field.
The IAS website and newsletters are a good way of
developing the global community of people working
in the HIV response. Members should use their
regional representatives to raise issues of importance
to the global and regional responses to HIV.
Q: W
hy would you advise someone to become
a member of the IAS?
The IAS is the international organization for people
working in the HIV response. It is multidisciplinary
and has a place for people committed to HIV from
all walks of life. Joining the IAS is a great way to
work with national and international colleagues
working in your field and to put you in contact
with like-minded people.
The IAS invites you to visit our website at www.iasociety.org or get in touch with us at: International AIDS Society HQ | Avenue de France 23, CH-1202, Geneva,
Switzerland | Phone: +41-(0)22-7100 800 | Fax: +41-(0)22-7100 899 | Our email address is [email protected] | We are looking forward to hearing from you.
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ISBN number for Spring 2014 newsletter is 978-92-95069-32-9 | Newsletter design: www.acw.uk.com