Saturday, July 24, 2010

AIDS 2010 - Day 6

The XVIII International AIDS Conference has come to a close. During the final day, summaries of the meeting were presented and the organizers of the next meeting were introduced.

In 2012, the XIX International AIDS Conference will be held in Washington, DC. The meeting is being held in the US for the first time sonic 1990 because the US recently lifted it's ban on the entry of HIV positive people.

I'll write more about this meeting in the next couple weeks. Right now, though, it's time to pack.

Friday, July 23, 2010

AIDS 2010 - Day 5

At this meeting, the official sessions - plenary talks, poster presentations, panel discussions - are only half of the story. For the week of he International AIDS Conference, the city of Vienna has been awash with other events, all related to the conference. It's hard to make time for everything, but I've tried my best!

One day this week, I visited a counseling center for female sex workers in Vienna. The visit was one of several local engagement tours organized by the conference to give participants a closer look at programs related to HIV/AIDS in Vienna. On my tour, I visited Sophie ( The director talked to us about the legality of sex work in Austria and the issues faced by sex workers in Vienna.

On another day, I visited a exhibition kf works by Keith Haring, the influential artist who died of AIDS in 1990. The exhibit, at the Kunsthalle Wien, focused on his works from 1978 to 1982. The show was great. I was especially intrigued by the detailed notebooks he kept while painting.

Finally, we attended the AIDS Gala Concert by the Royal Philharmonic Orchestra. They performed works by Mozart, Tchaikovsky, and Beethoven. Quite simply, it was amazing.

Many other events, from film series to dance performances, have been ongoing throughout the week.

Wednesday, July 21, 2010

AIDS 2010 - Day 3 & 4

The big news at the conference on Tuesday was the announcement of an effective vaginal microbicide. Dr. Abdool Karim and colleagues from South Africa made the announcement to a very enthusiastic crowd. For the first time in the 30 year battle against AIDS, there now is some hope that women may some day be able to control their risk of infection.

In thus study, the researchers provided women in both an urban and a rural area with capsules of a gel containing 1% tenofovir. Other women received capsules containing a placebo. This antiretroviral drug is a nucleoside analog that has been well studies and shown to effectively reduce viral replication. Women were told to apply the gel intra-vaginally no more than 12 hours before having sex, and again no more than 12 hours after having sex. Participants were tested regularly.

After 30 months, women who used 1% tenofovir showed 38% reduction in HIV infections, a significant difference.

The researchers noted this was only a proof of concept study. Additional studies, examining doses, timing, and other factors need to be tested. But these first tests are exciting.

Monday, July 19, 2010

AIDS 2010 - Day 2

Today was the first full day of activities at the XVIII International AIDS Conference. And what a day it was. Again, I'm amazed by the energy and excitement associated with this meeting. And at this year's conference, unlike previous AIDS conferences that I have attended, there seems to be a legitimate sense of optimism.

As we have heard from several speakers, remarkable progress has been made over the past few years. More drugs have been developed and these drugs are available to more people. Thanks to programs like PEPFAR, The Global Fund, and the Clinton Foundation, more people in developing countries are receiving antiretroviral treatment. The progress has been amazing.

But, as former president Clinton noted, this is only the end of the beginning.treatment alone is not the answer. Dr. Sharon Lewin, in a wonderful opening session talk, expertly explained why we cannot rely on treatment alone. First, studies have shown that even the best treatment regimens do not fully restore life expectancy. This, she noted, is not acceptable. Second, sh explained that treatment is not a cure. Viral reservoirs remain in the body during treatment. Virus may remain latent in resting T cells or in various tissues, such as the brain.

So what does this mean? We must continue our prevention efforts. A solution
requires increased treatment, increased testing, and increased prevention efforts.

Tomorrow - a visit to the Global Village at the conference center and a visit to a Vienna site for sex worker education.

Sunday, July 18, 2010

Rights here, right now - AIDS 2010

Today marked the opening of the XVIII International AIDS Conference in Vienna, Austria. What strikes me most about this biennial conference is the energy and excitement. People from all over the world gather with a single goal - the end of the AIDS pandemic. Everyone here, from scientists to politicians to educators to activists are passionate about their work and united in their desire.

After being here for only a day, a few themes seem to be emerging. First, this conference feels very much like a conference about and for Eastern Europe. As we heard from several speakers already, Eastern European and Central Asian countries are seeing the fastest growing HIV epidemic. Another theme that has emerged is the need for harm reduction policies. Finally, we have heard about the need for policy based on evidence, not ideology.

I'm looking forward to day 2.

Wednesday, July 07, 2010

Born HIV Free campaign to end mother-to-child-transmission

“By 2015, let us end the transmission of HIV from mother to child. This is not a dream: we can do it.”

Carla Bruni-Sarkozy,
The Global Fund Ambassador

With that simple statement from Ms. Bruni-Sarkozy as its guiding principle, the Global Fund to Fight AIDS, Tuberculosis, and Malaria has launched Born HIV Free. The goal of this new initiative is straightforward – stop the mother-to-child transmission of HIV. As Ms. Bruni-Sarkozy notes, this goal is achievable. We have at our disposal the means of protecting our children from infection.

When an HIV+ woman becomes pregnant and gives birth, the virus can be transmitted to the infant during gestation, during delivery, or through subsequent breast-feeding. These types of transmission collectively are referred to as mother-to-child transmission. The terms vertical transmission and perinatal transmission also may be used.

We now know that relatively simple and relatively cheat antiviral regimens can dramatically reduce the rate of mother-to-child transmission. In a 1999 study, Dr. Mary Lou Lindegren and colleagues noted that rates of perinatal transmission dropped significantly in concert with zidovudine (AZT) treatment for the mothers. With the development of better drug regimens, these drops in transmission rates have continued. According to the CDC, an estimated 1,650 HIV-infected infants were born in the US in 1991. In 2004, that number had dropped to less than 200.

This success, however, has not been mirrored in developing countries. The causes of this disparity are several-fold. The most important factors affecting the continued problem of mother-to-child transmission of HIV in developing countries include access to treatment and access to testing. In recent years, antiretroviral drugs have become more available throughout the developing world, thanks, in large part, to the influx of money from sources such as the United States PEPFAR program and the United Nation’s Global Fund. Additionally, other groups, most notably the Clinton Foundation, have fought hard to make these drugs more affordable. But we need to do more. Too many HIV+ women still do not have access to the necessary treatments.

In addition to making drugs more available, we also must work diligently to increase the levels of testing. Treatment to prevent perinatal transmission requires that women know their HIV status.

To find out more about the Born HIV Free campaign, please visit their website at Let’s join Ms. Bruni-Sarkozy in ending the transmission of HIV from mother to child.