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1

Preventive HIV Vaccines What is a vaccine?  

E-print Network

Preventive HIV Vaccines What is a vaccine? A vaccine is a medical product designed to stimulate infection or make you sick. What is the difference between a preventive HIV vaccine and a therapeutic HIV vaccine? Therapeutic HIV vaccines are designed to control HIV infection in people who are already HIV

Levin, Judith G.

2

Social Vaccine for HIV Prevention  

Microsoft Academic Search

Nearly everywhere that AIDS has been found, HIV infection is fast spreading. No one is known to have recovered from HIV infection. There is no vaccine to cure AIDS (Population Reports, 1989 and The Hindu, dated 9.3.2000). Until a cure or vaccine for HIV infection is found, the only way to prevent the spread of the disease is by changing

M. Ubaidullah

2005-01-01

3

Local Knowledge and Experiences of Vaccination: Implications for HIV-Preventive Vaccine Trials in South Africa  

ERIC Educational Resources Information Center

This study forms part of the preparation of communities for HIV-preventive vaccine trials in South Africa. On the basis of the assumption that attitudes to any HIV vaccine or vaccine trials will partly be influenced by experiences of vaccination in general, this study aimed to investigate knowledge of, attitudes to, and experiences of vaccination

Lindegger, Graham; Quayle, Michael; Ndlovu, Moses

2007-01-01

4

Therapeutic HIV Vaccines What is a vaccine?  

E-print Network

Therapeutic HIV Vaccines What is a vaccine? A vaccine is a medical product designed to stimulate there are currently no vaccines to prevent or treat HIV, researchers are developing and testing potential HIV vaccines. HIV vaccines designed to prevent HIV infection in HIV negative people are called preventive vaccines

Levin, Judith G.

5

HIV vaccines and microbicides hold promise for prevent ing the acquisition of HIV1 and HIV2, the two viruses  

E-print Network

HIV vaccines and microbicides hold promise for prevent ing the acquisition of HIV1 and HIV2, the two viruses that cause AIDS, but the success of designing such agents needs a clear understanding of where HIV first encoun ters its target cells -- primarily T cells, macrophages and dendritic cells (DCs

Cai, Long

6

Macaque studies of vaccine and microbicide combinations for preventing HIV-1 sexual transmission  

E-print Network

Vaccination and the application of a vaginal microbicide have traditionally been considered independent methods to prevent the sexual transmission of HIV-1 to women. Both techniques can be effective in macaque models, and ...

Klasse, Per Johan

7

Social justice and HIV vaccine research in the age of pre-exposure prophylaxis and treatment as prevention.  

PubMed

The advent of pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) as means of HIV prevention raises issues of justice concerning how most fairly and equitably to apportion resources in support of the burgeoning variety of established HIV treatment and prevention measures and further HIV research, including HIV vaccine research. We apply contemporary approaches to social justice to assess the ethical justification for allocating resources in support of HIV vaccine research given competing priorities to support broad implementation of HIV treatment and prevention measures, including TasP and PrEP. We argue that there is prima facie reason to believe that a safe and effective preventive HIV vaccine would offer a distinct set of ethically significant benefits not provided by current HIV treatment or prevention methods. It is thereby possible to justify continued support for HIV vaccine research despite tension with priorities for treatment, prevention, and other research. We then consider a counter-argument to such a justification based on the uncertainty of successfully developing a safe and effective preventive HIV vaccine. Finally, we discuss how HIV vaccine research might now be ethically designed and conducted given the new preventive options of TasP and PrEP, focusing on the ethically appropriate standard of prevention for HIV vaccine trials. PMID:24033297

Bailey, Theodore C; Sugarman, Jeremy

2013-09-01

8

Social Justice and HIV Vaccine Research in the Age of Pre-Exposure Prophylaxis and Treatment as Prevention  

PubMed Central

The advent of pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) as means of HIV prevention raises issues of justice concerning how most fairly and equitably to apportion resources in support of the burgeoning variety of established HIV treatment and prevention measures and further HIV research, including HIV vaccine research. We apply contemporary approaches to social justice to assess the ethical justification for allocating resources in support of HIV vaccine research given competing priorities to support broad implementation of HIV treatment and prevention measures, including TasP and PrEP. We argue that there is prima facie reason to believe that a safe and effective preventive HIV vaccine would offer a distinct set of ethically significant benefits not provided by current HIV treatment or prevention methods. It is thereby possible to justify continued support for HIV vaccine research despite tension with priorities for treatment, prevention, and other research. We then consider a counter-argument to such a justification based on the uncertainty of successfully developing a safe and effective preventive HIV vaccine. Finally, we discuss how HIV vaccine research might now be ethically designed and conducted given the new preventive options of TasP and PrEP, focusing on the ethically appropriate standard of prevention for HIV vaccine trials. PMID:24033297

Bailey, Theodore C.; Sugarman, Jeremy

2014-01-01

9

Ensuring Access to HIV Prevention Services in South African HIV Vaccine Trials: Correspondence Between Guidelines and Practices  

PubMed Central

Researchers and sponsors are required to assist HIV prevention trial participants to remain HIV-uninfected by ensuring access to prevention services. Ethics guidelines require that these HIV risk-reduction services be state of the art. This and related ethics recommendations have been intensely debated. This descriptive study aimed to identify actual HIV prevention practices for two HIV vaccine trials at five South African sites, to explore whether actual practices meet guideline recommendations and to discuss implications for practices and ethics guidelines. Practices were examined through a review of site documents and interviews with site staff and network representatives, as well as community advisory board and research ethics committee representatives. A thematic analysis of HIV prevention practices, perspectives and perceived challenges was undertaken. Findings indicated that there was a high degree of correspondence between actual practices in South African HIV vaccine trials and guideline recommendations. Key challenges for implementing prevention services were identified as partnerships, provider-promotion of services and participant uptake of services. Practices deviated most from guidelines with regard to the description of prevention plans in informed consent forms. Recommendations are made for both practices and ethics guidelines. PMID:25031609

Essack, Zaynab

2014-01-01

10

Social vaccine for HIV prevention: a study on truck drivers in South India.  

PubMed

Nearly everywhere that AIDS has been found, HIV infection is fast spreading. No one is known to have recovered from HIV infection. There is no vaccine to cure AIDS (Population Reports, 1989 and The Hindu, dated 9.3.2000). Until a cure or vaccine for HIV infection is found, the only way to prevent the spread of the disease is by changing people's behaviour through AIDS education programmes (Population Reports, 1986). Many national governments are using broadcast, print media, personal contact, counselling methods, etc., to educate people on AIDS and safer sex. Thus, the best vaccine is the 'Social Vaccine.' Social vaccine involves spreading education on how to protect oneself, hundred percent condom use, and changing sexual behaviour. In fact, the social vaccine was so successful in Thailand that the infection rate has come down by 50 per cent (The Hindu, dated 9.3.2000). Truck drivers, prostitutes, and young adults are considered high risk groups for HIV/AIDS in India. An action research study was conducted in Chittoor District of Andhra Pradesh (India) among truck drivers. As part of this study, different strategies, namely mass media, personal contact, group discussion, folk media, and counselling, were adopted to provide AIDS education, to encourage increase in condom use for safer sex, and bring changes in their sexual behaviour. The strategies adopted in this study greatly enhanced the knowledge of the truck drivers on AIDS, changed their attitudes on sex, increased the use of condoms, and modified their sexual behaviour. Thus, the social vaccine would help spread education on AIDS, bring changes in the sexual behaviour of the people, increase condom use, and thus help to prevent the AIDS scourge throughout the world. The social vaccine suggested in this study can also be extended to all the high risk group population for successful prevention of this dreadful disease in the world. PMID:15774403

Ubaidullah, M

2004-01-01

11

Knowledge and attitudes regarding preventative HIV vaccine clinical trials in Italy: Results of a national survey  

Microsoft Academic Search

We carried out a telephone survey to assess willingness to participate in HIV vaccine trials. The survey was conducted by interviewing randomly selected callers to the Italian National AIDS Help line. The questionnaire consisted of four sections: demographic information, knowledge about HIV vaccines and vaccines in general, factors related to participation in HIV vaccine trials, and acceptability of a future

F. Starace; T. M. Wagner; A. M. Luzi; L. Cafaro; P. Gallo; G. Rezza

2006-01-01

12

The potential role of biomarkers in HIV preventive vaccine trials: a critical review  

PubMed Central

Background Successful conduct of HIV vaccine efficacy trials entails identification and enrollment of at-risk populations, assessment of appropriate endpoints as measures of vaccine efficacy for prevention of HIV acquisition and amelioration of disease course among infected vaccinees, as well as identification of potential confounders or effect modifiers. While not invariably useful and bringing their own cost in terms of measurement and validation, a variety of biomarkers may aid at each stage of trial conduct. Methods A review of selected articles, chosen based on quality, relevance of the biomarker to HIV vaccine trials, and availability of the publication, was conducted. The authors also drew experience from current trials and other planned or ongoing trials. Conclusions Biomarkers are available to assess HIV incidence in potential study populations but care is needed in interpreting results of these assays. During trial conduct, STIs such as HSV-2 may act as effect modifiers on primary and secondary endpoints, including HIV incidence and set point viral load. The utility of STI biomarkers will likely depend heavily on local epidemiology at clinical trial sites. Analyses from recent large HIV vaccine efficacy trials point to the complexities in interpreting trial results and underscore the potential utility of biomarkers in evaluating confounding and effect modification. PMID:19512938

MacLachlan, Ellen; Mayer, Kenneth; Barnabas, Ruanne; Sanchez, Jorge; Koblin, Beryl; Duerr, Ann

2010-01-01

13

The end or the beginning of the drive to an HIV-preventive vaccine: a view from over 20 years  

Microsoft Academic Search

Richard Horton has seriously questioned the possibility of developing a successful HIV- preventive vaccine and has appropriately criticised an over optimistic attitude promoted by some individuals in the HIV-vaccine research community.1 Horton's piece is, for the most part, on the mark and useful. However, there are points that I believe will benefit from clarification. Whereas he rightly points out that

2005-01-01

14

HIV vaccines: the Uganda experience  

Microsoft Academic Search

By late 1980s Uganda was the epicenter of the AIDS epidemic in the world but strong preventive interventions and committed leadership has turned the epidemic round. HIV incidence and prevalence have declined but infection rates remain unacceptably high, making HIV vaccine research a priority.Uganda pioneered the first HIV vaccine trial in Africa but had to overcome ethical, scientific and logistical

Peter N Mugyenyi

2002-01-01

15

Stakeholder views of ethical guidance regarding prevention and care in HIV vaccine trials  

PubMed Central

Background South Africa is a major hub of HIV prevention trials, with plans for a licensure trial to start in 2015. The appropriate standards of care and of prevention in HIV vaccine trials are complex and debated issues and ethical guidelines offer some direction. However, there has been limited empirical exploration of South African stakeholders’ perspectives on ethical guidance related to prevention and care in HIV vaccine trials. Methods Site staff, Community Advisory Board members and Research Ethics Committee members involved with current HIV vaccine trials in South Africa were invited to participate in an exploration of their views. A questionnaire listed 10 care and 10 prevention recommendations drawn from two widely available sets of ethical guidelines for biomedical HIV prevention trials. Respondents (n?=?98) rated each recommendation on five dimensions: “Familiarity with”, “Ease of Understanding”, “Ease of Implementing”, “Perceived Protection”, and “Agreement with” each ethical recommendation. The ratings were used to describe stakeholder perspectives on dimensions for each recommendation. Dimension ratings were averaged across the five dimensions and used as an indication of overall merit for each recommendation. Differences were explored across dimensions, between care-oriented and prevention-oriented recommendations, and between stakeholder groups. Results Both care and prevention recommendations were rated highly overall, with median ratings well above the scale midpoint. In general, informed consent recommendations were most positively rated. Care-related recommendations were rated significantly more positively than prevention-related recommendations, with the five lowest-rated recommendations being prevention-related. The most problematic dimension across all recommendations was “Ease of Implementing,” and the least problematic was “Agreement with,” suggesting the most pressing stakeholder concerns are practical rather than theoretical; that is, respondents agree with but see barriers to the attainment of these recommendations. Conclusions We propose that prevention recommendations be prioritized for refinement, especially those assigned bottom-ranking scores for “Ease of Implementing”, and/ or “Ease of Understanding” in order to assist vaccine stakeholders to better comprehend and implement these recommendations. Further qualitative research could also assist to better understand nuances in stakeholder reservations about implementing such recommendations. PMID:24981027

2014-01-01

16

HIV Vaccine Research Curriculum  

NSDL National Science Digital Library

This is a series of PDF files including an overview, a series of 5 lessons, assessments, an appendix and extended resources such as a lab activity. The lessons should span approximately 2 weeks, depending on the amount of activities and depth of review. This unit explores the scientific and ethical issues involved in clinical HIV vaccine trials using human research participants. The unit begins by examining studentsÃÂ current knowledge of HIV, and by reviewing HIV structure and transmission. Next, it familiarizes students with types of vaccines and with challenges related to creating an HIV vaccine. Students are encouraged to explore issues related to human research participants using basic ethical principles and historical case studies. Lastly, global issues regarding the pandemic are explored to give the students an understanding of cultural issues involved in the spread of HIV. This cultural context introduces students to ethical dilemmas inherent in the selection of human participants in global vaccine trials. The lessons culminate in having students design their own hypothetical HIV vaccine clinical trial, based upon knowledge of HIV structure, vaccine characteristics, human research participants considerations, and global contexts.

Joan Griswold (NWABR)

2007-01-01

17

How can we design better vaccines to prevent HIV infection in women?  

PubMed Central

The human immunodeficiency virus (HIV) burden in women continues to increase, and heterosexual contact is now the most common route of infection worldwide. Effective protection of women against HIV-1 infection may require a vaccine specifically targeting mucosal immune responses in the female genital tract (FGT). To achieve this goal, a much better understanding of the immunology of the FGT is needed. Here we review the architecture of the immune system of the FGT, recent studies of potential methods to achieve the goal of mucosal protection in women, including systemic-prime, mucosal-boost, FGT-tropic vectors and immune response altering adjuvants. Advances in other fields that enhance our understanding of female genital immune correlates and the interplay between hormonal and immunological systems may also help to achieve protection of women from HIV infection. PMID:25408686

Rafferty, Hannah; Sibeko, Sengeziwe; Rowland-Jones, Sarah

2014-01-01

18

Is an HIV vaccine possible?  

PubMed

Although many new prevention modalities that include the use of antiretroviral drugs show promise, there is no question that a global solution to the HIV epidemic will not be economically or logistically feasible without the development of vaccine that provides durable protection. In the best case scenario, the vaccine has to protect against acquisition of infection, likely mediated by Env-specific B-cell responses combined with CD4+ T-cell responses to evoke full maturation and maintenance of protective antibodies. But HIV-specific CD8+ T-cell responses are also likely to be a key element, particularly for those inevitable situations in which full vaccine-induced protection from acquisition is not achieved, in which case durable control of established infection will be required. Although there is reason to be optimistic that an effective HIV vaccine is possible, one of the major constraints moving forward will likely be constraint on funding to support a diversity of concepts at a time that the correlates of protection from acquisition and disease progression are still unknown. Given the scope of the epidemic and the economic climate, we must strive to do much more with less and seek to access additional resources, both scientific and monetary, from every possible source. PMID:22772390

McElrath, M Juliana; Walker, Bruce D

2012-08-01

19

Future HIV Vaccine Acceptability Among Young Adults in South Africa  

PubMed Central

Developing and disseminating a preventive HIV vaccine is a primary scientific and public health objective. However, little is known about HIV vaccine acceptability in the high prevalence setting of South Africa—where young adults are likely to be targeted in early dissemination efforts. In 2007, we conducted six focus groups (n=42) with South Africans aged 18-24 years old. We used a deductive framework approach to identify key motivators and barriers to future HIV vaccine uptake. Participants identified HIV testing, HIV stigma, mistrust of the health care system, and concerns about sexual disinhibition as barriers to vaccine uptake. For women, family members and friends were strong motivators for vaccine uptake, while men were more likely to see vaccines as an opportunity to stop using HIV prevention strategies such as condoms and partner reductions. Implications of these findings for developing HIV vaccine dissemination strategies and policy in South Africa are discussed. PMID:19509123

Sayles, Jennifer N.; Macphail, Catherine L.; Newman, Peter A.; Cunningham, William E.

2010-01-01

20

HIV Prevention  

MedlinePLUS

... your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral ... your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) ...

21

Attempts to cure and prevent HIV/AIDS in central Nigeria between 1997 and 2002: opening a way to a vaccine-based solution to the problem?  

PubMed

Like other sub-Saharan countries Nigeria is ravaged by HIV/AIDS. The author is a general surgeon with some training in Immunology and practises in central Nigeria. He conceived and developed a safe therapeutic HIV vaccine prepared from the blood of HIV-infected persons and applied the remedy to over 3500 such patients with their informed and written consent. He also developed a safe HIV preventive vaccine from the same source and applied it to himself and over 300 willing HIV antibody negative persons. This work reports his efforts and the findings so far even though some of the patients involved are still undergoing the therapy. The therapy has not affected, to any significant statistical level, either the overall weight gain in all the patients or the CD4+ count in those patients that were able to pay for the tests. The therapy also resulted in a maintained seroreversion to negative (normal) in some of the patients who, prior to therapy, had established seropositivity for HIV antibodies (20 patients), hepatitis C virus (HCV) antibodies (16 patients) and hepatitis B surface antigen (HBsAg) (50 patients). Neither the therapeutic nor the preventive vaccine is associated with the production of anti-HIV antibodies. PMID:15364427

Abalaka, Jeremiah Ojonemi Alabi

2004-09-28

22

"If It's Not Working, Why Would They Be Testing It?": mental models of HIV vaccine trials and preventive misconception among men who have sex with men in India  

PubMed Central

Background Informed consent based on comprehension of potential risks and benefits is fundamental to the ethical conduct of clinical research. We explored mental models of candidate HIV vaccines and clinical trials that may impact on the feasibility and ethics of biomedical HIV prevention trials among men who have sex with men (MSM) in India. Methods A community-based research project was designed and implemented in partnership with community-based organizations serving MSM in Chennai and Mumbai. We conducted 12 focus groups (n?=?68) with diverse MSM and 14 key informant interviews with MSM community leaders/service providers using a semi-structured interview guide to explore knowledge and beliefs about HIV vaccines and clinical trials. Focus groups (60–90 minutes) and interviews (45–60 minutes) were conducted in participants’ native language (Tamil in Chennai; Marathi or Hindi in Mumbai), audio-taped, transcribed and translated into English. We explored focus group and interview data using thematic analysis and a constant comparative method, with a focus on mental models of HIV vaccines and clinical trials. Results A mental model of HIV vaccine-induced seropositivity as “having HIV” resulted in fears of vaccine-induced infection and HIV stigma. Some participants feared inactivated vaccines might “drink blood” and “come alive”. Pervasive preventive misconception was based on a mental model of prevention trials as interventions, overestimation of likely efficacy of candidate vaccines and likelihood of being assigned to the experimental group, with expectations of protective benefits and decreased condom use. Widespread misunderstanding and lack of acceptance of placebo and random assignment supported perceptions of clinical trials as “cheating”. Key informants expressed concerns that volunteers from vulnerable Indian communities were being used as “experimental rats” to benefit high-income countries. Conclusions Evidence-informed interventions that engage with shared mental models among potential trial volunteers, along with policies and funding mechanisms that ensure local access to products that demonstrate efficacy in trials, may support the safe and ethical implementation of HIV vaccine trials in India. PMID:23919283

2013-01-01

23

Nanotechnology Applications to HIV Vaccines and Microbicides  

PubMed Central

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains one of the most serious threats to global health. Today there are no HIV vaccines which can prevent HIV infection. All of the candidates being studied are in the experimental stage. Preventive vaccine candidates are being tested in HIV-negative people to see if they can prevent infection. With of the development of a safe and effective vaccine still likely to be years away, topical microbicide formulations that are applied vaginally and rectally are receiving greater interest as an effective alternative to slow down the global spread of HIV. Current microbicide trials that aim to prevent the sexual transmission of HIV are using gels, creams, rings, films and there is also work underway to explore other types of ‘delivery’ systems. There have been numerous reports on safety and lack of toxicity of the application of nanotechnology for targeted delivery and slow, sustained release of drugs, proteins, peptides or nucleic acids by any route to maximize effectiveness and minimize adverse effects. The application of nanotechnology for targeting drugs and macromolecules to specific tissues or cells is one of the most important areas in nanomedicine research. Thus far nanoparticles provide a strong platform to combine protein and DNA based vaccines/microbicides and will facilitate the production, preclinical evaluation and clinical testing in the future. PMID:22529630

Boyapalle, Sandhya; Mohapatra, Subhra; Mohapatra, Shyam

2012-01-01

24

Preventive HIV Vaccine Acceptability and Behavioral Risk Compensation among a Random Sample of High-Risk Adults in Los Angeles (LA VOICES)  

PubMed Central

Objective To assess HIV vaccine acceptability among high-risk adults in Los Angeles. Study Setting Sexually transmitted disease clinics, needle/syringe exchange programs, Latino community health/HIV prevention programs. Study Design Cross-sectional survey using conjoint analysis. Participants were randomly selected using three-stage probability sampling. Data Collection Sixty-minute structured interviews. Participants rated acceptability of eight hypothetical vaccines, each with seven dichotomous attributes, and reported post-vaccination risk behavior intentions. Principal Findings Participants (n=1164; 55.7 percent male, 82.4 percent ethnic minority, mean age=37.4 years) rated HIV vaccine acceptability from 28.4 to 88.6; mean=54.5 (SD=18.8; 100-point scale). Efficacy had the greatest impact on acceptability, followed by side effects and out-of-pocket cost. Ten percent would decrease condom use after vaccination. Conclusions Findings support development of social marketing interventions to increase acceptability of “partial efficacy” vaccines, behavioral interventions to mitigate risk compensation, and targeted cost subsidies. PMID:19780857

Newman, Peter A; Lee, Sung-Jae; Duan, Naihua; Rudy, Ellen; Nakazono, Terry K; Boscardin, John; Kakinami, Lisa; Shoptaw, Steven; Diamant, Allison; Cunningham, William E

2009-01-01

25

Social and Behavioral Challenges of HIV Vaccines: Implications for Social Work and Social Science  

Microsoft Academic Search

A safe and efficacious HIV vaccine would be a tremendous asset to halting the spread of HIV. Nevertheless, HIV vaccines face a range of social and behavioral challenges that will determine their ultimate contribution to prevention. HIV vaccine development and clinical trials raise thorny social, behavioral, and ethical issues around resource allocation, recruitment and enrollment, trial implementation, and post-trial follow-up

Peter A. Newman

2009-01-01

26

Immunization of HIV-infected children with varicella vaccine  

Microsoft Academic Search

Objective: To determine the safety and immunogenicity of varicella vaccine in children with human immunodeficiency virus (HIV) infection. Children (n = 41) who were mildly affected by HIV (Centers for Disease Control and Prevention stage N1 or A1) and had no history or serum antibody indicative of prior varicella infection were immunized with two doses of live attenuated varicella vaccine.

Myron J. Levin; Anne A. Gershon; Adriana Weinberg; Suzette Blanchard; Barbara Nowak; Paul Palumbo; Christina Y. Chan

2001-01-01

27

Future HIV Vaccine Acceptability among Young Adults in South Africa  

ERIC Educational Resources Information Center

Developing and disseminating a preventive HIV vaccine is a primary scientific and public health objective. However, little is known about HIV vaccine acceptability in the high-prevalence setting of South Africa--where young adults are likely to be targeted in early dissemination efforts. This study reports on six focus groups (n = 42) conducted in…

Sayles, Jennifer N.; Macphail, Catherine L.; Newman, Peter A.; Cunningham, William E.

2010-01-01

28

HIV Infection and Adult Vaccination  

MedlinePLUS

... gotten two doses of this vaccine or have immunity to this disease If you have HIV infection and your CD4 count is less than 200[ 2 ], talk with your doctor about: Influenza vaccine each year to protect against seasonal flu ...

29

Vaccinations and HIV  

MedlinePLUS

... Do not measure your viral load within 4 weeks of any vaccination. Flu shots have been studied ... live” vaccination in the past 2 or 3 weeks. Still, the “MMR” vaccine against measles, mumps and ...

30

Closer to HIV vaccine goal with new insight into viral factors  

E-print Network

- 1 - Closer to HIV vaccine goal with new insight into viral factors February 14, 2012 New insight of HIV infection is critical to developing vaccines The HIV-1 pandemic afflicts more than 34 million infection. The best hope to relieve this humanitarian disaster is to develop an effective vaccine to prevent

31

The Epidemiological Impact of an HIV\\/AIDS Vaccine in Developing Countries  

Microsoft Academic Search

Many people see an effective preventive AIDS vaccine as the best solution to the HIV\\/AIDS pandemic. Ten years ago many scientists had hoped that a vaccine would be available by now. Most scientists are still optimistic that vaccines will be developed and many candidates are being tested. Strategies to implement HIV\\/AIDS vaccination need to be developed to be ready when

John Stover; Geoff P. Garnett; Steve Seitz; Steven Forsythe

2002-01-01

32

Socioecological Influences on Community Involvement in HIV Vaccine Research  

PubMed Central

Objective This study investigated socioecological factors influencing HIV vaccine research participation among communities living in geographic areas with high HIV prevalence and high poverty rates. Methods We surveyed a sample of 453 adults ? 18 years from areas of high poverty and high HIV prevalence in metro Atlanta and differentiated the effects of individual-, social/organizational-, and community-level characteristics on participation in HIV vaccine research via multilevel modeling techniques that incorporated questionnaire, program, and census data. Results Models that adjusted for both individual-level covariates (such as race, gender, attitudes, and beliefs concerning HIV research), social/organizational- and community-level factors such as local HIV prevalence rates, revealed that the extent of HIV prevention-related programs and services in census tracts contributed to individuals’ likelihood of participation in an HIV vaccine study. Additionally, neighborhood-based organizations offering HIV medical and treatment programs, support groups, and services (e.g., food, shelter, and clothing) encourage greater HIV vaccine research participation. Conclusions The findings support the hypothesis that community-level factors facilitate participation in HIV vaccine research independent of both individual- and social/organizational-level factors. PMID:21722689

Frew, Paula M.; Archibald, Matthew; Hixson, Brooke; del Rio, Carlos

2011-01-01

33

A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand.  

PubMed

A safe and efficacious preventive HIV vaccine would be a tremendous asset for low- and middle-income country (LMIC) settings, which bear the greatest global impact of AIDS. Nevertheless, substantial gaps between clinical trial efficacy and real-world effectiveness of already licensed vaccines demonstrate that availability does not guarantee uptake. In order to advance an implementation science of HIV vaccines centred on LMIC settings, we explored sociocultural and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand, the site of the largest HIV vaccine trial ever conducted. Cross-cutting challenges for HIV vaccine uptake - social stigma, discrimination in healthcare settings and out-of-pocket vaccine cost - emerged in addition to population-specific barriers and opportunities. A 'social vaccine' describes broad sociocultural and structural interventions - culturally relevant vaccine promotion galvanised by communitarian norms, mitigating anti-gay, anti-injecting drug user and HIV-related stigma, combating discrimination in healthcare, decriminalising adult sex work and injecting drug use and providing vaccine cost subsidies - that create an enabling environment for HIV vaccine uptake among most-at-risk populations. By approaching culturally relevant social and structural interventions as integral mechanisms to the success of new HIV prevention technologies, biomedical advances may be leveraged in renewed opportunities to promote and optimise combination prevention. PMID:22780324

Newman, Peter A; Roungprakhon, Surachet; Tepjan, Suchon; Yim, Suzy; Walisser, Rachael

2012-01-01

34

Towards a coronavirus-based HIV multigene vaccine  

Microsoft Academic Search

Human immunodeficiency virus (HIV) infection represents one of the major health threats in the developing world. The costly treatment of infected individuals with multiple highly efficient anti-HIV drugs is only affordable in industrialized countries. Thus, an efficient vaccination strategy is required to prevent the further spread of the infection. The molecular biology of coronaviruses and particular features of the human

Klara K. Eriksson; Divine Makia; Reinhard Maier; Burkhard Ludewig; Volker Thiel

2006-01-01

35

HIV Vaccines: Building broad-based support for HIV Vaccine Research  

NSDL National Science Digital Library

This is a PowerPoint Presentation providing background on the nature of HIV and AIDS as well as how vaccines are developed and tested. The purpose is to generate broad-based support of HIV vaccine research and trials.

2001-10-04

36

Patent data mining: a tool for accelerating HIV vaccine innovation.  

PubMed

Global access to advanced vaccine technologies is challenged by the interrelated components of intellectual property (IP) management strategies, technology transfer (legal and technical) capabilities and the capacity necessary for accelerating R&D, commercialization and delivery of vaccines. Due to a negative association with the management of IP, patents are often overlooked as a vast resource of freely available, information akin to scientific journals as well as business and technological information and trends fundamental for formulating policies and IP management strategies. Therefore, a fundamental step towards facilitating global vaccine access will be the assembly, organization and analysis of patent landscapes, to identify the amount of patenting, ownership (assignees) and fields of technology covered. This is critical for making informed decisions (e.g., identifying licensees, building research and product development collaborations, and ascertaining freedom to operate). Such information is of particular interest to the HIV vaccine community where the HIV Vaccine Enterprise, have voiced concern that IP rights (particularly patents and trade secrets) may prevent data and materials sharing, delaying progress in research and development of a HIV vaccine. We have compiled and analyzed a representative HIV vaccine patent landscape for a prime-boost, DNA/adenoviral vaccine platform, as an example for identifying obstacles, maximizing opportunities and making informed IP management strategy decisions towards the development and deployment of an efficacious HIV vaccine. PMID:21496469

Clark, K; Cavicchi, J; Jensen, K; Fitzgerald, R; Bennett, A; Kowalski, S P

2011-05-31

37

A Polyvalent Clade B Virus-Like Particle HIV Vaccine Combined with Partially Protective Oral Preexposure Prophylaxis Prevents Simian-Human Immunodeficiency Virus Infection in Macaques and Primes for Virus-Amplified Immunity.  

PubMed

Abstract Vaccination and preexposure prophylaxis (PrEP) with antiretrovirals have shown only partial protection from HIV-1 infection in human trials. Oral Truvada (emtricitabine/tenofovir disoproxil fumarate) is FDA approved as PrEP but partial adherence reduces efficacy. If combined as biomedical preventions (CBP), an HIV vaccine could protect when PrEP adherence is low and PrEP could prevent vaccine breakthroughs. The efficacy of combining oral PrEP with an HIV vaccine has not been evaluated in humans. We determined the efficacy of combining a DNA/virus-like particle (VLP) vaccine with partially effective intermittent PrEP in Indian rhesus macaques (RM). Eight RM received intramuscular inoculations of five DNA plasmids encoding four HIV-1 Clade B primary isolate Envs and SIVmac239 Gag (at weeks 0 and 4), followed by intramuscular and intranasal inoculations of homologous Gag VLPs and four Env VLPs (at weeks 12, 16, and 53). At week 61, we initiated weekly rectal exposures with heterologous SHIV162p3 (10 TCID50) along with oral Truvada (TDF, 22?mg/kg; FTC 20?mg/kg) dosing 2?h before and 22?h after each exposure. This PrEP regimen previously demonstrated 50% efficacy. Five controls (no vaccine, no PrEP) received weekly SHIV162p3. All controls were infected after a median of four exposures; the mean peak plasma viral load (VL) was 3.9×10(7) vRNA copies/ml. CBP protected seven of eight (87.5%) RM. The one infected CBP RM had a reduced peak VL of 8.8×10(5) copies/ml. SHIV exposures during PrEP amplified Gag and Env antibody titers in protected RM. These results suggest that combining oral PrEP with HIV vaccines could enhance protection against HIV-1 infection. PMID:24914761

Ross, Ted M; Pereira, Lara E; Luckay, Amara; McNicholl, Janet M; García-Lerma, J Gerardo; Heneine, Walid; Eugene, Hermancia S; Pierce-Paul, Brooke R; Zhang, Jining; Hendry, R Michael; Smith, James M

2014-11-01

38

HIV treatment for prevention.  

PubMed

"No virus, no transmission." Studies have repeatedly shown that viral load (the quantity of virus present in blood and sexual secretions) is the strongest predictor of HIV transmission during unprotected sex or transmission from infected mother to child. Effective treatment lowers viral load to undetectable levels. If one could identify and treat all HIV-infected people immediately after infection, the HIV/AIDS epidemic would eventually disappear.Such a radical solution is currently unrealistic. In reality, not all people get tested, especially when they fear stigma and discrimination. Thus, not all HIV-infected individuals are known. Of those HIV-positive individuals for whom the diagnosis is known, not all of them have access to therapy, agree to be treated, or are taking therapy effectively. Some on effective treatment will stop, and in others, the development of resistance will lead to treatment failure. Furthermore, resources are limited: should we provide drugs to asymptomatic HIV-infected individuals without indication for treatment according to guidelines in order to prevent HIV transmission at the risk of diverting funding from sick patients in urgent need? In fact, the preventive potential of anti-HIV drugs is unknown. Modellers have tried to fill the gap, but models differ depending on assumptions that are strongly debated. Further, indications for antiretroviral treatments expand; in places like Vancouver and San Francisco, the majority of HIV-positive individuals are now under treatment, and the incidence of new HIV infections has recently fallen. However, correlation does not necessarily imply causation. Finally, studies in couples where one partner is HIV-infected also appear to show that treatment reduces the risk of transmission.More definite studies, where a number of communities are randomized to either receive the "test-and-treat" approach or continue as before, are now in evaluation by funding agencies. Repeated waves of testing would precisely measure the incidence of HIV infection. Such trials face formidable logistical, practical and ethical obstacles. However, without definitive data, the intuitive appeal of "test-and-treat" is unlikely to translate into action on a global scale. In the meantime, based on the available evidence, we must strive to provide treatment to all those in medical need under the current medical guidelines. This will lead to a decrease in HIV transmission while "test-and-treat" is fully explored in prospective clinical trials. PMID:21612619

Ambrosioni, Juan; Calmy, Alexandra; Hirschel, Bernard

2011-01-01

39

Which Antibody Functions are Important for an HIV Vaccine?  

PubMed Central

HIV antibody (Ab) functions capable of preventing mucosal cell-free or cell-to-cell HIV transmission are critical for the development of effective prophylactic and therapeutic vaccines. In addition to CD4+ T cells, other potential HIV-target cell types including antigen-presenting cells (APCs) (dendritic cells, macrophages) residing at mucosal sites are infected. Moreover, the interactions between APCs and HIV lead to HIV cell-to-cell transmission. Recently discovered broadly neutralizing antibodies (NAbs) are able to neutralize a broad spectrum of HIV strains, inhibit cell-to-cell transfer, and efficiently protect from infection in the experimentally challenged macaque model. However, the 31% protection observed in the RV144 vaccine trial in the absence of detectable NAbs in blood samples pointed to the possible role of additional Ab inhibitory functions. Increasing evidence suggests that IgG Fc? receptor (Fc?R)-mediated inhibition of Abs present at the mucosal site may play a role in protection against HIV mucosal transmission. Moreover, mucosal IgA Abs may be determinant in protection against HIV sexual transmission. Therefore, defining Ab inhibitory functions that could lead to protection is critical for further HIV vaccine design. Here, we review different inhibitory properties of HIV-specific Abs and discuss their potential role in protection against HIV sexual transmission. PMID:24995008

Su, Bin; Moog, Christiane

2014-01-01

40

How Should HIV Vaccine Efficacy Trials Be Conducted? Diverse U.S. Communities Speak Out  

ERIC Educational Resources Information Center

Developing an effective vaccine remains a critical long-term approach to HIV prevention. Every efficacy trial should be responsive to the concerns of participating communities because the successful development of an HIV preventive vaccine will require long-term involvement of people who have been marginalized and who distrust the government and…

Kegeles, Susan M.; Johnson, Mallory O.; Strauss, Ronald P.; Ralston, Brady; Hays, Robert B.; Metzger, David S.; McLellan-Lemal, Eleanor; MacQueen, Kathleen M.

2006-01-01

41

Current strategies and limitations of HIV vaccines.  

PubMed

There is currently no cure for HIV infection, and the possibility of developing a vaccine in the near future appears unlikely. With more than 33 million individuals living with HIV/AIDS worldwide, there is a distinct need for a prophylactic vaccine against HIV infection. However, conventional vaccine strategies aimed at eliciting antibody and T-cell responses have failed to protect against the virus. Current research has been directed toward the more realistic goal of controlling viral replication during the early stages of infection, thus reducing the viral setpoint, through the use of novel vaccine delivery systems and techniques. In this review, several of the key milestones achieved as a result of research efforts aimed at developing an effective HIV vaccine are identified, and future prospects are examined. PMID:20112169

Kawalekar, Omkar U; Shedlock, Devon J; Weiner, David B

2010-02-01

42

Potential Population Health Outcomes and Expenditures of HIV Vaccination Strategies in the United States  

PubMed Central

Estimating the potential health benefits and expenditures of a partially effective HIV vaccine is an important consideration in the debate about whether HIV vaccine research should continue. We developed an epidemic model to estimate HIV prevalence, new infections, and the cost-effectiveness of vaccination strategies in the U.S. Vaccines with modest efficacy could prevent 300,000–700,000 HIV infections and save $30 billion in healthcare expenditures over 20 years. Targeted vaccination of high-risk individuals is economically efficient, but difficulty in reaching these groups may mitigate these benefits. Universal vaccination is cost-effective for vaccines with 50%-efficacy and price similar to other infectious disease vaccines. PMID:19591796

Long, Elisa F.; Brandeau, Margaret L.; Owens, Douglas K.

2009-01-01

43

Novel vaccine vectors for HIV-1  

PubMed Central

The ultimate solution to the global HIV-1 epidemic will probably require the development of a safe and effective vaccine. Multiple vaccine platforms have been evaluated in both preclinical and clinical trials, but, given the disappointing results of the clinical efficacy studies so far, novel vaccine approaches are needed. In this Opinion article, we discuss the scientific basis and clinical potential of novel adenovirus and cytomegalovirus vaccine vectors for HIV-1 as two contrasting, but potentially complementary, vector approaches. Both of these vector platforms have demonstrated partial protection against stringent simian immunodeficiency virus challenges in rhesus monkeys using different immunological mechanisms. PMID:25296195

Picker, Louis J.

2014-01-01

44

Community preparedness for HIV vaccine trials in the Democratic Republic of Congo  

Microsoft Academic Search

This paper reports on an assessment of community preparedness for HIV vaccine trials in the Democratic Republic of Congo. Formative research was conducted in the capital city of Kinshasa during the period October 2003 to March 2004 to answer questions pertinent to planning trials of a preventive HIV vaccine and to identify related issues. Twenty?seven in?depth interviews and two focus

John Olin; Jacques Kokolamami; Francois B. Lepira; Kashamuka Mwandagalirwa; Bavon Mupenda; Michel Lubaki Ndongala; Suzanne Maman; Robert Bollinger; Jean Nachega; John Mokili

2006-01-01

45

A BLUEPRINT FOR HIV VACCINE DISCOVERY  

PubMed Central

Despite numerous attempts over many years to develop an HIV vaccine based on classical strategies, none has convincingly succeeded to date. A number of approaches are being pursued in the field, including building upon possible efficacy indicated by the recent RV144 clinical trial, which combined two HIV vaccines. Here, we argue for an approach based, in part, on understanding the HIV envelope spike and its interaction with broadly neutralizing antibodies (bnAbs) at the molecular level and using this understanding to design immunogens as possible vaccines. BnAbs can protect against virus challenge in animal models and many such antibodies have been isolated recently. We further propose that studies focused on how best to provide T cell help to B cells that produce bnAbs are crucial for optimal immunization strategies. The synthesis of rational immunogen design and immunization strategies, together with iterative improvements, offers great promise for advancing toward an HIV vaccine. PMID:23084910

Burton, Dennis R.; Ahmed, Rafi; Barouch, Dan H.; Butera, Salvatore T.; Crotty, Shane; Godzik, Adam; Kaufmann, Daniel E.; McElrath, M. Juliana; Nussenzweig, Michel C.; Pulendran, Bali; Scanlan, Chris N.; Schief, William R.; Silvestri, Guido; Streeck, Hendrik; Walker, Bruce D.; Walker, Laura M.; Ward, Andrew B.; Wilson, Ian A.; Wyatt, Richard

2012-01-01

46

NEW APPROACHES TO DESIGN HIV-1 T CELL VACCINES  

PubMed Central

Purpose of review Following the evidence that T cell responses are crucial in the control of HIV-1 infection, vaccines targeting T cell responses were tested in recent clinical trials. However these vaccines showed a lack of efficacy. This review attempts to define the qualitative and quantitative features that are desirable for T cell induced responses by vaccines. We also describe strategies that could lead to achievement of this goal. Recent findings Using the yellow fever vaccine as a benchmark of an efficient vaccine, recent studies identified factors of immune protection and more importantly innate immune pathways needed for the establishment of long-term protective adaptive immunity. Summary To prevent or control HIV-1 infection, a vaccine must induce efficient and persistent Ag-specific T cells endowed with mucosal homing capacity. Such cells should have the capability to counteract HIV-1 diversity and its rapid spread from the initial site of infection. To achieve this goal, the activation of a diversified innate immune response is critical. New systems biology approaches will provide more precise correlates of immune protection that will pave the way for new approaches in T cell based vaccines. PMID:20978376

Helene, Perrin; Glenda, Canderan; Rafick-Pierre, Sekaly; Lydie, Trautmann

2010-01-01

47

Vaccine Preventable Disease on Campus.  

ERIC Educational Resources Information Center

While morbidity and mortality from vaccine preventable diseases have declined, some college students remain susceptible to measles, rubella, diptheria, tetanus, or polio. Colleges and universities have the opportunity to ensure protection of students, faculty, and employees by establishing and enforcing immunization requirements. (Author/DF)

Bart, Kenneth J.

1984-01-01

48

In “Step” with HIV Vaccines? A Content Analysis of Local Recruitment Campaigns for an International HIV Vaccine Study  

PubMed Central

During the past two decades of the HIV/AIDS pandemic, several recruitment campaigns were designed to generate community involvement in preventive HIV vaccine clinical trials. These efforts utilized a blend of advertising and marketing strategies mixed with public relations and community education approaches to attract potential study participants to clinical trials (integrated marketing communications). Although more than 30,000 persons worldwide have participated in preventive HIV vaccine studies, no systematic analysis of recruitment campaigns exists. This content analysis study was conducted to examine several United States and Canadian recruitment campaigns for one of the largest-scale HIV vaccine trials to date (the “Step Study”). This study examined persuasive features consistent with the Elaboration Likelihood Model (ELM) including message content, personal relevance of HIV/AIDS and vaccine research, intended audiences, information sources, and other contextual features. The results indicated variation in messages and communication approaches with gay men more exclusively targeted in these regions. Racial/ethnic representations also differed by campaign. Most of the materials promote affective evaluation of the information through heuristic cueing. Implications for subsequent campaigns and research directions are discussed. PMID:19609373

Frew, Paula M.; Macias, Wendy; Chan, Kayshin; Harding, Ashley C.

2009-01-01

49

Using Social Networks to Recruit an HIV Vaccine Preparedness Cohort  

PubMed Central

Objective Evaluate a social network approach to develop an adolescent cohort for HIV vaccine preparedness and investigate characteristics that influence recruitment. Methods We summarize baseline data from a prospective cohort study that included four sessions over six months. Fifty-nine HIV-infected adolescent and adult patients of a family-based HIV clinic named significant others and indicated willingness to involve them in this study. Sixty-two adolescent and adult significant others not known to be HIV-infected were enrolled. Logistic regression was used to estimate factors associated with willingness. Results Participants identified 624 social network members including 276 (44%) adolescents. Network member's awareness of the index's HIV-positivity (P<0.01) and older age (P=0.05) affected willingness. Respondents were less willing to invite drug-risk alters (P=0.006). Adolescents were willing to invite more adolescents than were adults (P<.0001). Adolescents <18 years old reported fewer sexual and drug-using risk behaviors than expected. Conclusions HIV-infected patients are willing to recruit their social networks provided concerns about disclosure of HIV status are addressed. Using social networks to identify and recruit adolescent populations is appropriate and feasible for vaccine preparedness activities, future vaccine trials, and other prevention programs, but procedures are needed to selectively identify and retain high-risk youth. PMID:19584741

Valente, Thomas W.; Zogg, Jennifer B.; Christensen, Shawna; Richardson, Jean; Kovacs, Andrea; Operskalski, Eva

2009-01-01

50

Virology: Moving Forward in HIV Vaccine Development  

NSDL National Science Digital Library

Access to the article is free a year after publication, registration and sign-in are required: While the pursuit of basic laboratory research will continue to be important in the development of an HIV vaccine, the results of the Thai trial underscore the extraordinary importance of also performing focused human clinical trials of vaccine strategies.

Norman L. Letvin (Harvard Medical School;Department of Medicine)

2009-11-27

51

The potential global market size and public health value of an HIV1 vaccine in a complex global market  

Microsoft Academic Search

An effective HIV vaccine will be essential for the control of the HIV pandemic. This study evaluated the potential global market size and value of a hypothetical HIV vaccine and considered clade diversity, disease burden, partial prevention of acquisition, impact of a reduction in viral load resulting in a decrease in transmission and delay to treatment, health care system differences

Carol A. Marzetta; Stephen S. Lee; Sandra J. Wrobel; Kanwarjit J. Singh; Nina Russell; José Esparza

2010-01-01

52

Past, present and future of HIV vaccine trials in developing countries  

Microsoft Academic Search

A safe, effective and accessible preventive vaccine is our best long-term hope for the control of the HIV\\/AIDS pandemic. The first phase I trial of an HIV vaccine was conducted in the US in 1987. Since then, >30 candidate vaccines have been tested in over 60 phase I\\/II clinical trials, involving >8000 healthy human volunteers. The majority of these trials

José Esparza; Saladin Osmanov; Claire Pattou-Markovic; Coumba Touré; Marie-Louise Chang; Stephanie Nixon

2002-01-01

53

Development of prophylactic vaccines against HIV-1  

PubMed Central

The focus of most current HIV-1 vaccine development is on antibody-based approaches. This is because certain antibody responses correlated with protection from HIV-1 acquisition in the RV144 phase III trial, and because a series of potent and broad spectrum neutralizing antibodies have been isolated from infected individuals. Taken together, these two findings suggest ways forward to develop a neutralizing antibody-based vaccine. However, understanding of the correlates of protection from disease in HIV-1 and other infections strongly suggests that we should not ignore CTL-based research. Here we review recent progress in the field and highlight the challenges implicit in HIV-1 vaccine design and some potential solutions. PMID:23866844

2013-01-01

54

A tale of two vaccines: lessons from polio that could inform the development of an HIV vaccine.  

PubMed

Two vaccine trials that were conducted 50 years apart are reviewed and compared: the 1954 field trial of the Salk inactivated polio vaccine and the RV144 HIV vaccine trial conducted in Thailand between 2003 and 2009. Despite the obvious differences in science and historical periods, several lessons were identified that could inform the future HIV vaccine effort. Those lessons are related to paradigm changes that occur when science progresses, the need to test scientific hypothesis in efficacy trials, the controversies surrounding those trials, the need for strong community and political support, the participation of government and nongovernment institutions, the balance between implementation of other preventive and therapeutic interventions, and the priority given by society to develop a vaccine. If we have the humility and courage to apply some of those lessons, we may be able accelerate the development of an urgently needed HIV vaccine. PMID:23018439

Esparza, José

2013-01-01

55

HIV and Immunizations  

MedlinePLUS

... a disease outbreak. Is there a vaccine against HIV? Testing is underway on experimental vaccines to prevent ... can benefit from vaccines against other diseases. Can HIV infection affect the safety and effectiveness of vaccines? ...

56

Design of HIV Vaccine Trials JID 2003:188 (15 July) 179 M A J O R A R T I C L E  

E-print Network

Design of HIV Vaccine Trials · JID 2003:188 (15 July) · 179 M A J O R A R T I C L E What Constitutes Efficacy for a Human Immunodeficiency Virus Vaccine that Ameliorates Viremia: Issues Involving Initial human immunodeficiency virus (HIV) vaccines are unlikely to prevent acquisition of HIV in all

Gilbert, Peter

57

Preventing HIV infection in women.  

PubMed

Although the number of new infections has declined recently, women still constitute almost half of the world's 34 million people with HIV infection, and HIV remains the leading cause of death among women of reproductive age. Prevention research has made considerable progress during the past few years in addressing the biological, behavioral, and social factors that influence women's vulnerability to HIV infection. Nevertheless, substantial work still must be performed to implement scientific advancements and to resolve many questions that remain. This article highlights some of the recent advances and persistent gaps in HIV prevention research for women and outlines key research and policy priorities. PMID:23764631

Adimora, Adaora A; Ramirez, Catalina; Auerbach, Judith D; Aral, Sevgi O; Hodder, Sally; Wingood, Gina; El-Sadr, Wafaa; Bukusi, Elizabeth A

2013-07-01

58

Challenges in the development of an HIV-1 vaccine  

E-print Network

REVIEWS Challenges in the development of an HIV-1 vaccine Dan H. Barouch1 The development of a safe and effective human immunodeficiency virus (HIV)-1 vaccine is a critically important global health priority scientific obstacles remain. Prototype HIV-1 vaccine candidates aimed at eliciting humoral and cellular

Cai, Long

59

A Small Dose of HIV? HIV Vaccine Mental Models and Risk Communication  

ERIC Educational Resources Information Center

Existing knowledge and beliefs related to HIV vaccines provide an important basis for the development of risk communication messages to support future HIV vaccine dissemination. This study explored HIV vaccine mental models among adults from segments of the population disproportionately affected by HIV/AIDS. Nine focus groups were conducted with…

Newman, Peter A.; Seiden, Danielle S.; Roberts, Kathleen J.; Kakinami, Lisa; Duan, Naihua

2009-01-01

60

Family Wellness, Not HIV Prevention  

PubMed Central

HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences. PMID:19148744

Swendeman, Dallas; Flannery, Diane

2010-01-01

61

Civil society perspectives on negative biomedical HIV prevention trial results and implications for future trials  

Microsoft Academic Search

Community engagement is crucial to ongoing development and testing of sorely needed new biomedical HIV prevention technologies. Yet, negative trial results raise significant challenges for community engagement in HIV prevention trials, including the early termination of the Cellulose Sulfate microbicide trial and two Phase IIb HIV vaccine trials (STEP and Phambili). The present study aimed to explore the perspectives and

Zaynab Essack; Jennifer Koen; Catherine Slack; Graham Lindegger; Peter A. Newman

2012-01-01

62

Prevention of HIV Among Adolescents  

Microsoft Academic Search

Adolescents are at risk for HIV primarily through their sexual behavior. A comprehensive prevention strategy includes a national HIV campaign based on social marketing principles; targeted social marketing, intensive skill building, and sexually transmitted disease control programs for youth at high risk; programs targeting institutions (e.g., school health clinics), providers, and parents; and interventions to identify and reduce risk acts

Mary Jane Rotheram-Borus; Zane O'Keefe; Robin Kracker; Hsin-Hsin Foo

2000-01-01

63

Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and  

E-print Network

and Infectious Diseases, died unexpectedly on March 5, 2012.Dr. Handelsman was a pediatrician dedicated ................................................................................B-1 Preventing Vaccine-Preventable Diseases in HIV-Infected Children and Adolescents

Bandettini, Peter A.

64

Progress in HIV-1 Vaccine Development  

PubMed Central

Purpose of the Review In this review, examples of recent progress in HIV-1 vaccine research are discussed. Recent Findings New insights from the immune correlates analyses of the RV144 efficacy trial have accelerated vaccine development with leads to follow in non-human primate studies and improved vaccine designs. Several new vaccine vector approaches offer promise in exquisite control of acute infection and in improving the breadth of T cell responses. New targets of broadly neutralizing antibodies (BnAbs) have been elucidated, and improved understanding of how the human host controls BnAb development have emerged from BnAb knockin mice and from analyses of BnAb maturation and virus evolution in subjects followed from the time of HIV-1 transmission to BnAb induction. Summary Based on these observations, it is clear that development of a successful HIV-1 vaccine will require new vaccine approaches and iterative testing of immunogens in well-designed animal and human trials. PMID:23743722

Haynes, Barton F.; McElrath, M. Juliana

2014-01-01

65

HIV vaccine acceptability among high-risk drug users in Appalachia: a cross-sectional study  

PubMed Central

Background A vaccine could substantially impact the HIV epidemic, but inadequate uptake is a serious concern. Unfortunately, people who use drugs, particularly those residing in rural communities, have been underrepresented in previous research on HIV vaccine acceptability. This study examined HIV vaccine acceptability among high-risk drug users in a rural community in the United States. Methods Interviewer-administered questionnaires included questions about risk behavior and attitudes toward HIV vaccination from 433 HIV-negative drug users (76% with history of injection) enrolled in a cohort study in Central Appalachia. HIV vaccine acceptability was measured on a 4-point Likert scale. Generalized linear mixed models were used to determine correlates to self-report of being “very likely” to receive a 90% effective HIV vaccine (i.e. “maximum vaccine acceptability”, or MVA). Adjusted odds ratios (AORs) and corresponding 95% confidence intervals (CIs) are reported. Results Most (91%) reported that they would accept a preventive HIV vaccine, but concerns about cost, dosing, transportation constraints, vaccine-induced seropositivity, and confidentiality were expressed. Cash incentives, oral-administration, and peer/partner encouragement were anticipated facilitators of uptake. In multivariate analysis, men were significantly less likely to report MVA (AOR: 0.33, CI: 0.21 – 0.52). MVA was more common among participants who believed that they were susceptible to HIV (AOR: 2.31, CI: 1.28 – 4.07), that an HIV vaccine would benefit them (AOR: 2.80, CI: 1.70 – 4.64), and who had positive experiential attitudes toward HIV vaccination (AOR: 1.85, CI: 1.08 – 3.17). MVA was also more common among participants who believed that others would encourage them to get vaccinated and anticipated that their behavior would be influenced by others' encouragement (AOR: 1.81, 95% 1.09 – 3.01). Conclusions To our knowledge, this study was among the first to explore and provide evidence for feasibility of HIV vaccination in a rural, high-risk population in the United States. This study provides preliminary evidence that gender-specific targeting in vaccine promotion may be necessary to promoting vaccine uptake in this setting, particularly among men. The data also underscore the importance of addressing perceived risks and benefits, social norms, and logistical constraints in efforts to achieve widespread vaccine coverage in this high-risk population. PMID:24885970

2014-01-01

66

An Hepatitis B Vaccine Model for HIV Vaccine Trials in Drug Users  

ClinicalTrials.gov

Using Cocaine or Heroin in the Last 7 Days,; Age Over 18 Years Old,; Competent to Sign Informed Consent for HIV/HBV/HCV Testing,; HIV/HBV Negatives Will be Randomized for HB Vaccine Study; HIV Infections

2009-03-12

67

HIV Related High Risk Behaviors and Willingness to Participate in HIV Vaccine Trials among China MSM by Computer Assisted Self-Interviewing Survey  

PubMed Central

Background. The number of new HIV infections among MSM of China is rapidly increasing in recent years and behavioral interventions have had limited effectiveness. To control the HIV pandemic may lie in an HIV vaccine. This study examined the factors associated with willingness to participate (WTP) in HIV vaccine clinical trials among China MSM. Methods. A cross-sectional survey was carried out among MSM from three cities in northeast China. Questionnaires pertaining to MSM risk behavior and WTP in HIV vaccine trials were administered through computer assisted self-interviewing (CASI). Results. A total of 626 MSM participated in this survey. 54.8% had occasional male partners and 52.2% always used condoms with male sex partners. HIV prevalence was 5.0%. 76.7% were WTP in a preventive HIV vaccine clinical trial. Results showed that HIV vaccination is a means of protection for spouses and family; family support to participate in vaccine trials and desire for economic incentives were significantly associated with WTP. Conclusions. There was a high proportion of WTP in HIV vaccine trials among Chinese MSM. The high HIV prevalence and high proportion of risky sexual behavior indicate that Liaoning MSM are potential candidates for HIV vaccine trials. PMID:24371825

Xu, Junjie; Reilly, Kathleen Heather; Lu, Chunming; Hu, Qinghai; Ma, Ning; Zhang, Min; Zhang, Jing; Jiang, Yongjun; Geng, Wenqing; Shang, Hong

2013-01-01

68

Electroporation-mediated administration of candidate DNA vaccines against HIV-1.  

PubMed

Vaccines to prevent HIV remain desperately needed, but a number of challenges, including retroviral integration, establishment of anatomic reservoir sites, high sequence diversity, and heavy envelope glycosylation. have precluded development of a highly effective vaccine. DNA vaccines have been utilized as candidate HIV vaccines because of their ability to generate cellular and humoral immune responses, the lack of anti-vector response allowing for repeat administration, and their ability to prime the response to viral-vectored vaccines. Because the HIV epidemic has disproportionately affected the developing world, the favorable thermostability profile and relative ease and low cost of manufacture of DNA vaccines offer additional advantages. In vivo electroporation (EP) has been utilized to improve immune responses to DNA vaccines as candidate HIV-1 vaccines in standalone or prime-boost regimens with both proteins and viral-vectored vaccines in several animal models and, more recently, in human clinical trials. This chapter describes the preclinical and clinical development of candidate DNA vaccines for HIV-1 delivered by EP, including challenges to bringing this technology to the developing world. PMID:24510833

Vasan, Sandhya

2014-01-01

69

Use of Human Mucosal Tissue to Study HIV-1 Pathogenesis and Evaluate HIV-1 Prevention Modalities  

PubMed Central

The use of human mucosal tissue models is an important tool advancing our understanding of the specific mechanisms of sexual HIV transmission. Despite 30 years of study, major gaps remain, including how HIV-1 transverses the epithelium and the identity of the early immune targets (gate keepers). Because defining HIV-1 transmission in vivo is difficult, mucosal tissue is being used ex vivo to identify key steps in HIV-1 entry and early dissemination. Elucidating early events of HIV-1 infection will help us develop more potent and specific HIV-1 preventatives such as microbicides and vaccines. Mucosal tissue has been incorporated into testing regimens for antiretroviral drugs and monoclonal antibodies. The use of mucosal tissue recapitulates the epithelium and immune cells that would be exposed in vivo to virus and drug. This review will discuss the use of mucosal tissue to better understand HIV-1 pathogenesis and prevention modalities. PMID:23224426

Dezzutti, Charlene S.; Hladik, Florian

2014-01-01

70

Efficacy of influenza vaccination in HIV-positive patients: a systematic review and meta-analysis  

Microsoft Academic Search

Background International treatment guidelines recommend that HIV-positive patients be vaccinated for influenza annually. Evidence supporting this recommendation is limited. We assessed the efficacy of influenza vaccines in preventing influenza in HIV-positive patients through a systematic review and meta-analysis. Methods We searched 10 electronic databases independently, in duplicate (from inception to June 2007). We extracted data on study design, population characteristics

A Anema; E Mills; J Montaner; JS Brownstein; C Cooper

2008-01-01

71

Vaccine-preventable diseases and vaccination rates in South Dakota.  

PubMed

Vaccine-preventable diseases have historically caused much illness and death in South Dakota. Sixty-seven diphtheria deaths were reported in 1892 and 1,017 polio cases were reported at the peak of the polio epidemic in 1952. As vaccines have been developed, licensed and put into wide use, the rates of diphtheria, polio, measles, smallpox and other diseases have successfully decreased leading to control, statewide elimination or eradication. Other diseases, such as pertussis, have been more difficult to control by vaccination alone. Although current vaccination coverage rates for South Dakota's kindergarten children surpass the Healthy People 2020 targets of 95 percent, the coverage rates for 2-year-old children and teenagers are below the target rates. Until vaccine-preventable diseases are eradicated globally, we must vigilantly maintain high vaccination coverage rates and aggressively apply control measures to limit transmission when diseases do occur in South Dakota. PMID:23444597

Kightlinger, Lon

2013-01-01

72

Will studies in individuals with systemic lupus erythematosus be the key to future HIV vaccine design?  

PubMed

The induction of HIV-1 broadly neutralizing antibodies (bnAbs) remains the primary goal of a preventive HIV-1 vaccine but no HIV-1 vaccine candidate has succeeded in inducing bnAbs. All the bnAbs isolated from chronically HIV-1 infected subjects display one or more traits associated with control by host tolerance and immunoregulatory mechanisms, including reactivity against self antigens. Recent studies on a HIV-1 patient with concurrent systemic lupus erythematosus have informed on how similar bnAbs are to typical autoantibodies controlled by immune tolerance mechanisms. Future studies aimed at elucidating the intersection between autoantibodies generated in the context of systemic lupus erythematosus and the development of HIV-1 bnAbs will further our knowledge of specific roadblocks that hamper the production of bnAbs and, ultimately, inform us on how to implement vaccine strategies to circumvent them. PMID:25017952

Bonsignori, Mattia

2014-11-01

73

HIV-1 Vaccine Trials: Evolving Concepts and Designs  

PubMed Central

An effective prophylactic HIV-1 vaccine is needed to eradicate the HIV/AIDS pandemic but designing such a vaccine is a challenge. Despite many advances in vaccine technology and approaches to generate both humoral and cellular immune responses, major phase-II and -III vaccine trials against HIV/AIDS have resulted in only moderate successes. The modest achievement of the phase-III RV144 prime-boost trial in Thailand re-emphasized the importance of generating robust humoral and cellular responses against HIV. While antibody-directed approaches are being pursued by some groups, others are attempting to develop vaccines targeting cell-mediated immunity, since evidence show CTLs to be important for the control of HIV replication. Phase-I and -IIa multi-epitope vaccine trials have already been conducted with vaccine immunogens consisting of known CTL epitopes conserved across HIV subtypes, but have so far fallen short of inducing robust and consistent anti-HIV CTL responses. The concepts leading to the development of T-cell epitope-based vaccines, the outcomes of related clinical vaccine trials and efforts to enhance the immunogenicity of cell-mediated approaches are summarized in this review. Moreover, we describe a novel approach based on the identification of SIV and FIV antigens which contain conserved HIV-specific T-cell epitopes and represent an alternative method for developing an effective HIV vaccine against global HIV isolates. PMID:23289052

Sanou, Missa P; De Groot, Anne S; Murphey-Corb, Michael; Levy, Jay A; Yamamoto, Janet K

2012-01-01

74

College Student Invulnerability Beliefs and HIV Vaccine Acceptability  

ERIC Educational Resources Information Center

Objective: To examine behavioral history, beliefs, and vaccine characteristics as predictors of HIV vaccine acceptability. Methods: Two hundred forty-five US under graduates were surveyed regarding their sexual history, risk beliefs, and likelihood of accepting hypothetical HIV vaccines. Results: Multivariate regression analysis indicated that…

Ravert, Russell D.; Zimet, Gregory D.

2009-01-01

75

REVIEW Open Access Rational design of HIV vaccines and microbicides  

E-print Network

infection with HIV have been tested in the past year, and the field is rapidly evolving. EUROPRISEREVIEW Open Access Rational design of HIV vaccines and microbicides: report of the EUROPRISE including integrated developmental research on HIV vaccines and microbicides from discovery to early

Paris-Sud XI, Université de

76

Safety and Reactogenicity of Canarypox ALVAC-HIV (vCP1521) and HIV1 gp120 AIDSVAX B\\/E Vaccination in an Efficacy Trial in Thailand  

Microsoft Academic Search

BackgroundA prime-boost vaccination regimen with ALVAC-HIV (vCP1521) administered intramuscularly at 0, 4, 12, and 24 weeks and gp120 AIDSVAX B\\/E at 12 and 24 weeks demonstrated modest efficacy of 31.2% for prevention of HIV acquisition in HIV-uninfected adults participating in a community-based efficacy trial in Thailand.Methodology\\/Principal FindingsReactogenicity was recorded for 3 days following vaccination. Adverse events were monitored every 6

Punnee Pitisuttithum; Supachai Rerks-Ngarm; Valai Bussaratid; Jittima Dhitavat; Wirach Maekanantawat; Swangjai Pungpak; Pravan Suntharasamai; Sirivan Vanijanonta; Sorachai Nitayapan; Jaranit Kaewkungwal; Michael Benenson; Patricia Morgan; Robert J. OConnell; Jeffrey Berenberg; Sanjay Gurunathan; Donald P. Francis; Robert Paris; Joseph Chiu; Donald Stablein; Nelson L. Michael; Jean-Louis Excler; Merlin L. Robb; Jerome H. Kim

2011-01-01

77

Willingness to Participate in HIV Therapeutic Vaccine Trials among HIV-Infected Patients on ART in China  

PubMed Central

Background More and more HIV therapeutic vaccines will enter clinical trials; however, little is known about the willingness to participate (WTP) in HIV therapeutic vaccine trials among HIV-positive individuals. Objective To investigate the WTP in HIV therapeutic vaccine trials among Chinese HIV-infected patients. Methods We conducted a cross-sectional survey on HIV-positive inpatients and outpatients at Shanghai Public Health Center. A total of 447 participants were recruited into this study. Following an introduction with general information on HIV therapeutic vaccine and its potential effectiveness and side effects, each participant completed a questionnaire in a self-administered form. The questionnaires covered demographics, high-risk behaviors, clinical characteristics and willingness to participate in HIV therapeutic vaccine trial. Results The overall willingness to participate in HIV therapeutic vaccine trials was 91.5%. Interestingly, multivariate logistic regression analyses demonstrated that the willingness was higher for those sexually infected by HIV (odds ratio [OR]: 4.36; 95% confidence interval [CI]: 1.53–12.41), diagnosed as HIV-1 infection for greater than 5 years (OR: 7.12, 95% CI: 1.83–27.76), and with the presence of infectious complications (OR: 2.75; 95% CI: 1.02–7.45). The primary reason for participation was to delay or reduce antiretroviral treatment (ART) and to avoid ART side effects (76.6%), and then followed by delaying disease progression (74.9%), increasing immune response to suppress opportunistic infections (57.7%) and preventing the development of drug resistance (37.1%). Reasons for unwillingness to participate mainly included concern for safety (37.0%), lack of knowledge on therapeutic vaccine (33.3%), and satisfaction with ART effectiveness (22.2%). Conclusions The WTP in HIV therapeutic vaccine trials was high among HIV-infected Chinese patients. HIV+ subjects who acquired infection through sexual contact and who were diagnosed for more than 5 years may represent a good candidate population for enrollment in therapeutic vaccine trials. PMID:25372044

Dong, Yuan; Shen, Xiaoxing; Guo, Ruizhang; Liu, Baochi; Zhu, Lingyan; Wang, Jing; Zhang, Linxia; Sun, Jun; Zhang, Xiaoyan; Xu, Jianqing

2014-01-01

78

Mycobacterium tuberculosis Infection Interferes with HIV Vaccination in Mice  

PubMed Central

Tuberculosis (TB) has emerged as the most prominent bacterial disease found in human immunodeficiency virus (HIV)-positive individuals worldwide. Due to high prevalence of asymptomatic Mycobacterium tuberculosis (Mtb) infections, the future HIV vaccine in areas highly endemic for TB will often be administrated to individuals with an ongoing Mtb infection. The impact of concurrent Mtb infection on the immunogenicity of a HIV vaccine candidate, MultiHIV DNA/protein, was investigated in mice. We found that, depending on the vaccination route, mice infected with Mtb before the administration of the HIV vaccine showed impairment in both the magnitude and the quality of antibody and T cell responses to the vaccine components p24Gag and gp160Env. Mice infected with Mtb prior to intranasal HIV vaccination exhibited reduced p24Gag-specific serum IgG and IgA, and suppressed gp160Env-specific serum IgG as compared to respective titers in uninfected HIV-vaccinated controls. Importantly, in Mtb-infected mice that were HIV-vaccinated by the intramuscular route the virus neutralizing activity in serum was significantly decreased, relative to uninfected counterparts. In addition mice concurrently infected with Mtb had fewer p24Gag-specific IFN-?-expressing T cells and multifunctional T cells in their spleens. These results suggest that Mtb infection might interfere with the outcome of prospective HIV vaccination in humans. PMID:22848444

Ignatowicz, Lech; Mazurek, Jolanta; Leepiyasakulchai, Chaniya; Skold, Markus; Hinkula, Jorma; Kallenius, Gunilla; Pawlowski, Andrzej

2012-01-01

79

101 Biomedical Prevention of HIV/AIDS in Russia  

PubMed Central

The epidemic of HIV/AIDS in Russia is currently in its concentrated phase characterized by concomitant coinfections (hepatitides B and C and tuberculosis). Although subtype A1 is dominant, subtype B and CRF 03 (A/B recombinant) are also present. Recent subepidemic eruptions of HIV infection in Siberia/Urals and the Far East have involved A/G recombinant and subtype C, respectively. Approaches to biomedical prevention of HIV/AIDS in Russia include vaccine and microbicide development. Candidate HIV vaccines have been developed independently by three Russian research centers. In one of them, the conjugated protein–polymer vaccine VICHREPOL, use is made of an original domestic immunoadjuvant polyoxydonium. This candidate, developed in the Institute of Immunology, is currently undergoing a phase II clinical trial. A broad-coverage screening of natural and synthetic compounds for anti-HIV activity is currently underway in Russia, aiming at identification of chemicals appropriate for pre-exposure prophylaxis and use as microbicides. Unique compositions of antivirals have been developed, as well as nanotechnology-based means of their delivery, the combinations thereof showing significant promise as microbicide preparations. The presentation will highlight the present state of research on biomedical prevention of HIV/AIDS in Russia.

Karamov, E.V.; Khaitov, R.M.

2014-01-01

80

HIV Vaccine Trial Exploits a Dual and Central Role for Innate Immunity.  

PubMed

Limited understanding of correlates of protection from HIV transmission hinders development of an efficacious vaccine. D. J. M. Lewis and colleagues (J. Virol. 88:11648-11657, 2014, doi:10.1128/JVI.01621-14) now report that vaginal immunization with an HIVgp140 vaccine linked to the 70-kDa heat shock protein downregulated the human immunodeficiency virus (HIV) coreceptor CCR5 (chemokine [C-C motif] receptor 5) and increased expression of the HIV resistance factor APOBEC3G (apolipoprotein B mRNA-editing, enzyme-catalytic, polypeptide-like 3G), in women. These effects correlated with HIV suppression ex vivo. Thus, vaccine-induced innate responses not only facilitate adaptive immunity-they may prove to be critical for preventing HIV transmission. PMID:25122775

Fuller, Deborah Heydenburg; Richert-Spuhler, Laura E; Klatt, Nichole R

2014-10-15

81

HIV/AIDS and Vaccines  

MedlinePLUS

... AIDS.gov Mission and Team • Contact Us • Privacy Policy • Disclaimer Network blog.aids.gov • locator.aids.gov • facing.aids.gov • providertools.aids.gov • HIV/AIDS Service Locator Locator ... & Viewers HHS 508 Privacy Policy White House USA.gov This is an official ...

82

Immunogenicity of a Human Immunodeficiency Virus (HIV) Polytope Vaccine Containing Multiple HLA A2 HIV CD8+ Cytotoxic T-Cell Epitopes  

PubMed Central

Compelling evidence now suggests that ?? CD8 cytotoxic T lymphocytes (CTL) have an important role in preventing human immunodeficiency virus (HIV) infection and/or slowing progression to AIDS. Here, we describe an HIV type 1 CTL polyepitope, or polytope, vaccine comprising seven contiguous minimal HLA A2-restricted CD8 CTL epitopes conjoined in a single artificial construct. Epitope-specific CTL lines derived from HIV-infected individuals were able to recognize every epitope within the construct, and HLA A2-transgenic mice immunized with a recombinant virus vaccine coding for the HIV polytope also generated CTL specific for different epitopes. Each epitope in the polytope construct was therefore processed and presented, illustrating the feasibility of the polytope approach for HIV vaccine design. By simultaneously inducing CTL specific for different epitopes, an HIV polytope vaccine might generate activity against multiple challenge isolates and/or preempt the formation of CTL escape mutants. PMID:10364278

Woodberry, T.; Gardner, J.; Mateo, L.; Eisen, D.; Medveczky, J.; Ramshaw, I. A.; Thomson, S. A.; Ffrench, R. A.; Elliott, S. L.; Firat, H.; Lemonnier, F. A.; Suhrbier, A.

1999-01-01

83

Vaccine to Prevent Cervical Cancer  

Cancer.gov

Researchers are testing a vaccine in women infected with HPV-16 who have cell changes associated with HPV infection (LSIL or ASCUS) to determine whether the vaccine will help develop the appropriate immune response to resolve the cell changes and clear the viral infection.

84

HIV vaccine development: would more (public) money bring quicker results?  

PubMed

Globally, $200-250 million/year are devoted to HIV vaccine research. Most of those funds pay for basic research rather than product development. Moreover, most of the funds are aimed at the HIV strain commonly found in the US and Europe, and not at the strains common to Africa and other developing countries. While US President Bill Clinton set in 1997 a 10-year target for the development of an HIV vaccine, that target date is looking increasingly unlikely. International vaccine and pharmaceutical companies typically drive vaccine research and development. However, concern over the ultimate profitability of developing and marketing an HIV vaccine, and the fear of major litigation should an eventual vaccine go awry have caused such firms to shy away from investing large amounts of money into HIV vaccine development. These companies somehow have to be attracted back into the field. A World Bank special task force is slated to present its report by mid-1999 on possible funding mechanisms to promote HIV vaccine development. It remains to be resolved whether public funds could and should be used, perhaps through a pooled international vaccine development fund. 2 new International AIDS Vaccine Initiative projects are described. PMID:12295120

Winsbury, R

1999-01-01

85

HIV-1 diversity, drug-resistant mutations, and viral evolution among high-risk individuals in phase II HIV vaccine trial sites in southern China.  

PubMed

HIV-1 prevalence in Guangxi, China, has been growing since 1996, when the first case was reported. Over half of HIV-1 positive patients in Guangxi Province were injecting drug users (IDUs), possibly because of the province's location near drug-trafficking routes. Since a phase II HIV vaccine trial is ongoing there, a current characterization of the subtypes of HIV-1 among IDUs in Guangxi would provide critical information for future HIV vaccine trials, as well as further control and prevention of HIV-1 transmission. Thus, we conducted a molecular epidemiological investigation of HIV-1 samples from 2008-2010 among IDUs in multiple cities in Guangxi Province. Our results, based on the gag/pol fragment, indicated a very high proportion (78.47%) of HIV-1 CRF08_BC recombinants, some CRF01_AE (15.38%) recombinants, and a low proportion of CRF07_BC (6.15%) recombinants among the IDUs. The high proportion of CRF08 HIV-1 strains among recent IDUs matches the vaccine candidate constructs. However, future vaccine development should also incorporate CRF01-targeted vaccine candidates. Distinct Env sequence evolution patterns were observed for CRF08_BC and CRF01_AE, indicating that different local selection pressures have been exerted on these two HIV-1 subtypes. Unique drug-resistant mutations were also detected, and our data indicate that HIV treatment programs should consider pre-existing drug-resistant mutations. PMID:23869225

Qi, Haiyan; Zhao, Ke; Xu, Fei; Zhang, Xuzhao; Zhang, Zhiyong; Yang, Li; Li, Chunling; Liang, Xu; Guo, Weigui; Chen, Shihai; Liu, Zhihao; Zhang, Wenyan; Yu, Xiao-Fang

2013-01-01

86

654 JID 2005:191 (1 March) rgp120 HIV Vaccine Study Group M A J O R A R T I C L E  

E-print Network

) vaccines [12­14]. Phase 1 and 2 studies in uninfected humans have demonstrated that rgp120 is safe and able654 · JID 2005:191 (1 March) · rgp120 HIV Vaccine Study Group M A J O R A R T I C L E Placebo-Controlled Phase 3 Trial of a Recombinant Glycoprotein 120 Vaccine to Prevent HIV-1 Infection The rgp120 HIV

Gilbert, Peter

87

Providers' lack of knowledge about herpes zoster in HIV-infected patients is among barriers to herpes zoster vaccination.  

PubMed

Identification of perceptions about herpes zoster (HZ) disease, vaccine effectiveness and safety, and vaccine recommendations may impact immunization practices of physicians for HIV-infected patients. A survey was used to quantify knowledge of HZ as well as determine physician immunization perceptions and practices. There were 272/1700 respondents (16%). Correct answers for the incidence of varicella zoster virus (VZV) infection in adults and incidence of HZ in HIV-infected patients were recorded by 14% and 10% of providers, respectively. Providers reported poor knowledge of the incidence of disease recurrence in HIV-infected patients (41% correct), potency of HZ vaccine (47.5% correct) and mechanism of protection against reactivation of VZV (66% correct). Most (88%) agreed that HZ was a serious disease, and 73% believed that the burden of disease made vaccination important. A majority (75%) did not vaccinate HIV patients with HZ vaccine regardless of antiretroviral therapy status. Barriers to administration included safety concerns, concern that vaccine would not prevent HZ, risk of HZ dissemination, reimbursement issues and lack of Infectious Diseases Society of America (IDSA) guidelines. Only 38% of providers agreed that CDC guidelines were clear and 50% believed that clinical trials were needed prior to use of HZ vaccine in HIV-infected patients. Education about HZ is needed among HIV providers. Providers perceived vaccination as important, but data on vaccine safety and clear guidance from the CDC on this issue are lacking. PMID:23970744

Aziz, M; Kessler, H; Huhn, G

2013-06-01

88

HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment  

MedlinePLUS

... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / Summer ... and have resulted in a dramatic decrease in AIDS deaths in the U.S. NIH Research to Results ...

89

METHODOLOGY Open Access Accelerating clinical development of HIV vaccine  

E-print Network

METHODOLOGY Open Access Accelerating clinical development of HIV vaccine strategies: methodological , Yves Lévy3,6,7,8 , Geneviève Chêne1,2,3,4 , Rodolphe Thiébaut1,2,3,4,5,10* for the Vaccine Research Institute (VRI) Abstract Background: Many candidate vaccine strategies against human immunodeficiency virus

Paris-Sud XI, Université de

90

Combination HIV Prevention: Significance, Challenges, and Opportunities  

Microsoft Academic Search

No single HIV prevention strategy will be sufficient to control the HIV pandemic. However, a growing number of interventions\\u000a have shown promise in partially protecting against HIV transmission and acquisition, including knowledge of HIV serostatus,\\u000a behavioral risk reduction, condoms, male circumcision, needle exchange, treatment of curable sexually transmitted infections,\\u000a and use of systemic and topical antiretroviral medications by both HIV-infected

Ann E. Kurth; Connie Celum; Jared M. Baeten; Sten H. Vermund; Judith N. Wasserheit

2011-01-01

91

HIV prevention transformed: the new prevention research agenda  

PubMed Central

SUMMARY We have entered a new era in HIV prevention whereby priorities have expanded from biomedical discovery to include implementation, effectiveness, and the effect of combination prevention at the population level. However, gaps in knowledge and implementation challenges remain. In this Review we analyse trends in the rapidly changing landscape of HIV prevention, and chart a new path for HIV prevention research that focuses on the implementation of effective and efficient combination prevention strategies to turn the tide on the HIV pandemic. PMID:21763938

Padian, Nancy S.; McCoy, Sandra I.; Karim, Salim Abdool; Hasen, Nina; Kim, Julia; Bartos, Michael; Katabira, Elly; Bertozzi, Stefano; Schwartländer, Bernhard; Cohen, Myron S.

2013-01-01

92

The influence of delivery vectors on HIV vaccine efficacy  

PubMed Central

Development of an effective HIV/AIDS vaccine remains a big challenge, largely due to the enormous HIV diversity which propels immune escape. Thus novel vaccine strategies are targeting multiple variants of conserved antibody and T cell epitopic regions which would incur a huge fitness cost to the virus in the event of mutational escape. Besides immunogen design, the delivery modality is critical for vaccine potency and efficacy, and should be carefully selected in order to not only maximize transgene expression, but to also enhance the immuno-stimulatory potential to activate innate and adaptive immune systems. To date, five HIV vaccine candidates have been evaluated for efficacy and protection from acquisition was only achieved in a small proportion of vaccinees in the RV144 study which used a canarypox vector for delivery. Conversely, in the STEP study (HVTN 502) where human adenovirus serotype 5 (Ad5) was used, strong immune responses were induced but vaccination was more associated with increased risk of HIV acquisition than protection in vaccinees with pre-existing Ad5 immunity. The possibility that pre-existing immunity to a highly promising delivery vector may alter the natural course of HIV to increase acquisition risk is quite worrisome and a huge setback for HIV vaccine development. Thus, HIV vaccine development efforts are now geared toward delivery platforms which attain superior immunogenicity while concurrently limiting potential catastrophic effects likely to arise from pre-existing immunity or vector-related immuno-modulation. However, it still remains unclear whether it is poor immunogenicity of HIV antigens or substandard immunological potency of the safer delivery vectors that has limited the success of HIV vaccines. This article discusses some of the promising delivery vectors to be harnessed for improved HIV vaccine efficacy.

Ondondo, Beatrice O.

2014-01-01

93

Preexposure prophylaxis for HIV prevention.  

PubMed

Reducing the incidence of HIV remains one of our greatest public health challenges. However, there is growing optimism that preexposure prophylaxis (PrEP) could have a major impact on preventing incident HIV infection. Recently presented data on the use of oral PrEP in men who have sex with men (MSM) have provided proof-of-principle for this strategy. Additional clinical trials are evaluating whether PrEP provides similar protection to risk groups other than MSM, such as heterosexual persons and injection drug users. Still unanswered questions include optimal dosing strategies, long-term safety, maximizing adherence and minimizing costs, addressing drug resistance in the face of PrEP failure, optimizing access, and assessing effects on risk behavior. Future implementation will be guided by the results of clinical trials in progress. This article provides a review of the data on the potential strengths and limitations of PrEP as an HIV prevention strategy, identifies challenges to implementation of this approach, and outlines knowledge gaps. PMID:21465112

Kelesidis, Theodoros; Landovitz, Raphael J

2011-06-01

94

High need for MMR vaccination in HIV infected adults in Austria.  

PubMed

Current guidelines recommend screening for HIV infected patients susceptible for vaccine preventable diseases and offering of immunization. However, data regarding the vaccination coverage among this group are largely missing. This study analyzed the serostatus for Measles, Mumps and Rubella of more than 700 HIV infected patients residing in Austria. These patients were representative for the Austrian HIV cohort regarding sex, age, transmission risk and HIV progression markers. 73.6% were on suppressive HAART, mean CD4 cell count was 603c/?l. Seronegativity was 8.4% for Measles, 33.4% for Mumps and 18.8% for Rubella. In total, out of the 713 HIV infected adults analyzed, almost half (47.8%) would require MMR vaccination. In a multivariate analysis migration was significantly associated with seronegativity for Measles (OR 0.5, CI 0.27-0.9) and Mumps (OR 0.57, CI 0.39-0.81). Importantly due to the well preserved immune status of nearly all participants vaccination would be feasible in the majority of the seronegative patients. Thus, a proactive approach would largely reduce the number of patients at risk for vaccine-preventable diseases. PMID:25203449

Grabmeier-Pfistershammer, K; Poeppl, W; Herkner, H; Touzeau-Roemer, V; Huschka, Emilia; Rieger, A; Burgmann, H

2014-10-14

95

Safety, immunogenicity and efficacy of pneumococcal conjugate vaccine in HIV-infected individuals  

PubMed Central

Streptococcus pneumoniae is the leading bacterial opportunistic infection in HIV-infected individuals. Anti-retroviral treatment (ART) of HIV-infected individuals reduces their risk of invasive pneumococcal disease (IPD), however, it remains 20- to 40-fold greater compared with age-matched general population. This review summarizes the available published data on the immunogenicity, safety and efficacy of pneumococcal polysaccharide-protein conjugate vaccines (PCV) in HIV-infected children and adults.   Several studies have demonstrated that PCV are safe in the HIV-infected persons. Although PCV are immunogenic in HIV-infected infants, the antibodies produced are functionally impaired, there is possibly a lack or loss of anamnestic responses and immunity declines in later life However, quantitative and qualitative antibody responses to PCV in HIV-infected infants are enhanced when vaccination occurs whilst on ART, as well as if vaccination occurs when the CD4+ cell percentage is ? 25% and if the nadir CD4+ is >15%. Although the efficacy of PCV was lower, the vaccine preventable burden of hospitalization for IPD and clinical pneumonia were 18-fold and 9-fold greater, respectively, in HIV-infected children compared with –uninfected children. In HIV-infected adults, PCV vaccination induces more durable and functional antibody responses in individuals on ART at the time of vaccination than in ART-naive adults, independently of baseline CD4+ cell count, although there does not appear to be much benefit from a second-dose of PCV. PCV has also been shown to reduce the risk of recurrent IPD by 74% in HIV-infected adults not on ART, albeit, also with subsequent decline in immunity and protection. PMID:22426374

Nunes, Marta C.; Madhi, Shabir A.

2012-01-01

96

Cancer Prevention by Vaccination Against Hepatitis B  

Microsoft Academic Search

Chronic inflammation caused by persistent infection is closely related to a number of cancers; these include hepatitis B (HBV)\\u000a or C and hepatoma, human papilloma virus and cervical cancer, and Helicobacter pylori and gastric cancer. The first evidence of cancer prevention by vaccination in humans was provided by HBV vaccination in infants.\\u000a Chronic HBV is related to approximately 60%–90% of

Mei-Hwei Chang

97

Preventing Cervical Cancer: The Development of HPV Vaccines  

Cancer.gov

Cervical cancer can be prevented with HPV vaccines. NCI-supported researchers helped establish HPV as a cause of cervical cancer. They also helped create the first HPV vaccines, were involved in the vaccine trials, and contribute to ongoing studies.

98

Rational design of HIV vaccines and microbicides: report of the EUROPRISE network annual conference 2010  

Microsoft Academic Search

Novel, exciting intervention strategies to prevent infection with HIV have been tested in the past year, and the field is\\u000a rapidly evolving. EUROPRISE is a network of excellence sponsored by the European Commission and concerned with a wide range\\u000a of activities including integrated developmental research on HIV vaccines and microbicides from discovery to early clinical\\u000a trials. A central and timely

Sarah Brinckmann; Kelly da Costa; Marit J van Gils; David Hallengärd; Katja Klein; Luisa Madeira; Lara Mainetti; Paolo Palma; Katharina Raue; David Reinhart; Marc Reudelsterz; Nicolas Ruffin; Janna Seifried; Katrein Schäfer; Enas Sheik-Khalil; Annette Sköld; Hannes Uchtenhagen; Nicolas Vabret; Serena Ziglio; Gabriella Scarlatti; Robin Shattock; Britta Wahren; Frances Gotch

2011-01-01

99

HIV Prevention Readiness in Undergraduates and Inmates.  

ERIC Educational Resources Information Center

Prevention of Human Immunodeficiency Virus (HIV) transmission is increasingly an international priority. Education of high-risk populations, such as incarcerated individuals, is particularly important in thwarting the spread of HIV. To address this concern, the attitudes, beliefs, and knowledge of inmates concerning HIV and AIDS related issues are…

Antonio, Michael E.; And Others

100

Combination HIV Prevention: Significance, Challenges, and Opportunities  

PubMed Central

No single HIV prevention strategy will be sufficient to control the HIV pandemic. However, a growing number of interventions have shown promise in partially protecting against HIV transmission and acquisition, including knowledge of HIV serostatus, behavioral risk reduction, condoms, male circumcision, needle exchange, treatment of curable sexually transmitted infections, and use of systemic and topical antiretroviral medications by both HIV-infected and uninfected persons. Designing the optimal package of interventions that matches the epidemiologic profile of a target population, delivering that package at the population level, and evaluating safety, acceptability, coverage, and effectiveness, all involve methodological challenges. Nonetheless, there is an unprecedented opportunity to develop “prevention packages” that combine various arrays of evidence-based strategies, tailored to the needs of diverse subgroups and targeted to achieve high coverage for a measurable reduction in population-level HIV transmission. HIV prevention strategies that combine partially effective interventions should be scaled up and evaluated. PMID:20941553

Celum, Connie; Baeten, Jared M.; Vermund, Sten H.; Wasserheit, Judith N.

2010-01-01

101

YELLOW FEVER PREVENTION STRATEGIES AWARENESS AMONG HIV-INFECTED PATIENTS IN S?O PAULO, BRAZIL  

PubMed Central

Introduction: Vaccination is the main preventive strategy against Yellow Fever (YF), which is a public health concern in Brazil. However, HIV-infected patients might have insufficient knowledge regarding YF, YF prevention, and vaccines in general. Methods: In this questionnaire-based study, data from 158 HIV-infected individuals were addressed in three distinct outpatient clinics in São Paulo. Information was collected on demographic and clinical characteristics, as well as patients' knowledge of vaccines, YF and YF preventive strategies. In addition, individual YF vaccine recommendations and vaccine status were investigated. Results: Although most participants adequately ascertain the vaccine as the main prevention strategy against YF, few participants were aware of the severity and lack of specific treatment for YF. Discrepancy in YF vaccine (patients who should have taken the vaccine, but did not) was observed in 18.8% of participants. Conclusion: YF is an important and preventable public health concern, and these results demonstrate that more information is necessary for the HIV-infected population. PMID:25229222

Avelino-Silva, Vivian Iida; Francelino, Hilario Sousa; Kallas, Esper Georges

2014-01-01

102

HIV/AIDS epidemiology, pathogenesis, prevention, and treatment  

PubMed Central

The HIV-1 pandemic is a complex mix of diverse epidemics within and between countries and regions of the world, and is undoubtedly the defining public-health crisis of our time. Research has deepened our understanding of how the virus replicates, manipulates, and hides in an infected person. Although our understanding of pathogenesis and transmission dynamics has become more nuanced and prevention options have expanded, a cure or protective vaccine remains elusive. Antiretroviral treatment has transformed AIDS from an inevitably fatal condition to a chronic, manageable disease in some settings. This transformation has yet to be realised in those parts of the world that continue to bear a disproportionate burden of new HIV-1 infections and are most a% ected by increasing morbidity and mortality. This Seminar provides an update on epidemiology, pathogenesis, treatment, and prevention interventions pertinent to HIV-1. PMID:16890836

Simon, Viviana; Ho, David D; Karim, Quarraisha Abdool

2010-01-01

103

Immunological and virological mechanisms of vaccine-mediated protection against SIV and HIV.  

PubMed

A major challenge for the development of a highly effective AIDS vaccine is the identification of mechanisms of protective immunity. To address this question, we used a nonhuman primate challenge model with simian immunodeficiency virus (SIV). We show that antibodies to the SIV envelope are necessary and sufficient to prevent infection. Moreover, sequencing of viruses from breakthrough infections revealed selective pressure against neutralization-sensitive viruses; we identified a two-amino-acid signature that alters antigenicity and confers neutralization resistance. A similar signature confers resistance of human immunodeficiency virus (HIV)-1 to neutralization by monoclonal antibodies against variable regions 1 and 2 (V1V2), suggesting that SIV and HIV share a fundamental mechanism of immune escape from vaccine-elicited or naturally elicited antibodies. These analyses provide insight into the limited efficacy seen in HIV vaccine trials. PMID:24352234

Roederer, Mario; Keele, Brandon F; Schmidt, Stephen D; Mason, Rosemarie D; Welles, Hugh C; Fischer, Will; Labranche, Celia; Foulds, Kathryn E; Louder, Mark K; Yang, Zhi-Yong; Todd, John-Paul M; Buzby, Adam P; Mach, Linh V; Shen, Ling; Seaton, Kelly E; Ward, Brandy M; Bailer, Robert T; Gottardo, Raphael; Gu, Wenjuan; Ferrari, Guido; Alam, S Munir; Denny, Thomas N; Montefiori, David C; Tomaras, Georgia D; Korber, Bette T; Nason, Martha C; Seder, Robert A; Koup, Richard A; Letvin, Norman L; Rao, Srinivas S; Nabel, Gary J; Mascola, John R

2014-01-23

104

HIV/AIDS/STD. Education for Prevention.  

ERIC Educational Resources Information Center

The contents of this booklet come from contributions to the 1995 Global Conference on School Health and HIV/AIDS Prevention. The objectives of the booklet are: (1) to strengthen the awareness of teachers and education personnel regarding the importance of developing school health and HIV/AIDS prevention curricula; (2) to show the specific roles of…

Mayes, Jane Ruthven, Ed.

105

The prevention of Lyme disease with vaccine  

Microsoft Academic Search

Lyme disease is a potentially serious and debilitating infection caused by Borrelia burgdorferi that is endemic in North America, Europe, and Asia. Personal protective and environmental measures have not significantly impacted its increasing incidence. An adjuvanted recombinant vaccine (LYMErix™) has been approved in the United States for the prevention of Lyme disease in adults, and has demonstrated both safety and

Gregory A. Poland; Robert M. Jacobson

2001-01-01

106

HIV gp120 vaccine - VaxGen: AIDSVAX, AIDSVAX B/B, AIDSVAX B/E, HIV gp120 vaccine - Genentech, HIV gp120 vaccine AIDSVAX - VaxGen, HIV vaccine AIDSVAX - VaxGen.  

PubMed

VaxGen is developing prophylactic vaccines against HIV-1 consisting of two recombinant gp120 surface proteins from different HIV-1 strains.This profile has been selected from R&D Insight, a pharmaceutical intelligence database produced by Adis International Ltd. The bivalent vaccines [AIDSVAX B/B and AIDSVAX B/E] are being evaluated in two phase III trials. The first multicentre phase III trial of AIDSVAX B/B, was conducted principally in Canada and the US but also at some sites in the Netherlands and Puerto Rico. The trial was completed at the end of 2002. The second phase III trial is being conducted in Thailand with the AIDSVAX B/E vaccine. VaxGen announced in July 2002 that it would be delaying its Biologics License Application (BLA) for AIDSVAX until 2004 to enable the company to fulfil pre-approval manufacturing requirements. AIDSVAX is based on an earlier monovalent gp120 vaccine developed by Genentech that was shown to be safe in humans. VaxGen (formerly Genenvax) was formed as a spin-off company from Genentech with the sole purpose of developing the gp120 vaccine. VaxGen announced in July 2002 that the original License and Supply agreement with Genentech, signed in May 1997, had been amended. Under the revised agreement, Genentech maintains its right to market and sell AIDSVAX in North America, but has relinquished its options to commercialise the vaccine candidate in the rest of the world. Genentech's earlier decision to waive its option to manufacture AIDSVAX has also been formalised in this agreement. Additionally, VaxGen's royalty payments to Genentech for sales to the WHO or UN for underdeveloped nations have also been reduced by up to 50% and Genentech has extended the milestone date associated with VaxGen submitting an NDA. A $US120 million joint venture (Celltrion) has been formed between VaxGen and South Korean investors to manufacture more than 200 million doses of AIDSVAX a year. Celltrion will build and operate two biotechnology manufacturing facilities: a pilot plant in South San Francisco and a larger plant in Incheon, South Korea. VaxGen will retain a 44% interest in the new company, as well as any profit generated by the AIDS vaccine. If AIDSVAX wins regulatory approval, VaxGen is committed to purchasing a minimum of 87 million doses a year. Celltrion announced in July 2002 that it had acquired 24 acres of land in Incheon, South Korea, for the site of its major biologics manufacturing facility. The facility is scheduled to be ready for commercial operation by 2005. The US FDA granted fast-track designations to the two vaccines AIDSVAX B/B and AIDSVAX B/E in December 2002. The study volunteers included 5108 men who have sex with men and 309 at-risk women, all of whom were meant to be HIV negative when they joined the trial. During the 36-month trial, a total of seven injections were administered at months 0, 1, 6, 12, 18, 24 and 30. The ratio of vaccine to placebo recipients was 2:1. On February 24 2003, VaxGen announced that AIDSVAX B/B did not prove effective in the trials conducted in North America and Europe. The study did not show a statistically significant reduction of HIV infection within the study population as a whole, which was the primary endpoint of the trial. However, the study did show a statistically significant reduction of HIV infection in certain vaccinated groups. Trial data indicate that black and Asian volunteers appeared to produce higher levels of antibodies against HIV. White and Hispanic volunteers appeared to develop consistently lower levels of protective antibodies following vaccination. VaxGen intends to conduct additional analyses to confirm if there was a direct correlation between the level of antibodies and the prevention of infection. The company intends to continue development of the vaccine through licensure, including any studies necessary to evaluate the protective riticism in the media about the statistical analysis of the non-Caucasian data, VaxGen issued a statement on 27 February 2003 claiming that the analysis of data from the trial followed a statistica

2003-01-01

107

New HIV Vaccine Holds Promise of Global Effectiveness  

NSDL National Science Digital Library

This site describes recently launched clinical tests of a new vaccine directed at the three most globally important HIV subtypes, as developed by scientists at the Dale and Betty Bumpers Vaccine Research Center of the National Institute of Allergy and infectious Diseases.

2002-01-01

108

Recombinant vesicular stomatitis virus as an HIV1 vaccine vector  

Microsoft Academic Search

Recombinant vesicular stomatitis virus (rVSV) is currently under evaluation as a human immunodeficiency virus (HIV)-1 vaccine vector. The most compelling reasons to develop rVSV as a vaccine vector include a very low seroprevalence in humans, the ability to infect and robustly express foreign antigens in a broad range of cells, and vigorous growth in continuous cell lines used for vaccine

David K. Clarke; David Cooper; Michael A. Egan; R. Michael Hendry; Christopher L. Parks; Stephen A. Udem

2006-01-01

109

[Prevention of HIV and other sexually transmitted infections (STI)].  

PubMed

The number of new HIV-1 infections remains stable in Switzerland over the last years thanks to the effective prevention programs. However, the aim to halve the new HIV infection rate has not been reached. Early identification of patients at risk of acquiring HIV infection and counselling "safer sex" rules as well as treating HIV-infected patients plays a decisive role in this program. Studies are -ongoing to investigate additional preventive measures such as pre-exposure prophylaxis, microbicides and vaccines, but none of those approaches permit omitting "safer sex". Incidences of other sexual transmitted infections are increasing rapidly, in particular the incidence of Syphilis. Transmission occurs more often orally or rectally than vaginally and patients are often asymptomatic. Condoms provide only limited protection. In addition antibiotic resistance emerges complicating the therapy, as for example for gonorrhea. Testing and treatment of infected patients is primordial as well as contact tracing. In this work, we discuss the different elements for preventing STIs with major emphasis on HIV. PMID:25093318

Stoliaroff-Pépin, Anna; Speck, Roberto F; Vernazza, Pietro

2014-08-01

110

Effectiveness of 7-Valent Pneumococcal Conjugate Vaccine Against Invasive Pneumococcal Disease in HIV-Infected and -Uninfected Children in South Africa: A Matched Case-Control Study  

PubMed Central

Background.?South Africa introduced 7-valent pneumococcal conjugate vaccine (PCV7) in April 2009 using a 2 + 1 schedule (6 and 14 weeks and 9 months). We estimated the effectiveness of ?2 PCV7 doses against invasive pneumococcal disease (IPD) in human immunodeficiency virus (HIV)–infected and -uninfected children. Methods.?IPD (pneumococcus identified from a normally sterile site) cases were identified through national laboratory-based surveillance. Specimens were serotyped by Quellung or polymerase chain reaction. Four controls, matched for age, HIV status, and hospital were sought for each case. Using conditional logistic regression, we calculated vaccine effectiveness (VE) as 1 minus the adjusted odds ratio for vaccination. Results.?From March 2010 through November 2012, we enrolled 187 HIV-uninfected (48 [26%] vaccine serotype) and 109 HIV-infected (43 [39%] vaccine serotype) cases and 752 HIV-uninfected and 347 HIV-infected controls aged ?16 weeks. Effectiveness of ?2 PCV7 doses against vaccine-serotype IPD was 74% (95% confidence interval [CI], 25%–91%) among HIV-uninfected and ?12% (95% CI, ?449% to 77%) among HIV-infected children. Effectiveness of ?3 doses against vaccine-serotype IPD was 90% (95% CI, 14%–99%) among HIV-uninfected and 57% (95% CI, ?371% to 96%) among HIV-infected children. Among HIV-exposed but -uninfected children, effectiveness of ?2 doses was 92% (95% CI, 47%–99%) against vaccine-serotype IPD. Effectiveness of ?2 doses against all-serotype multidrug-resistant IPD was 96% (95% CI, 62%–100%) among HIV-uninfected children. Conclusions.?A 2 + 1 PCV7 schedule was effective in preventing vaccine-serotype IPD in HIV-uninfected and HIV-exposed, uninfected children. This finding supports the World Health Organization recommendation for this schedule as an alternative to a 3-dose primary series among HIV-uninfected individuals. PMID:24917657

Cohen, Cheryl; von Mollendorf, Claire; de Gouveia, Linda; Naidoo, Nireshni; Meiring, Susan; Quan, Vanessa; Nokeri, Vusi; Fortuin-de Smit, Melony; Malope-Kgokong, Babatyi; Moore, David; Reubenson, Gary; Moshe, Mamokgethi; Madhi, Shabir A.; Eley, Brian; Hallbauer, Ute; Kularatne, Ranmini; Conklin, Laura; O'Brien, Katherine L.; Zell, Elizabeth R.; Klugman, Keith; Whitney, Cynthia G.; von Gottberg, Anne; Moore, David; Verwey, Charl; Varughese, Sheeba; Archary, Moherndran; Naby, Fathima; Dawood, Khathija; Naidoo, Ramola; Elliott, Gene; Hallbauer, Ute; Eley, Brian; Nuttall, James; Cooke, Louise; Finlayson, Heather; Rabie, Helena; Whitelaw, Andrew; Perez, Dania; Jooste, Pieter; Naidoo, Dhamiran; Kularatne, Ranmini; Reubenson, Gary; Cohen, Cheryl; de Gouveia, Linda; du Plessis, Mignon; Govender, Nevashan; Meiring, Susan; Quan, Vanessa; von Mollendorf, Claire; Fortuin-de Smidt, Melony; Naidoo, Nireshni; Malope-Kgokong, Babatyi; Nokeri, Vusi; Ncha, Relebohile; Lindani, Sonwabo; von Gottberg, Anne; Spies, Barry; Sono, Lino; Maredi, Phasweni; Hamese, Ken; Moshe, Mamokgethi; Nchabeleng, Maphosane; Ngcobo, Ntombenhle; van den Heever, Johann; Madhi, Shabir; Conklin, Laura; Verani, Jennifer; Whitney, Cynthia; Zell, Elizabeth; Loo, Jennifer; Nelson, George; Klugman, Keith; O'Brien, Katherine

2014-01-01

111

On Modeling HIV and T Cells In Vivo: Assessing Causal Estimators in Vaccine Trials  

Microsoft Academic Search

The first efficacy trials—named STEP—of a T cell vaccine against HIV\\/AIDS began in 2004. The unprecedented structure of these trials raised new modeling and statistical challenges. Is it plausible that memory T cells, as opposed to antibodies, can actually prevent infection? If they fail at prevention, to what extent can they ameliorate disease? And how do we estimate efficacy in

W. David Wick; Peter B. Gilbert; Steven G. Self

2006-01-01

112

Paying for prevention: challenges to health insurance coverage for biomedical HIV prevention in the United States.  

PubMed

Reducing the incidence of HIV infection continues to be a crucial public health priority in the United States, especially among populations at elevated risk such as men who have sex with men, transgender women, people who inject drugs, and racial and ethnic minority communities. Although most HIV prevention efforts to date have focused on changing risky behaviors, the past decade yielded efficacious new biomedical technologies designed to prevent infection, such as the prophylactic use of antiretroviral drugs and the first indications of an efficacious vaccine. Access to prevention technologies will be a significant part of the next decade's response to HIV and advocates are mobilizing to achieve more widespread use of these interventions. These breakthroughs, however, arrive at a time of escalating healthcare costs; health insurance coverage therefore raises pressing new questions about priority-setting and the allocation of responsibility for public health. The goals of this Article are to identify legal challenges and potential solutions for expanding access to biomedical HIV prevention through health insurance coverage. This Article discusses the public policy implications of HIVprevention coverage decisions, assesses possible legal grounds on which insurers may initially deny coverage for these technologies, and evaluates the extent to which these denials may survive external and judicial review. Because several of these legal grounds may be persuasive, particularly denials on the basis of medical necessity, this Article also explores alternative strategies for financing biomedical HIV prevention efforts. PMID:23356098

Underhill, Kristen

2012-01-01

113

Antibodies in HIV-1 Vaccine Development and Therapy  

PubMed Central

Despite 30 years of study there is no HIV-1 vaccine and until recently there was little hope for a protective immunization. Renewed optimism in this area of research comes in part from the results of a recent vaccine trial, and the use of single cell antibody cloning techniques that uncovered naturally arising, broad and potent HIV-1 neutralizing antibodies (bNAbs). These antibodies can protect against infection and suppress established HIV-1 infection in animal models. The finding that these antibodies develop in a fraction of infected individuals supports the idea that new approaches to vaccination might be developed by adapting the natural immune strategies or by structure-based immunogen design. Moreover, the success of passive immunotherapy in small animal models suggests that bNAbs may become a valuable addition to the armamentarium of anti-HIV-1 drugs. PMID:24031012

Klein, Florian; Mouquet, Hugo; Dosenovic, Pia; Scheid, Johannes; Scharf, Louise; Nussenzweig, Michel C.

2014-01-01

114

Predictors of HVTN 503 MRK-AD5 HIV-1 gag/pol/nef Vaccine Induced Immune Responses  

PubMed Central

Background Phambili, the Merck (MRK)-Adenovirus Type 5 (Ad5) HIV-1 gag/pol/nef subtype B vaccine study, conducted in South Africa, suspended enrollment and vaccination when companion study, Step, was found non-efficacious. Although the vaccine did not prevent HIV-1 infection or lower viral-load setpoint, immune responses recognized clades B and C HIV-1 subtypes. We investigated predictors of the vaccine-induced antigen-specific immune responses. Methods Vaccine-induced immunogenicity was ascertained by interferon-? ELISpot assays on the first 186 enrolled participants receiving two vaccinations. Analyses, stratified by study arm/sex, were performed on baseline demographics [sex, age, Body Mass Index (BMI), site, Adenovirus Type-5 (Ad5) titer, Herpes Simplex Virus Type-2 (HSV2) status, heavy drinking]. Multivariate logistic regression determined predictors. Results Of the 186 participants, 53.7% (n?=?100) were female, median BMI was 22.5 [IQR: 20.4–27.0], 85.5% (n?=?159) were Ad5 seropositive, and 18.8% (n?=?35) drank heavily. All vaccine recipients responded to both clade B (n?=?87; 47%) and/or C (n?=?74; 40%), p?=?0.17. In multivariate analysis, female sex [Adjusted Odds Ratio (AOR): 6.478; p?=?0.0159], overweight/obese BMI (AOR: 0.186; p?=?0.0452), and heavy drinking (AOR: 0.270; p?=?0.048) significantly predicted immune response to clade C for any antigens. A marginally significant predictor of clade C-pol antigen was female sex (AOR: 3.182; p?=?0.0500). Conclusions Sex, BMI, and heavy drinking affected vaccine-induced HIV-1 specific immune responses to clade C antigens. The role of female sex and overweight/obese BMI boosting and suppressing vaccine-induced HIV-1 specific immune responses, respectively, requires elucidation, including any effect on HIV vaccine efficacy, especially in the era of colliding epidemics (HIV and obesity). PMID:25090110

Hopkins, Kathryn L.; Laher, Fatima; Otwombe, Kennedy; Churchyard, Gavin; Bekker, Linda-Gail; DeRosa, Stephen; Nchabeleng, Maphoshane; Mlisana, Koleka; Kublin, James; Gray, Glenda

2014-01-01

115

The Role of Vaccines in Cancer Prevention  

Microsoft Academic Search

\\u000a From 1796, when Edward Jenner infected a young boy with cowpox in hopes of preventing smallpox, to the present day, vaccinations\\u000a have changed the incidence of many diseases worldwide. The history of immunology actually predates Jenner to ancient China,\\u000a India and Persia. The observation that recovery from a particular disease rendered people “immune” to a second episode of\\u000a that same

Samir N. Khleif; Helen Frederickson

116

Vaccines to prevent pneumonia and improve child survival  

Microsoft Academic Search

For more than 30 years, vaccines have played an important part in pneumonia prevention. Recent advances have created opportunities for further improving child survival through prevention of childhood pneumonia by vaccination. Maximizing routine immunization with pertussis and measles vaccines, coupled with provision of a second opportunity for measles immunization, has rapidly reduced childhood deaths in low-income countries especially in sub-Saharan

Shabir A Madhi; Orin S Levine; Rana Hajjeh; Osman D Mansoor; Thomas Cherian

2008-01-01

117

Conference Report: "Functional Glycomics in HIV Type 1 Vaccine Design" Workshop Report, Bethesda, Maryland, April 30-May 1, 2012  

PubMed Central

Abstract A vital part of the renewed hope for a vaccine against the human immunodeficiency virus (HIV-1) is based on recent studies that have highlighted major sites of HIV-1 vulnerability that could be effectively targeted by a preventive vaccine. One of these potential vulnerabilities includes the dense cluster of carbohydrates surrounding HIV-1's envelope glycoproteins gp120 and gp41, typically referred to as the “glycan shield.” Recent data from several laboratories have shown that glycans on the HIV-1 envelope form key epitopes for broadly neutralizing antibodies (bNAb). Moreover, HIV-1 envelope glycans play an important role in viral transmission, antigenicity, and immunogenicity. The recent availability of novel tools and technologies has now allowed investigators to leverage glycomic structure–function relationships in the design of candidate HIV-1 vaccines. Additionally, glycans modulate the immune response, playing an essential role in Fc receptor and complement activity. To promote cross-disciplinary collaboration and promote synergistic HIV-1- glycomics research, the National Institutes of Health (NIH) cosponsored and convened a 1.5-day workshop entitled “Functional Glycomics in HIV-1 Vaccine Design.” The meeting focused on the role of glycan interactions with neutralizing antibodies, the influence of immunoglobulin G (IgG) Fc receptor glycosylation, newly available glycomics technologies, and how new information on the role of glycans could be applied in HIV-1 immunogen design strategies. This report summarizes the discussions of this workshop. PMID:23767872

Collins, Brenda S.; Dell, Anne; Alter, Galit

2013-01-01

118

Conference report: "Functional Glycomics in HIV Type 1 Vaccine Design" workshop report, Bethesda, Maryland, April 30-May 1, 2012.  

PubMed

A vital part of the renewed hope for a vaccine against the human immunodeficiency virus (HIV-1) is based on recent studies that have highlighted major sites of HIV-1 vulnerability that could be effectively targeted by a preventive vaccine. One of these potential vulnerabilities includes the dense cluster of carbohydrates surrounding HIV-1's envelope glycoproteins gp120 and gp41, typically referred to as the "glycan shield." Recent data from several laboratories have shown that glycans on the HIV-1 envelope form key epitopes for broadly neutralizing antibodies (bNAb). Moreover, HIV-1 envelope glycans play an important role in viral transmission, antigenicity, and immunogenicity. The recent availability of novel tools and technologies has now allowed investigators to leverage glycomic structure-function relationships in the design of candidate HIV-1 vaccines. Additionally, glycans modulate the immune response, playing an essential role in Fc receptor and complement activity. To promote cross-disciplinary collaboration and promote synergistic HIV-1- glycomics research, the National Institutes of Health (NIH) cosponsored and convened a 1.5-day workshop entitled "Functional Glycomics in HIV-1 Vaccine Design." The meeting focused on the role of glycan interactions with neutralizing antibodies, the influence of immunoglobulin G (IgG) Fc receptor glycosylation, newly available glycomics technologies, and how new information on the role of glycans could be applied in HIV-1 immunogen design strategies. This report summarizes the discussions of this workshop. PMID:23767872

Malaspina, Angela; Collins, Brenda S; Dell, Anne; Alter, Galit; Onami, Thandi M

2013-11-01

119

A peptide-based nanofibrous hydrogel as a promising DNA nanovector for optimizing the efficacy of HIV vaccine.  

PubMed

This report shows that a nanovector composed of peptide-based nanofibrous hydrogel can condense DNA to result in strong immune responses against HIV. This nanovector can strongly activate both humoral and cellular immune responses to a balanced level rarely reported in previous studies, which is crucial for HIV prevention and therapy. In addition, this nanovector shows good biosafety in vitro and in vivo. Detailed characterizations show that the nanofibrous structure of the hydrogel is critical for the dramatically improved immune responses compared to existing materials. This peptide-based nanofibrous hydrogel shows great potential for efficacious HIV DNA vaccines and can be potentially used for delivering other vaccines and drugs. PMID:24564254

Tian, Yue; Wang, Huaimin; Liu, Ye; Mao, Lina; Chen, Wenwen; Zhu, Zhening; Liu, Wenwen; Zheng, Wenfu; Zhao, Yuyun; Kong, Deling; Yang, Zhimou; Zhang, Wei; Shao, Yiming; Jiang, Xingyu

2014-03-12

120

HIV/STD/TB PREVENTION NEWS DATABASE  

EPA Science Inventory

The CDC National Prevention Information Network (NPIN) is the U.S. reference, referral, and distribution service for information on HIV/AIDS, sexually transmitted diseases (STDs), and tuberculosis (TB). NPIN produces, collects, catalogs, processes, stocks, and disseminates materi...

121

January 2012, Hiv prevention strategies  

E-print Network

initiatives, including programs to enhance women's education and economic independence, and laws to combat sexual violence and trafficking Involvement of communities and HIV-infected individuals in educating

Bushman, Frederic

122

ith no vaccine to show for more than 20 years of work, the HIV-  

E-print Network

W ith no vaccine to show for more than 20 years of work, the HIV- vaccine community is being forced will really speed progress towards a vaccine. When the Bill & Melinda Gates Foundation announced a US$300-million call for propos- als in HIV vaccine research last year, it marked a key change for researchers

Strong, Roland K.

123

Prospect of a prophylactic vaccine for HIV  

Microsoft Academic Search

Human immunodeficiency virus (HIV) continues to infect about 15,000 people every day, 90% of whom live in non-industrialised countries. So far, education programmes have only managed to slow, but not cease, the HIV spread, while powerful drug combinations are too costly and complex for the majority of HIV- infected people and in any case fail to clear HIV from the

T Hanke

2001-01-01

124

On Modeling HIV and T Cells In Vivo: Assessing Causal Estimators in Vaccine Trials  

PubMed Central

The first efficacy trials—named STEP—of a T cell vaccine against HIV/AIDS began in 2004. The unprecedented structure of these trials raised new modeling and statistical challenges. Is it plausible that memory T cells, as opposed to antibodies, can actually prevent infection? If they fail at prevention, to what extent can they ameliorate disease? And how do we estimate efficacy in a vaccine trial with two primary endpoints, one traditional, one entirely novel (viral load after infection), and where the latter may be influenced by selection bias due to the former? In preparation for the STEP trials, biostatisticians developed novel techniques for estimating a causal effect of a vaccine on viral load, while accounting for post-randomization selection bias. But these techniques have not been tested in biologically plausible scenarios. We introduce new stochastic models of T cell and HIV kinetics, making use of new estimates of the rate that cytotoxic T lymphocytes—CTLs; the so-called killer T cells—can kill HIV-infected cells. Based on these models, we make the surprising discovery that it is not entirely implausible that HIV-specific CTLs might prevent infection—as the designers explicitly acknowledged when they chose the endpoints of the STEP trials. By simulating thousands of trials, we demonstrate that the new statistical methods can correctly identify an efficacious vaccine, while protecting against a false conclusion that the vaccine exacerbates disease. In addition to uncovering a surprising immunological scenario, our results illustrate the utility of mechanistic modeling in biostatistics. PMID:16789816

Wick, W. David; Gilbert, Peter B; Self, Steven G

2006-01-01

125

102 HIV/AIDS vaccines in Russia: clinical trials and estimation of acceptance in population  

PubMed Central

HIV/AIDS vaccines and also PrEP are considered as the most perspective approaches to control HIV/AIDS epidemic. Candidate conjugated polymer-subunit HIV vaccine VICHREPOL, developed in Moscow Institute of Immunology, successfully passed phase I clinical trials and now is at the start of phase II trials. Two other candidate vaccines (DNA-based and viral vector-based) are also passed phase I trials. Positive effect of vaccination depends of the coverage of population and this coverage depends of vaccine uptake. Estimation of possible uptake of HIV vaccine is very important to provide its further effective application. Pilot investigation of readiness for HIV vaccination in Russia (Moscow region) was performed [416 persons, 254 (61%)—men, 162 (39%)—women, age of 16–55]. Sixty percent of respondents were ready for HIV vaccination. Seventy nine percent of respondents with risk of HIV infection, agreed to be vaccinated vs 48% of those disclaimed the risk of HIV infection. Readiness for HIV vaccination is 20% lower in respondents with children vs childless. In case of 30% vaccine efficacy readiness for vaccination was 3.5 points of 10; in case of 50% efficacy—5.2 points of 10; 8.8 points of 10—in case of 90%–95% efficacy. Readiness for vaccination also depends from its duration, number of doses in course, possible adverse side effects, mode of vaccination. Twenty percent of respondents agreed only for free vaccination, 45%—for paid vaccination. Readiness for HIV vaccination is lower in general population (60% vs 78%) and in HIV infection risk groups (79% vs 95%–97%) in Russia vs some other countries (Suraratdecha et al., 2005). It is necessary to improve education programs aimed to inform on HIV vaccines development, its safety and application.

Gudima, G.; Sidorovich, I.; Karamov, E.; Bogachanskaya, N.; Pavlov, S.; Efimenko, S.; Reshetnikov, A.; Khaitov, R.

2014-01-01

126

Effectiveness of varicella vaccine in children infected with HIV.  

PubMed

Although varicella vaccine is given to clinically stable human immunodeficiency virus (HIV)-infected children, its effectiveness is unknown. We assessed its effectiveness by reviewing the medical records of closely monitored HIV-infected children, including those receiving highly active antiretroviral therapy (HAART) between 1989 and 2007. Varicella immunization and development of varicella or herpes zoster were noted. Effectiveness was calculated by subtracting from 1 the rate ratios for the incidence rates of varicella or herpes zoster in vaccinated versus unvaccinated children. The effectiveness of the vaccine was 82% (95% confidence interval [CI], 24%-99%; P = .01) against varicella and was 100% (95% CI, 67%-100%; P < .001) against herpes zoster. When the analysis was controlled for receipt of HAART, vaccination remained highly protective against herpes zoster. PMID:20441519

Son, Moeun; Shapiro, Eugene D; LaRussa, Philip; Neu, Natalie; Michalik, David E; Meglin, Michelle; Jurgrau, Andrea; Bitar, Wally; Vasquez, Marietta; Flynn, Patricia; Gershon, Anne A

2010-06-15

127

Promoting HIV Vaccine Research in African American Communities: Does the Theory of Reasoned Action Explain Potential Outcomes of Involvement?  

PubMed Central

The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms. The Theory of Reasoned Action (TRA) may be a useful framework for exploration of community engagement outcomes including future attendance, community mobilization, and study participation. Within the context of HIV vaccine outreach, we conducted a cross-sectional survey in early 2007 with 175 African-American adults (? 18 years). Confirmatory factor analysis and structural equation modeling were performed and the findings support the potential of the model in understanding behavioral intentions toward HIV vaccine research. PMID:20686675

Frew, Paula M.; Archibald, Matthew; Martinez, Nina; del Rio, Carlos; Mulligan, Mark J.

2009-01-01

128

Improving comprehension for HIV vaccine trial information among adolescents at risk of HIV  

Microsoft Academic Search

A simplified version of the HIVNET prototype HIV vaccine process was developed for adolescents at risk of HIV by: (1) reducing reading level; (2) reorganizing; (3) adding illustrations; and (4) obtaining focus group feedback. Then adolescents (N?=?187) in three cities were randomly assigned to the standard or simplified version. Adolescents receiving the simplified version had significantly higher comprehension scores (80%

D. A. Murphy; D. Hoffman; G. R. Seage Iii; M. Belzer; J. Xu; S. J. Durako; M. Geiger; Aids Interventions

2007-01-01

129

Socially-Integrated Transdisciplinary HIV Prevention.  

PubMed

Current ideas about HIV prevention include a mixture of primarily biomedical interventions, socio-mechanical interventions such as sterile syringe and condom distribution, and behavioral interventions. This article presents a framework for socially-integrated transdisciplinary HIV prevention that may improve current prevention efforts. It first describes one socially-integrated transdisciplinary intervention project, the Transmission Reduction Intervention Project. We focus on how social aspects of the intervention integrate its component parts across disciplines and processes at different levels of analysis. We then present socially-integrated perspectives about how to improve combination antiretroviral treatment (cART) processes at the population level in order to solve the problems of the treatment cascade and make "treatment as prevention" more effective. Finally, we discuss some remaining problems and issues in such a social transdisciplinary intervention in the hope that other researchers and public health agents will develop additional socially-integrated interventions for HIV and other diseases. PMID:24165983

Friedman, Samuel R; Downing, Martin J; Smyrnov, Pavlo; Nikolopoulos, Georgios; Schneider, John A; Livak, Britt; Magiorkinis, Gkikas; Slobodianyk, Liudmyla; Vasylyeva, Tetyana I; Paraskevis, Dimitrios; Psichogiou, Mina; Sypsa, Vana; Malliori, Melpomeni M; Hatzakis, Angelos

2014-10-01

130

Heterologous Prime-Boost HIV-1 Vaccination Regimens in Pre-Clinical and Clinical Trials  

PubMed Central

Currently, there are more than 30 million people infected with HIV-1 and thousands more are infected each day. Vaccination is the single most effective mechanism for prevention of viral disease, and after more than 25 years of research, one vaccine has shown somewhat encouraging results in an advanced clinical efficacy trial. A modified intent-to-treat analysis of trial results showed that infection was approximately 30% lower in the vaccine group compared to the placebo group. The vaccine was administered using a heterologous prime-boost regimen in which both target antigens and delivery vehicles were changed during the course of inoculations. Here we examine the complexity of heterologous prime-boost immunizations. We show that the use of different delivery vehicles in prime and boost inoculations can help to avert the inhibitory effects caused by vector-specific immune responses. We also show that the introduction of new antigens into boost inoculations can be advantageous, demonstrating that the effect of ‘original antigenic sin’ is not absolute. Pre-clinical and clinical studies are reviewed, including our own work with a three-vector vaccination regimen using recombinant DNA, virus (Sendai virus or vaccinia virus) and protein. Promising preliminary results suggest that the heterologous prime-boost strategy may possibly provide a foundation for the future prevention of HIV-1 infections in humans. PMID:20407589

Brown, Scott A.; Surman, Sherri L.; Sealy, Robert; Jones, Bart G.; Slobod, Karen S.; Branum, Kristen; Lockey, Timothy D.; Howlett, Nanna; Freiden, Pamela; Flynn, Patricia; Hurwitz, Julia L.

2010-01-01

131

Faith and HIV prevention: the conceptual framing of HIV prevention among Pentecostal Batswana teenagers  

PubMed Central

Background There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana; - a country with one of the highest HIV prevalence in the world. Method Participants were 213 Pentecostal church members (67% female; age range 12 to 23 years; median age?=?19 years). We engaged the participants in a mixed-method inductive process to collect data on their implicit framing of HIV prevention concepts, taking into account the centrality of religion concepts to them and the moderating influences of age, gender and sexual experience. After, we analysed the data using multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) to map the ways the church youths framed HIV prevention. Results The findings suggest the church youth to conceptually frame their HIV prevention from both faith-oriented and secular-oriented perspectives, while prioritizing the faith-oriented concepts based on biblical teachings and future focus. In their secular-oriented framing of HIV prevention, the church youths endorsed the importance to learn the facts about HIV and AIDS, understanding of community norms that increased risk for HIV and prevention education. However, components of secular-oriented framing of HIV prevention concepts were comparatively less was well differentiated among the youths than with faith-oriented framing, suggesting latent influences of the church knowledge environment to undervalue secular oriented concepts. Older and sexually experienced church youths in their framing of HIV prevention valued future focus and prevention education less than contrasting peer cohorts, suggesting their greater relative risk for HIV infection. Conclusion A prospective HIV prevention intervention with the Pentecostal church youths would combine both faith and secular informed concepts. It also would need to take into account the ways in which these youth interpret secular-oriented health concepts in the context of their religious beliefs. PMID:24593140

2014-01-01

132

Positive Prevention: HIV Prevention with people living with HIV  

NSDL National Science Digital Library

The International HIV/AIDS Alliance works to support "community action on AIDS in developing countries" through advocacy efforts, research, and outreach programs. Over the past several years, they have also released a number of papers designed to assist non-governmental organizations and service providers with providing quality health care to those living with HIV. This 36-page guide was released in September 2007, and is divided into four sections, including "Community Mobilisation" and "Individually focused health education and support". Each section contains concrete suggestions, along with examples drawn from case studies in Mexico, Senegal, and other places. After reading through this publication, visitors are welcome to offer their own comments and feedback on the International HIV/AIDS Alliance website.

2007-01-01

133

An Extended Model of Reasoned Action to Understand the Influence of Individual and Network-Level Factors on African Americans’ Participation in HIV Vaccine Research  

Microsoft Academic Search

In the United States, the number and proportion of HIV\\/AIDS cases among black\\/African Americans continue to highlight the\\u000a need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention\\u000a strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral\\u000a change strategies to stem the HIV epidemic. Although black\\/African Americans

Paula M. Frew; Matthew Archibald; Dazon Dixon Diallo; Su-I Hou; Takeia Horton; Kayshin Chan; Mark J. Mulligan; Carlos del Rio

2010-01-01

134

Prevention of pneumococcal disease through vaccination.  

PubMed

The Millennium Development Goals (MDGs), adopted by world leaders in the year 2000 with an aim to accomplish them by 2015, provide concrete benchmarks for tackling extreme poverty in its many dimensions. One aim is to reduce by two thirds the mortality rate among children <5 years of age. The deaths of nearly 3 million children under 5 each year worldwide can be attributed to diarrhea and pneumonia. Pneumonia, one form of pneumococcal disease, causes almost 1 in 5 deaths of children under 5 worldwide-more than 1.6 million children each year. Pneumococcal disease is preventable by vaccination; because antibiotic resistance is a growing problem worldwide, there is a great need to promote effective pneumococcal vaccines. Vaccines differ from other types of drugs, because they are administered to healthy individuals. Therefore, a good safety profile is required, there is a large governmental regulatory role, and low efficacy is unacceptable. Other important considerations are as follows: vaccines are often used in infants, are typically given in multiple doses, the manufacturing is a larger part of cost, requires high regulatory and quality control burden and minimization of costs. From a biological standpoint, the induction of vaccine-mediated protection is a complex procedure. Long-term protection typically requires the persistence of anti-microbial antibodies and/or the generation of immune memory cells capable of rapid and effective reactivation after microbial re-exposure. Appreciation of the predominant role of B cells in the efficacy of current vaccines should not minimize the importance of generating a T cell response, as this is essential for the induction of high affinity antibodies and immune memory. Pneumococcal capsular polysaccharides typically elicit B cell responses in a T-independent manner. Because of this, capsular polysaccharides are poorly immunogenic in children below 2 years of age and will generate an IgM isotype-based primary response with only short-lived protection. The conjugation of capsular polysaccharides to a protein carrier provides an antigenic complex in a form that can be presented to the immune system and thus recruit antigen specific CD4? cells (T-dependent antibody). Pneumococcal conjugate vaccines (PCVs), comprising pneumococcal polysaccharides conjugated to a protein carrier, not only induce antibodies but also prime the immune system for protective memory response. These vaccines provide protection in children below 2 years of age, generate long-term protection (highly specific IgG antibodies), generate herd immunity (indirect protection of nonimmunized individuals) and have demonstrated effectiveness in regions that have incorporated them into the national immunization schedules. Global implementation of PCVs has contributed to substantial progress toward reducing childhood mortality, but increased vaccine uptake in developing regions such as Latin America and the Caribbean is necessary to continue toward accomplishing the goals outline in the MDGs. PMID:21896348

Gentile, Angela; Bazán, Virginia

2011-09-14

135

NJ Department of Health Vaccine Preventable Disease Program  

E-print Network

NJ Department of Health Vaccine Preventable Disease Program Meningococcal Disease Frequently Asked of the meningococcal bacteria. We are still waiting for results from the most recent case. Is there a vaccine against this infection? The meningococcal vaccine provides protection against four different serogroups (strains

Rowley, Clarence W.

136

Preventing Mother-to-Child Transmission of HIV After Birth  

MedlinePLUS

... receive HIV medicines to prevent mother-to-child transmission of HIV? Within 6 to 12 hours after ... advancing and to reduce the risk of sexual transmission of HIV . The recommendation is strongest for those ...

137

Common Factors in Effective HIV Prevention Programs  

Microsoft Academic Search

We propose a set of common factors in evidence-based interventions (EBI) for HIV prevention, which cut across theoretical\\u000a models of behavior change. Three existing literatures support this agenda: (1) Common factors in psychotherapy; (2) core elements\\u000a from the Centers for Disease Control and Prevention EBIs; and (3) component analyses of EBI. To stimulate discussion among\\u000a prevention researchers, we propose a

Mary Jane Rotheram-Borus; Dallas Swendeman; Diane Flannery; Eric Rice; David M. Adamson; Barbara Ingram

2009-01-01

138

Community-based organizations and HIV prevention for incarcerated populations: three HIV prevention program models.  

PubMed

Inevitably, challenges result from the disconnect between the objectives of correctional facilities, which are safety and conformity, and community-based organizations (CBOs), whose primary function is to provide inmates with primary and secondary HIV prevention and information. This is cause for concern because prisons have a high potential for serving as a reservoir for HIV transmission. CBOs, when accessible, may be the only source of HIV/AIDS prevention, education, and information for incarcerated populations. People living with HIV/AIDS in correctional settings face unique challenges. Among other populations, condoms and bleach kits have been successful in reducing HIV transmission. However, because these prevention tools are not available to incarcerated populations, new HIV prevention strategies are needed. This article focuses on successful intervention practices such as peer-led education and discharge planning services that have been essential components of HIV prevention and provides a context for operating such programs within correctional facilities. The article also highlights the challenges CBOs encounter in providing HIV prevention in various correctional institutions throughout the United States. PMID:12413195

Ehrmann, Tanya

2002-10-01

139

Performance of a Redesigned HIV Selectest Enzyme-Linked Immunosorbent Assay Optimized To Minimize Vaccine-Induced Seropositivity in HIV Vaccine Trial Participants  

PubMed Central

Vaccine-induced seropositivity (VISP) or seroreactivity (VISR), defined as the reaction of antibodies elicited by HIV vaccines with antigens used in HIV diagnostic immunoassays, can result in reactive assay results for vaccinated but uninfected individuals, with subsequent misclassification of their infection status. The eventual licensure of a vaccine will magnify this issue and calls for the development of mitigating solutions in advance. An immunoassay that discriminates between antibodies elicited by vaccine antigens and those elicited by infection has been developed to address this laboratory testing need. The HIV Selectest is based on consensus and clade-specific HIV peptides that are omitted in many HIV vaccine constructs. The assay was redesigned to enhance performance across worldwide clades and to simplify routine use via a standard kit format. The redesigned assay was evaluated with sera from vaccine trial participants, HIV-infected and uninfected individuals, and healthy controls. The HIV Selectest exhibited specificities of 99.5% with sera from uninfected recipients of 6 different HIV vaccines and 100% with sera from normal donors, while detecting HIV-1 infections, including intercurrent infections, with 95 to 100% sensitivity depending on the clade, with the highest sensitivities for clades A and C. HIV Selectest sensitivity decreased in very early seroconversion specimens, which possibly explains the slightly lower sensitivity observed for asymptomatic blood donors than for clinical HIV cases. Thus, the HIV Selectest provides a new laboratory tool for use in vaccine settings to distinguish the immune response to HIV vaccine antigens from that due to true infection. PMID:24403525

Penezina, Oksana; Krueger, Neil X.; Rodriguez-Chavez, Isaac R.; Busch, Michael P.; Hural, John; Kim, Jerome H.; O'Connell, Robert J.; Hunter, Eric; Aboud, Said; Higgins, Keith; Kovalenko, Victor; Clapham, David; Crane, David

2014-01-01

140

An Automated HIV-1 Env-Pseudotyped Virus Production for Global HIV Vaccine Trials  

PubMed Central

Background Infections with HIV still represent a major human health problem worldwide and a vaccine is the only long-term option to fight efficiently against this virus. Standardized assessments of HIV-specific immune responses in vaccine trials are essential for prioritizing vaccine candidates in preclinical and clinical stages of development. With respect to neutralizing antibodies, assays with HIV-1 Env-pseudotyped viruses are a high priority. To cover the increasing demands of HIV pseudoviruses, a complete cell culture and transfection automation system has been developed. Methodology/Principal Findings The automation system for HIV pseudovirus production comprises a modified Tecan-based Cellerity system. It covers an area of 5×3 meters and includes a robot platform, a cell counting machine, a CO2 incubator for cell cultivation and a media refrigerator. The processes for cell handling, transfection and pseudovirus production have been implemented according to manual standard operating procedures and are controlled and scheduled autonomously by the system. The system is housed in a biosafety level II cabinet that guarantees protection of personnel, environment and the product. HIV pseudovirus stocks in a scale from 140 ml to 1000 ml have been produced on the automated system. Parallel manual production of HIV pseudoviruses and comparisons (bridging assays) confirmed that the automated produced pseudoviruses were of equivalent quality as those produced manually. In addition, the automated method was fully validated according to Good Clinical Laboratory Practice (GCLP) guidelines, including the validation parameters accuracy, precision, robustness and specificity. Conclusions An automated HIV pseudovirus production system has been successfully established. It allows the high quality production of HIV pseudoviruses under GCLP conditions. In its present form, the installed module enables the production of 1000 ml of virus-containing cell culture supernatant per week. Thus, this novel automation facilitates standardized large-scale productions of HIV pseudoviruses for ongoing and upcoming HIV vaccine trials. PMID:23300558

Fuss, Martina; Mazzotta, Angela S.; Sarzotti-Kelsoe, Marcella; Ozaki, Daniel A.; Montefiori, David C.; von Briesen, Hagen; Zimmermann, Heiko; Meyerhans, Andreas

2012-01-01

141

HIV Antigen Incorporation within Adenovirus Hexon Hypervariable 2 for a Novel HIV Vaccine Approach  

PubMed Central

Adenoviral (Ad) vectors have been used for a variety of vaccine applications including cancer and infectious diseases. Traditionally, Ad-based vaccines are designed to express antigens through transgene expression of a given antigen. However, in some cases these conventional Ad-based vaccines have had sub-optimal clinical results. These sub-optimal results are attributed in part to pre-existing Ad serotype 5 (Ad5) immunity. In order to circumvent the need for antigen expression via transgene incorporation, the “antigen capsid-incorporation” strategy has been developed and used for Ad-based vaccine development in the context of a few diseases. This strategy embodies the incorporation of antigenic peptides within the capsid structure of viral vectors. The major capsid protein hexon has been utilized for these capsid incorporation strategies due to hexon's natural role in the generation of anti-Ad immune response and its numerical representation within the Ad virion. Using this strategy, we have developed the means to incorporate heterologous peptide epitopes specifically within the major surface-exposed domains of the Ad capsid protein hexon. Our study herein focuses on generation of multivalent vaccine vectors presenting HIV antigens within the Ad capsid protein hexon, as well as expressing an HIV antigen as a transgene. These novel vectors utilize HVR2 as an incorporation site for a twenty-four amino acid region of the HIV membrane proximal ectodomain region (MPER), derived from HIV glycoprotein gp41 (gp41). Our study herein illustrates that our multivalent anti-HIV vectors elicit a cellular anti-HIV response. Furthermore, vaccinations with these vectors, which present HIV antigens at HVR2, elicit a HIV epitope-specific humoral immune response. PMID:20676400

Matthews, Qiana L.; Fatima, Aiman; Tang, Yizhe; Perry, Brian A.; Tsuruta, Yuko; Komarova, Svetlana; Timares, Laura; Zhao, Chunxia; Makarova, Natalia; Borovjagin, Anton V.; Stewart, Phoebe L.; Wu, Hongju; Blackwell, Jerry L.; Curiel, David T.

2010-01-01

142

Efficacy assessment of a cell-mediated immunity HIV-1 vaccine (the Step Study): a double-blind, randomised, placebo-controlled, test-of-concept trial  

PubMed Central

Background Observational data and non-human primate challenge studies suggest that cell-mediated immune (CMI) responses may provide control of HIV replication. The Step Study is the first direct assessment of the efficacy of a CMI vaccine to protect against HIV infection or alter early plasma HIV levels in humans. Method HIV-seronegative participants (3000) were randomized (1:1) to receive 3 injections of MRKAd5 HIV-1 gag/pol/nef vaccine or placebo. Randomization was pre-stratified by gender, baseline adenovirus type 5 (Ad5) titer, and study site. Participants were tested ~every 6 months for HIV acquisition; early plasma HIV RNA was measured ~3 months post-HIV diagnosis. Findings The vaccine elicited IFN-? ELISPOT responses in 75% of vaccinees. In a pre-specified interim analysis among participants with baseline Ad5 ?200, 24 of 741 vaccinees became HIV infected, versus 21 of 762 placebo recipients. All but one infection occurred in men. The early geometric mean plasma HIV RNA was comparable in infected vaccine and placebo recipients. In exploratory multivariate analyses, HIV incidence was higher in vaccinees versus placebo recipients among Ad5 seropositive men (5.1% versus 2.2% per year, respectively) and uncircumcised men (5.2% versus 1.4% per year, respectively). HIV incidence was similar in vaccinees versus placebo recipients among Ad5 seronegative men and circumcised men. Interpretation This CMI vaccine did not prevent HIV infection or lower early viral level. Mechanisms for failure of the vaccine to protect and for the increased HIV infection rates in subgroups of vaccinees are being explored. Additional follow-up will determine if elevated HIV incidence in vaccinee subgroups persists. PMID:19012954

Buchbinder, Susan P.; Mehrotra, Devan V.; Duerr, Ann; Fitzgerald, Daniel W.; Mogg, Robin; Li, David; Gilbert, Peter B.; Lama, Javier R.; Marmor, Michael; Rio, Carlos del; McElrath, M. Juliana; Casimiro, Danilo R.; Gottesdiener, Keith M.; Chodakewitz, Jeffrey A.; Corey, Lawrence; Robertson, Michael N.

2009-01-01

143

A neonatal Fc receptor-targeted mucosal vaccine strategy effectively induces HIV1 antigen-specific immunity to genital infection  

Microsoft Academic Search

Strategies to prevent the sexual transmission of HIV include vaccines that elicit durable, protective mucosal immune responses. A key to effective mucosal immunity is the capacity for antigens administered locally to cross epithelial barriers. Given the role of neonatal Fc receptor (FcRn) in transferring IgG across polarized epithelial cells which line mucosal surfaces, FcRn might be useful for delivering HIV

L Lu; S Palaniyandi; R Zeng; Y Bai; X Liu; Y Wang; C D Pauza; D C Roopenian; X Zhu

2011-01-01

144

Can money prevent the spread of HIV? A review of cash payments for HIV prevention.  

PubMed

Cash payments to improve health outcomes have been used for many years; however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. We identified 16 studies meeting our criteria; 10 are completed. The majority of studies have been conducted with adolescents in developing countries and payments are focused on addressing structural risk factors such as poverty. Most have seen reductions in sexual behavior and one large trial has documented a difference in HIV prevalence between young women getting cash transfers and those not. Cash transfer programs focused on changing risky sexual behaviors to reduce HIV risk suggest promise. The context in which programs are situated, the purpose of the cash transfer, and the population will all affect the impact of such programs; ongoing RCTs with HIV incidence endpoints will shed more light on the efficacy of cash payments as strategy for HIV prevention. PMID:22760738

Pettifor, Audrey; MacPhail, Catherine; Nguyen, Nadia; Rosenberg, Molly

2012-10-01

145

Can money prevent the spread of HIV? A review of cash payments for HIV prevention  

PubMed Central

Cash payments to improve health outcomes have been used for many years, however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. We identified 16 studies meeting our criteria; 10 are completed. The majority of studies have been conducted with adolescents in developing countries and payments are focused on addressing structural risk factors such as poverty. Most have seen reductions in sexual behavior and one large trial has documented a difference in HIV prevalence between young women getting cash transfers and those not. Cash transfer programs focused on changing risky sexual behaviors to reduce HIV risk suggest promise. The context in which programs are situated, the purpose of the cash transfer, and the population will all affect the impact of such programs; ongoing RCTs with HIV incidence endpoints will shed more light on the efficacy of cash payments as strategy for HIV prevention. PMID:22760738

Pettifor, Audrey; MacPhail, Catherine; Nguyen, Nadia; Rosenberg, Molly

2013-01-01

146

Harnessing CD4? T cell responses in HIV vaccine development.  

PubMed

CD4(+) T cells can perform a panoply of tasks to shape an effective response against a pathogen. Limited attention has been paid to the potential importance of functional CD4(+) T cell responses in the context of the development of next-generation vaccines, including HIV vaccines. Many CD4(+) T cell functions are newly appreciated and only partially understood. A workshop was held as a forum to bring together a small group of experts to exchange ideas on the role of CD4(+) T cells in developing durable functional antibody responses, via follicular helper T cells, as well as on the roles of CD4(+) T cells in other aspects of protective immunity. Here we discuss whether CD4(+) T cell responses may represent a beneficial component of an efficacious HIV vaccine. PMID:23389614

Streeck, Hendrik; D'Souza, M Patricia; Littman, Dan R; Crotty, Shane

2013-02-01

147

Harnessing CD4+ T cell responses in HIV vaccine development  

PubMed Central

CD4+ T cells can perform a panoply of tasks to shape an effective response against a pathogen. Limited attention has been paid to the potential importance of functional CD4+ T cell responses in the context of the development of next-generation vaccines, including HIV vaccines. Many CD4+ T cell functions are newly appreciated and only partially understood. A workshop was held as a forum to bring together a small group of experts to exchange ideas on the role of CD4+ T cells in developing durable functional antibody responses, via follicular helper T cells, as well as on the roles of CD4+ T cells in other aspects of protective immunity. Here we discuss whether CD4+ T cell responses may represent a beneficial component of an efficacious HIV vaccine. PMID:23389614

Streeck, Hendrik; D’Souza, M Patricia; Littman, Dan R; Crotty, Shane

2013-01-01

148

Can Influenza Epidemics Be Prevented by Voluntary Vaccination?  

E-print Network

Can Influenza Epidemics Be Prevented by Voluntary Vaccination? Raffaele Vardavas, Romulus Breban the vaccination coverage level necessary for preventing influenza epidemics, but have not shown whether individual-level decisions. By including the effects of adaptive decision-making within an epidemic model, we

Blower, Sally

149

Antiretroviral Therapy: A Promising HIV Prevention Strategy?  

PubMed Central

The use of antiretroviral therapy (ART) has been associated with significant improvement in morbidity and survival of persons living with HIV. In addition, recently, there has also been intense interest in the potential impact of ART on HIV transmission and consequently on the trajectory of the HIV epidemic globally. Evidence from mathematical modeling analyses as well as observational, and ecological studies supports the potential for ART as prevention. However, definitive data from clinical trials are awaited. In the United States, the feasibility and potential of using ART as a prevention strategy presents particular challenges: the large number of individuals with undiagnosed HIV; the predominance of disenfranchised individuals affected by the epidemic; evidence of delay in engagement in HIV care after diagnosis with attendant late initiation of ART; and difficulties with consistent, long-term adherence to ART as well as concerns regarding long-term risk-behavior change. Thus, for this novel effort to succeed, a multidimensional approach is necessary that must include policy changes, social mobilization, and improved access to clinical and supportive services for persons living with HIV, with a particular focus on the unique needs of at-risk populations, combined with engagement of all cadres of health care providers and community constituencies. PMID:21406980

El-Sadr, Wafaa M.; Affrunti, Megan; Gamble, Theresa; Zerbe, Allison

2010-01-01

150

JAMA Patient Page: Medications to Prevent HIV Infection  

MedlinePLUS

... HIV Infection Human immunodeficiency virus (HIV) prevention (or prophylaxis ) includes both safe sex practices and medications. Preventing ... use of medications: preexposure prophy- laxis and postexposure prophylaxis . Preexposure Prophylaxis In preexposure prophylaxis, someone who does ...

151

Occupational HIV Transmission and Prevention among Health Care Workers  

MedlinePLUS

... Share Compartir Occupational HIV Transmission and Prevention Among Health Care Workers Fast Facts Occupational transmission of HIV to ... every hour counts. Building Better Prevention Programs for Health Care Workers Continued diligence in the following areas is ...

152

Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge, Attitudes, and Beliefs among Injecting Drug Users in Viet Nam  

ERIC Educational Resources Information Center

In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of…

Nguyen, France

2007-01-01

153

HIV Prevention and AIDS Education: Resources for Special Educators.  

ERIC Educational Resources Information Center

This guide was developed out of a 5-year project aimed at preventing the transmission of the human immunodeficiency virus (HIV) by promoting HIV prevention and AIDS (acquired immunodeficiency syndrome) education in school health programs. This document includes recommendations of a January, 1989 forum which addressed HIV prevention education for…

Byrom, Elizabeth, Ed.; Katz, Ginger, Ed.

154

Advancing community stakeholder engagement in biomedical HIV prevention trials: principles, practices and evidence.  

PubMed

Community stakeholder engagement is foundational to fair and ethically conducted biomedical HIV prevention trials. Concerns regarding the ethical engagement of community stakeholders in HIV vaccine trials and early terminations of several international pre-exposure prophylaxis trials have fueled the development of international guidelines, such as UNAIDS' good participatory practice (GPP). GPP aims to ensure that stakeholders are effectively involved in all phases of biomedical HIV prevention trials. We provide an overview of the six guiding principles in the GPP and critically examine them in relation to existing social and behavioral science research. In particular, we highlight the challenges involved in operationalizing these principles on the ground in various global contexts, with a focus on low-income country settings. Increasing integration of social science in biomedical HIV prevention trials will provide evidence to advance a science of community stakeholder engagement to support ethical and effective practices informed by local realities and sociocultural differences. PMID:25174764

Newman, Peter A; Rubincam, Clara

2014-12-01

155

Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa  

E-print Network

Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa ABTRACT (243 of sexual HIV transmission within the couple for women who had been prenatally tested for HIV. In this study.6%, (p=0.302) at 18 months post-partum. In our study, although women had been prenatally tested for HIV

Boyer, Edmond

156

Evolving T-cell vaccine strategies for HIV, the virus with a thousand faces  

SciTech Connect

HIV's rapid global spread and the human suffering it has left in its wake have made AIDS a global heath priority for the 25 years since its discovery. Yet its capacity to rapidly evolve has made combating this virus a tremendous challenge. The obstacles to creating an effective HIV vaccine are formidable, but there are advances in the field on many fronts, in terms of novel vectors, adjuvants, and antigen design strategies. SIV live attenuated vaccine models are able to confer protection against heterologous challenge, and this continues to provide opportunities to explore the biological underpinnings of a protective effect (9). More indirect, but equally important, is new understanding regarding the biology of acute infection (43), the role of immune response in long-term non-progression (6,62, 81), and defining characteristics of broadly neutralizing antibodies (4). In this review we will focus on summarizing strategies directed towards a single issue, that of contending with HIV variation in terms of designing aT-cell vaccine. The strategies that prove most effective in this area can ultimately be combined with the best strategies under development in other areas, with the hope of ultimately converging on a viable vaccine candidate. Only two large HIV vaccine efficacy trials have been completed and both have failed to prevent infection or confer a benefit to infected individual (23,34), but there is ample reason to continue our efforts. A historic breakthrough came in 1996, when it was realized that although the virus could escape from a single antiretroviral (ARV) therapy, it could be thwarted by a combination of medications that simultaneously targeted different parts of the virus (HAART) (38). This revelation came after 15 years of research, thought, and clinical testing; to enable that vital progress the research and clinical communities had to first define and understand, then develop a strategy to counter, the remarkable evolutionary potential of the virus. HAART, for the first time, provided an effective treatment to help those with living with HIV stay healthy. Nonetheless, the treatment has limitations. People with HIV face a lifetime of expensive daily multi-drug regimens, often with side effects; drug resistance at the individual and population level are issues (56); and universal access, despite substantial progress, is a dream not yet realized for many of the millions of the world's poor who are living with HIV (68). These issues, combined with the growing numbers of people infected globally and impact of HIV on society, make the development of an HIV vaccine or a prophylactic prevention strategy a crucial if elusive goal. In some ways, the history of HIV vaccine deVelopment has paralleled the early stages of designing effective therapy. We had to test the simple strategies first, but meanwhile the story of the impact of diversity from an immunological perspective is still unfolding, and novel ideas countermeasures are being explored.

Korber, Bette [Los Alamos National Laboratory

2009-01-01

157

Induction of Potent and Long-Lived Antibody and Cellular Immune Responses in the Genitorectal Mucosa Could be the Critical Determinant of HIV Vaccine Efficacy  

PubMed Central

The field of HIV prevention has indeed progressed in leaps and bounds, but with major limitations of the current prevention and treatment options, the world remains desperate for an HIV vaccine. Sadly, this continues to be elusive, because more than 30?years since its discovery there is no licensed HIV vaccine. Research aiming to define immunological biomarkers to accurately predict vaccine efficacy have focused mainly on systemic immune responses, and as such, studies defining correlates of protection in the genitorectal mucosa, the primary target site for HIV entry and seeding are sparse. Clearly, difficulties in sampling and analysis of mucosal specimens, as well as their limited size have been a major deterrent in characterizing the type (mucosal antibodies, cytokines, chemokines, or CTL), threshold (magnitude, depth, and breadth) and viral inhibitory capacity of HIV-1-specific immune responses in the genitorectal mucosa, where they are needed to immediately block HIV acquisition and arrest subsequent virus dissemination. Nevertheless, a few studies document the existence of HIV-specific immune responses in the genitorectal mucosa of HIV-infected aviremic and viremic controllers, as well as in highly exposed persistently seronegative (HEPS) individuals with natural resistance to HIV-1. Some of these responses strongly correlate with protection from HIV acquisition and/or disease progression, thus providing significant clues of the ideal components of an efficacious HIV vaccine. In this study, we provide an overview of the key features of protective immune responses found in HEPS, elite and viremic controllers, and discuss how these can be achieved through mucosal immunization. Inevitably, HIV vaccine development research will have to consider strategies that elicit potent antibody and cellular immune responses within the genitorectal mucosa or induction of systemic immune cells with an inherent potential to home and persist at mucosal sites of HIV entry. PMID:24847327

Chanzu, Nadia; Ondondo, Beatrice

2014-01-01

158

Recombinant Salmonella enterica Serovar Typhimurium as a Vaccine Vector for HIV-1 Gag  

PubMed Central

The HIV/AIDS epidemic remains a global health problem, especially in Sub-Saharan Africa. An effective HIV-1 vaccine is therefore badly required to mitigate this ever-expanding problem. Since HIV-1 infects its host through the mucosal surface, a vaccine for the virus needs to trigger mucosal as well as systemic immune responses. Oral, attenuated recombinant Salmonella vaccines offer this potential of delivering HIV-1 antigens to both the mucosal and systemic compartments of the immune system. So far, a number of pre-clinical studies have been performed, in which HIV-1 Gag, a highly conserved viral antigen possessing both T- and B-cell epitopes, was successfully delivered by recombinant Salmonella vaccines and, in most cases, induced HIV-specific immune responses. In this review, the potential use of Salmonella enterica serovar Typhimurium as a live vaccine vector for HIV-1 Gag is explored. PMID:23989890

Chin'ombe, Nyasha

2013-01-01

159

Weighing the Gold in the Gold Standard: Challenges in HIV Prevention Research  

PubMed Central

Objective(s) Few HIV prevention interventions have been evaluated in randomized controlled trials (RCTs). We examined design, implementation, and contextual considerations that may limit detection of a positive or adverse effect in HIV prevention trials. Design A systematic review of late phase RCTs for prevention of sexual transmission of HIV that 1) randomly allocated intervention and comparison groups; 2) evaluated interventions to prevent sexual transmission in non-pregnant populations; and 3) reported HIV incidence as the primary or secondary outcome. Methods PubMed/MEDLINE, other electronic databases, and electronic conference proceedings of recent HIV/AIDS-related conferences were searched to identify published or unpublished trials meeting the inclusion criteria. Descriptive, methodological, and contextual factors were abstracted from each trial. Results The review included 36 HIV prevention RCTs reporting on 38 unique interventions. Only six RCTs, all evaluating biomedical interventions, demonstrated definitive effects on HIV incidence. Five of the six RCTs significantly reduced HIV infection: all three male circumcision trials, one trial of STI treatment and care, and one vaccine trial. One microbicide trial of nonoxynol-9 gel produced adverse results. Lack of statistical power, poor adherence, and diluted versions of the intervention in comparison groups may have been important issues for the other trials that demonstrated “flat” results. Conclusions Almost 90% of HIV prevention trials had “flat” results, which may be attributable to trial design and/or implementation. The HIV prevention community must not only examine evidence from significant RCTs, but must also examine flat trials, and address design and implementation issues that limit detection of an effect. PMID:20179575

PADIAN, Nancy S.; McLOY, Sandra I.; BALKUS, Jennifer E.; WASSERHEIT, Judith N.

2013-01-01

160

Cytokine production and dysregulation in HIV pathogenesis: Lessons for development of therapeutics and vaccines  

PubMed Central

Numerous studies have characterized the cytokine modulation observed in human immunodeficiency virus (HIV) infected individuals, from initial infection through chronic disease. Progressive and non-progressive HIV infection models show the cytokine milieu differs in terms of production and responsiveness in these two groups, suggesting an understanding of the role cytokines play during infection is necessary for directing the immune response toward viral control. This review will cover cytokine induction and dysfunction during HIV pathogenesis, with a focus on the interplay between cytokines and transcription factors, T cell activation, and exhaustion. We highlight cytokines that have either vaccine adjuvant or therapeutic potential and discuss the need to identify key factors required for prevention of progression, clearance of infection, or protection from acquisition. PMID:22743036

Reuter, Morgan A.; Pombo, Carolina; Betts, Michael R.

2012-01-01

161

The prevention of HIV transmission in Hispanic adolescents  

Microsoft Academic Search

This article reviews the state of the science in HIV prevention for Hispanic adolescents. The article discusses the importance of preventing HIV in Hispanic adolescents. Literature is reviewed in three broad areas: (1) the prevalence rates of drug and alcohol misuse, sexual practices, and HIV infection; (2) risk and protective factors for drug and alcohol misuse and unprotected sex (in

Guillermo Prado; Seth J. Schwartz; Angela Pattatucci-Aragón; Michael Clatts; Hilda Pantin; M. Isabel Fernández; Barbara Lopez; Ervin Briones; Hortensia Amaro; José Szapocznik

2006-01-01

162

ETHICAL CONSIDERATIONS IN DETERMINING STANDARD OF PREVENTION PACKAGES FOR HIV PREVENTION TRIALS: EXAMINING PREP  

PubMed Central

The successful demonstration that antiretroviral (ARV) drugs can be used in diverse ways to reduce HIV acquisition or transmission risks - either taken as pre-exposure prophylaxis (PrEP) by those who are uninfected or as early treatment for prevention (T4P) by those living with HIV - expands the armamentarium of existing HIV prevention tools. These findings have implications for the design of future HIV prevention research trials. With the advent of multiple effective HIV prevention tools, discussions about the ethics and the feasibility of future HIV prevention trial designs have intensified. This article outlines arguments concerning the inclusion of newly established ARV-based HIV prevention interventions as standard of prevention in HIV prevention trials from multiple perspectives. Ultimately, there is a clear need to incorporate stakeholders in a robust discussion to determine the appropriate trial design for each study population. PMID:23725227

Haire, Bridget; Folayan, Morenike Oluwatoyin; Hankins, Catherine; Sugarman, Jeremy; McCormack, Sheena; Ramjee, Gita; Warren, Mitchell

2013-01-01

163

HPV vaccines and cancer prevention, science versus activism  

PubMed Central

The rationale behind current worldwide human papilloma virus (HPV) vaccination programs starts from two basic premises, 1) that HPV vaccines will prevent cervical cancers and save lives and, 2) have no risk of serious side effects. Therefore, efforts should be made to get as many pre-adolescent girls vaccinated in order to decrease the burden of cervical cancer. Careful analysis of HPV vaccine pre- and post-licensure data shows however that both of these premises are at odds with factual evidence and are largely derived from significant misinterpretation of available data. PMID:23369430

2013-01-01

164

HIV Immune Complexes Prevent Excitotoxicity by Interaction with NMDA Receptors  

PubMed Central

Purpose Human immunodeficiency virus-1 (HIV)-associated neurocognitive disorder (HAND) is a neurodegenerative disease for which there is no available neuroprotective therapy. Viral proteins, such as Tat, have been implicated as agents of neurotoxicity via multiple mechanisms, including effects by directly binding to the NMDA receptor. We evaluated ability of the immune response against Tat to modulate neurotoxicity at glutamate receptors. Methods Neurotoxicity was measured in primary neuronal-glial cultures and in hippocampal slice cultures. We used immunoprecipitation experiments to demonstrate interaction between Tat, NMDA receptor, and anti-Tat antibody. Using known structures of Tat and NMDA receptors, we developed a model of their interactions. Results Antibodies to Tat attenuated Tat-mediated neurotoxicity. Interestingly, Tat immune complexes also blocked neurotoxicity caused by NMDA receptor agonists but not kainate/AMPA receptor agonists. Neither Tat nor antibody alone blocked the excitotoxic effect, nor did an unrelated antigen-antibody complex. The protective effect of the Tat immune complexes was also lost when Tat was modified by nitrosylation or by using a deletion mutant of Tat. Conclusions The ability of viral immune complexes to interact with NMDA receptors and prevent excitotoxicity represents a novel host defense mechanism. Host immune responses may influence host susceptibility to various effects of viral proteins, modulating HIV complications, such as onset of HAND. These observations provide rationale for development of vaccine therapies targeting Tat for prevention of HAND. PMID:22940423

Rumbaugh, Jeffrey A.; Bachani, Muznabanu; Li, Wenxue; Butler, Tracy R.; Smith, Katherine J.; Bianchet, Mario A.; Wang, Tongguang; Prendergast, Mark A.; Sacktor, Ned; Nath, Avindra

2012-01-01

165

Current approaches to prevention of HIV infections.  

PubMed

The HIV education and prevention strategy of the Centers for Disease Control has three principal components: (a) public information and education, (b) education for school-aged populations, and (c) risk reduction education and individual counseling and testing services for people at increased risk of HIV infection. The most visible components of the public information and education programs are the National Public Information Campaign ("America Responds to AIDS"), the National AIDS Hotline system, and the National AIDS Information Clearinghouse. Components of the youth education program consist of funding for national health and education organizations, funding for State and local education departments, training, surveillance of education efforts, and evaluation. Counseling and testing has entailed performance of approximately 2,500,000 HIV antibody tests with pre- and post-test counseling, notification and counseling of sexual and needle-sharing partners of those infected with HIV, and targeted risk reduction education through community-based organizations. Over time, these activities will continue to evolve and become more effective. PMID:1850530

Roper, W L

1991-01-01

166

Dendritic Cells Exposed to MVA-Based HIV1 Vaccine Induce Highly Functional HIV1Specific CD8+ T Cell Responses in HIV1Infected Individuals  

Microsoft Academic Search

Currently, MVA virus vectors carrying HIV-1 genes are being developed as HIV-1\\/AIDS prophylactic\\/therapeutic vaccines. Nevertheless, little is known about the impact of these vectors on human dendritic cells (DC) and their capacity to present HIV-1 antigens to human HIV-specific T cells. This study aimed to characterize the interaction of MVA and MVA expressing the HIV-1 genes Env-Gag-Pol-Nef of clade B

Núria Climent; Susana Guerra; Felipe García; Cristina Rovira; Laia Miralles; Carmen Elena Gómez; Núria Piqué; Cristina Gil; José María Gatell; Mariano Esteban; Teresa Gallart

2011-01-01

167

Immunogenicity following the first and second doses of 7-valent pneumococcal conjugate vaccine in HIV-infected and -uninfected infants?,??  

PubMed Central

Background The immunogenicity of pneumococcal conjugate vaccine (PCV) has not been evaluated in HIV-infected infants following the first and second PCV-doses. We studied antibody kinetics of serotypes included in 7-valent PCV in HIV-infected and HIV-uninfected infants prior to and following each of three PCV-doses. Methods HIV-uninfected infants born to HIV-uninfected (HUU) and HIV-infected mothers (HEU); and perinatal HIV-infected children with CD4+ < 25% randomized to initiate antiretroviral treatment (ART) when clinically and/or immunologically indicated (ART?) or immediately (ART+) were enrolled. Vaccination occurred at approximately 7.4, 11.5 and 15.5 weeks of age. Serotype-specific antibody was measured by ELISA following each PCV-dose and opsonophagocytic activity (OPA) to three serotypes following the second and third doses. Results Pre-vaccination, antibody geometric mean concentrations (GMCs) were higher in HUU compared to HIV-exposed groups for most serotypes. GMCs and proportion of infants with antibody ?0.35 ?g/ml were similar in HUU compared to other groups following the second PCV-dose. In all groups, GMCs were greater following the third compared to post-second dose; and a higher proportion within each group had antibody ?0.35 ?g/ml to 6B and 23F. OPA GMTs increased after the third compared to post-second dose for studied-serotypes; as did the proportion with OPA ?8 to 23F. Conclusion A two-dose primary-series of PCV probably confers similar protection against invasive pneumococcal disease in HIV-infected compared to HUU children. The inferior response to serotypes 6B and 23F, and lower GMCs and OPA GMTs, following two compared to after three PCV-doses may have implications in the prevention of pneumococcal disease in high-burden countries. PMID:23228814

Madhi, Shabir A.; Izu, Alane; Violari, Avye; Cotton, Mark F.; Panchia, Ravindre; Dobbels, Els; Sewraj, Poonam; van Niekerk, Nadia; Jean-Philippe, Patrick; Adrian, Peter V.

2013-01-01

168

Preexisting Adenovirus Seropositivity Is Not Associated With Increased HIV-1 Acquisition in Three HIV-1 Vaccine Efficacy Trials  

PubMed Central

The Step study of a recombinant adenovirus serotype 5 (Ad5)–based human immunodeficiency virus type 1 (HIV-1) vaccine revealed an increased risk of HIV-1 acquisition in vaccinees who were Ad5 seropositive at baseline. We therefore investigated whether preexisting Ad seropositivity to 7 different Ad serotypes was associated with increased risk of HIV-1 infection in 3 HIV-1 vaccine efficacy trials. In a case-control study involving 1570 adults enrolled in the VAX003 and VAX004 trials of a recombinant protein subunit HIV-1 vaccine and in the Step study, we observed that preexisting seropositivity to multiple Ad serotypes was not intrinsically associated with increased risk of HIV-1 acquisition. PMID:22492863

Stephenson, Kathryn E.; Hural, John; Buchbinder, Susan P.; Sinangil, Faruk; Barouch, Dan H.

2012-01-01

169

Future of Phylogeny in HIV Prevention  

PubMed Central

The success of the HPTN 052 trial has led to revisions in HIV-1 treatment guidelines. Antiretroviral therapy (ART) may reduce the risk of HIV-1 transmissions at the population-level. The design of successful Treatment as Prevention interventions will be predicated on a comprehensive understanding of the spatial, temporal, and biological dynamics of heterosexual (HET), men having sex with men (MSM), and intravenous drug user (IDU) epidemics. Viral phylogenetics can capture the underlying structure of transmission networks based on the genetic interrelatedness of viral sequences and cluster networks that could not be otherwise identified. This article describes the phylogenetic expansion of the Montreal MSM epidemic over the last decade. High rates of co-clustering of primary infections are associated with one infection leading to 13 onward transmissions. Phylogeny substantiates the role of primary and recent stage infection in transmission dynamics, underlying the importance of timely diagnosis and immediate ART initiation to avert transmission cascades. PMID:23764643

Brenner, Bluma G.; Wainberg, Mark A.

2013-01-01

170

Community-Level Approaches to Preventing HIV: Guest Editors' Introduction  

Microsoft Academic Search

In this paper we introduce the contributions included in the special section on community-level efforts to prevent HIV. Authors of several recent review papers have suggested that individual-level approaches to prevent the spread of HIV produce short-term changes in behavior among intervention participants. However, many HIV prevention researchers believe that changing individuals' behavior alone is insufficient to stem the tide

Robin Lin Miller; James G. Kelly

2002-01-01

171

HIV-Infected Children Living in Central Africa Have Low Persistence of Antibodies to Vaccines Used in the  

E-print Network

HIV-Infected Children Living in Central Africa Have Low Persistence of Antibodies to Vaccines Used is similar for HIV-infected children; the introduction of antiretroviral therapy (ART) should considerably to the EPI vaccines in HIV-infected and HIV-exposed uninfected children who previously received

Paris-Sud XI, Université de

172

Healthcare providers as sources of vaccine-preventable diseases.  

PubMed

Vaccine-preventable infectious diseases may be introduced into the healthcare setting and pose a serious risk to vulnerable populations including immunocompromised patients. Healthcare providers (HCPs) are exposed to these pathogens through their daily tasks and may serve as a reservoir for ongoing disease transmission in the healthcare setting. The primary method of protection from work-related infection risk is vaccination that protects not only an individual HCP from disease, but also subsequent patients in contact with that HCP. Individual HCPs and healthcare institutions must balance the ethical and professional responsibility to protect their patients from nosocomial transmission of preventable infections with HCP autonomy. This article reviews known cases of HCP-to-patient transmission of the most common vaccine-preventable infections encountered in the healthcare setting including hepatitis B virus, influenza virus, Bordetella pertussis, varicella-zoster virus, measles, mumps and rubella virus. The impact of HCP vaccination on patient care and current recommendations for HCP vaccination against vaccine-preventable infectious diseases are also reviewed. PMID:24726251

Sydnor, Emily; Perl, Trish M

2014-08-27

173

Preferential infection of human Ad5-specific CD4 T cells by HIV in Ad5 naturally exposed and recombinant Ad5-HIV vaccinated individuals.  

PubMed

Efficacy trials of adenovirus 5-vectored candidate HIV vaccines [recombinant Ad5 (rAd5)-HIV] were halted for futility due to lack of vaccine efficacy and unexpected excess HIV infections in the vaccine recipients. The potential immunologic basis for these observations is unclear. We comparatively evaluated the HIV susceptibility and phenotypes of human CD4 T cells specific to Ad5 and CMV, two viruses that have been used as HIV vaccine vectors. We show that Ad5-specific CD4 T cells, either induced by natural Ad5 exposure or expanded by rAd5 vaccination, are highly susceptible to HIV in vitro and are preferentially lost in HIV-infected individuals compared with CMV-specific CD4 T cells. Further investigation demonstrated that Ad5-specific CD4 T cells selectively display a proinflammatory Th17-like phenotype and express macrophage inflammatory protein 3? and ?4?7 integrin, suggestive of gut mucosa homing potential of these cells. Analysis of HIV p24 and cytokine coexpression using flow cytometry revealed preferential infection of IL-17- and IL-2-producing, Ad5-specific CD4 T cells by HIV in vitro. Our data suggest a potential mechanism explaining the excess HIV infections in vaccine recipients after rAd5-HIV vaccination and highlight the importance of testing the HIV susceptibility of vaccine-generated, vector and insert-specific CD4 T cells in future HIV vaccine studies. PMID:25197078

Hu, Haitao; Eller, Michael A; Zafar, Shah; Zhou, Yu; Gu, Mengnan; Wei, Zhi; Currier, Jeffrey R; Marovich, Mary A; Kibuuka, Hannah N; Bailer, Robert T; Koup, Richard A; Robb, Merlin L; Michael, Nelson L; Kim, Jerome H; Ratto-Kim, Silvia

2014-09-16

174

Insight into Jordanian thinking about HIV: knowledge of Jordanian men and women about HIV prevention.  

PubMed

Research on HIV prevention programs for countries with large Muslim populations is scarce. HIV knowledge, attitudes, and beliefs were assessed in a convenience sample of 128 women and 88 men at two universities in Jordan with the goal of gaining insight into how to approach HIV risk behaviors. In general terms, 97% of participants had heard of AIDS and the majority understood the common methods of transmission. Misconceptions were common; most participants did not recognize condoms as an HIV prevention method. A sense of fatalism regarding the acquisition of HIV was common. In Jordan, challenges to HIV-prevention interventions includes misconceptions about HIV transmission, gender-related differences in the willingness to discuss sexual issues, and fatalism regarding the acquisition of HIV. Silence about sexual activity, particularly among women, was pervasive. Culturally tailored interventions are needed to decrease stigma and address gender inequalities that may contribute to increased risks of HIV in Jordan. PMID:24135312

Alkhasawneh, Esra; McFarland, Willi; Mandel, Jeffery; Seshan, Vidya

2014-01-01

175

[Vaccines and preventive activities in patients with inflammatory arthritis].  

PubMed

Patients with inflammatory arthritis and eligible for immunosuppressive therapy account for more than 1% of general population, and represents a significant workload on family doctors. They are prone to other comorbidities, with an increased cardiovascular risk and a higher incidence of infections than the general population, especially skin infections and pneumonitis. This comorbidity can be considered vulnerable to a prevention program-prevention of cardiovascular risk, cancer screening, vaccination schedule for adults. As for prevention through vaccination, importance should be given to pneumococcal infection - significant in adults aged 50 or over, especially amongst immunosuppressed patients. The 13-valent conjugate vaccine, which has been recently approved for adults, must be considered. An attempt has been made to write a simple, applicable document on preventive measures that should be implemented both at primary and secondary care level for those adults. PMID:24095166

Casals-Sánchez, J L; Casals Vázquez, C; Vázquez Sánchez, M Á; Giménez Basallote, S

2013-10-01

176

78 FR 43055 - Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care...  

Federal Register 2010, 2011, 2012, 2013

...Order 13649--Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative Presidential Documents...July 15, 2013 Accelerating Improvements in HIV Prevention and Care in the United States...

2013-07-18

177

DermaVir: A Novel Topical Vaccine for HIV\\/AIDS  

Microsoft Academic Search

Human immunodeficiency virus (HIV) vaccines have the potential to improve antiretroviral drug treatment by inducing cytotoxic killing of HIV-infected cells. Prophylactic vaccines utilize new antigens to initiate immunity; however, in HIV-infected individuals the load of viral antigen is not the limiting factor for the restoration of immune responses. Here we describe a novel immunization strategy with DermaVir that improves viral

Julianna Lisziewicz; Jeffrey Trocio; Lucia Whitman; Georg Varga; Jianqing Xu; Nyasha Bakare; Patrick Erbacher; Cecil Fox; Ruth Woodward; Phil Markham; Suresh Arya; Jean-Paul Behr; Franco Lori

2005-01-01

178

HIV Prevention with Male Prostitutes and Patrons of Hustler Bars: Replication of an HIV Preventive Intervention  

Microsoft Academic Search

The core objectives of this study were to document the process by which a community-based organization replicated and adapted an experimentally developed intervention to its own use and to explore the effectiveness of that HIV prevention program for male prostitutes and other patrons in New York City “hustler” bars. The intervention model employed was based on previous research with gay

Robin Lin Miller; David Klotz; Haftan M. Eckholdt

1998-01-01

179

Integrating IPV and HIV prevention into hospital services in Thailand  

Microsoft Academic Search

This project aimed to integrating program of intimate partner violence (IPV) and HIV prevention into hospital services by first identification of the interrelation between IPV and HIV which focusing on sexual relationship power in terms of ability to negotiate for safe sex and condom use.Data had been collected from two women groups: victims of violence (86 cases) and HIV positive

S Grisurapong

2010-01-01

180

DNA-based HIV vaccines do not induce generalized activation in mucosal tissue T cells  

PubMed Central

HIV preferentially infects activated T cells, and activated mucosal CD4+ T cells are the primary sites of viral replication. One potential explanation for increased HIV acquisition rates in the STEP study is that vaccination with adenoviral (Ad) vectors increased CD4+ T cell activation levels at the site of infection, a concept that others and we continue to explore.1,2 Whether vaccination with HIV vaccine platforms increases the activation state of CD4+ T cells within peripheral tissues, such as the gastro-intestinal (GI) mucosa, is exceptionally important to determine as a vaccine safety measure, given the susceptibility of activated CD4+ T cells to HIV infection.   In this study we examined whether vaccination with DNA plasmids and chemokine adjuvants alter the activation state of T cells within the GI mucosa, inguinal LN, and peripheral blood. T cell activation state was measured by expression of CD25, CD69, and HLA-DR over the course of the prime/boost study. DNA plasmid vaccination did not increase expression of any of these markers in the 3 tissues studied. Addition of the gut-homing chemokine TECK during DNA plasmid vaccination did not alter activation levels of CD4+ T cells at any of these sites. These findings indicate that DNA vaccines do not elicit generalized mucosal T cell activation. Thus, DNA platforms may be especially suitable for HIV vaccine development, where bystander activation could promote increased HIV transmission. PMID:23111167

Reuter, Morgan A.; Yuan, Sally; Marx, Preston A.; Kutzler, Michele A.; Weiner, David B.; Betts, Michael R.

2012-01-01

181

The evidence for using conjugate vaccines to protect HIV-infected children against pneumococcal disease  

Microsoft Academic Search

Pneumococcal conjugate vaccines (PCVs) are a potentially useful complement to existing treatment strategies in HIV-infected children, for whom pneumococcal infections are common and serious. This Review summarises available data on the burden of pneumococcal disease and the safety and effi cacy of PCVs in HIV-infected children. The data demonstrate that children with HIV have signifi cantly increased risk of pneumococcal

Sandra J Bliss; Katherine L O'Brien; Edward N Janoff; Mark F Cotton; Philippa Musoke; Hoosen Coovadia; Orin S Levine

2008-01-01

182

New South Wales annual vaccine-preventable disease report, 2012.  

PubMed

We aim to describe the epidemiology of selected vaccine-preventable diseases in New South Wales (NSW) for 2012. Data from the NSW Notifiable Conditions Information Management System were analysed by: local health district of residence, age, Aboriginality, vaccination status and organism, where available. Risk factor and vaccination status data were collected by public health units for cases following notification under the NSW Public Health Act 2010. The largest outbreak of measles since 1998 was reported in 2012. Pacific Islander and Aboriginal people were at higher risk as were infants less than 12 months of age. Notifications of invasive pneumococcal disease (IPD) in children less than five years declined; however, the overall number of notifications for IPD increased. Mumps case notifications were also elevated. There were no Haemophilus influenzae type b case notifications in children less than five years of age for the first time since the vaccine was introduced. Invasive meningococcal disease case notifications were at their lowest rates since case notification began in 1991. Case notification rates for other selected vaccine-preventable diseases remained stable. Vaccine-preventable disease control is continually strengthening in NSW with notable successes in invasive bacterial infections. However, strengthening measles immunization in Pacific Islander and Aboriginal communities remains essential to maintain measles elimination. PMID:25077033

Rosewell, Alexander; Spokes, Paula; Gilmour, Robin

2014-01-01

183

Telling stories of vaccine-preventable diseases: why it works.  

PubMed

In this paper, we explore the benefits of storytelling in health communication and, in particular, immunization education. During the mid-20th century polio epidemic, both personal stories and scientific information abounded in the media. However, as rates of vaccine-preventable diseases declined, narratives about the dangers of such diseases faded as did the public fear of them. Meanwhile, anti-vaccine advocates flooded the media and Internet with stories of injured children and tied those injuries, such as autism, to vaccines. Medical experts often counter anti-vaccine concerns with scientific information which can fail to persuade parents. Furthermore, evidence suggests that many people misunderstand quantitative information resulting in a misinterpretation of risk. Compared to scientific information, stories relate life lessons and values. They are effective because they are memorable and relatable. Evidence also suggests that storytelling can effectively improve health knowledge and behaviors. Inspired by In Harm's Way--True Stories of Uninsured Texas Children by the Children's Defense Fund and Faces of Influenza by the American Lung Association, we published Vaccine-Preventable Disease: The Forgotten Story, a collection of photographs and personal stories of families affected by vaccine-preventable diseases. We have found that the stories included in our booklet capture all the benefits of storytelling. Given the many benefits of storytelling, providers should strive to include stories along with medical facts in their daily practice. PMID:23444587

Cunningham, Rachel M; Boom, Julie A

2013-01-01

184

75 FR 70270 - Submission for OMB Review; Comment Request; Pretesting of NIAID's Biomedical HIV Prevention...  

Federal Register 2010, 2011, 2012, 2013

...Request; Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages...Title: Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages...and program activities about biomedical HIV prevention research. The primary...

2010-11-17

185

76 FR 6484 - Submission for OMB Review; Comment Request; Pretesting of NIAID's Biomedical HIV Prevention...  

Federal Register 2010, 2011, 2012, 2013

...Request; Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages...Title: Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages...and program activities about biomedical HIV prevention research. The primary...

2011-02-04

186

Sustaining youth peer HIV / STD prevention education.  

PubMed

This article describes an adolescent, peer-education training program in Jamaica that was developed and operated by the Red Cross Societies of Jamaica and the US and was funded by AIDSCAP. The program aimed to develop a training system to prepare youth peer educators in preventing the spread of HIV infections and sexually transmitted diseases. The goal was to increase knowledge about, change attitudes toward, and develop prevention skills for HIV/AIDS. The initial program was to be replicated on a large scale and be sustainable over time. The program was developed in response to the 1500+ Jamaicans diagnosed with AIDS and the 20,000 or so with HIV infections. Transmission is mostly heterosexual. 15% of girls and 47% of boys are sexually active by 14 years of age, and almost 50% of syphilis and gonorrhea cases are among adolescents. The national training program relies on peer educators, aged 14-19 years, who are literate to the 6th-grade level. Training sessions are conducted for 10-21 persons/session for 27 hours over 3 weekends. Training relies on engaging games and activities. Trainees are taught how to facilitate 14 specific activities, including the correct way to use a condom. Peer educators work together in groups of twos or threes among groups of 10-15 adolescents, aged 10-15 years. By the third year of operation, most of the systems and materials were in place and the program expanded; cost-benefit analysis revealed that costs were returned. The program has continued with a variety of funds and delivery systems and new funding will likely shift the program emphasis. The program has survived with the enthusiasm and support of the trainers. Other start-up programs should ensure the involvement of youth at all stages of development. PMID:12293325

Kauffman, C; Hue, L

1997-01-01

187

Male prisoners and HIV prevention: a call for action ignored.  

PubMed

US prison inmates are disproportionately indigent young men of color. These individuals are severely affected by HIV/AIDS, largely owing to the high-risk behavior that they engage in prior to incarceration. Researchers and practitioners have issued a call for the importance of offering HIV prevention services in prison settings. However, this call has largely been ignored. In this article, we outline reasons why these recommendations have been largely ignored, discuss innovative HIV prevention programs that are currently being implemented in prison settings, and offer recommendations for securing support for HIV prevention services in correctional settings. PMID:18687601

Braithwaite, Ronald L; Arriola, Kimberly R J

2008-09-01

188

Male prisoners and HIV prevention: a call for action ignored.  

PubMed

US prison inmates are disproportionately indigent young men of color. These individuals are severely affected by HIV/AIDS, largely owing to the high-risk behavior that they engage in prior to incarceration. Researchers and practitioners have issued a call for the importance of offering HIV prevention services in prison settings. However, this call has largely been ignored. In this article, we outline reasons why these recommendations have been largely ignored, discuss innovative HIV prevention programs that are currently being implemented in prison settings, and offer recommendations for securing support for HIV prevention services in correctional settings. PMID:12721138

Braithwaite, Ronald L; Arriola, Kimberly R J

2003-05-01

189

The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine.  

PubMed

This paper estimates the marginal willingness-to-pay for attributes of a hypothetical HIV vaccine using discrete choice modeling. We use primary data from 326 respondents from Bangkok and Chiang Mai, Thailand, in 2008-2009, selected using purposive, venue-based sampling across two strata. Participants completed a structured questionnaire and full rank discrete choice modeling task administered using computer-assisted personal interviewing. The choice experiment was used to rank eight hypothetical HIV vaccine scenarios, with each scenario comprising seven attributes (including cost) each of which had two levels. The data were analyzed in two alternative specifications: (1) best-worst; and (2) full-rank, using logit likelihood functions estimated with custom routines in Gauss matrix programming language. In the full-rank specification, all vaccine attributes are significant predictors of probability of vaccine choice. The biomedical attributes of the hypothetical HIV vaccine (efficacy, absence of VISP, absence of side effects, and duration of effect) are the most important attributes for HIV vaccine choice. On average respondents are more than twice as likely to accept a vaccine with 99% efficacy, than a vaccine with 50% efficacy. This translates to a willingness to pay US$383 more for a high efficacy vaccine compared with the low efficacy vaccine. Knowledge of the relative importance of determinants of HIV vaccine acceptability is important to ensure the success of future vaccination programs. Future acceptability studies of hypothetical HIV vaccines should use more finely grained biomedical attributes, and could also improve the external validity of results by including more levels of the cost attribute. PMID:23747452

Cameron, Michael P; Newman, Peter A; Roungprakhon, Surachet; Scarpa, Riccardo

2013-08-12

190

Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines.  

PubMed

An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts. PMID:24581979

Gottlieb, Sami L; Low, Nicola; Newman, Lori M; Bolan, Gail; Kamb, Mary; Broutet, Nathalie

2014-03-20

191

Perceptions of a community sample about participation in future HIV vaccine trials in south India.  

PubMed

Focus group discussions were conducted to assess factors that might impact participation of subgroups in Chennai for future HIV vaccine trials. The participants were 112 men and women representing the following: (1) transport workers; (2) clients who attended a sexually transmitted disease clinic; (3) injection drug users; (4) men having sex with men; (5) women in sex work; and (6) monogamous married women. Participants expressed an intense interest in future HIV vaccine trials. Willingness to participate in future trials included altruism and the desire to have a protective vaccine for the future. Assurances regarding stigma and confidentiality, and compensation for families in the event of a poor outcome with a future HIV vaccine trial were reported. Concerns also centered on the impact of seroconverting, and a possible increase in risk behaviors. The need for education and counseling about the dangers of engaging in risky behavior during and after participating in a future HIV vaccine trial is discussed. PMID:17016758

Nyamathi, Adeline M; Suhadev, Mohanarani; Swaminathan, Soumya; Fahey, John L

2007-07-01

192

Development of replication-competent viral vectors for HIV vaccine delivery  

PubMed Central

Purpose of review Briefly describe some of the replication-competent (RC) vectors being investigated for development of candidate HIV vaccines focusing primarily on technologies that have advanced to testing in macaques or have entered clinical trials. Recent findings RC viral vectors have advanced to the stage were decisions can be made regarding future development of HIV vaccines. The viruses being used as RC vector platforms vary considerably, and their unique attributes make it possible to test multiple vaccine design concepts and also mimic various aspects of an HIV infection. RC viral vectors encoding SIV or HIV proteins can be used to safely immunize macaques, and in some cases, there is evidence of significant vaccine efficacy in challenge protection studies. Several live HIV vaccine vectors are in clinical trials to evaluate immunogenicity, safety, the effect of mucosal delivery, and potential effects of pre-existing immunity. Summary A variety of DNA and RNA viruses are being used to develop RC viral vectors for HIV vaccine delivery. Multiple viral vector platforms have proven to be safe and immunogenic with evidence of efficacy in macaques. Some of the more advanced HIV vaccine prototypes based on vesicular stomatitis virus, vaccinia virus, measles virus, and Sendai virus are in clinical trials. PMID:23925000

Parks, Christopher L.; Picker, Louis J.; King, C. Richter

2014-01-01

193

Evaluation of the Positive Prevention HIV/STD Curriculum  

ERIC Educational Resources Information Center

This study evaluated the effectiveness of Positive Prevention, a theory-based, HIV/STD prevention education curriculum for high school youth. Three hundred fifty-three students participated in a longitudinal experimental design to determine the impact of the curriculum on HIV/AIDS knowledge, self-efficacy to abstain from sex, self-efficacy of…

LaChausse, Robert G.

2006-01-01

194

Getting Personal: Progress and Pitfalls in HIV Prevention among Latinas  

ERIC Educational Resources Information Center

This article first presents the political, personal, and epidemiological context of Hortensia Amaro's 1988 publication in "Psychology of Women Quarterly" ("PWQ"), "Considerations for Prevention of HIV Infection Among Hispanic Women" (Amaro, 1988). Second, it provides a brief summary of progress in HIV prevention with Latinas. The third section…

Amaro, Hortensia; Raj, Anita; Reed, Elizabeth; Ulibarri, Monica

2011-01-01

195

HIV Prevention for Adolescents: Where Do We Go from Here?  

ERIC Educational Resources Information Center

The World Health Organization estimates that 50% of the 30 million HIV infections worldwide occurred in young people between the ages of 15 and 24 years. In the United States, national statistics estimate that almost 40% of new HIV cases occur in youth ages 13-29 (Centers for Disease Control and Prevention, 2011). Therefore, a focus on preventing

Lightfoot, Marguerita

2012-01-01

196

Influence of HIV and HCV on T cell antigen presentation and challenges in the development of vaccines  

PubMed Central

Some of the central challenges for developing effective vaccines against HIV and hepatitis C virus (HCV) are similar. Both infections are caused by small, highly mutable, rapidly replicating RNA viruses with the ability to establish long-term chronic pathogenic infection in human hosts. HIV has caused 60 million infections globally and HCV 180 million and both viruses may co-exist among certain populations by virtue of common blood-borne, sexual, or vertical transmission. Persistence of both pathogens is achieved by evasion of intrinsic, innate, and adaptive immune defenses but with some distinct mechanisms reflecting their differences in evolutionary history, replication characteristics, cell tropism, and visibility to mucosal versus systemic and hepatic immune responses. A potent and durable antibody and T cell response is a likely requirement of future HIV and HCV vaccines. Perhaps the single biggest difference between the two vaccine design challenges is that in HCV, a natural model of protective immunity can be found in those who resolve acute infection spontaneously. Such spontaneous resolvers exhibit durable and functional CD4+ and CD8+ T cell responses (Diepolder et al., 1995; Cooper et al., 1999; Thimme et al., 2001; Grakoui et al., 2003; Lauer et al., 2004; Schulze Zur Wiesch et al., 2012). However, frequent re-infection suggests partial or lack of protective immunity against heterologous HCV strains, possibly indicative of the degree of genetic diversity of circulating HCV genotypes and subtypes. There is no natural model of protective immunity in HIV, however, studies of “elite controllers,” or individuals who have durably suppressed levels of plasma HIV RNA without antiretroviral therapy, has provided the strongest evidence for CD8+ T cell responses in controlling viremia and limiting reservoir burden in established infection. Here we compare and contrast the specific mechanisms of immune evasion used by HIV and HCV, which subvert adaptive human leukocyte antigen (HLA)-restricted T cell immunity in natural infection, and the challenges these pose for designing effective preventative or therapeutic vaccines. PMID:25352836

John, Mina; Gaudieri, Silvana

2014-01-01

197

Highly active antiretroviral treatment for the prevention of HIV transmission  

PubMed Central

In 2007 an estimated 33 million people were living with HIV; 67% resided in sub-Saharan Africa, with 35% in eight countries alone. In 2007, there were about 1.4 million HIV-positive tuberculosis cases. Globally, approximately 4 million people had been given highly active antiretroviral therapy (HAART) by the end of 2008, but in 2007, an estimated 6.7 million were still in need of HAART and 2.7 million more became infected with HIV. Although there has been unprecedented investment in confronting HIV/AIDS - the Joint United Nations Programme on HIV/AIDS estimates $13.8 billion was spent in 2008 - a key challenge is how to address the HIV/AIDS epidemic given limited and potentially shrinking resources. Economic disparities may further exacerbate human rights issues and widen the increasingly divergent approaches to HIV prevention, care and treatment. HIV transmission only occurs from people with HIV, and viral load is the single greatest risk factor for all modes of transmission. HAART can lower viral load to nearly undetectable levels. Prevention of mother to child transmission offers proof of the concept of HAART interrupting transmission, and observational studies and previous modelling work support using HAART for prevention. Although knowing one's HIV status is key for prevention efforts, it is not known with certainty when to start HAART. Building on previous modelling work, we used an HIV/AIDS epidemic of South African intensity to explore the impact of testing all adults annually and starting persons on HAART immediately after they are diagnosed as HIV positive. This theoretical strategy would reduce annual HIV incidence and mortality to less than one case per 1000 people within 10 years and it would reduce the prevalence of HIV to less than 1% within 50 years. To explore HAART as a prevention strategy, we recommend further discussions to explore human rights and ethical considerations, clarify research priorities and review feasibility and acceptability issues. PMID:20205768

2010-01-01

198

Antiviral agents and HIV prevention: controversies, conflicts, and consensus  

PubMed Central

Antiviral agents can be used to prevent HIV transmission before exposure as preexpo-sure prophylaxis (PrEP), after exposure as postexposure prophylaxis, and as treatment of infected people for secondary prevention. Considerable research has shed new light on antiviral agents for PrEP and for prevention of secondary HIV transmission. While promising results have emerged from several PrEP trials, the challenges of poor adherence among HIV-negative clients and possible increase in sexual risk behaviors remain a concern. In addition, a broader pipeline of antiviral agents for PrEP that focuses on genital tract pharmacology and safety and resistance issues must be developed. Antiretroviral drugs have also been used to prevent HIV transmission from HIV-infected patients to their HIV-discordant sexual partners. The HIV Prevention Trials Network 052 trial demonstrated nearly complete prevention of HIV transmission by early treatment of infection, but the generalizability of the results to other risk groups – including intravenous drug users and MSM – has not been determined. Most importantly, the best strategy for use of antiretroviral agents to reduce the spread of HIV at either the individual level or the population level has not been developed, and remains the ultimate goal of this area of investigation. PMID:22507927

Cohen, Myron S.; Muessig, Kathryn E.; Smith, M. Kumi; Powers, Kimberly A.; Kashuba, Angela D.M.

2013-01-01

199

Sexual prevention of HIV within the couple after prenatal HIV-testing in West Brou Hermann 1 2 *  

E-print Network

Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa Brou Hermann 1 transmission within the couple for women who had been prenatally tested for HIV. In this study, we have women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV

Paris-Sud XI, Université de

200

CD4 binding determinant mimicry for HIV vaccine design  

PubMed Central

The immunodominant epitopes expressed by the HIV-1 envelope protein gp120 are hypermutable, defeating attempts to develop an effective HIV vaccine. Targeting the structurally conserved gp120 determinant that binds host CD4 receptors (CD4BD) and initiates infection is a more promising route to vaccination, but this has proved difficult because of the conformational flexibility of gp120 and immune evasion mechanisms used by the virus. Mimicking the outer CD4BD conformational epitopes is difficult because of their discontinuous nature. The CD4BD region composed of residues 421–433 (CD4BDcore) is a linear epitope, but this region possesses B cell superantigenic character. While superantigen epitopes are vulnerable to a small subset of spontaneously produced neutralizing antibodies present in humans without infection (innate antibodies), their non-covalent binding to B cell receptors (BCRs) does not stimulate an effective adaptive response from B cells. Covalent binding at naturally occurring nucleophilic sites of the BCRs by an electrophilic gp120 (E-gp120) analog is a promising solution. E-gp120 induces the synthesis of neutralizing antibodies the CD4BDcore. The highly energetic covalent reaction is hypothesized to convert the abortive superantigens–BCR interaction into a stimulatory signal, and the binding of a spatially distinct epitope at the traditional combining site of the BCRs may furnish a second stimulatory signal. Flexible synthetic peptides can detect pre-existing CD4BDcore-specific neutralizing antibodies. However, induced-fit conformational transitions of the peptides dictated by the antibody combining site structure may induce the synthesis of non-neutralizing antibodies. Successful vaccine targeting of the CD4BD will require a sufficiently rigid immunogen that mimics the native epitope conformation and bypasses B cell checkpoints restricting synthesis of the neutralizing antibodies. PMID:23251137

Nishiyama, Yasuhiro; Planque, Stephanie; Hanson, Carl V.; Massey, Richard J.; Paul, Sudhir

2012-01-01

201

Getting to zero the biomedical way in Africa: outcomes of deliberation at the 2013 Biomedical HIV Prevention Forum in Abuja, Nigeria  

PubMed Central

Background Over the last few decades, biomedical HIV prevention research had engaged multiple African stakeholders. There have however been few platforms to enable regional stakeholders to engage with one another. In partnership with the World AIDS Campaign International, the Institute of Public Health of Obafemi Awolowo University, and the National Agency for the Control of AIDS in Nigeria, the New HIV Vaccine and Microbicide Advocacy Society hosted a forum on biomedical HIV prevention research in Africa. Stakeholders’ present explored evidences related to biomedical HIV prevention research and development in Africa, and made recommendations to inform policy, guidelines and future research agenda. Discussion The BHPF hosted 342 participants. Topics discussed included the use of antiretrovirals for HIV prevention, considerations for biomedical HIV prevention among key populations; HIV vaccine development; HIV cure; community and civil society engagement; and ethical considerations in implementation of biomedical HIV prevention research. Participants identified challenges for implementation of proven efficacious interventions and discovery of other new prevention options for Africa. Concerns raised included limited funding by African governments, lack of cohesive advocacy and policy agenda for biomedical HIV prevention research and development by Africa, varied ethical practices, and limited support to communities’ capacity to actively engaged with clinical trial conducts. Participants recommended that the African Government implement the Abuja +12 declaration; the civil society build stronger partnerships with diverse stakeholders, and develop a coherent advocacy agenda that also enhances community research literacy; and researchers and sponsors of trials on the African continent establish a process for determining appropriate standards for trial conduct on the continent. Conclusion By highlighting key considerations for biomedical HIV prevention research and development in Africa, the forum has helped identify key advocacy issues that Civil Society can expend efforts on so as to strengthen support for future biomedical HIV prevention research on the continent.

2014-01-01

202

The economics of HIV prevention strategies in NSW.  

PubMed

HIV in Australia was first diagnosed in NSW in the early 1980s, and has had a significant effect on public health. The NSW Government commenced its investment in HIV/AIDS in 1984 and the investment now encompasses research, primary and secondary prevention, and care, treatment and support for people living with HIV/AIDS. A recent study examined the historical impact of the HIV/AIDS epidemic and projected its future impact in NSW. The analysis indicates that the NSW HIV/AIDS investment program has been highly effective in reducing HIV transmission, and has also been cost effective in: avoiding future health-care costs; life years saved; and quality of life benefits. The analysis also indicates that any scaling back of prevention initiatives would result in an increase in the number of people living with HIV. PMID:20513302

Hales, James R

2010-01-01

203

Shedding of Live Vaccine Virus, Comparative Safety, and Influenza-Specific Antibody Responses after Administration of Live Attenuated and Inactivated Trivalent Influenza Vaccines to HIV-Infected Children  

PubMed Central

HIV-infected children (n = 243), ?5 to <18 years old, receiving stable antiretroviral therapy, were stratified by immunologic status and randomly assigned to receive intranasal live attenuated influenza vaccine (LAIV) or intramuscular trivalent inactivated influenza vaccine (TIV). The safety profile after LAIV or TIV closely resembled the previously reported tolerability to these vaccines in children without HIV infection. Post-vaccination hemagglutination inhibition (HAI) antibody responses and shedding of LAIV virus were also similar, regardless of immunological stratum, to antibody responses and shedding previously reported for children without HIV infection. LAIV should be further evaluated for a role in immunizing HIV-infected children. PMID:18597900

Levin, Myron J.; Song, Lin-Ye; Fenton, Terrence; Nachman, Sharon; Patterson, Julie; Walker, Robert; Kemble, George; Allende, Maria; Hultquist, Micki; Yi, Tingting; Nowak, Barbara; Weinberg, Adriana

2008-01-01

204

Uptake of Genital Mucosal Sampling in HVTN 097, a Phase 1b HIV Vaccine Trial in South Africa  

PubMed Central

Because sexual transmission of HIV occurs across mucosal membranes, understanding the immune responses of the genital mucosa to vaccines may contribute knowledge to finding an effective candidate HIV vaccine. We describe the uptake of rectal secretion, cervical secretion and seminal mucosal secretion sampling amongst volunteers in a Phase 1b HIV vaccine trial. Age at screening, gender, study site and the designation of the person conducting the informed consent procedure were collected for volunteers who screened for the HVTN 097 study. A total of 211 volunteers (54% female) were screened at three sites in South Africa: Soweto (n?=?70, 33%), Cape Town (n?=?68, 32%) and Klerksdorp (n?=?73, 35%). Overall uptake of optional mucosal sampling amongst trial volunteers was 71% (n?=?149). Compared to Cape Town, volunteers from Soweto and Klerksdorp were less likely to consent to sampling (Soweto OR 0.08 CI: 0.03–0.25 p<0.001 and Klerksdorp OR 0.13 CI: 0.04–0.41 p?=?0.001). In contrast, volunteers over 25 years of age were 2.39 times more likely to consent than younger volunteers (CI: 1.13–5.08, p?=?0.02). Further studies are required to better understand the cultural, demographic and sociobehavioral factors which influence willingness to participate in mucosal sampling in HIV prevention studies. Trial Registration ClinicalTrials.gov: NCT02109354 PMID:25401780

Lazarus, Erica Maxine; Otwombe, Kennedy; Adonis, Tania; Sebastian, Elaine; Gray, Glenda; Grunenberg, Nicole; Roux, Surita; Churchyard, Gavin; Innes, Craig; Laher, Fatima

2014-01-01

205

Non-human primate models for HIV/AIDS vaccine development  

PubMed Central

The development of HIV vaccines has been hampered by the lack of an animal model that can accurately predict vaccine efficacy. Chimpanzees can be infected with HIV-1 but are not practical for research. However, several species of macaques are susceptible to the Simian Immunodeficiency Viruses (SIV) that causes a disease in macaques that closely mimics HIV in humans. Thus, macaque-SIV models of HIV infection have become a critical foundation for AIDS vaccine development. Here, we examine the multiple variables and considerations that must be taken into account to use this NHP model effectively. These include the species and subspecies of macaques, virus strain, dose and route of administration and macaque genetics including Major Histocompatibility Complex molecules that affect immune responses and other virus restriction factors. We illustrate how these NHP models can be used to carry out studies of immune responses in mucosal and other tissues than could not easily be performed on human volunteers. Futhermore macaques are an ideal model system to optimize adjuvants, test vaccine platforms, and identify correlates of protection that can advance the HIV vaccine field. We also illustrate techniques used to identify different macaque lymphocyte populations and review some poxvirus vaccine candidates that are in various stages of clinical trials. Understanding how to effectively use this valuable model will greatly increase the likelihood of finding a successful vaccine for HIV. PMID:24510515

Sui, Yongjun; Gordon, Shari; Franchini, Genoveffa; Berzofsky, Jay A.

2013-01-01

206

Back to the future: covalent epitope-based HIV vaccine development  

PubMed Central

Traditional HIV vaccine approaches have proved ineffective because the immunodominant viral epitopes are mutable and the conserved epitopes necessary for infection are not sufficiently immunogenic. The CD4 binding site expressed by the HIV envelope protein of glycoprotein 120 is essential for viral entry into host cells. In this article, we review the B-cell superantigenic character of the CD4 binding site as the cause of its poor immunogenicity. We summarize evidence supporting development of covalent immunization as the first vaccine strategy with the potential to induce an antibody response to a conserved HIV epitope that neutralizes genetically divergent HIV strains. PMID:20822346

Paul, Sudhir; Planque, Stephanie; Nishiyama, Yasuhiro; Escobar, Miguel; Hanson, Carl

2010-01-01

207

Messages HIV clinicians use in prevention with positives interventions  

Microsoft Academic Search

Prevention with Positives (PwP) is a component of the US HIV prevention strategy that targets HIV-infected persons who are aware of their seropositive status. This paper examines the use of prevention messages by clinical providers during the PwP intervention period of the US Health Resources and Services Administration's Special Projects of National Significance program. Quantitative approaches were used to learn

Carol Dawson Rose; Kimberly A. Koester; Mi-Suk Kang Dufour; Janet J. Myers; Starley B. Shade; Karen McCready; Stephen Morin

2012-01-01

208

Positive prevention: Contemporary issues facing HIV positive people negotiating sex in the UK  

Microsoft Academic Search

Over 40,000 people are now living with diagnosed HIV in the UK. The term ‘positive prevention’ has been coined to describe HIV prevention that focuses on people living with an HIV diagnosis. There is uncertainty, however, about how people with HIV manage risk and how their ability to prevent the transmission of HIV is linked to their mental health and

Damien Ridge; Sue Ziebland; Jane Anderson; Ian Williams; Jonathan Elford

2007-01-01

209

Advances in HIV treatment and prevention: Should treatment optimism lead to prevention pessimism?  

Microsoft Academic Search

Advances in HIV treatment have changed the natural history of HIV disease and improved the life of infected people. But, paradoxically, the transformation of a lethal disease into a chronic condition has lead many people to pessimism regarding the future of HIV prevention. Post-exposure prophylaxis and prophylaxis of vertical transmission have added new tools, although they do not change the

F. Lert

2000-01-01

210

Why Vaccines and Therapies for HIV are So Challenging: New Strategies to Outwit the Virus  

NSDL National Science Digital Library

This is a PowerPoint presentation outlining HIV and AIDS background, as well as specifically showing the progress and future goals of vaccination attempts. The level of specificity goes to cell biology.

PhD Nancy L Haigwood (Seattle Biomedical Research Institute University of Washington)

2007-01-12

211

From HIV protein sequences to viral fitness landscapes: a new paradigm for in silico vaccine design  

E-print Network

Background: An inexpensive prophylactic vaccine offers the best hope to curb the HIV/AIDS epidemic gripping sub-Saharan Africa. Systematic means to guide the design of an effective immunogen for this, and other, infectious ...

Ferguson, AL

212

HIV Vaccine Trial participation in South Africa - an ethical assessment.  

PubMed

Trial participation in the proposed HIV Vaccine Trials in South Africa is discussed in the context of the ethical tension that exists between international ethical research standards and local standards of care and cultural norms in the Third World. The important concepts of informed consent, risk-benefit ratio and fair treatment of trial participants are interpreted differently in traditional, rural African communities, where a moderate form of communitarianism referred to as "Ubuntu" or "communalism" is still prevalent. Research is an altruistic endeavor that benefits communities and societies as a result of risks taken by individuals. Universal ethical guidelines that are highly individualistic and fail to emphasize communalism may represent serious problems for the sort of research needed in Africa today. PMID:11961697

Moodley, Keymanthri

2002-04-01

213

78 FR 45246 - Office of Clinical and Preventive Services National HIV Program: Enhanced HIV/AIDS Screening and...  

Federal Register 2010, 2011, 2012, 2013

...Office of Clinical and Preventive Services National HIV Program: Enhanced HIV/AIDS Screening and Engagement in Care Announcement...Funding Announcement Number: HHS-2013-IHS-OCPS-HIV-0001. Catalog of Federal Domestic Assistance...

2013-07-26

214

Brain Abnormalities in HIV and Stimulant Users: Interventions and Prevention  

PubMed Central

The session, “HIV and other Infectious Diseases,” was chaired by Dr. Jacques Normand, Director of the AIDS Research Program of the U.S. National Institute on Drug Abuse. The two presenters (and their presentation topics) were: Dr. Linda Chang (“Neural Correlates of Cognitive Deficits and Training Effects on Brain Function in HIV-infected Individuals”) and Dr. Steven Shoptaw (“HIV Prevention in Substance Users”).

Chang, Linda; Shoptaw, Steven; Normand, Jacques

2014-01-01

215

HIV Prevention Messages Targeting Young Latino Immigrant MSM.  

PubMed

Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay. PMID:24864201

Solorio, Rosa; Norton-Shelpuk, Pamela; Forehand, Mark; Martinez, Marcos; Aguirre, Joel

2014-01-01

216

A typology of structural approaches to HIV prevention  

PubMed Central

Renewed enthusiasm for biomedical HIV prevention strategies has followed the recent publication of several high-profile HIV antiretroviral therapy-based HIV prevention trials. In a recent article, Roberts & Matthews (2012) accurately note some of the shortcomings of these individually targeted approaches to HIV prevention and advocate for increased emphasis on structural interventions that have more fundamental effects on the population distribution of HIV. However, they make some implicit assumptions about the extent to which structural interventions are user-independent and more sustainable than biomedical or behavioral interventions. In this article, I elaborate a simple typology of structural interventions along these two axes and suggest that they may be neither user-independent nor sustainable and therefore subject to the same sustainability concerns, costs, and potential unintended consequences as biomedical and behavioral interventions. PMID:22877933

Tsai, Alexander C.

2012-01-01

217

Independent clinical predictors of impaired response to hepatitis B vaccination in HIV-infected persons  

PubMed Central

Summary Protective response rates to hepatitis B (HB) vaccination have been reported as low as 18-62% in HIV-infected persons. The relative importance of various predictors for this poor response has not been fully characterized. In this retrospective cohort study, we examined the relationship between clinical characteristics and vaccine non-response (HB surface antibody <10 IU/L) among patients attending an urban HIV clinic. Among the 97 patients who met the inclusion criteria, 43 (44%) developed a protective antibody response. In multivariate analyses, age >40 years (odds ratio [OR] 3.03 [95% confidence interval [CI], 1.14-8.06]; P = 0.026) and alcohol abuse (OR 4.92 [95% CI, 1.72-20.89]; P = 0.007) were independent predictors of failure to develop vaccine response. In addition, CD4 nadir <200 (OR 7.24 [95% CI, 1.91-27.41]; P = 0.004), rather than CD4 current to vaccination, remained a strong independent risk factor. Patients with HIV viral suppression on highly active antiretroviral therapy had a significantly lower rate of vaccine failure (OR 0.31 [95% CI, 0.11-0.91]; P = 0.033), after adjusting for these other covariates. Our findings underscore the importance of confirming seroconversion after HB vaccination in HIV-infected patients and initiating vaccination early in the course of HIV infection. PMID:18725550

Kim, H Nina; Harrington, Robert D; Van Rompaey, Stephen E; Kitahata, Mari M

2009-01-01

218

Sources of Racial/Ethnic Differences in Awareness of HIV Vaccine Trials  

PubMed Central

Objectives We explored the relative effects of 2 awareness components—exposure and attention—on racial/ethnic differences in HIV vaccine trial awareness among men who have sex with men (MSM). Methods Surveys assessing awareness of and attitudes toward HIV vaccine trials were administered to 1723 MSM in 6 US cities. Proxy measures of exposure included use of HIV resources and other health care services, community involvement, income, and residence. Attention proxy measures included research attitudes, HIV susceptibility, and HIV message fatigue. Using logistic regression models, we assessed the extent to which these proxies accounted for racial/ethnic differences in vaccine trial awareness. Results White MSM reported significantly (P < .01) higher rates of HIV vaccine trial awareness (22%) compared with Latino (17%), Black (13%) and “other” (13%) MSM. Venue-based exposure proxies and research-directed attitudinal attention proxies were significantly associated with awareness, but only accounted for the White-Latino disparity in awareness. No proxies accounted for the White-Black or White- “other” differentials in awareness. Conclusions Sources of disparities in awareness of HIV vaccine trials remain to be explained. Future trials seeking to promote diverse participation should explore additional exposure and attention mediators. PMID:24922153

Arnold, Michael P.; Andrasik, Michele; Landers, Stewart; Karuna, Shelly; Mimiaga, Matthew J.; Wakefield, Steven; Mayer, Kenneth; Buchbinder, Susan; Koblin, Beryl A.

2014-01-01

219

Will HIV Vaccination Reshape HIV Risk Behavior Networks? A Social Network Analysis of Drug Users' Anticipated Risk Compensation  

PubMed Central

Background An HIV vaccine could substantially impact the epidemic. However, risk compensation (RC), or post-vaccination increase in risk behavior, could present a major challenge. The methodology used in previous studies of risk compensation has been almost exclusively individual-level in focus, and has not explored how increased risk behavior could affect the connectivity of risk networks. This study examined the impact of anticipated HIV vaccine-related RC on the structure of high-risk drug users' sexual and injection risk network. Methods A sample of 433 rural drug users in the US provided data on their risk relationships (i.e., those involving recent unprotected sex and/or injection equipment sharing). Dyad-specific data were collected on likelihood of increasing/initiating risk behavior if they, their partner, or they and their partner received an HIV vaccine. Using these data and social network analysis, a "post-vaccination network" was constructed and compared to the current network on measures relevant to HIV transmission, including network size, cohesiveness (e.g., diameter, component structure, density), and centrality. Results Participants reported 488 risk relationships. Few reported an intention to decrease condom use or increase equipment sharing (4% and 1%, respectively). RC intent was reported in 30 existing risk relationships and vaccination was anticipated to elicit the formation of five new relationships. RC resulted in a 5% increase in risk network size (n?=?142 to n?=?149) and a significant increase in network density. The initiation of risk relationships resulted in the connection of otherwise disconnected network components, with the largest doubling in size from five to ten. Conclusions This study demonstrates a new methodological approach to studying RC and reveals that behavior change following HIV vaccination could potentially impact risk network connectivity. These data will be valuable in parameterizing future network models that can determine if network-level change precipitated by RC would appreciably impact the vaccine's population-level effectiveness. PMID:24992659

Young, April M.; Halgin, Daniel S.; DiClemente, Ralph J.; Sterk, Claire E.; Havens, Jennifer R.

2014-01-01

220

Expectation of Volunteers Towards the Vaccine Efficacy of the Prime-Boost HIV Vaccine Phase III Trial During Unblinding.  

PubMed

Abstract A Phase III community-based HIV vaccine trial using the ALVAC-HIV and AIDSVAX B/E prime-boost regimen (RV144) showed a modest vaccine efficacy of 31.2% against HIV acquisition. Participant's understanding of the trial is a key element of its success. This study aimed to understand participant's expectation and response to the overall results of the trial as well after unblinding. Using an open-ended questionnaire, data were collected from 400 participants who came for the unblinding visit. Fifty-three percent received the vaccine and 47% were placebo recipients. The median age was 30 years (range: 22-37). The observed vaccine efficacy of 31.2% was lower than expected by 67.75% of participants compared to higher than expected (by 6%), as expected (by 11.25%), and those with no expectation (15%). A majority of participants (71.5%) were happy and proud, and indicated that it was a good result. The rest were sad or disappointed (22.75%) or acquiescent (5.75%). After unblinding, 67.92% of the vaccine recipients had a positive response and 32.08% were acquiescent. Among placebo recipients, 85.11% were acquiescent and 10.11% indicated that being assigned to the vaccine group would have been better even though vaccine efficacy was only 31.2%. Despite the modest vaccine efficacy, a majority of study participants acknowledged the value of the trial and hoped that information from RV144 could be used for future vaccine development. PMID:24906244

Khowsroy, Kessuda; Dhitavat, Jittima; Sabmee, Yupa; Laowarakul, Pataramon; Wattanakitwichai, Jutarat; Auetian, Jiraporn; Lothong, Kannika; Boondao, Roongtip; Maythaarttaphong, Sarawan; Yaemwong, Sunee; Excler, Jean-Louis; Rerks-Ngarm, Supachai; Pitisuttithum, Punnee

2014-11-01

221

Transgender HIV prevention: implementation and evaluation of a workshop  

Microsoft Academic Search

Virtually no HIV prevention education has specifically targeted the transgender commun- ity. To fill this void, a transgender HIV preven- tion workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evalu- ation using a pre-, post- and follow-up

Walter O. Bockting; B. R. Simon Rosser; Karen Scheltema

1999-01-01

222

Evolving T-cell vaccine strategies for HIV, the virus with a thousand faces  

Microsoft Academic Search

HIV's rapid global spread and the human suffering it has left in its wake have made AIDS a global heath priority for the 25 years since its discovery. Yet its capacity to rapidly evolve has made combating this virus a tremendous challenge. The obstacles to creating an effective HIV vaccine are formidable, but there are advances in the field on

Bette

2009-01-01

223

A review of vaccine research and development: The human immunodeficiency virus (HIV)  

Microsoft Academic Search

Since the discovery of AIDS in 1981, the global spread of HIV has reached pandemic proportions, representing a global developmental and public health threat. The development of a safe, globally effective and affordable HIV vaccine offers the best hope for the future control of the pandemic. Significant progress has been made over the past years in the areas of basic

Marc P. Girard; Saladin K. Osmanov; Marie Paule Kieny

2006-01-01

224

Emerging nanotechnology approaches for HIV/AIDS treatment and prevention  

E-print Network

Emerging nanotechnology approaches for HIV/AIDS treatment and prevention The emergence of AIDS effects and is ineffective in patients in whom the virus develops resistance. Nanotechnology of nanotechnology to provide more effective treatment and preven

von Andrian, Ulrich H.

225

A qualitative assessment of perspectives on the inclusion of adolescents in HIV vaccine trials in South Africa  

PubMed Central

Summary Adolescents are at high risk for HIV acquisition, and thus need to be included in HIV vaccine trials. In preparation for inclusion of adolescents in HIV vaccine trials in an urban community in Cape Town with a high antenatal HIV prevalence, the study assessed the attitudes towards the inclusion of adolescents in HIV vaccine trials. A total of 18 focus group discussions were conducted using a semistructured interview guide. The participants (n = 200) were adolescents, young adults, parents and other key informants. Participants from all groups welcomed the inclusion of adolescents in HIV vaccine trials due to their high-risk status. There were, however, concerns about sexual disinhibition, fear of side-effects, fear of HIV testing and disclosure of HIV status, mistrust of nurses and clinics. The study highlighted a number of ethical and social issues that need to be addressed before the trials. PMID:20215620

Jaspan, H B; Soka, N F; Mathews, C; Flisher, A J; Mark, D; Middelkoop, K; Wood, R; Bekker, L-G

2013-01-01

226

Behavioral and biomedical combination strategies for HIV prevention.  

PubMed

Around 2.5 million people become infected with HIV each year. This extraordinary toll on human life and public health worldwide will only be reversed with effective prevention. What's more, in the next few years, it is likely at least, that no single prevention strategy will be sufficient to contain the spread of the disease. There is a need for combination prevention as there is for combination treatment, including biomedical, behavioral, and structural interventions. Expanded HIV prevention must be grounded in a systematic analysis of the epidemic's dynamics in local contexts. Although 85% of HIV is transmitted sexually, effective combinations of prevention have been shown for people who inject drugs. Combination prevention should be based on scientifically derived evidence, with input and engagement from local communities that fosters the successful integration of care and treatment. PMID:22908192

Bekker, Linda-Gail; Beyrer, Chris; Quinn, Thomas C

2012-01-01

227

Common Processes in Evidence-Based Adolescent HIV Prevention Programs  

Microsoft Academic Search

Dissemination of evidence-based HIV prevention programs for adolescents will be increased if community interventionists are\\u000a able to distinguish core, essential program elements from optional, discretionary ones. We selected five successful adolescent\\u000a HIV prevention programs, used a qualitative coding method to identify common processes described in the procedural manuals,\\u000a and then compared the programs. Nineteen common processes were categorized as structural

Barbara L. Ingram; Diane Flannery; Amy Elkavich; Mary Jane Rotheram-Borus

2008-01-01

228

Drug abuse treatment as an HIV prevention strategy: a review  

Microsoft Academic Search

We review drug abuse treatment as a means of preventing infection with HIV. Thirty-three studies, with an aggregate of over seventeen thousand subjects, were published in peer-reviewed journals from 1988–1998. Research on the utility of drug abuse treatment as an HIV prevention strategy has focused primarily on methadone maintenance treatment (MMT) rather than other modalities such as residential or outpatient

James L. Sorensen; Amy L. Copeland

2000-01-01

229

AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research  

PubMed Central

The current analysis considers the HIV prevention research record in the social sciences. We do so with special reference to what has been termed “AIDS Exceptionalism”— departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for “Prevention for Positives,” supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to addresses effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior. At the first quarter century of the AIDS epidemic, it is important to weigh our accomplishments against our failures in the fight against AIDS…Future historians will conclude that we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven “prevention” that only served a particular political agenda. Editorial: A Quarter Century of AIDS. American Journal of Public Health. (Stall & Mills, 2006, p. 961) PMID:23667386

Fisher, William A.; Kohut, Taylor; Fisher, Jeffrey D.

2013-01-01

230

AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research.  

PubMed

The current analysis considers the HIV prevention research record in the social sciences. We do so with special reference to what has been termed "AIDS Exceptionalism"- departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for "Prevention for Positives," supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to addresses effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior. At the first quarter century of the AIDS epidemic, it is important to weigh our accomplishments against our failures in the fight against AIDS…Future historians will conclude that we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven "prevention" that only served a particular political agenda.Editorial: A Quarter Century of AIDS. American Journal of Public Health. (Stall & Mills, 2006, p. 961). PMID:23667386

Fisher, William A; Kohut, Taylor; Fisher, Jeffrey D

2009-12-01

231

HIV vaccine trial preparedness among Spanish-speaking Latinos in the US  

Microsoft Academic Search

Latinos are under-represented in HIV\\/AIDS medical research in the US. Although they are disproportionately impacted by HIV\\/AIDS, Latinos may be reluctant to participate in HIV vaccine trials. Three focus groups were conducted with 32 Spanish-speaking Latinos recruited from two community-based healthcare organizations in Los Angeles, California. A qualitative focus group interview guide was developed to explore concerns, motivators and intentions

R. A. Brooks; P. A. Newman; N. Duan; D. J. Ortiz

2007-01-01

232

HIV prevention is not enough: child survival in the context of prevention of mother to child HIV transmission  

Microsoft Academic Search

ABSTRACT: Clinical and epidemiologic research has identified increasingly effective interventions to reduce mother to child HIV transmission in resource-limited settings These scientific breakthroughs have been implemented in some programmes, although much remains to be done to improve coverage and quality of these programmes. But prevention of HIV transmission is not enough. It is necessary also to consider ways to improve

Louise Kuhn; Moses Sinkala; Don M Thea; Chipepo Kankasa; Grace M Aldrovandi

2009-01-01

233

Human Papillomavirus Vaccine: A New Chance to Prevent Cervical Cancer  

Microsoft Academic Search

Human papillomavirus (HPV) is a significant source of morbidity and mortality throughout the world and is the most common\\u000a sexually transmitted infection in the United States. HPV is the primary etiologic agent of cervical cancer and dysplasia.\\u000a Thus, cervical cancer and other HPV-associated malignancies might be prevented or treated by HPV vaccines. Recent research\\u000a on the safety and efficacy of

Bradley J. Monk; Ali Mahdavi

234

Civil society perspectives on negative biomedical HIV prevention trial results and implications for future trials.  

PubMed

Community engagement is crucial to ongoing development and testing of sorely needed new biomedical HIV prevention technologies. Yet, negative trial results raise significant challenges for community engagement in HIV prevention trials, including the early termination of the Cellulose Sulfate microbicide trial and two Phase IIb HIV vaccine trials (STEP and Phambili). The present study aimed to explore the perspectives and experiences of civil society organization (CSO) representatives regarding negative HIV prevention trial results and perceived implications for future trials. We conducted in-depth interviews with 14 respondents from a broad range of South African and international CSOs, and analyzed data using thematic analysis. CSO representatives reported disappointment in response to negative trial results, but acknowledged such outcomes as inherent to clinical research. Respondents indicated that in theory negative trial results seem likely to impact on willingness to participate in future trials, but that in practice people in South Africa have continued to volunteer. Negative trial results were described as having contributed to improving ethical standards, and to a re-evaluation of the scientific agenda. Such negative results were identified as potentially impacting on funding for trials and engagement activities. Our findings indicate that trial closures may be used constructively to support opportunities for reflection and renewed vigilance in strategies for stakeholder engagement, communicating trial outcomes, and building research literacy among communities; however, these strategies require sustained resources for community engagement and capacity-building. PMID:22360605

Essack, Zaynab; Koen, Jennifer; Slack, Catherine; Lindegger, Graham; Newman, Peter A

2012-01-01

235

Methodological issues in evaluating HIV prevention community planning.  

PubMed Central

To be effective, HIV prevention programs should be planned in partnership with affected communities and should be built on a solid scientific foundation. In 1994, the Centers for Disease Control and Prevention (CDC) and its prevention partners implemented HIV prevention community planning to achieve primarily these two objectives. In order to manage the community planning process effectively, extensive evaluation activities were employed at both the grantee and national level. This paper describes the first year evaluation goals and methods in detail. Throughout, reasons for collecting specific types of information and for using particular methodologies are highlighted. PMID:8862165

Holtgrave, D R; Harrison, J; Gerber, R A; Aultman, T V; Scarlett, M

1996-01-01

236

Vaccine-elicited human T cells recognizing conserved protein regions inhibit HIV-1  

PubMed Central

Virus diversity and escape from immune responses are the biggest challenges to the development of an effective vaccine against HIV-1. We hypothesized that T-cell vaccines targeting the most conserved regions of the HIV-1 proteome, which are common to most variants and bear fitness costs when mutated, will generate effectors that efficiently recognize and kill virus-infected cells early enough after transmission to potentially impact on HIV-1 replication and will do so more efficiently than whole protein-based T-cell vaccines. Here, we describe the first-ever administration of conserved immunogen vaccines vectored using prime-boost regimens of DNA, simian adenovirus and modified vaccinia virus Ankara to uninfected UK volunteers. The vaccine induced high levels of effector T cells that recognized virus-infected autologous CD4+ cells and inhibited HIV-1 replication by up to 5.79 log10. The virus inhibition was mediated by both Gag- and Pol- specific effector CD8+ T cells targeting epitopes that are typically subdominant in natural infection. These results provide proof of concept for using a vaccine to target T cells at conserved epitopes, showing that these T cells can control HIV-1 replication in vitro. PMID:24166483

Hayes, Peter; Rose, Annie; Ebrahimsa, Umar; Hayton, Emma-Jo; Black, Antony; Bridgeman, Anne; Rosario, Maximillian; Hill, Adrian V.S.; Berrie, Eleanor; Moyle, Sarah; Frahm, Nicole; Cox, Josephine; Colloca, Stefano; Nicosia, Alfredo; Gilmour, Jill; McMichael, Andrew J.; Dorrell, Lucy; Hanke, Tomas

2013-01-01

237

T Cell Responses of HIV-Infected Children after Administration of Inactivated or Live Attenuated Influenza Vaccines  

PubMed Central

Abstract Live-attenuated influenza vaccine (LAIV) prevents significantly more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the T cell responses to LAIV or TIV in HIV-infected children. IFN-?-ELISPOT for the three vaccine-contained influenza strains, two mismatched strains, and phytohemagglutinin (PHA), was performed at 0, 4, and 24 weeks postimmunization in 175 HIV-infected children randomly assigned to LAIV or TIV. The contribution of CD8 T cells to the influenza-specific response (CD8-ELISPOT) was evaluated by CD8-cell depletion. CD8 T cells accounted for ?87% of the total influenza-ELISPOT. At baseline, total influenza-ELISPOT and CD8-ELISPOT values were similar or higher in TIV compared with LAIV recipients. Four and 24 weeks after TIV, total influenza-ELISPOT and CD8-ELISPOT results were significantly lower than baseline results (p???0.001). Responses to PHA also tended to decrease at 4 weeks after TIV (p?=?0.06), but rebounded to baseline levels at 24 weeks. Four weeks after LAIV, total influenza-ELISPOT responses to vaccine-contained strains A H3N2 and B significantly decreased. Other ELISPOT values at 4 weeks and all values at 24 weeks were similar to the baseline values. At 4 and 24 weeks, TIV compared to LAIV administration resulted in a significantly greater decrease in influenza-specific ELISPOT values for vaccine-contained influenza A strains (p???0.02). Responses to PHA also tended to decrease more in TIV recipients (p?=?0.07). HIV-infected children immunized with TIV had significant and persistent decreases in ELISPOT responses to influenza. LAIV administration suppressed ELISPOT responses less. The clinical significance of these findings deserves further study. PMID:20059397

Song, Lin-Ye; Fenton, Terence; Nachman, Sharon A.; Read, Jennifer S.; Patterson-Bartlett, Julie; Levin, Myron J.

2010-01-01

238

Toward Effective HIV Vaccination INDUCTION OF BINARY EPITOPE REACTIVE ANTIBODIES WITH BROAD HIV NEUTRALIZING ACTIVITY  

SciTech Connect

We describe murine monoclonal antibodies (mAbs) raised by immunization with an electrophilic gp120 analog (E-gp120) expressing the rare ability to neutralize genetically heterologous human immunodeficiency virus (HIV) strains. Unlike gp120, E-gp120 formed covalent oligomers. The reactivity of gp120 and E-gp120 with mAbs to reference neutralizing epitopes was markedly different, indicating their divergent structures. Epitope mapping with synthetic peptides and electrophilic peptide analogs indicated binary recognition of two distinct gp120 regions by anti-E-gp120 mAbs, the 421-433 and 288-306 peptide regions. Univalent Fab and single chain Fv fragments expressed the ability to recognize both peptides. X-ray crystallography of an anti-E-gp120 Fab fragment revealed two neighboring cavities, the typical antigen-binding cavity formed by the complementarity determining regions (CDRs) and another cavity dominated by antibody heavy chain variable (VH) domain framework (FR) residues. Substitution of the FR cavity VH Lys-19 residue by an Ala residue resulted in attenuated binding of the 421-433 region peptide probe. The CDRs and VH FR replacement/silent mutation ratios exceeded the ratio for a random mutation process, suggesting adaptive development of both putative binding sites. All mAbs studied were derived from VH1 family genes, suggesting biased recruitment of the V gene germ line repertoire by E-gp120. The conserved 421-433 region of gp120 is essential for HIV binding to host CD4 receptors. This region is recognized weakly by the FR of antibodies produced without exposure to HIV, but it usually fails to induce adaptive synthesis of neutralizing antibodies. We present models accounting for improved CD4-binding site recognition and broad HIV neutralizing activity of the mAbs, long sought goals in HIV vaccine development.

Nishiyama, Yasuhiro; Planque, Stephanie; Mitsuda, Yukie; Nitti, Giovanni; Taguchi, Hiroaki; Jin, Lei; Symersky, Jindrich; Boivin, Stephane; Sienczyk, Marcin; Salas, Maria; Hanson, Carl V.; Paul, Sudhir; (Texas-MED); (Viral Rickettsial)

2009-11-23

239

Challenges in the Design of a T Cell Vaccine in the Context of HIV-1 Diversity  

PubMed Central

The extraordinary variability of HIV-1 poses a major obstacle to vaccine development. The effectiveness of a vaccine is likely to vary dramatically in different populations infected with different HIV-1 subtypes, unless innovative vaccine immunogens are developed to protect against the range of HIV-1 diversity. Immunogen design for stimulating neutralizing antibody responses focuses on “breadth” – the targeting of a handful of highly conserved neutralizing determinants on the HIV-1 Envelope protein that can recognize the majority of viruses across all HIV-1 subtypes. An effective vaccine will likely require the generation of both broadly cross-neutralizing antibodies and non-neutralizing antibodies, as well as broadly cross-reactive T cells. Several approaches have been taken to design such broadly-reactive and cross-protective T cell immunogens. Artificial sequences have been designed that reduce the genetic distance between a vaccine strain and contemporary circulating viruses; “mosaic” immunogens extend this concept to contain multiple potential T cell epitope (PTE) variants; and further efforts attempt to focus T cell immunity on highly conserved regions of the HIV-1 genome. Thus far, a number of pre-clinical and early clinical studies have been performed assessing these new immunogens. In this review, the potential use of these new immunogens is explored. PMID:25341662

Tongo, Marcel; Burgers, Wendy A.

2014-01-01

240

Prevention strategies other than male condoms employed by low-income women to prevent HIV infection.  

PubMed

This study sought to determine HIV prevention strategies other than male condom use employed by low-income women who have sex with men (WSM) and to identify variables that predict use of these strategies. A cross-sectional survey of nearly 4,000 women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties was conducted. The response rate was 58%, with 2,256 completed questionnaires returned. Women were asked to indicate one or more of nine methods they had ever used to prevent HIV infection. Women were also asked about their use of male condoms, preference for male condoms versus female condoms, and which partner usually made decisions about STD/HIV prevention. Of the 2,256 questionnaires returned, 1,325 WSM indicated use of at least one HIV prevention strategy other than condom use. Strategies were: being tested for HIV (68.2%), partner being tested for HIV (44.1%), asking partner about his sex history (41.1%), using oral contraceptives (18.8%), asking him if he has HIV (13.7%), douching (11.8%), withdrawal (9.4%), and having anal or oral sex (6.6%). Common predictors of these strategies were race, education, history of STD, condom use, and marital status. Basic misunderstandings about HIV prevention are common in specified subpopulations of low-income women. HIV prevention programs for low-income WSM should capitalize on women's efforts to prevent HIV by designing programs to help women replace ineffective prevention strategies with effective prevention strategies. PMID:10675053

Crosby, R A; Yarber, W L; Meyerson, B

2000-01-01

241

Recruitment of urban US women at risk for HIV infection and willingness to participate in future HIV vaccine trials  

PubMed Central

Enrollment of US women with sufficient risk of HIV infection into HIV vaccine efficacy trials has proved challenging. A cohort of 799 HIV-negative women, aged 18-45, recruited from three US cities was enrolled to assess recruitment strategies based on geographic risk pockets, social and sexual networks and occurrence of sexual concurrency and to assess HIV seroincidence during follow-up (to be reported later). Among enrolled women, 90% lived or engaged in risk behaviors within a local risk pocket, 64% had a male partner who had concurrent partners and 50% had a male partner who had been recently incarcerated. Nearly half (46%) were recruited through peer referral. At enrollment, 86% of women said they were willing to participate in a vaccine efficacy trial. Results indicate that participant and partner risk behaviors combined with a peer referral recruitment strategy may best identify an at-risk cohort willing to participate in future trials. PMID:23090677

Metch, Barbara; Frank, Ian; Novak, Richard; Swann, Edith; Metzger, David; Morgan, Cecilia; Lucy, Debbie; Dunbar, Debora; Graham, Parrie; Madenwald, Tamra; Escamilia, Gina; Koblin, Beryl

2012-01-01

242

Experience in international clinical research: the HIV Prevention Trials Network  

PubMed Central

The HIV Prevention Trials Network (HPTN) is supported by the NIH to conduct randomized clinical trials to assess the efficacy of HIV prevention strategies and technologies to reduce HIV transmission between adults. A special focus of attention is on the use of antiretroviral drugs to prevent HIV transmission, both by reducing infectiousness among HIV-infected persons taking combination antiretroviral therapy (cART) and also by reducing susceptibility among HIV-uninfected persons taking antiretrovirals for pre-exposure prophylaxis. Studies may be developmental in nature to assess novel ideas for interventions or for assessing trial feasibility. However, pivotal efficacy trials to test HIV-specific prevention strategies and technologies are the main HPTN priority. Examples include a major protocol investigating the impact of expanded testing and linkage to care on HIV surveillance indicators in the USA (HPTN 065). Another protocol is addressing similar issues while also investigating how combinations of prevention approaches are best deployed to make a community-level impact in southern Africa (HPTN 071). HPTN 068 is evaluating a novel conditional cash transfer structural intervention to increase school completion rates in young girls and thereby reduce their HIV risk. Studies outside the US address the epidemic in most at-risk populations and include an assessment of opiate agonist therapy to reduce risk of HIV seroconversion among injection drug users (HTPN 058), methods to increase HIV testing rates (HTPN 043), as well as methods for reducing high-risk behaviors, and increasing adherence to cART in HIV-infected individuals (HPTN 062 and HPTN 063, respectively). The recent HPTN 052 study demonstrated that a 96% reduction in HIV transmission could be achieved between serodiscordant sexual partners by providing the infected partners with cART at a CD4+ cell count (350–550/µl) above the level that would usually qualify them for therapy in low- and middle-income countries. The immediate relevance to public health policy showcased in these trials is a paradigm for the HPTN: design and conduct of clinical trials using available licensed tools that can be rapidly translated for implementation (‘Prevention NOW!’). PMID:22348195

Sista, Nirupama Deshmane; Abdool Karim, Quarraisha; Hinson, Kathy; Donnell, Deborah; Eshleman, Susan H; Vermund, Sten H

2012-01-01

243

Translation of biomedical prevention strategies for HIV: prospects and pitfalls.  

PubMed

Early achievements in biomedical approaches for HIV prevention included physical barriers (condoms), clean injection equipment (both for medical use and for injection drug users), blood and blood product safety, and prevention of mother-to-child transmission. In recent years, antiretroviral drugs to reduce the risk of transmission (when the infected person takes the medicines; treatment as prevention) or reduce the risk of acquisition (when the seronegative person takes them; preexposure prophylaxis) have proven to be efficacious. Circumcision of men has also been a major tool relevant for higher prevalence regions such as sub-Saharan Africa. Well-established prevention strategies in the control of sexually transmitted diseases and tuberculosis are highly relevant for HIV (ie, screening, linkage to care, early treatment, and contact tracing). Unfortunately, only slow progress is being made in some available HIV-prevention strategies such as family planning for HIV-infected women who do not want more children and prevention of mother-to-child HIV transmission. Current studies seek to integrate strategies into approaches that combine biomedical, behavioral, and structural methods to achieve prevention synergies. This review identifies the major biomedical approaches demonstrated to be efficacious that are now available. We also highlight the need for behavioral risk reduction and adherence as essential components of any biomedical approach. PMID:23673881

Vermund, Sten H; Tique, José A; Cassell, Holly M; Pask, Megan E; Ciampa, Philip J; Audet, Carolyn M

2013-06-01

244

Translation of biomedical prevention strategies for HIV: Prospects and pitfalls  

PubMed Central

Early achievements in biomedical approaches for HIV prevention included physical barriers (condoms), clean injection equipment (both for medical use and for injection drug users), blood and blood product safety, and prevention of mother to child transmission. In recent years, antiretroviral drugs to reduce risk of transmission (when the infected person takes the medicines; treatment as prevention or TasP) or reduce risk of acquisition (when the seronegative person takes them; pre-exposure prophylaxis or PrEP) have proven efficacious. Circumcision of men has also been a major tool relevant for higher prevalence regions such as sub-Saharan Africa. Well-established prevention strategies in the control of sexually transmitted diseases and tuberculosis are highly relevant for HIV (i.e., screening, linkage to care, early treatment, and contact tracing). Unfortunately, only slow progress is being made in some available HIV prevention strategies such as family planning for HIV-infected women who do not want more children and prevention mother-to-child HIV transmission. Current studies seek to integrate strategies into approaches that combine biomedical, behavioral, and structural methods to achieve prevention synergies. This review identifies the major biomedical approaches demonstrated to be efficacious that are now available. We also highlight the need for behavioral risk reduction and adherence as essential components of any biomedical approach. PMID:23673881

Vermund, Sten H.; Tique, Jose A.; Cassell, Holly M.; Johnson, Megan E.; Ciampa, Philip J.; Audet, Carolyn M.

2013-01-01

245

HIV-1 transmission linkage in an HIV-1 prevention clinical trial  

SciTech Connect

HIV-1 sequencing has been used extensively in epidemiologic and forensic studies to investigate patterns of HIV-1 transmission. However, the criteria for establishing genetic linkage between HIV-1 strains in HIV-1 prevention trials have not been formalized. The Partners in Prevention HSV/HIV Transmission Study (ClinicaITrials.gov NCT00194519) enrolled 3408 HIV-1 serodiscordant heterosexual African couples to determine the efficacy of genital herpes suppression with acyclovir in reducing HIV-1 transmission. The trial analysis required laboratory confirmation of HIV-1 linkage between enrolled partners in couples in which seroconversion occurred. Here we describe the process and results from HIV-1 sequencing studies used to perform transmission linkage determination in this clinical trial. Consensus Sanger sequencing of env (C2-V3-C3) and gag (p17-p24) genes was performed on plasma HIV-1 RNA from both partners within 3 months of seroconversion; env single molecule or pyrosequencing was also performed in some cases. For linkage, we required monophyletic clustering between HIV-1 sequences in the transmitting and seroconverting partners, and developed a Bayesian algorithm using genetic distances to evaluate the posterior probability of linkage of participants sequences. Adjudicators classified transmissions as linked, unlinked, or indeterminate. Among 151 seroconversion events, we found 108 (71.5%) linked, 40 (26.5%) unlinked, and 3 (2.0%) to have indeterminate transmissions. Nine (8.3%) were linked by consensus gag sequencing only and 8 (7.4%) required deep sequencing of env. In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner, illustrating the relevance of these methods in the design of future HIV-1 prevention trials in serodiscordant couples. A hierarchy of sequencing techniques, analysis methods, and expert adjudication contributed to the linkage determination process.

Leitner, Thomas [Los Alamos National Laboratory; Campbell, Mary S [UNIV OF WASHINGTON; Mullins, James I [UNIV OF WASHINGTON; Hughes, James P [UNIV OF WASHINGTON; Wong, Kim G [UNIV OF WASHINGTON; Raugi, Dana N [UNIV OF WASHINGTON; Scrensen, Stefanie [UNIV OF WASHINGTON

2009-01-01

246

HIV prevention in prisons and jails: obstacles and opportunities.  

PubMed

High rates of human immunodeficiency virus (HIV) infection among jail and prison inmates suggest that HIV prevention efforts should focus on incarcerated populations. Overcrowding, the high prevalence of injection drug use, and other high-risk behaviors among inmates create a prime opportunity for public health officials to affect the course of the HIV epidemic if they can remedy these problems. Yet, along with the opportunity, there are certain obstacles that correctional institutions present to public health efforts. The various jurisdictions have differing approaches to HIV prevention and control. Whether testing should be mandatory or voluntary, whether housing should be integrated or segregated by HIV serostatus, and whether condoms, bleach, or clean needles should be made available to the prisoners, are questions hotly debated by public health and correctional officials. Even accurate assessment of risk-taking within the institutions leads to controversy, as asking questions could imply acceptance of the very behaviors correctional officials are trying to prevent. Education and risk-reduction counseling are the least controversial and most widely employed modes of prevention, but the effectiveness of current prevention efforts in reducing HIV transmission in this high-risk population is largely undetermined. PMID:7938381

Polonsky, S; Kerr, S; Harris, B; Gaiter, J; Fichtner, R R; Kennedy, M G

1994-01-01

247

HIV prevention research: taking stock and the way forward.  

PubMed

Previous papers in this supplement have reviewed the evidence of the effectiveness of alternative HIV prevention methods from randomized controlled trials and other studies. This paper draws together the main conclusions from these reviews. A conceptual framework is presented that maps the proximal and distal determinants of sexual HIV transmission and helps to identify the stages in the causal pathway at which each intervention approach acts. The advances, gaps and challenges emerging from the reviews of individual intervention methods are summarized and cross-cutting themes identified. Approximately 90% of HIV prevention trials have found no effect on HIV incidence and we explore the alternative explanations for the large number of 'flat' trials. We conclude that there is no single explanation for these flat results, which may be due to interventions that are ineffective or inappropriately targeted or implemented, or to factors related to the design or conduct of trials. We examine the lessons from these flat results and provide recommendations on what should be done differently in future trials. HIV prevention remains of critical importance in an era of expanded delivery of antiretroviral therapy. In future HIV prevention research, it is important that resources are used as efficiently as possible to provide rigorous evidence of the effectiveness of a wider array of complementary prevention tools. PMID:21042056

Hayes, Richard; Kapiga, Saidi; Padian, Nancy; McCormack, Sheena; Wasserheit, Judith

2010-10-01

248

Messages HIV clinicians use in prevention with positives interventions.  

PubMed

Prevention with Positives (PwP) is a component of the US HIV prevention strategy that targets HIV-infected persons who are aware of their seropositive status. This paper examines the use of prevention messages by clinical providers during the PwP intervention period of the US Health Resources and Services Administration's Special Projects of National Significance program. Quantitative approaches were used to learn which prevention topics were most discussed and qualitative interviews were also utilized to better understand the clinician perspective in providing prevention counseling. At 12-month follow-up, there was a significant increase in the percent of patients receiving all PwP counseling messages (p<0.01). Providers reported discussing safer sex with 91% of patients when sexually transmitted infection (STI) screening was conducted during a visit, an increase from baseline (83.5%). The percent of providers reporting they regularly explained the risk of superinfection to their clients also increased from 75% at baseline to 90% at 12-month follow up (p<0.001). Qualitative data suggest that providers prioritize individual care over public health approaches to PwP in counseling. Discussing superinfection offered providers a way to discuss HIV prevention from a non-judgmental clinical perspective while focusing on a patient-centered philosophy of care. However, the threat of superinfection may not be the best counseling option. Examples such as STI screening, giving messages to reduce the number of sexual partners and adherence to medication, are more evidence-based approaches to changing HIV transmission risk behavior and may be more important in PwP. Findings suggest that in order for HIV care providers to incorporate HIV prevention discussions into their practice, acceptable approaches to speaking about risk behavior and prevention of HIV transmission must be developed. PMID:22299672

Rose, Carol Dawson; Koester, Kimberly A; Kang Dufour, Mi-Suk; Myers, Janet J; Shade, Starley B; McCready, Karen; Morin, Stephen

2012-01-01

249

Prevention for HIV-Positive Families  

Microsoft Academic Search

topping transmission of HIV to new partners has been the primary focus of HIV pre- vention for positive individuals.1 Yet, transmission acts among seropositive persons in the United States have dropped from 100% in the 1980s to approximately 5% of seroposi- tive persons transmitting currently.2 Transmission acts among seropositive women are far less common. Only 30% of seropositive women have

Mary Jane Rotheram-Borus; Diane Flannery; Patricia Lester; Eric Rice

2004-01-01

250

Antibody persistence and T-cell balance: Two key factors confronting HIV vaccine development  

PubMed Central

The quest for a prophylactic AIDS vaccine is ongoing, but it is now clear that the successful vaccine must elicit protective antibody responses. Accordingly, intense efforts are underway to identify immunogens that elicit these responses. Regardless of the mechanism of antibody-mediated protection, be it neutralization, Fc-mediated effector function, or both, antibody persistence and appropriate T-cell help are significant problems confronting the development of a successful AIDS vaccine. Here, we discuss the evidence illustrating the poor persistence of antibody responses to Env, the envelope glycoprotein of HIV-1, and the related problem of CD4+ T-cell responses that compromise vaccine efficacy by creating excess cellular targets of HIV-1 infection. Finally, we propose solutions to both problems that are applicable to all Env-based AIDS vaccines regardless of the mechanism of antibody-mediated protection. PMID:25349379

Lewis, George K.; DeVico, Anthony L.; Gallo, Robert C.

2014-01-01

251

Hepatitis B Vaccination in HIV-Infected Youth: A Randomized Trial of Three Regimens  

PubMed Central

Background HIV-infected youth are at risk of hepatitis B (HBV) infection and should be vaccinated. Previous reports suggest reduced response to standard HBV vaccine regimens. Methods HIV-infected youth, age 12 to <25 years, were randomly assigned to one of three treatment arms: Arm 1: Engerix B®, 20 mcg HBsAg; Arm 2: Engerix B®, 40 mcg; and Arm 3: Twinrix®, 20mcg HBsAg combined with 720 ELU hepatitis A antigen. Vaccines were administered at weeks 0, 4 and 24. Results Characteristics of evaluable patients (n=336) at entry were similar in the study arms. At enrollment, median CD4+ T-cell count was 460 cells/mm3 (IQR: 305 to 668); 13% were < 200 cells/mm3. Among Engerix B®, 20 mcg recipients, 60.4% responded to vaccine (HBsAb ? 10 IU/mL at week 28). Improved vaccine response was seen in recipients of Engerix B®, 40 mcg, (73.2%, vs. Arm 1, p=0.04) and Twinrix® (75.4%, vs. Arm 1, p=0.02). In multivariate analysis, only baseline CD4+ T-cell count and study arm were independent predictors of vaccine response. Conclusions In HIV-infected youth, a three dose vaccination regimen with Engerix B®, 40 mcg, or Twinrix® and higher baseline CD4+ T-cell counts were independently associated with improved vaccine response. PMID:21350366

Flynn, Patricia M.; Cunningham, Coleen K.; Rudy, Bret; Wilson, Craig M.; Kapogiannis, Bill; Worrell, Carol; Bethel, James; Monte, Dina; Bojan, Kelly

2011-01-01

252

HIV prevention for South African youth: which interventions work? A systematic review of current evidence  

Microsoft Academic Search

BACKGROUND: In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. METHODS: Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains:

Abigail Harrison; Marie-Louise Newell; John Imrie; Graeme Hoddinott

2010-01-01

253

Cost-effectiveness of HIV prevention interventions in Andhra Pradesh state of India  

Microsoft Academic Search

BACKGROUND: Information on cost-effectiveness of the range of HIV prevention interventions is a useful contributor to decisions on the best use of resources to prevent HIV. We conducted this assessment for the state of Andhra Pradesh that has the highest HIV burden in India. METHODS: Based on data from a representative sample of 128 public-funded HIV prevention programs of 14

Lalit Dandona; SG Prem Kumar; G Anil Kumar; Rakhi Dandona

2010-01-01

254

Using HIV Transmission Networks to Investigate Community Effects in HIV Prevention Trials  

Microsoft Academic Search

Effective population screening of HIV and prevention of HIV transmission are only part of the global fight against AIDS. Community-level effects, for example those aimed at thwarting future transmission, are potential outcomes of treatment and may be important in stemming the epidemic. However, current clinical trial designs are incapable of detecting a reduction in future transmission due to treatment. We

Joel O. Wertheim; Sergei L. Kosakovsky Pond; Susan J. Little; Victor De Gruttola

2011-01-01

255

Ethical and regulatory considerations for the inclusion of adolescents in HIV biomedical prevention research.  

PubMed

Adolescents should be enrolled in ethically appropriate and scientifically rigorous HIV biomedical prevention research involving vaccines, pre-exposure prophylaxis, or microbicides. There is general agreement that children should only be enrolled in a clinical trial if the scientific objectives cannot be met either through enrolling adult subjects who can provide informed consent personally or through conducting research using animal models. In addition, the risks to which children are exposed in a clinical trial without the possibility of direct therapeutic benefit must be low. Children also should not be placed at a disadvantage after being enrolled in a clinical trial by, for example, being exposed to an unnecessarily risky intervention or by failing to receive a comparable treatment that would prevent significant morbidity or mortality. In light of this shared framework, we discuss the timing of enrolling adolescents in HIV prevention trials; some general study design considerations that may be necessary for adequate labeling of products for an adolescent indication; the use of data obtained from international studies for licensure applications in the United States; the role of parental permission and adolescent assent to research participation; and the inclusion of pregnant adolescents in HIV biomedical prevention research. PMID:20571419

Nelson, Robert M; Lewis, Linda L; Struble, Kimberly; Wood, Susan F

2010-07-01

256

Evaluation of a Prevention Intervention to Reduce HIV Risk among Angolan Soldiers  

Microsoft Academic Search

We developed and evaluated a military-focused HIV prevention intervention to enhance HIV risk-reduction knowledge, motivation,\\u000a and behaviors among Angolan soldiers. Twelve bases were randomly assigned to HIV prevention or control conditions, yielding\\u000a 568 participants. HIV prevention participants received training in preventing HIV (4.5 days) and malaria (0.5 days). Control\\u000a participants received the reverse. Monthly booster sessions were available after each intervention. We

Eric G. Bing; Karen G. Cheng; Daniel J. Ortiz; Ricardo E. Ovalle-Bahamón; Francisco Ernesto; Robert E. Weiss; Cherrie B. Boyer

2008-01-01

257

The effects of HIV Tat DNA on regulating the immune response of HIV DNA vaccine in mice  

PubMed Central

Background HIV trans-activator protein (Tat) is the crucial factor to control HIV transcription, and is usually considered as an important immunogen for the design of HIV vaccine. Recent studies reported some special bio-activities of Tat protein on immunoregulation. However, to date, few studies have focused on exploring the effects of Tat expression plasmid (pTat) on regulating the immune responses induced by HIV DNA vaccines. In this study, our main objective is to investigate the immunoregulation mediated by pTat in mice. Methods Four gene-coding plasmids (pTat, pGag, pEnv and pPol) were constructed, and the gene expression was detected by western blot method. The effects of pTat on regulating the immune responses to antigens Gag, Env, Pol were assessed by enzyme-linked immunospot and enzyme-linked immunosorbent assay. The data was analysed by one-way analysis of variance. Results After two immunizations, mice vaccinated with antigen expressing plasmid (pGag, pEnv or pPol) plus pTat exhibited significantly stronger IFN-gamma response than that vaccinated with the corresponding antigen alone. Moreover, mice receiving two injections of antigen plus pTat exhibited the same strong IFN-gamma response as those receiving three injections of antigen alone did. Furthermore, addition of pTat not only induced a more balanced Th1 and Th2 response, but also broadened IgG subclass responses to antigens Gag and Pol. Conclusion pTat exhibited the appreciable effects on modulating immune responses to HIV antigens Gag, Env and Pol, providing us interesting clues on how to optimize HIV DNA vaccine. PMID:24073803

2013-01-01

258

MTV's "Staying Alive" global campaign promoted interpersonal communication about HIV and positive beliefs about HIV prevention.  

PubMed

In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household surveys. Using linear regression techniques, our evaluation examined the effects of campaign exposure on interpersonal communication about HIV and the effects of campaign exposure and interpersonal communication on beliefs about HIV prevention. We found a consistent positive effect of exposure on interpersonal communication across all sites, though there were differences among sites with regard to whom the respondent talked about HIV. We also found a consistent positive effect of exposure on HIV prevention beliefs across sites when interpersonal communication was simultaneously entered into the model. Finally, in two sites we found a relationship between interpersonal communication and HIV prevention beliefs, controlling for exposure, though again, the effects differed by the type of person the communication was with. These similar findings in three diverse sites provide ecological validity of the findings that "Staying Alive" promoted interpersonal communication and influenced young people's beliefs about HIV prevention in a positive way, evidence for the potential of a global media campaign to have an impact on social norms. PMID:17411389

Geary, Cynthia Waszak; Burke, Holly McClain; Castelnau, Laure; Neupane, Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

2007-02-01

259

Vaccine-Induced Env V1-V2 IgG3 Correlates with Lower HIV-1 Infection Risk and Declines Soon After Vaccination  

PubMed Central

HIV-1–specific immunoglobulin G (IgG) subclass antibodies bind to distinct cellular Fc receptors. Antibodies of the same epitope specificity but of a different subclass therefore can have different antibody effector functions. The study of IgG subclass profiles between different vaccine regimens used in clinical trials with divergent efficacy outcomes can provide information on the quality of the vaccine-induced B cell response. We show that HIV-1–specific IgG3 distinguished two HIV-1 vaccine efficacy studies (RV144 and VAX003 clinical trials) and correlated with decreased risk of HIV-1 infection in a blinded follow-up case-control study with the RV144 vaccine. HIV-1–specific IgG3 responses were not long-lived, which was consistent with the waning efficacy of the RV144 vaccine. These data suggest that specific vaccine-induced HIV-1 IgG3 should be tested in future studies of immune correlates in HIV-1 vaccine efficacy trials. PMID:24648342

Yates, Nicole L.; Liao, Hua-Xin; Fong, Youyi; deCamp, Allan; Vandergrift, Nathan A.; Williams, William T.; Alam, S. Munir; Ferrari, Guido; Yang, Zhi-yong; Seaton, Kelly E.; Berman, Phillip W.; Alpert, Michael D.; Evans, David T.; O'Connell, Robert J.; Francis, Donald; Sinangil, Faruk; Lee, Carter; Nitayaphan, Sorachai; Rerks-Ngarm, Supachai; Kaewkungwal, Jaranit; Pitisuttithum, Punnee; Tartaglia, James; Pinter, Abraham; Zolla-Pazner, Susan; Gilbert, Peter B.; Nabel, Gary J.; Michael, Nelson L.; Kim, Jerome H.; Montefiori, David C.; Haynes, Barton F.; Tomaras, Georgia D.

2014-01-01

260

Combination HIV Prevention: The Value and Interpretation of Mathematical Models  

PubMed Central

Mathematical models of HIV prevention interventions often provide critical insights related to programmatic design and economic efficiency. One recent dynamic model by Long et al highlights that a combination prevention approach – with testing, treatment, circumcision, microbicides and PrEP – may decrease transmissions by over 60% and may be very cost-effective in South Africa. In this analysis, the authors introduce the critical concept of joint effectiveness of preventions programs and demonstrate how some programs operate synergistically (HIV screening coupled with early treatment) while others may create redundancies (microbicides coupled with pre-exposure prophylaxis). Whether combination HIV prevention programs perform with additive, multiplicative or maximal effectiveness will be important to consider in anticipation of their combined transmission impact. PMID:23797377

Walensky, Rochelle P.

2013-01-01

261

Expanded breadth of the T-cell response to mosaic HIV-1 envelope DNA vaccination  

SciTech Connect

An effective AIDS vaccine must control highly diverse circulating strains of HIV-1. Among HIV -I gene products, the envelope (Env) protein contains variable as well as conserved regions. In this report, an informatic approach to the design of T-cell vaccines directed to HIV -I Env M group global sequences was tested. Synthetic Env antigens were designed to express mosaics that maximize the inclusion of common potential Tcell epitope (PTE) 9-mers and minimize the inclusion of rare epitopes likely to elicit strain-specific responses. DNA vaccines were evaluated using intracellular cytokine staining (ICS) in inbred mice with a standardized panel of highly conserved 15-mer PTE peptides. I, 2 and 3 mosaic sets were developed that increased theoretical epitope coverage. The breadth and magnitude ofT-cell immunity stimulated by these vaccines were compared to natural strain Env's; additional comparisons were performed on mutant Env's, including gpl60 or gpl45 with or without V regions and gp41 deletions. Among them, the 2 or 3 mosaic Env sets elicited the optimal CD4 and CD8 responses. These responses were most evident in CD8 T cells; the 3 mosaic set elicited responses to an average of 8 peptide pools compared to 2 pools for a set of3 natural Env's. Synthetic mosaic HIV -I antigens can therefore induce T-cell responses with expanded breadth and may facilitate the development of effective T -cell-based HIV -1 vaccines.

Korber, Bette [Los Alamos National Laboratory; Fischer, William [Los Alamos National Laboratory; Wallstrom, Timothy [Los Alamos National Laboratory

2009-01-01

262

Balancing collective responsibility, individual opportunities and risks: a qualitative study on how police officers reason around volunteering in an HIV vaccine trial in Dar es Salaam, Tanzania  

Microsoft Academic Search

BACKGROUND: Results from HIV vaccine trials on potential volunteers will contribute to global efforts to develop an HIV vaccine. The purpose of this study among police officers in Dar es Salaam, Tanzania, was to explore the underlying reasons that induce people to enrol in an HIV vaccine trial. METHODS: We conducted discussions with eight focus groups, containing a total of

Edith A. M. Tarimo; Anna Thorson; Thecla W. Kohi; Joachim Mwami; Muhammad Bakari; Eric Sandström; Asli Kulane

2010-01-01

263

Disabled persons’ knowledge of HIV prevention and access to health care prevention services in South Africa  

Microsoft Academic Search

The main research question in this article is how access to information about HIV\\/AIDS and level of HIV\\/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV\\/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed

Arne Henning Eide; Clare Schür; Chitra Ranchod; Poul Rohleder; Leslie Swartz; Marguerite Schneider

2011-01-01

264

Loss of long term protection with the inclusion of HIV pol to a DNA vaccine encoding gag.  

PubMed

Traditional vaccine strategies that induce antibody responses have failed to protect against HIV infection in clinical trials, and thus cell-mediated immunity is now an additional criterion. Recent clinical trials that aimed to induce strong T cell responses failed to do so. Therefore, to enhance induction of protective T cell responses, it is crucial that the optimum antigen combination is chosen. Limited research has been performed into the number of antigens selected for an HIV vaccine. This study aimed to compare DNA vaccines encoding either a single HIV antigen or a combination of two antigens, using intradermal vaccination of C57BL/6 mice. Immune assays were performed on splenocytes, and in vivo protection was examined by challenge with a chimeric virus, EcoHIV, able to infect mouse but not human leukocytes, at 10 days (short term) and 60 days (long term) post final vaccination. At 60 days there was significantly lower frequency of induced antigen-specific CD8(+) T cells in the spleens of pCMVgag-pol-vaccinated mice compared with mice which received pCMVgag only. Most importantly, short term viral control of EcoHIV was similar for pCMVgag and pCMVgag-pol-vaccinated mice at day 10, but only the pCMVgag-vaccinated significantly controlled EcoHIV at day 60 compared with pCMV-vaccinated mice, showing that control was reduced with the inclusion of the HIV pol gene. PMID:25152448

Garrod, Tamsin J; Gargett, Tessa; Yu, Wenbo; Major, Lee; Burrell, Christopher J; Wesselingh, Steven; Suhrbier, Andreas; Grubor-Bauk, Branka; Gowans, Eric J

2014-11-01

265

Endpoints and regulatory issues in HIV vaccine clinical trials: lessons from a workshop.  

PubMed

A successful HIV vaccine would have a substantial impact on acquisition of infection, progression of disease among the infected, or infectiousness of the infected. Current vaccine candidates are anticipated to have their major effect on viremia, however, with the expectation that this would induce or be concordant with a reduced rate of AIDS, death, or infectiousness. Although direct assessment of disease progression or infectiousness may be impractical, available potential surrogates for these endpoints may be misleading. This article summarizes the proceedings of a National Institute of Allergy and Infectious Disease-sponsored workshop to explore the use of surrogate endpoints for licensure of an HIV vaccine. Early, medium, and late endpoints were discussed, along with challenges such as surrogate validity, the confounding effect of antiretroviral therapy initiation, and potential selection bias in the vaccine and placebo recipients who become infected. Results from 5 hypothetic HIV vaccine clinical trials with ambiguously successful results were presented to an expert panel for interpretation and discussion of next steps. Key recommendations included assessing magnitude and durability of surrogate effects, generalization across populations, and directed improvement of vaccines. Use of acquisition and a postinfection surrogate as coprimary endpoints was supported, along with use of composite endpoints and exploration of heterogeneity in vaccine efficacy by characteristics of the host and virus. PMID:17075387

Follmann, Dean; Duerr, Ann; Tabet, Stephen; Gilbert, Peter; Moodie, Zoe; Fast, Patricia; Cardinali, Massimo; Self, Steve

2007-01-01

266

Preventing HIV among Young People: research priorities for the future  

PubMed Central

Objective To review the current state of knowledge on the prevention of sexual transmission of HIV in adolescents and to highlight existing gaps and priority areas for future research. Background A disproportionate burden of HIV infections falls on adolescents, a developmental stage marked by unique neural, biological, and social transition. Successful interventions are critical to prevent the spread of HIV in this vulnerable population. Methods We summarized the current state of research on HIV prevention in adolescents by providing examples of successful interventions and best practices, and highlighting current research gaps. Results Adolescent interventions fall into three main categories: biomedical, behavioral, and structural. The majority of current research has focused on individual behavior change, while promising biomedical and structural interventions have been largely understudied in adolescents. Combination prevention interventions may be particularly valuable to this group. Conclusions Adolescents have unique needs with respect to HIV prevention and, thus, interventions should be designed to most effectively reach this population with information and services that will be relevant to them. PMID:23764629

Pettifor, Audrey; Bekker, Linda-Gail; Hosek, Sybil; DiClemente, Ralph; Rosenberg, Molly; Bull, Sheana; Allison, Susannah; Delany-Moretlwe, Sinead; Kapogiannis, Bill G.; Cowan, Frances

2013-01-01

267

77 FR 36550 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...  

Federal Register 2010, 2011, 2012, 2013

...Preventive Services Funding Opportunity: National HIV Program for Enhanced HIV/AIDS Screening and Engagement in Care Announcement...Funding Announcement Number: HHS-2012-IHS-OCPS-HIV-0001. Catalog of Federal Domestic Assistance...

2012-06-19

268

77 FR 41190 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...  

Federal Register 2010, 2011, 2012, 2013

...Preventive Services Funding Opportunity: National HIV Program for Enhanced HIV/AIDS Screening and Engagement in Care AGENCY: Indian...Funding Announcement Number: HHS-2012-IHS-OCPS-HIV-0001. Catalog of Federal Domestic Assistance...

2012-07-12

269

BART to HIVEd: Adapting an HIV Education Prevention Program  

Microsoft Academic Search

One of the fastest growing segments of the population infected with HIV is the nation's youths. Thus, prevention in this high-risk population is vital. The authors detail the process of adapting an evidence-based HIV\\/AIDS educational program (HIVEd) to the unique needs of high-risk youths in adjudicated and detained facilities and alternative high schools. The HIVEd program derives from St. Lawrence's

Georgia N. L. J. Polacek; Jennifer Coker; Kayan L. Lewis; Monica Minter; Verónica Villela-Perez; Anthony A. Scott

2008-01-01

270

HIV Treatment as Prevention: Issues in Economic Evaluation  

Microsoft Academic Search

Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, “Investigating the Impact of Treatment on New HIV Infections”, that economic evaluations of antiretroviral therapy (ART) in currently existing programs and in HIV treatment as prevention (TasP) programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope

Till Bärnighausen; Joshua A. Salomon; Nalinee Sangrujee

2012-01-01

271

Common Principles Embedded in Effective Adolescent HIV Prevention Programs  

Microsoft Academic Search

Each interpersonally delivered, evidence-based (EB) program for HIV prevention shares common features that aim to shift HIV\\u000a risk behaviors. We used qualitative research methods to examine manuals from five EB programs for adolescents and identified\\u000a 10 core principles embedded in each program’s activities. Principles reflect the stated goals and anticipated lessons in an activity. The principles were: Believe in your

Mary Jane Rotheram-Borus; Barbara L. Ingram; Dallas Swendeman; Diane Flannery

2009-01-01

272

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: balancing methodological rigor and research ethics.  

PubMed

The growing evidence base for biomedical HIV prevention interventions - such as oral pre-exposure prophylaxis, microbicides, male circumcision, treatment as prevention, and eventually prevention vaccines - has given rise to concerns about the ways in which users of these biomedical products may adjust their HIV risk behaviors based on the perception that they are prevented from infection. Known as risk compensation, this behavioral adjustment draws on the theory of "risk homeostasis," which has previously been applied to phenomena as diverse as Lyme disease vaccination, insurance mandates, and automobile safety. Little rigorous evidence exists to answer risk compensation concerns in the biomedical HIV prevention literature, in part because the field has not systematically evaluated the study designs available for testing these behaviors. The goals of this Commentary are to explain the origins of risk compensation behavior in risk homeostasis theory, to reframe risk compensation as a testable response to the perception of reduced risk, and to assess the methodological rigor and ethical justification of study designs aiming to isolate risk compensation responses. Although the most rigorous methodological designs for assessing risk compensation behavior may be unavailable due to ethical flaws, several strategies can help investigators identify potential risk compensation behavior during Phase II, Phase III, and Phase IV testing of new technologies. Where concerns arise regarding risk compensation behavior, empirical evidence about the incidence, types, and extent of these behavioral changes can illuminate opportunities to better support the users of new HIV prevention strategies. This Commentary concludes by suggesting a new way to conceptualize risk compensation behavior in the HIV prevention context. PMID:23597916

Underhill, Kristen

2013-10-01

273

Recent advances in humanized mice: accelerating the development of an HIV vaccine.  

PubMed

Recent advances in the development of humanized mice hold great promise to advance our understanding of protective immunity to human immunodeficiency virus (HIV) infection and to aid in the design of an effective HIV vaccine. This supplement of the Journal of Infectious Diseases summarizes work in the humanized mouse model presented at an HIV Humanized Mouse workshop in Boston, Massachusetts, in November 2012, including recent advances in the development of humanized mice, the trafficking of human immune cells following mucosal HIV transmission, the role of immune activation and Toll-like receptor agonists in the control of HIV, the induction and efficacy of HIV-specific cellular and humoral immune responses, and the preclinical modeling of novel anti-HIV therapeutics. Many gaps remain in our understanding of how to design an effective HIV vaccine and novel therapeutics to eliminate the viral reservoir. Promising early results from studies in humanized mice suggest great potential and enthusiasm for this model to accelerate these critical areas of HIV research. PMID:24151317

Tager, Andrew M; Pensiero, Michael; Allen, Todd M

2013-11-01

274

HIV prevention in the Hispanic community: sex, culture, and empowerment.  

PubMed

To address the serious HIV epidemic in the Hispanic community in the United States, the underlying causes of the epidemic must be addressed. Marginalization, including homophobia, poverty, and racism, as well as cultural factors such as machismo and sexual silence disempower people, making HIV prevention difficult. This article reviews evidence for the impact of marginalization and cultural factors on HIV risk and proposes a cycle of disempowerment. Three examples of empowerment interventions developed specifically for Hispanics (targeting heterosexuals, women, and gay men) are presented, and how these interventions address disempowerment is discussed. One intervention is used to illustrate principles of developing culturally appropriate interventions. PMID:12861921

Marín, Barbara VanOss

2003-07-01

275

Role of pneumococcal vaccination in prevention of pneumococcal disease among adults in Singapore  

PubMed Central

The burden of disease associated with Streptococcus pneumoniae infection in adults can be considerable but is largely preventable through routine vaccination. Although substantial progress has been made with the recent licensure of the new vaccines for prevention of pneumonia in adults, vaccine uptake rates need to be improved significantly to tackle adult pneumococcal disease effectively. Increased education regarding pneumococcal disease and improved vaccine availability may contribute to a reduction in pneumococcal disease through increased vaccination rates. The increase in the elderly population in Singapore as well as globally makes intervention in reducing pneumococcal disease an important priority. Globally, all adult vaccines remain underused and family physicians give little priority to pneumococcal vaccination for adults in daily practice. Family physicians are specialists in preventive care and can be leaders in ensuring that adult patients get the full benefit of protection against vaccine-preventable diseases. They can play a key role in the immunization delivery of new and routine vaccines by educating the public on the risks and benefits associated with vaccines. Local recommendations by advisory groups on vaccination in adults will also help to tackle vaccine preventable diseases in adults. PMID:24729726

Eng, Philip; Lim, Lean Huat; Loo, Chian Min; Low, James Alvin; Tan, Carol; Tan, Eng Kiat; Wong, Sin Yew; Setia, Sajita

2014-01-01

276

Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, Australia 2003 to 2006.  

PubMed

This, the second report on vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people, brings together the relevant sources of routinely collected data on vaccine preventable diseases--notifications, hospitalisations, deaths, and childhood and adult vaccination coverage. As a result of continued improvements in the collection of data on Indigenous status, this second report is considerably more comprehensive, with data available from more jurisdictions, and more detailed presentation, including time trends and vaccination coverage by jurisdiction. Vaccination coverage data provide evidence of successful program delivery and highlight some areas for improvement. For universally funded vaccines in children, coverage is similar in Indigenous and non-Indigenous children by 24 months of age. However, delayed vaccination is more common in Indigenous children, with 6%-8% fewer children fully vaccinated at 12 months of age. More timely vaccination, particularly within the first six months of life, is particularly important in reducing the disproportionate burdens of disease due to pertussis and Haemophilus influenzae type b (Hib). For vaccination programs targeted specifically at Aboriginal and Torres Strait Islander children and adults, coverage is substantially lower than for those programs targeted at all Australians. This is true for hepatitis A and polysaccharide pneumococcal vaccine for children, and influenza and polysaccharide pneumococcal vaccine for adults. Targeted vaccination programs present a particular challenge for health services in urban areas. Nevertheless, the impact of vaccination programs in preventing disease and reducing the disparity of disease burden between Aboriginal and Torres Strait Islander and non-Indigenous people has been substantial. This is evident in data on notifications, hospitalisations and deaths. Diseases which, in the past, have had devastating and often disproportionately high impact on Indigenous people, such as diphtheria, measles, poliomyelitis, smallpox and tetanus, are now completely or almost completely absent from Australia. Hepatitis B infection, another disease responsible for high levels of infection and substantial serious illness and death in the pre-vaccine era, is also now well controlled in age groups eligible for vaccination. Although invasive Hib disease is now rare in Australia since the introduction of vaccination in 1993, higher rates of disease persist in Aboriginal and Torres Strait Islander children. More research is needed into the contribution of environmental factors, delayed vaccination and vaccine failure to this continued disparity. Hepatitis A has disproportionately affected Aboriginal and Torres Strait Islander children in the past. Vaccination programs in north Queensland and in various other countries have been very successful in reducing the burden of hepatitis A. It is too early to assess the impact of the vaccination program for Aboriginal and Torres Strait Islander children that commenced in regions outside north Queensland in November 2005. For some other diseases the situation is more complicated. The substantial impact of the national meningococcal C vaccination program since 2003 is evident in this report, although the higher proportion of non-vaccine preventable serotype B disease in Aboriginal and Torres Strait Islander people underlines the need for a new vaccine to cover this serotype. Pneumonia remains the most important communicable disease contributor to premature mortality in Aboriginal and Torres Strait Islander people of all ages. In young Indigenous adults, the eightfold higher rate of hospitalisation compared with their non-Indigenous peers, and the 11-fold higher rate of invasive pneumococcal disease, suggest the need for more widespread use of influenza and pneumococcal vaccines in this age group. Current coverage for Indigenous 15-49 year olds, where influenza and pneumococcal vaccines are funded only for those with risk factors, is low even though some 70% of this age group have one or m

Menzies, Robert; Turnour, Caroline; Chiu, Clayton; McIntyre, Peter

2008-06-01

277

Methodological issues in sampling the local immune system of the female genital tract in the context of HIV prevention trials.  

PubMed

The spread of HIV continues unabated in the most vulnerable populations of the world. HIV prevention methods, such as a vaginal microbicide, a mucosal vaccine, pre-exposure prophylaxis or a vaccine, are urgently needed in the fight against new infections. We must make a commitment to supporting innovative research and product design, so that one or more of these products provide a halt to the spread of HIV. Above all, these products should be proven to be safe and not negatively disturb the local immune system in a way that facilitates or enhances heterosexual transmission of HIV. HIV specific and non specific cellular and humoral local vaginal immunity must be assessed in clinical trials when testing prevention products for safety or efficacy. A proven, well-documented and standardized sampling strategy will provide high quality data to be able to assess both safety and local immune responses. In this paper, we will discuss methods for vaginal immunology sampling in the context of clinical trials. PMID:21199064

Jespers, Vicky; Francis, Suzanna C; van de Wijgert, Janneke; Crucitti, Tania

2011-03-01

278

Development of Topical Microbicides to Prevent the Sexual Transmission of HIV  

PubMed Central

Women comprise almost 50% of the population of people living with HIV and the majority of these women contracted the virus through sexual transmission in monogamous relationships in the developing world. In these environments, where women are not empowered to protect themselves through the negotiation of condom use, effective means of preventing HIV transmission are urgently needed. In the absence of an approved and effective vaccine, microbicides have become the strategy of choice to provide women with the ability to prevent HIV transmission from their infected partners. Topical microbicides are agents specifically developed and formulated for use in either the vaginal or rectal environment that prevent infection by sexually transmitted infectious organisms, including pathogenic viruses, bacteria and fungi. Although a microbicidal product will have many of the same properties as other anti-infective agents and would be similarly developed through human clinical trials, microbicide development bears its own challenges related to formulation and delivery and the unique environment in which the product must act, as well as the requirement to develop a product that is acceptable to the user. Herein, perspectives based on preclinical and clinical microbicide development experience, which have led to an evolving microbicide development algorithm, will be discussed. This article forms part of a special issue of Antiviral Research marking the 25th anniversary of antiretroviral drug discovery and development, Vol 85, issue 1, 2010”. PMID:19874851

Buckheit, Robert W.; Watson, Karen M.; Morrow, Kathleen M.; Ham, Anthony S.

2009-01-01

279

Vocational Training with HIV Prevention for Ugandan Youth  

PubMed Central

In a pilot study, young people in slums in Kampala, Uganda received an HIV prevention program (Street Smart) and were randomized to receive vocational training immediately (Immediate) or four months later (Delayed). Youth were monitored at recruitment, 4 months (85% retention), and 24 months (74% retention). Employment increased dramatically: Only 48% had ever been employed at recruitment, 86% were employed from months 21 to 24 post recruitment. Over two years, decreases were recorded in the number of sexual partners, mental health symptoms, delinquent acts, and drug use; condom use increased. Providing employment in low income countries, in conjunction with HIV prevention, may provide sustained support to young people to prevent HIV acquisition. PMID:21800180

Rotheram-Borus, Mary Jane; Lightfoot, Marguerita; Kasirye, Rogers; Desmond, Katherine

2013-01-01

280

HIV/AIDS prevention in the Nepalese context.  

PubMed

With their numbers now approaching almost 30 million, Nepalese feature importantly in the South Asian demography. Yet, it has been only 60 years since Nepal gained international recognition as a nation-state. Nepal at present is one of the world's poorest countries and is in dire need of development, especially in the area of health. Given the current civil instability coupled with rapid modernization, the health and well-being of the Nepalese people have been increasingly affected by newer threats, such as HIV/AIDS. The present study discusses the uniqueness of the Nepalese context in relation to HIV/AIDS prevention. The authors suggest that HIV/AIDS prevention programs in Nepal should now focus more on adolescents from rural regions. The authors also suggest the ways one may approach the task of developing a prevention program targeting rural youths. PMID:18349353

Pokhrel, Pallav; Regmi, Shekhar; Piedade, Erica

2008-06-01

281

Spin models inferred from patient data faithfully describe HIV fitness landscapes and enable rational vaccine design  

E-print Network

Mutational escape from vaccine induced immune responses has thwarted the development of a successful vaccine against AIDS, whose causative agent is HIV, a highly mutable virus. Knowing the virus' fitness as a function of its proteomic sequence can enable rational design of potent vaccines, as this information can focus vaccine induced immune responses to target mutational vulnerabilities of the virus. Spin models have been proposed as a means to infer intrinsic fitness landscapes of HIV proteins from patient-derived viral protein sequences. These sequences are the product of non-equilibrium viral evolution driven by patient-specific immune responses, and are subject to phylogenetic constraints. How can such sequence data allow inference of intrinsic fitness landscapes? We combined computer simulations and variational theory \\'{a} la Feynman to show that, in most circumstances, spin models inferred from patient-derived viral sequences reflect the correct rank order of the fitness of mutant viral strains. Our f...

Shekhar, Karthik; Ferguson, Andrew L; Barton, John P; Kardar, Mehran; Chakraborty, Arup K

2013-01-01

282

Challenges in Mucosal HIV Vaccine Development: Lessons from Non-Human Primate Models  

PubMed Central

An efficacious HIV vaccine is urgently needed to curb the AIDS pandemic. The modest protection elicited in the phase III clinical vaccine trial in Thailand provided hope that this goal might be achieved. However, new approaches are necessary for further advances. As HIV is transmitted primarily across mucosal surfaces, development of immunity at these sites is critical, but few clinical vaccine trials have targeted these sites or assessed vaccine-elicited mucosal immune responses. Pre-clinical studies in non-human primate models have facilitated progress in mucosal vaccine development by evaluating candidate vaccine approaches, developing methodologies for collecting and assessing mucosal samples, and providing clues to immune correlates of protective immunity for further investigation. In this review we have focused on non-human primate studies which have provided important information for future design of vaccine strategies, targeting of mucosal inductive sites, and assessment of mucosal immunity. Knowledge gained in these studies will inform mucosal vaccine design and evaluation in human clinical trials. PMID:25196380

Tuero, Iskra; Robert-Guroff, Marjorie

2014-01-01

283

Soc Sci Med . Author manuscript From prenatal HIV testing of the mother to prevention of sexual HIV  

E-print Network

Soc Sci Med . Author manuscript Page /1 13 From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple Annabel Desgr es Du Loé û 1 * , Hermann Brou 1 2 , Annick Tijou Loé û Abstract The first step of prevention of mother-to-child HIV

Paris-Sud XI, Université de

284

For personal use. Only reproduce with permission from Elsevier Ltd. Most current candidate HIV vaccines seem to produce little  

E-print Network

vaccines seem to produce little protection against infection, but reduce viral load and slow the decline in CD4 lymphocyte numbers. Such disease- modifying vaccines could potentially provide important the following question: could disease-modifying HIV vaccines cause population-level perversity (ie, increase

Blower, Sally

285

Combination implementation for HIV prevention: moving from evidence to population-level impact  

PubMed Central

Summary The promise of combination HIV prevention—the application of multiple HIV prevention interventions to maximize population-level impact—has never been greater. However, to succeed in achieving significant reductions in HIV incidence, an additional concept needs to be considered—combination implementation. Combination implementation for HIV prevention is defined here as the pragmatic, localized application of evidence-based strategies to realize high sustained uptake and quality of HIV prevention interventions. This review explores diverse implementation strategies including HIV testing and counseling models, task shifting, linkage to and retention in care, antiretroviral therapy support, behavior change, demand creation, and structural interventions and discusses how they could be used in the provision of HIV prevention interventions such as medical male circumcision and treatment as prevention. Only through careful consideration of how to implement and operationalize HIV prevention interventions will the HIV community be able to move from clinical trial evidence to population-level impact. PMID:23257232

Chang, Larry W; Serwadda, David; Quinn, Thomas C; Wawer, Maria J; Gray, Ronald H; Reynolds, Steven J

2013-01-01

286

Using HIV Networks to Inform Real Time Prevention Interventions  

PubMed Central

Objective To reconstruct the local HIV-1 transmission network from 1996 to 2011 and use network data to evaluate and guide efforts to interrupt transmission. Design HIV-1 pol sequence data were analyzed to infer the local transmission network. Methods We analyzed HIV-1 pol sequence data to infer a partial local transmission network among 478 recently HIV-1 infected persons and 170 of their sexual and social contacts in San Diego, California. A transmission network score (TNS) was developed to estimate the risk of HIV transmission from a newly diagnosed individual to a new partner and target prevention interventions. Results HIV-1 pol sequences from 339 individuals (52.3%) were highly similar to sequences from at least one other participant (i.e., clustered). A high TNS (top 25%) was significantly correlated with baseline risk behaviors (number of unique sexual partners and insertive unprotected anal intercourse (p?=?0.014 and p?=?0.0455, respectively) and predicted risk of transmission (p<0.0001). Retrospective analysis of antiretroviral therapy (ART) use, and simulations of ART targeted to individuals with the highest TNS, showed significantly reduced network level HIV transmission (p<0.05). Conclusions Sequence data from an HIV-1 screening program focused on recently infected persons and their social and sexual contacts enabled the characterization of a highly connected transmission network. The network-based risk score (TNS) was highly correlated with transmission risk behaviors and outcomes, and can be used identify and target effective prevention interventions, like ART, to those at a greater risk for HIV-1 transmission. PMID:24901437

Little, Susan J.; Kosakovsky Pond, Sergei L.; Anderson, Christy M.; Young, Jason A.; Wertheim, Joel O.; Mehta, Sanjay R.; May, Susanne; Smith, Davey M.

2014-01-01

287

Evolving uses of oral reverse transcriptase inhibitors in the HIV-1 epidemic: from treatment to prevention  

PubMed Central

The HIV epidemic continues unabated, with no highly effective vaccine and no cure. Each new infection has significant economic, social and human costs and prevention efforts are now as great a priority as global antiretroviral therapy (ART) scale up. Reverse transcriptase inhibitors, the first licensed class of ART, have been at the forefront of treatment and prevention of mother to child transmission over the past two decades. Now, their use in adult prevention is being extensively investigated. We describe two approaches: treatment as prevention (TasP) - the use of combination ART (2NRTI and 1NNRTI) following HIV diagnosis to limit transmission and pre-exposure prophylaxis (PrEP) –the use of single or dual oral agents prior to sexual exposure. Prevention of mother-to-child transmission using NRTI has been highly successful, though does not involve sustained use of NRTI to limit transmission. Despite theoretical and preliminary support for TasP and PrEP, data thus far indicate that adherence, retention in care and late diagnosis are the major barriers to their successful, sustained implementation. Future advances in drug technologies will be needed to overcome the issue of drug adherence, through development of drugs that involve both less frequent dosing as well as reduced toxicity, possibly through specific targeting of infected cells. PMID:23902855

2013-01-01

288

Superior Control of HIV-1 Replication by CD8+ T Cells Targeting Conserved Epitopes: Implications for HIV Vaccine Design  

PubMed Central

A successful HIV vaccine will likely induce both humoral and cell-mediated immunity, however, the enormous diversity of HIV has hampered the development of a vaccine that effectively elicits both arms of the adaptive immune response. To tackle the problem of viral diversity, T cell-based vaccine approaches have focused on two main strategies (i) increasing the breadth of vaccine-induced responses or (ii) increasing vaccine-induced responses targeting only conserved regions of the virus. The relative extent to which set-point viremia is impacted by epitope-conservation of CD8+ T cell responses elicited during early HIV-infection is unknown but has important implications for vaccine design. To address this question, we comprehensively mapped HIV-1 CD8+ T cell epitope-specificities in 23 ART-naïve individuals during early infection and computed their conservation score (CS) by three different methods (prevalence, entropy and conseq) on clade-B and group-M sequence alignments. The majority of CD8+ T cell responses were directed against variable epitopes (p<0.01). Interestingly, increasing breadth of CD8+ T cell responses specifically recognizing conserved epitopes was associated with lower set-point viremia (r?=?- 0.65, p?=?0.009). Moreover, subjects possessing CD8+ T cells recognizing at least one conserved epitope had 1.4 log10 lower set-point viremia compared to those recognizing only variable epitopes (p?=?0.021). The association between viral control and the breadth of conserved CD8+ T cell responses may be influenced by the method of CS definition and sequences used to determine conservation levels. Strikingly, targeting variable versus conserved epitopes was independent of HLA type (p?=?0.215). The associations with viral control were independent of functional avidity of CD8+ T cell responses elicited during early infection. Taken together, these data suggest that the next-generation of T-cell based HIV-1 vaccines should focus on strategies that can elicit CD8+ T cell responses to multiple conserved epitopes of HIV-1. PMID:23741326

Kunwar, Pratima; Hawkins, Natalie; Dinges, Warren L.; Liu, Yi; Gabriel, Erin E.; Swan, David A.; Stevens, Claire E.; Maenza, Janine; Collier, Ann C.; Mullins, James I.; Hertz, Tomer; Yu, Xuesong; Horton, Helen

2013-01-01

289

Superior control of HIV-1 replication by CD8+ T cells targeting conserved epitopes: implications for HIV vaccine design.  

PubMed

A successful HIV vaccine will likely induce both humoral and cell-mediated immunity, however, the enormous diversity of HIV has hampered the development of a vaccine that effectively elicits both arms of the adaptive immune response. To tackle the problem of viral diversity, T cell-based vaccine approaches have focused on two main strategies (i) increasing the breadth of vaccine-induced responses or (ii) increasing vaccine-induced responses targeting only conserved regions of the virus. The relative extent to which set-point viremia is impacted by epitope-conservation of CD8(+) T cell responses elicited during early HIV-infection is unknown but has important implications for vaccine design. To address this question, we comprehensively mapped HIV-1 CD8(+) T cell epitope-specificities in 23 ART-naïve individuals during early infection and computed their conservation score (CS) by three different methods (prevalence, entropy and conseq) on clade-B and group-M sequence alignments. The majority of CD8(+) T cell responses were directed against variable epitopes (p<0.01). Interestingly, increasing breadth of CD8(+) T cell responses specifically recognizing conserved epitopes was associated with lower set-point viremia (r?=?- 0.65, p?=?0.009). Moreover, subjects possessing CD8(+) T cells recognizing at least one conserved epitope had 1.4 log10 lower set-point viremia compared to those recognizing only variable epitopes (p?=?0.021). The association between viral control and the breadth of conserved CD8(+) T cell responses may be influenced by the method of CS definition and sequences used to determine conservation levels. Strikingly, targeting variable versus conserved epitopes was independent of HLA type (p?=?0.215). The associations with viral control were independent of functional avidity of CD8(+) T cell responses elicited during early infection. Taken together, these data suggest that the next-generation of T-cell based HIV-1 vaccines should focus on strategies that can elicit CD8(+) T cell responses to multiple conserved epitopes of HIV-1. PMID:23741326

Kunwar, Pratima; Hawkins, Natalie; Dinges, Warren L; Liu, Yi; Gabriel, Erin E; Swan, David A; Stevens, Claire E; Maenza, Janine; Collier, Ann C; Mullins, James I; Hertz, Tomer; Yu, Xuesong; Horton, Helen

2013-01-01

290

Live attenuated rubella viral vectors stably express HIV and SIV vaccine antigens while reaching high titers  

PubMed Central

Live attenuated viruses make potent and effective vaccines. Despite the urgent need for an HIV vaccine, this approach has not been feasible, since it has not been possible to attenuate the virus reliably and guarantee vaccine safety. Instead, live viral vectors have been proposed that could present HIV vaccine antigens in the most immunogenic way, in the context of an active infection. We have adapted the rubella vaccine strain RA27/3 as a vector to express HIV and SIV antigens, and tested the effect of insert size and composition on vector stability and viral titer. We have identified an acceptor site in the rubella nonstructural gene region, where foreign genes can be expressed as a fusion protein with the nonstructural protein P150 without affecting essential viral functions. The inserts were expressed as early genes of rubella, under control of the rubella genomic promoter. At this site, HIV and SIV antigens were expressed stably for at least seven passages, as the rubella vectors reached high titers. Rubella readily infects rhesus macaques, and these animals will provide an ideal model for testing the new vectors for replication in vivo, immunogenicity, and protection against SIV or SHIV challenge. PMID:22776214

Virnik, Konstantin; Ni, Yisheng; Berkower, Ira

2012-01-01

291

Rational design of HIV vaccines and microbicides: report of the EUROPRISE annual conference 2011  

PubMed Central

Europrise is a Network of Excellence supported by the European Commission within the 6th Framework programme from 2007 to 2012. The Network has involved over 50 institutions from 13 European countries together with 3 industrial partners and 6 African countries. The Network encompasses an integrated program of research, training, dissemination and advocacy within the field of HIV vaccines and microbicides. A central and timely theme of the Network is the development of the unique concept of co-usage of vaccines and microbicides. Training of PhD students has been a major task, and some of these post-graduate students have here summarized novel ideas emanating from presentations at the last annual Europrise meeting in Prague. The latest data and ideas concerning HIV vaccine and microbicide studies are included in this review; these studies are so recent that the majority have yet to be published. Data were presented and discussed concerning novel immunisation strategies; microbicides and PrEP (alone and in combination with vaccines); mucosal transmission of HIV/SIV; mucosal vaccination; novel adjuvants; neutralizing antibodies; innate immune responses; HIV/SIV pathogenesis and disease progression; new methods and reagents. These – necessarily overlapping topics - are comprehensively summarised by the Europrise students in the context of other recent exciting data. PMID:22784600

2012-01-01

292

Safety and immunogenicity of a quadrivalent human papillomavirus vaccine in HIV-infected and HIV-negative adolescents and young adults.  

PubMed

Human papillomavirus (HPV) infection is highly prevalent and can lead to cancer; the development of safe and efficacious vaccines for HPV is a major public health concern. The two licensed HPV vaccines contain recombinant virus-like particles of HPV 16 and 18; one of such vaccines also protects against HPV types 6 and 11 which cause genital warts. We determined safety and immunogenicity of quadrivalent HPV vaccine in HIV-infected and HIV-negative adolescents and young adults, aged 13-27 years. The seroconversion rate, assessed by antibody titers, 1 month after the administration of the third vaccine dose was 0.85 (95% CI 0.75-0.95) in the HIV-infected group and 0.91 (0.83-0.99) in the HIV-negative subjects (p=0.52). The vaccine was generally safe and well tolerated; the most common side effect was local pain and the most frequent systemic side effect was headache. This is the first report on response to HPV vaccination in both female and male HIV-infected adolescents and young adults and highlights that this population may benefit from HPV immunoprophylaxis. Further studies are needed to examine the long term efficacy of this vaccine in HIV-infected individuals. PMID:25149430

Giacomet, Vania; Penagini, Francesca; Trabattoni, Daria; Viganò, Alessandra; Rainone, Veronica; Bernazzani, Giada; Bonardi, Claudia Maria; Clerici, Mario; Bedogni, Giorgio; Zuccotti, Gian Vincenzo

2014-09-29

293

Exploring the role of economic empowerment in HIV prevention.  

PubMed

It has been argued that women's economic vulnerability and dependence on men increases their vulnerability to HIV by constraining their ability to negotiate the conditions, including sexual abstinence, condom use and multiple partnerships, which shape their risk of infection. In the face of escalating infection rates among women, and particularly young women, many have pointed to the potential importance of economic empowerment strategies for HIV prevention responses. Global evidence suggests that the relationship between poverty and HIV risk is complex, and that poverty on its own cannot be viewed simplistically as a driver of the HIV epidemic. Rather, its role appears to be multidimensional and to interact with a range of other factors, including mobility, social and economic inequalities and social capital, which converge in a particularly potent way for young women living in southern Africa. To date, there have been few interventions that have explicitly attempted to combine economic empowerment with the goal of HIV prevention, and even fewer that have been rigorously evaluated. This paper explores how programmes such as microfinance, livelihood training and efforts to safeguard women's food security and access to property have begun to incorporate an HIV prevention focus. Although such circumscribed interventions, by themselves, are unlikely to lead to significant impacts on a national or regional scale, they are useful for testing cross-sectoral partnership models, generating practical lessons and providing a metaphor for what might be possible in promoting women's economic empowerment more broadly. Despite numerous calls to 'mainstream AIDS' in economic development, cross-sectoral responses have not been widely taken up by government or other stakeholders. We suggest potential reasons for limited progress to date and conclude by presenting programme and policy recommendations for further exploring and harnessing linkages between economic empowerment and HIV prevention in Southern Africa. PMID:19033756

Kim, Julia; Pronyk, Paul; Barnett, Tony; Watts, Charlotte

2008-12-01

294

Strategy to Better Select HIV-Infected Individuals for Latent TB Treatment in BCG-Vaccinated Population  

PubMed Central

Objective To evaluate the T-SPOT.TB interferon-? releasing assay and the tuberculin skin test (TST), for the diagnosis of latent tuberculosis infection(LTBI) and the development of subsequent active tuberculosis, in BCG-vaccinated HIV-infected individuals. Methods HIV-infected individuals without clinical suspicion of active TB or a past history of TB were enrolled from 1 January 2008 to 30 November 2010. Both T-SPOT.TB test and TST were offered to the participants whom were followed up prospectively until April 30, 2012 for development of TB. Results Among the 909 participants, 25% had positive TST reactions with cut-off point of 5 mm and 15% had positive T-SPOT.TB results. After a median follow-up of 2.97 years, there were 5 cases developed culture-confirmed active TB (all had dual positive TST and T-SPOT.TB results), and the incidence was 0.17 per 100 person-years. The relative risks (RRs) for subsequent active TB in HIV-infected individuals with positive TST results, positive T-SPOT.TB results and dual positive results compared with the risk for individuals with negative results were 40.6 (95% CI 2.1–767.9), 73.9 (95% CI 3.9–1397.7) and 226.5 (95% CI 12.0–4284), respectively. The number needed to treat to prevent one subsequent TB case among patients with a positive TST, a positive T-SPOT.TB and dual positive results was 35, 22 and 8 respectively. Conclusions Adopting positive results of the TST and T-SPOT.TB to screen LTBI among BCG-vaccinated HIV-infected individuals might be feasible. Number needed to treat for isoniazid preventive therapy could be reduced significantly by using dual positive strategy. PMID:24015285

Yang, Chin-Hui; Chan, Pei-Chun; Liao, Say-Tsung; Cheng, Shu-Hsing; Wong, Wing-Wai; Huang, Li-Min; Hsueh, Po-Ren; Chiou, Hung-Yi

2013-01-01

295

HIV Treatment as Prevention: Optimising the Impact of Expanded HIV Treatment Programmes  

Microsoft Academic Search

Until now, decisions about how to allocate ART have largely been based on maximising the therapeutic benefit of ART for patients. Since the results of the HPTN 052 study showed efficacy of antiretroviral therapy (ART) in preventing HIV transmission, there has been increased interest in the benefits of ART not only as treatment, but also in prevention. Resources for expanding

Wim Delva; Jeffrey W. Eaton; Fei Meng; Christophe Fraser; Richard G. White; Peter Vickerman; Marie-Claude Boily; Timothy B. Hallett

2012-01-01

296

HIV PREVENTION FOR MIGRANTS IN TRANSIT: DEVELOPING AND TESTING TRAIN  

PubMed Central

This study was a pilot investigation of the feasibility, acceptability, and effects of TRAIN (Transit to Russia AIDS Intervention with Newcomers) a three-session HIV preventive intervention for Tajik male labor migrants performed in transit. Sixty adult Tajik male labor migrants on the 5-day train ride from Dushanbe to Moscow were randomly assigned to either the intervention or a control condition. Each initially completed an in-person survey then another 3 days later (immediately postintervention), and participated in a cell phone survey three months later. All participants came to all intervention sessions, were satisfied with the program, and completed all postassessments. In comparison with the controls, the TRAIN group reported significant increases in condom use with sex workers and non-sex workers, condom knowledge, worry about HIV/AIDS, talking with persons about HIV/AIDS, talking with wife about HIV/AIDS, community activities, and religious activities. HIV/AIDS prevention performed in transit is feasible, accceptable, and potentially efficacious in diminishing HIV risk behaviors in labor migrants. PMID:21696244

Bahromov, Mahbat; Weine, Stevan

2013-01-01

297

HIV Treatment as Prevention: Considerations in the Design, Conduct, and Analysis of Cluster Randomized Controlled Trials of Combination HIV Prevention  

PubMed Central

The rigorous evaluation of the impact of combination HIV prevention packages at the population level will be critical for the future of HIV prevention. In this review, we discuss important considerations for the design and interpretation of cluster randomized controlled trials (C-RCTs) of combination prevention interventions. We focus on three large C-RCTs that will start soon and are designed to test the hypothesis that combination prevention packages, including expanded access to antiretroviral therapy, can substantially reduce HIV incidence. Using a general framework to integrate mathematical modelling analysis into the design, conduct, and analysis of C-RCTs will complement traditional statistical analyses and strengthen the evaluation of the interventions. Importantly, even with combination interventions, it may be challenging to substantially reduce HIV incidence over the 2- to 3-y duration of a C-RCT, unless interventions are scaled up rapidly and key populations are reached. Thus, we propose the innovative use of mathematical modelling to conduct interim analyses, when interim HIV incidence data are not available, to allow the ongoing trials to be modified or adapted to reduce the likelihood of inconclusive outcomes. The preplanned, interactive use of mathematical models during C-RCTs will also provide a valuable opportunity to validate and refine model projections. PMID:22807657

Boily, Marie-Claude; Masse, Benoit; Alsallaq, Ramzi; Padian, Nancy S.; Eaton, Jeffrey W.; Vesga, Juan F.; Hallett, Timothy B.

2012-01-01

298

HIV prevention for rural youth in Nigeria: background overview.  

PubMed

The negative impact of the HIV/AIDS epidemic has been a major challenge to sub-Saharan Africa. Although the rate of new HIV infections in sub-continent has decreased, the total number of people living with HIV continues to rise. Most of the people infected with HIV/AIDS in sub-Saharan Africa are within the age bracket of 15 to 35 years. It has been estimated that about 80% of the infected group are aged 20-29 years. It is against the background of the challenges posed by HIV/AIDS to young people that the Canadian-Nigerian partnership Action Research on HIV Prevention for Rural Youth was conceived. This paper provides the background to the outcomes reported in this special edition of this journal by reviewing the HIV/AIDS situation in sub-Saharan Africa and the nature of the associated response; discussing the rationale for the Action Research which focuses on Nigeria; and outlining the key components of the research. PMID:22916542

Onokerhoraye, Andrew G; Maticka-Tyndale, Eleanor

2012-06-01

299

Effective HIV prevention: the indispensable role of social science  

PubMed Central

This paper examines the ways in which HIV prevention is understood including “biomedical”, “behavioural”, “structural”, and “combination” prevention. In it I argue that effective prevention entails developing community capacity and requires that public health addresses people not only as individuals but also as connected members of groups, networks and collectives who interact (talk, negotiate, have sex, use drugs, etc.) together. I also examine the evaluation of prevention programmes or interventions and argue that the distinction between efficacy and effectiveness is often glossed and that, while efficacy can be evaluated by randomized controlled trials, the evaluation of effectiveness requires long-term descriptive strategies and/or modelling. Using examples from a number of countries, including a detailed account of the Australian HIV prevention response, effectiveness is shown to be dependent not only on the efficacy of the prevention technology or tool but also on the responses of people – individuals, communities and governments – to those technologies. Whether a particular HIV prevention technology is adopted and its use sustained depends on a range of social, cultural and political factors. The paper concludes by calling on biomedical and social scientists to work together and describes a “social public health”. PMID:22713254

Kippax, Susan

2012-01-01

300

Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here?  

PubMed

Antiretroviral drugs that inhibit viral replication were expected to reduce transmission of HIV by lowering the concentration of HIV in the genital tract. In 11 of 13 observational studies, antiretroviral therapy (ART) provided to an HIV-infected index case led to greatly reduced transmission of HIV to a sexual partner. In the HPTN 052 randomised controlled trial, ART used in combination with condoms and counselling reduced HIV transmission by 96·4%. Evidence is growing that wider, earlier initiation of ART could reduce population-level incidence of HIV. However, the full benefits of this strategy will probably need universal access to very early ART and excellent adherence to treatment. Challenges to this approach are substantial. First, not all HIV-infected individuals can be located, especially people with acute and early infection who are most contagious. Second, the ability of ART to prevent HIV transmission in men who have sex with men (MSM) and people who use intravenous drugs has not been shown. Indeed, the stable or increased incidence of HIV in MSM in some communities where widespread use of ART has been established emphasises the concern that not enough is known about treatment as prevention for this crucial population. Third, although US guidelines call for immediate use of ART, such guidelines have not been embraced worldwide. Some experts do not believe that immediate or early ART is justified by present evidence, or that health-care infrastructure for this approach is sufficient. These concerns are very difficult to resolve. Ongoing community-based prospective trials of early ART are likely to help to establish the population-level benefit of ART, and-if successful-to galvanise treatment as prevention. PMID:24152938

Cohen, Myron S; Smith, M Kumi; Muessig, Kathryn E; Hallett, Timothy B; Powers, Kimberly A; Kashuba, Angela D

2013-11-01

301

Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here?  

PubMed Central

Antiretroviral drugs that inhibit viral replication were expected to reduce transmission of HIV by lowering the concentration of HIV in the genital tract. In 11 of 13 observational studies, antiretroviral therapy (ART) provided to an HIV-infected index case led to greatly reduced transmission of HIV to a sexual partner. In the HPTN 052 randomised controlled trial, ART used in combination with condoms and counselling reduced HIV transmission by 96·4%. Evidence is growing that wider, earlier initiation of ART could reduce population-level incidence of HIV. However, the full benefits of this strategy will probably need universal access to very early ART and excellent adherence to treatment. Challenges to this approach are substantial. First, not all HIV-infected individuals can be located, especially people with acute and early infection who are most contagious. Second, the ability of ART to prevent HIV transmission in men who have sex with men (MSM) and people who use intravenous drugs has not been shown. Indeed, the stable or increased incidence of HIV in MSM in some communities where widespread use of ART has been established emphasises the concern that not enough is known about treatment as prevention for this crucial population. Third, although US guidelines call for immediate use of ART, such guidelines have not been embraced worldwide. Some experts do not believe that immediate or early ART is justified by present evidence, or that health-care infrastructure for this approach is sufficient. These concerns are very difficult to resolve. Ongoing community-based prospective trials of early ART are likely to help to establish the population-level benefit of ART, and—if successful—to galvanise treatment as prevention. PMID:24152938

Cohen, Myron S; Smith, M Kumi; Muessig, Kathryn E; Hallett, Timothy B; Powers, Kimberly A; Kashuba, Angela D

2013-01-01

302

Young people and HIV prevention in Australian schools.  

PubMed

Australia has not seen a Human Immunodeficiency Virus (HIV) epidemic among young people. However, early research in the Australian context had indicated that the degree of unprotected sexual activity, partner change, and STI infection in this cohort would fuel a young people's epidemic if HIV ever reached a tipping point in the country. The difficulty of reaching young people outside school for HIV prevention has been no more successfully addressed in Australia than elsewhere. Therefore, the investment of Australian HIV prevention funds for youth has had an emphasis on school-based programs. This emphasis on formal schooling has led to a history of engagement with the ad hoc and unreliable nature of sexuality education in Australian schools. It has particularly been the catalyst for a struggle to construct young people as sexually active and as possessing a right to appropriate education, against tides of both secular and religiously-motivated resistance. The eight state and territory education sectors, along with the independent sectors, have had differing and sometimes troubled histories with HIV prevention. This paper discusses the differing HIV education policies and programs that have emerged in Australian schooling historically, and in some cases been abandoned altogether, amid strong public debates. It also considers current approaches, the new national curriculum, and future challenges. Additionally, the particular case of same sex attracted young men, who have a heightened level of vulnerability to HIV, is explored. Australian schools have struggled to address both the imperative for relevant sexuality education for same-sex-attracted young people and the broader issue of combating homophobia, which research has linked directly to this vulnerability. PMID:24846485

Jones, Tiffany; Mitchell, Anne

2014-06-01

303

BART to HIVEd: adapting an HIV education prevention program.  

PubMed

One of the fastest growing segments of the population infected with HIV is the nation's youths. Thus, prevention in this high-risk population is vital. The authors detail the process of adapting an evidence-based HIV/AIDS educational program (HIVEd) to the unique needs of high-risk youths in adjudicated and detained facilities and alternative high schools. The HIVEd program derives from St. Lawrence's Becoming A Responsible Teen (BART) curriculum. This article describes the modification of BART into HIVEd, identifies the challenges encountered and lessons learned, and suggests future directions for HIVEd as a useful tool for prevention of HIV/AIDS and sexually transmitted infection in high-risk youths. PMID:18166667

Polacek, Georgia N L J; Coker, Jennifer; Lewis, Kayan L; Minter, Monica; Villela-Perez, Verónica; Scott, Anthony A

2008-01-01

304

Assessing vaccine efficacy for the prevention of acute otitis media by pneumococcal vaccination in children: A methodological overview of statistical practice in randomized controlled clinical trials  

Microsoft Academic Search

Acute otitis media (AOM) is the most common bacterial infectious disease among children. Vaccination is proposed to prevent otitis and several clinical trials were performed to assess the efficacy of pneumococcal vaccines. The way vaccine efficacy is analysed varies among trials. However, the clinical meaning of an estimate of vaccine effect and its statistical test depends on the applied statistical

Antje Jahn-Eimermacher; Jean-Baptist du Prel; Heinz-Josef Schmitt

2007-01-01

305

76 FR 66721 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment  

Federal Register 2010, 2011, 2012, 2013

...Prevention CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In accordance...activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health...

2011-10-27

306

Addressing HIV prevention research priorities in the United States  

PubMed Central

More than half a million Americans became newly infected with HIV in the first decade of the new millennium. The domestic epidemic has had the heaviest impact on men who have sex with men (MSM) and people from racial and ethnic minority populations, particularly African-Americans. For example, Black MSM represent <1% of the U.S. population but 25% of the new HIV cases, as per CDC estimates published in 2008. While Black and Hispanic women constitute 24% of all U.S. women, they accounted for 82% of HIV cases in women in 2005, based on data from 33 states with confidential name-based reporting. There is a nearly 23-fold higher rate of AIDS diagnoses for Black women (45.5/100,000 women) and nearly 6-fold higher rate for Hispanic women (11.2/100,000) compared to the rate for white women (2.0/100,000). Investigators from the HIV Prevention Trials Network (HPTN), an NIH-sponsored collaborative clinical trials group, have crafted a domestic research agenda with community input. Two new domestic studies are in progress (2009) and a community-based clinical trial feasibility effort is in development (2010 start date). These studies focus on outreach, testing, and treatment of infected persons as a backbone for HIV prevention. Reaching persons not receiving health message and service with novel approaches to both prevention and care/treatment is an essential priority for HIV control in the U.S.; our research is designed to guide the best approaches and assess the impact of bridging treatment and prevention. PMID:20397942

Vermund, Sten H.; Hodder, Sally L.; Justman, Jessica E.; Koblin, Beryl A.; Mastro, Timothy D.; Mayer, Kenneth H.; Wheeler, Darrell P.; El-Sadr, Wafaa M.

2010-01-01

307

A Theoretical Approach to School-based HIV Prevention.  

ERIC Educational Resources Information Center

Presents examples of appropriate intervention strategies for professionals working with school-based human immunodeficiency virus (HIV) prevention among adolescents. A multidisciplinary approach is advisable because influencing adolescent sexual behavior is a complex matter. Consistent, continuous messages through multiple channels and by multiple…

DeMuth, Diane; Symons, Cynthia Wolford

1989-01-01

308

Engaging Community Businesses in HIV Prevention: A Feasibility Study  

PubMed Central

Purpose To explore the feasibility of engaging community businesses in HIV prevention. Design Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-, and post-program. Customer feedback was obtained through an online survey. Setting San Diego, California neighborhood with a high rate of AIDS. Subjects Fifty-one business owners/managers representing 10 retail categories, and 52 customers. Measures Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction and willingness to provide future support for HIV prevention. Analysis Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. Results The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or refused to participate (41%), p <.05. Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures, p < .05. More than 90% of customers supported distributing condoms and brochures in businesses and 96% of business owners/managers described their program experience as “positive.” Conclusion Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested. PMID:20465150

Rovniak, Liza S.; Hovell, Melbourne F.; Hofstetter, C. Richard; Blumberg, Elaine J.; Sipan, Carol L.; Batista, Marcia F.; Martinez-Donate, Ana P.; Mulvihill, Mary M.; Ayala, Guadalupe X.

2009-01-01

309

Client Preferences for STD/HIV Prevention Programs.  

ERIC Educational Resources Information Center

Conducted a formative research study designed to elicit preferences for sexually transmitted disease (STD)/HIV prevention programs from clients at a midwestern STD clinic. Responses of 126 participants show preferences for mixed group or individual meetings with counselors, with extensive intervention less favored than single sessions. Discusses…

Hennessy, Michael; Mercier, Michele M.; Williams, Samantha P.; Arno, Janet N.

2002-01-01

310

Levels of childhood vaccination coverage and the impact of maternal HIV status on child vaccination status in rural KwaZulu-Natal, South Africa  

Microsoft Academic Search

Summary objectives To analyse coverage of childhood vaccinations in a rural South African population and investigate whether maternal HIV status is associated with children's vaccination status. methods 2 431 children with complete information, 12-23 months of age at some point during the period January 2005 through December 2006 and resident in the Africa Centre Demographic Surveil- lance Area at the

James Ndirangu; Till Bärnighausen; Frank Tanser; Khin Tint; Marie-Louise Newell

2009-01-01

311

The HIV-1 gp120 V1V2 loop: structure, function and importance for vaccine development.  

PubMed

Although the second variable loop (V2) of the HIV-1 gp120 envelope glycoprotein shows substantial sequence diversity between strains, its functional importance imposes critical conservation of structure, and within particular microdomains, of sequence. V2 influences HIV-1 viral entry by contributing to trimer stabilization and co-receptor binding. It is one of 4 key domains targeted by the broadly neutralizing antibodies that arise during HIV-1 infection. HIV-1 uses V1V2 sequence variation and glycosylation to escape neutralizing antibody. In the Thai Phase III HIV-1 vaccine trial, RV144, vaccine-induced IgG against V1V2 inversely correlated with the risk of HIV-1 acquisition, and HIV-1 strains infecting RV144 vaccine recipients differed from those infecting placebo recipients in the V2 domain. Similarly, non-human primate challenge studies demonstrated an inverse correlation between vaccine-induced anti-V2 responses and simian immunodeficiency virus acquisition. We hypothesize that increased magnitude, frequency and duration of vaccine-induced anti-V2 antibody responses should improve efficacy afforded by pox-protein prime-boost HIV vaccine strategies. PMID:25163695

O'Connell, Robert J; Kim, Jerome H; Excler, Jean-Louis

2014-12-01

312

My continuing efforts toward the eradication of the vaccine-preventable diseases from Japan  

Microsoft Academic Search

When compared to the Western countries, unfortunately, the progress toward the eradication of vaccine-preventable diseases in Japan has been relatively slow and hampered by some problems inherent to Japan. Concerning this, I have been working on the vaccine-preventable diseases, that is, measles, influenza, Haemophilus influenzae, and Streptcoccus pneumoniae infections. My first work was to produce monoclonal antibodies against measles virus

Takehiro Togashi

2011-01-01

313

Issues in Women's Participation in a Phase III Community HIV Vaccine Trial in Thailand  

PubMed Central

Abstract To assess qualities and outcomes of women participating in a large, community-based HIV vaccine trial, the present study was conducted among female participants of the RV 144 prime-boost trial in Thailand from 2003 to 2009. Qualities of participation refer to complete vaccination, retention, and status change. Outcomes of participation refer to incident rate, adverse event, and participation impact event. A total of 6,334 (38.6%) women participated in the trial, of whom about 50% were classified as low risk and 11% as high risk. About 85% of participants completed four vaccinations and 76% were included in the per-protocol analysis of the on-time vaccination schedule. More women (88%) completed 42 months follow-up compared with men (85%). Women aged 21 and above had more adverse events compared to younger age groups. More women (5%) compared with men (3%) reported participation impact events (PIEs). High-risk women had more PIEs and a higher infection rate compared to the low-risk group. Complete vaccination and retention on last follow-up were more common in married women aged above 21, and being a housewife. Female volunteers showed the same qualities and outcomes of participation as males in the HIV vaccine trial. There was no statistically significant difference in vaccine efficacy between men and women, especially among the high-risk and married women. The study highlighted the important behavioral, social, and cultural issues that could be considered for future HIV vaccine trial designs. PMID:23343395

Kaewkungwal, Jaranit; Rerks-ngarm, Supachai; Nitayaphan, Sorachai; Khamboonruang, Chirasak; Kunasol, Prayura; Suntharasamai, Pravan; Pungpak, Swangjai; Vanijanonta, Sirivan; Bussaratid, Valai; Maek-a-nantawat, Wirach; Dhitavat, Jittima; Thongcharoen, Prasert; Pawarana, Rungrawee; Sabmee, Yupa; Benenson, Mike W.; Morgan, Patricia; O’Connell, Robert J.; Kim, Jerome

2013-01-01

314

Supporting Healthy Alternatives through Patient Education: a theoretically driven HIV prevention intervention for persons living with HIV/AIDS.  

PubMed

In the third decade of the HIV/AIDS epidemic, empirically based HIV transmission risk reduction interventions for HIV infected persons are still needed. As part of a Health Resources Services Administration/Special Projects of National Significance initiative to increase prevention services among HIV infected persons, we implemented SHAPE (Supporting Healthy Alternatives through Patient Education). SHAPE is a behavioral HIV prevention intervention delivered to HIV infected persons receiving primary medical care at El Rio Health Center in Tucson, Arizona. The SHAPE intervention is based on Kalichman's "Healthy Relationships for Men and Women Living with HIV-AIDS." The intervention is interactive and uses a video discussion intervention format where educational activities, movie clips, and discussions are used to provide participants with information and skills to increase their comfort in disclosing their HIV status and in reducing HIV transmission. This paper describes the intervention in sufficient detail to replicate it in other settings. PMID:17265144

Estrada, Barbara D; Trujillo, Stephen; Estrada, Antonio L

2007-09-01

315

Using "epitomes" to model genetic diversity: Rational design of HIV vaccine cocktails  

E-print Network

vaccines covering a large number of immune system targets known as epitopes. Our experiments show and across instances of a certain class of a natural signal, such as a facial image, a bird song recording our algorithms are likely to have broader predicted coverage of immune targets in HIV than

Frey, Brendan J.

316

HIV Testing Practices and Attitudes on Prevention Efforts in Six Diverse Chicago Communities  

Microsoft Academic Search

Data describing local level HIV testing practices and attitudes regarding HIV prevention are rarely available, yet would be\\u000a useful for HIV policy and evaluation. A comprehensive health survey was conducted in six community areas of Chicago (n = 1,699) in 2002–2003. The HIV prevention module of this survey was used for this analysis. The proportion that ever tested\\u000a for HIV ranged from

Kristi L. Allgood; Abigail Silva; Ami Shah; Steven Whitman

2009-01-01

317

Effect of multivitamin supplementation on measles vaccine response among HIV-exposed uninfected Tanzanian infants.  

PubMed

Immunization and nutritional interventions are mainstays of child health programs in sub-Saharan Africa, yet few published data exist on their interactions. HIV-exposed (but uninfected) infants enrolled in a randomized placebo-controlled trial of multivitamin supplements (vitamins B complex, C, and E) conducted in Tanzania were sampled for an assessment of measles IgG quantity and avidity at 15 to 18 months. Infants were vaccinated between 8.5 and 12 months of age, and all mothers received high-dose multivitamins as the standard of care. Of 201 HIV-exposed infants who were enrolled, 138 (68.7%) were seropositive for measles. There were no effects of infant multivitamin supplementation on measles seroconversion proportions, IgG concentrations, or IgG avidity (P > 0.05). The measles seroconversion proportion was greater for HIV-exposed infants vaccinated at 10 to 11 months of age than for those vaccinated at 8.5 to 10 months (P = 0.032) and greater for infants whose mothers had a CD4 T-cell count of <200 cells/?l than for infants whose mothers had a CD4 T-cell count of >350 cells/?l (P = 0.039). Stunted infants had a significantly decreased IgG quantity compared to nonstunted infants (P = 0.012). As for measles avidity, HIV-exposed infants vaccinated at 10 to 11 months had increased antibody avidity compared to those vaccinated at 8.5 to 10 months (P = 0.031). Maternal CD4 T-cell counts of <200 cells/?l were associated with decreased avidity compared to counts of >350 cells/?l (P = 0.047), as were lower infant height-for-age z-scores (P = 0.016). Supplementation with multivitamins containing B complex, C, and E does not appear to improve measles vaccine responses for HIV-exposed infants. Studies are needed to better characterize the impact of maternal HIV disease severity on the immune system development of HIV-exposed infants and the effect of malnutrition interventions on vaccine responses. (This study has been registered at ClinicalTrials.gov under registration no. NCT00197730.). PMID:23720367

Sudfeld, Christopher R; Duggan, Christopher; Histed, Alex; Manji, Karim P; Meydani, Simin N; Aboud, Said; Wang, Molin; Giovannucci, Edward L; Fawzi, Wafaie W

2013-08-01

318

Efficacy of a preventive intervention for youths living with HIV.  

PubMed Central

OBJECTIVES: HIV transmission behaviors and health practices of HIV-infected youths were examined over a period of 15 months after they received a preventive intervention. METHODS: HIV-infected youths aged 13 to 24 years (n = 310; 27% African American, 37% Latino) were assigned by small cohort to (1) a 2-module ("Stay Healthy" and "Act Safe") intervention totaling 23 sessions or (2) a control condition. Among those in the intervention condition, 73% attended at least 1 session. RESULTS: Subsequent to the "Stay Healthy" module, number of positive lifestyle changes and active coping styles increased more often among females who attended the intervention condition than among those in the control condition. Social support coping also increased significantly among males and females attending the intervention condition compared with those attending the control condition. Following the "Act Safe" module, youths who attended the intervention condition reported 82% fewer unprotected sexual acts, 45% fewer sexual partners, 50% fewer HIV-negative sexual partners, and 31% less substance use, on a weighted index, than those in the control condition. CONCLUSIONS: Prevention programs can effectively reduce risk acts among HIV-infected youths. Alternative formats need to be identified for delivering interventions (e.g., telephone groups, individual sessions). PMID:11236404

Rotheram-Borus, M J; Lee, M B; Murphy, D A; Futterman, D; Duan, N; Birnbaum, J M; Lightfoot, M

2001-01-01

319

Cash transfers for HIV prevention: considering their potential  

PubMed Central

Introduction Cash payments to vulnerable households and/or individuals have increasingly garnered attention as a means to reduce poverty, improve health and achieve other development-related outcomes. Recent evidence from Malawi and Tanzania suggests that cash transfers can impact HIV-related behaviours and outcomes and, therefore, could serve as an important addition to HIV prevention efforts. Discussion This article reviews the current evidence on cash transfers for HIV prevention and suggests unresolved questions for further research. Gaps include (1) understanding more about the mechanisms and pathways through which cash transfers affect HIV-related outcomes; (2) addressing key operational questions, including the potential feasibility and the costs and benefits of different models of transfers and conditionality; and (3) evaluating and enhancing the wider impacts of cash transfers on health and development. Conclusions Ongoing and future studies should build on current findings to unpack unresolved questions and to collect additional evidence on the multiple impacts of transfers in different settings. Furthermore, in order to address questions on sustainability, cash transfer programmes need to be integrated with other sectors and programmes that address structural factors such as education and programming to promote gender equality and address HIV. PMID:23972159

Heise, Lori; Lutz, Brian; Ranganathan, Meghna; Watts, Charlotte

2013-01-01

320

New ways of preventing HIV infection: thinking simply, simply thinking  

PubMed Central

HIV infection is the greatest health crisis in human history. It continues to spread unchecked among the poor in the developing world because we have failed to design simple preventative methods that are available and affordable to those living on under $2 a day. Five new methods are discussed. (i) A natural microbicide. Intravaginal lime or lemon juice has been used for centuries as a traditional contraceptive. The juice can also kill HIV in the laboratory, but clinical trials are needed to see if vaginal application is acceptable, safe and effective. (ii) Intravaginal oestrogen. Monkeys can be protected from Simian immunodeficiency virus (SIV) infection by keratinizing the vagina with topical oestrogen. If women take the oral contraceptive pill vaginally it retains its contraceptive efficacy, and the oestrogen it contains should thicken the vagina and protect against HIV infection. Clinical trials are needed. (iii) Male circumcision. Removal of the inner foreskin removes the main site of HIV entry into the penis, resulting in a sevenfold reduction in susceptibility to infection. The practice needs to be promoted. (iv) Post-coital penile hygiene. Wiping the penis immediately after intercourse with lime or lemon juice or vinegar should kill the virus before it has had a chance to infect. A clinical trial of efficacy is needed. (v) PhotoVoice. Asking schoolchildren in developing countries to photograph their impressions of HIV/AIDS is a powerful way of getting them to discuss the subject openly, and develop their own preventative strategies. PMID:16627296

Short, R.V

2006-01-01

321

Are MSM willing to SMS for HIV prevention?  

PubMed

Text messaging is a potential HIV-prevention tool for men who have sex with men (MSM), specifically young MSM and MSM of color. To determine the willingness of MSM to receive text messages as part of an HIV-prevention intervention, we administered an online survey to MSM recruited from MySpace.com, which included questions about mobile phone ownership and willingness to participate in a future text message-based HIV research study. Of participants, 85% (n = 5,378) reported owning a mobile phone and 49% (n = 2,483) of mobile phone owners reported being willing to receive text messages in a future HIV research study. Black and Hispanic men were more willing than White non-Hispanic men to receive text messages. Men with a college degree were less willing to receive texts than men with a high school level of education, and men >22 years old were less likely to be willing to receive texts than those younger than 22 years of age. The authors' findings demonstrate that willingness to receive text messages as part of an HIV research study is moderate, and mirrors patterns of text message use in age and race. Variations in willingness should be taken into account when designing and implementing future interventions. PMID:23905653

Khosropour, Christine M; Lake, Jason G; Sullivan, Patrick S

2014-01-01

322

Biocompatible Anionic Polymeric Microspheres as Priming Delivery System for Effetive HIV/AIDS Tat-Based Vaccines  

PubMed Central

Here we describe a prime-boost regimen of vaccination in Macaca fascicularis that combines priming with novel anionic microspheres designed to deliver the biologically active HIV-1 Tat protein and boosting with Tat in Alum. This regimen of immunization modulated the IgG subclass profile and elicited a balanced Th1-Th2 type of humoral and cellular responses. Remarkably, following intravenous challenge with SHIV89.6Pcy243, vaccinees significantly blunted acute viremia, as compared to control monkeys, and this control was associated with significantly lower CD4+ T cell depletion rate during the acute phase of infection and higher ability to resume the CD4+ T cell counts in the post-acute and chronic phases of infection. The long lasting control of viremia was associated with the persistence of high titers anti-Tat antibodies whose profile clearly distinguished vaccinees in controllers and viremics. Controllers, as opposed to vaccinated and viremic cynos, exhibited significantly higher pre-challenge antibody responses to peptides spanning the glutamine-rich and the RGD-integrin-binding regions of Tat. Finally, among vaccinees, titers of anti-Tat IgG1, IgG3 and IgG4 subclasses had a significant association with control of viremia in the acute and post-acute phases of infection. Altogether these findings indicate that the Tat/H1D/Alum regimen of immunization holds promise for next generation vaccines with Tat protein or other proteins for which maintenance of the native conformation and activity are critical for optimal immunogenicity. Our results also provide novel information on the role of anti-Tat responses in the prevention of HIV pathogenesis and for the design of new vaccine candidates. PMID:25356594

Titti, Fausto; Maggiorella, Maria T.; Ferrantelli, Flavia; Sernicola, Leonardo; Bellino, Stefania; Collacchi, Barbara; Belasio, Emanuele Fanales; Moretti, Sonia; Pavone Cossut, Maria Rosaria; Belli, Roberto; Olivieri, Erika; Farcomeni, Stefania; Compagnoni, Daniela; Michelini, Zuleika; Sabbatucci, Michela; Sparnacci, Katia; Tondelli, Luisa; Laus, Michele; Cafaro, Aurelio; Caputo, Antonella; Ensoli, Barbara

2014-01-01

323

Structural Interventions for HIV Prevention in the United States  

PubMed Central

Background Structural interventions change the environment in which people act, in order to influence their health behaviors. Most structural interventions research for HIV infection has focused on developing countries, with the United States receiving substantially less attention. This article identifies some social determinants of HIV vulnerability in the United States and structural interventions to address them. Methods Review of the medical, public health, and social science literature. Results Evidence supports widespread implementation of a number of structural interventions in the United States clearly proximate to HIV, including comprehensive sex education, universal condom availability, expanded syringe access for drug users, health care coverage, and stable housing. Sociological plausibility supports evaluation and implementation of other interventions that target social determinants more distal but of relevance to HIV, such as initiatives to eliminate racial and ethnic disparities in criminal sentencing, to promote early childhood education, and to decrease poverty. Conclusion Structural interventions that address social determinants of HIV infection may be among the most cost effective methods of preventing HIV infection in the United States over the long term. PMID:21406983

Adimora, Adaora A.; Auerbach, Judith D.

2014-01-01

324

Short Communication: HIV-1 Nef Protein Carries Multiple Epitopes Suitable for Induction of Cellular Immunity for an HIV Vaccine in Africa.  

PubMed

Abstract Using the early protein HIV Nef, new HLA class I binding epitopes of importance for immune responses to HIV were predicted for common African alleles. In total we identified 45 epitopes previously not described for the HLA alleles A*30:01, A*30:02, B*58:01, and C*07:01 and compared them to reported epitopes, primarily from HLA-A*02:01, from the Los Alamos database and our own vaccine studies. Related to its small size, the Nef gene/protein appears to be able to contribute effectively to confer both stronger and broader cellular immunogenicity to an HIV-1 vaccine. We also propose feasible mutations of such an additional vaccine antigen to preserve its immunogenicity, modified not to confer HLA or CD4(+) down-regulating activities. This article includes data on a valuable HIV immunogenic component for a vaccine in Africa. PMID:24866397

Kilpeläinen, Athina; Axelsson Robertson, Rebecca; Leitner, Thomas; Sandström, Eric; Maeurer, Markus; Wahren, Britta

2014-11-01

325

Immunogenicity and safety of a virosomal hepatitis A vaccine in HIV-positive patients.  

PubMed

This short report presents results of an open uncontrolled single centre study which evaluated immunogenicity and safety of a virosome-formulated hepatitis A vaccine (Epaxal) in 14 HIV-positive adult patients and 64 healthy adults receiving a primary immunisation and a booster dose 12 months later. Seroconversion rates (> or =20 mIU/mL), geometric mean concentration (GMC) of anti-HAV antibodies, local and systemic adverse events (AEs) were assessed at baseline and at Months 1, 6, 12, and 13. The seroconversion rate was 63.6% at Month 1 and 91.7% at Month 13 in HIV-positive patients versus 93.8 and 100% in healthy adults. The booster dose increased GMCs from 25.5 to 659.2 mIU/mL in HIV-positive patients versus 104 and 2986 mIU/mL in healthy adults. Epaxal was well tolerated by the HIV-positive patients and was at least as immunogenic as reported for aluminium-adsorbed vaccines. In conclusion, Epaxal can be considered an immunogenic and safe hepatitis A vaccine in HIV-positive patients. PMID:17640777

Loutan, L; Bovier, P; Herzog, C

2007-08-21

326

Control of Viremia and Prevention of Clinical AIDS in Rhesus Monkeys by Cytokine-Augmented DNA Vaccination  

Microsoft Academic Search

With accumulating evidence indicating the importance of cytotoxic T lymphocytes (CTLs) in containing human immunodeficiency virus-1 (HIV-1) replication in infected individuals, strategies are being pursued to elicit virus-specific CTLs with prototype HIV-1 vaccines. Here, we report the protective efficacy of vaccine-elicited immune responses against a pathogenic SHIV-89.6P challenge in rhesus monkeys. Immune responses were elicited by DNA vaccines expressing SIVmac239

Dan H. Barouch; Sampa Santra; Jörn E. Schmitz; Marcelo J. Kuroda; Tong-Ming Fu; Wendeline Wagner; Miroslawa Bilska; Abie Craiu; Xin Xiao Zheng; Georgia R. Krivulka; Kristin Beaudry; Michelle A. Lifton; Christine E. Nickerson; Wendy L. Trigona; Kara Punt; Dan C. Freed; Liming Guan; Sheri Dubey; Danilo Casimiro; Adam Simon; Mary-Ellen Davies; Michael Chastain; Terry B. Strom; Rebecca S. Gelman; David C. Montefiori; Mark G. Lewis; Emilio A. Emini; John W. Shiver; Norman L. Letvin

2000-01-01

327

African-American and Hispanic Perceptions of HIV Vaccine Clinical Research: A Qualitative Study.  

PubMed

Abstract Purpose . To examine perceptions of phase-I human immunodeficiency virus (HIV) vaccine trial participation among African-Americans and Hispanics in San Francisco, California. Design . Qualitative, semistructured interviews. Setting . San Francisco Department of Health. Participants . Thirty-six African-American and Hispanic men and women, 18 to 50 years of age, residing in the San Francisco Bay Area. Method . Purposive sampling using advertisements, community-based organization rosters, and snowball referrals. Thematic analysis of transcripts identified salient themes and patterns. Results . Participants viewed participation in HIV research as important; however, they held that HIV was not a health priority given limited awareness about HIV research or beliefs that only infected or high-risk persons were eligible for participation. Altruism and personal gain, trustworthy trial staff, convenient schedules and facilities, and involvement of trusted community groups in recruitment were perceived to motivate participants. Concerns about the social consequences of participating in HIV research and product-related side effects were seen as discouraging participation. Limitations include the possibility that participants in interview research have more favorable views of biomedical research than those who refuse to participate. Conclusion . Historically, African-Americans and Hispanics in the United States have had limited participation in HIV trials. Understanding their perceptions of HIV biomedical research, identifying facilitators and barriers to participation, addressing misinformation about HIV, distorted risk perceptions, HIV stigma, and providing accessible opportunities to participate are imperative to ensure health equity and generalizability of findings. PMID:24432823

Toledo, Lauren; McLellan-Lemal, Eleanor; Arreola, Sonya; Campbell, Chadwick; Sutton, Madeline

2014-01-01

328

Correctional officers and prevention of HIV transmission among prisoners.  

PubMed

The problem of HIV transmission in prisons in Québec and elsewhere is increasingly urgent and requires the attention of federal and provincial authorities. Prison officers are among the key players who should be kept in mind when preventive measures are being developed. We reprint the executive summary of a study conducted in federal and provincial prisons in Québec. The goal of the study was to identify the factors influencing prison officers, with respect to whether they would agree or refuse to make accessible the tools needed for the prevention of HIV transmission among inmates (i.e., condoms, bleach, tattooing equipment, and needles). Among the factors studied are officers' perceptions and beliefs as well as their attitudes, perceived social norms, emotions, and perceived barriers with respect to making preventive tools accessible. PMID:11837035

Godin, G; Alary, M; Morissette, M; Noël, L

2001-01-01

329

Attenuated poxvirus vectors MVA and NYVAC as promising vaccine candidates against HIV/AIDS.  

PubMed

As yet, the only human infectious disease eradicated from our planet is smallpox, caused by variola virus a member of the poxvirus family. The vaccination success, with the declaration by WHO in 1980 of a worldwide free of smallpox, was largely due to the availability of a quite effective and stable live vaccine, as well as the restricted human host for virus infection. Variola was considered one of the most devastating diseases of human mankind. With the sudden appearance of the HIV/AIDS in 1981, an infection which spread rapidly to become a pandemic in a short time, causing up to date more than 22 million deaths, about 40 million people infected and a current incidence of about 3 million deaths per year, this dreadful pandemic has become one of the most severe diseases in the World, specially in poor countries. While different antiviral drugs have been developed that block virus replication at various stages of infection, however the rapid virus escape that follows during the drug therapy due to mutations, makes the development of vaccines the most secure option to control and eradicate the disease. Numerous vaccines have been developed, but to date the clinical trials have failed to show any efficacy against HIV infection. Due to the proven success of vaccinia virus in the control of smallpox as well as of poxvirus recombinants against veterinary diseases, a major effort has been directed to document the advantages of poxvirus vectors as vaccines against multiple diseases. Two of the most promising poxvirus vectors are the highly attenuated modified vaccinia virus Ankara (MVA) and the modified Copenhagen strain NYVAC. In this commentary I describe the biological characteristics of the attenuated poxvirus vectors, MVA and NYVAC, with emphasis in their application in HIV preclinical and clinical trials, and considerations as future HIV vaccines. PMID:19786840

Esteban, Mariano

2009-12-01

330

Incorporating couples-based approaches into HIV prevention for gay and bisexual men: opportunities and challenges.  

PubMed

Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67% of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services,and support mutual disclosure of HIV status. PMID:24233328

Purcell, David W; Mizuno, Yoko; Smith, Dawn K; Grabbe, Kristina; Courtenay-Quick, Cari; Tomlinson, Hank; Mermin, Jonathan

2014-01-01

331

Immune Activation and Viral Replication after Vaccination with an Influenza A H1N1 2009 Vaccine in HIV-Infected Children Receiving Antiretroviral Therapy  

PubMed Central

Immunization with a pandemic influenza A H1N1 2009 was recommended for HIV-infected patients. However, there is limited information concerning the impact of immunization with this vaccine on immune activation and HIV viral replication. In this study, 45 HIV-infected children and adolescents receiving antiretroviral therapy were immunized with a 2-dose series of nonadjuvated monovalent influenza A H1N1 2009 vaccine upon enrollment and approximately 1 month later. Immunogenicity was determined by haemagglutination inhibition assay. The level of immune activation was determined by identification of CD38 and HLA-DR on CD8+ T cells. Patients were divided into 2 groups which include patients who had an undetectable HIV viral load (HIV detectable group) and patients who show virological failure (HIV nondetectable group). The results showed seroconversion rate of 55.2% in HIV nondetectable group, whereas 31.3% was found in HIV detectable group. Both groups of patients showed no major increase in immune activation after immunization. Interestingly, a decrease in the frequency of CD8+ T cells that coexpressed CD38 and HLA-DR was observed after immunization in both groups of patients. We suggested that immunization with influenza A H1N1 2009 vaccine can induce immune response to the pandemic virus without major impact on HIV viral replication and immune activation. PMID:24167370

Onlamoon, Nattawat; Unpol, Petai; Boonchan, Michittra; Sukapirom, Kasama; Wittawatmongkol, Orasri; Chokephaibulkit, Kulkanya; Ammaranond, Palanee; Pattanapanyasat, Kovit

2013-01-01

332

HIV\\/AIDS Knowledge and Prevention Programming in Domestic Violence Shelters: How Are We Doing?  

Microsoft Academic Search

Domestic violence shelters (n = 59) in two southwestern states were surveyed about their services related to HIV prevention. Variables included organizational characteristics, agency protocols and practices, HIV\\/AIDS prevention programming, staffs’ HIV\\/AIDS knowledge, and staffs’ attitudes regarding HIV\\/AIDS prevention for women exposed to intimate partner violence. In this exploratory, descriptive study results indicated that most shelters had a significant awareness of how

Michele A. Rountree; Jeremy Goldbach; Tricia Bent-Goodley; Meredith Bagwell

2011-01-01

333

Internalized heterosexism among HIV-positive, gay-identified men: implications for HIV prevention and care.  

PubMed

Internalized heterosexism (IH), or the internalization of societal antihomosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and it has been inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, the authors tested a model framed in social action theory (C. K. Ewart, 1991, 2004) in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results support the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART nonadherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse and 17% of the variance in ART nonadherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men. PMID:18837600

Johnson, Mallory O; Carrico, Adam W; Chesney, Margaret A; Morin, Stephen F

2008-10-01

334

Towards Combination HIV Prevention for Injection Drug Users: Addressing Addictophobia, Apathy and Inattention  

PubMed Central

Purpose of the review Recent breakthroughs in HIV-prevention science led us to evaluate the current state of combination HIV-prevention for injection drug users (IDUs). We review the recent literature focusing on possible reasons why coverage of prevention interventions for HIV, HCV and tuberculosis among IDUs remains dismal. We make recommendations for future HIV research and policy. Recent findings IDUs disproportionately under-utilize VCT, primary care and ART, especially in countries that have the largest burden of HIV among IDUs. IDUs present later in the course of HIV infection and experience greater morbidity and mortality. Why are IDUs under-represented in HIV-prevention research, access to treatment for both HIV and addiction, and access to HIV combination prevention? Possible explanations include addictophobia, apathy, and inattention, which we describe in the context of recent literature and events. Summary This commentary discusses the current state of HIV-prevention interventions for IDUs including, VCT, NSP, OST, ART and PrEP, and discusses ways to work towards true combination HIV-prevention for IDU populations. Communities need to overcome tacit assumptions that IDUs can navigate through systems that are maintained as separate silos, and take a rights-based approach to HIV-prevention to ensure that IDUs have equitable access to life-saving prevention and treatments. PMID:22498479

Strathdee, Steffanie A.; Shoptaw, Steven; Dyer, Typhanye Penniman; Quan, Vu Minh; Aramrattana, Apinun

2013-01-01

335

Pediatric HIV: School-Based Sequelae and Curricular Interventions for Infection Prevention and Social Acceptance.  

ERIC Educational Resources Information Center

In response to the rising number of adolescents and infants who are infected with HIV, school psychologists must become experts in issues pertaining to pediatric HIV/AIDS. This article describes medical consequences of HIV and psychosocial sequalea. Discusses recommendations for school-based AIDS-education programs designed to prevent HIV

Landau, Steven; Pryor, John B.; Haefli, Katrine

1995-01-01

336

HIV in Vietnam: The Evolving Epidemic and the Prevention Response, 1996 Through 1999  

Microsoft Academic Search

Objectives: To describe epidemiologic patterns and trends in HIV infection in Vietnam from 1996 through 1999, and to summarize the national response to the epidemic. Methods: We reviewed nationwide HIV case reports, and we analyzed annual seroprevalence among different sentinel populations in 21 provinces, using the 2 test for linear trend to assess trends in HIV prevalence. HIV prevention efforts

Vu Minh Quan; A. Chung; Hoang Thuy Long; Timothy J. Dondero

2000-01-01

337

Opportunities for HIV Combination Prevention to Reduce Racial and Ethnic Health Disparities  

ERIC Educational Resources Information Center

Despite advances in HIV prevention and care, African Americans and Latino Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, and are less likely to have suppressed viral load than are Whites. The first National HIV/AIDS Strategy…

Grossman, Cynthia I.; Purcell, David W.; Rotheram-Borus, Mary Jane; Veniegas, Rosemary

2013-01-01

338

Knowledge and Attitudes About Male Circumcision for HIV1 Prevention among Heterosexual HIV1 Serodiscordant Partnerships in Kampala, Uganda  

Microsoft Academic Search

Male circumcision for HIV-1 prevention will require high uptake among at-risk populations. 318 HIV-1 serodiscordant couples\\u000a in Kampala, Uganda [155 (48.7%) with HIV-1 uninfected male partners] were interviewed about male circumcision for HIV-1 prevention.\\u000a 77.1% of men and 89.6% of women were aware that circumcision reduces men’s risk for HIV-1 acquisition. Almost all understood\\u000a the partial protective efficacy of circumcision

Kenneth K. MugwanyaJared; Jared M. Baeten; Edith Nakku-Joloba; Elly Katabira; Connie Celum; Daniel Tisch; Christopher Whalen

2010-01-01

339

Effectiveness of HIV Prevention for Women: What Is Working?  

PubMed

The HIV-AIDS remains a public health problem which disproportionally affects women. However, prevention strategies have rarely considered their specific efficacy for them. For this reason, this study examines the differential effectiveness of six intervention elements based on socio-cognitive theories addressing young women. A controlled between-groups design examined the change in risk profile among 167 young Spanish women (mean age 21.3 years old) involved in five sexual risk prevention interventions (informative talk, attitudinal discussion, role-play, fear induction and informative website) and one control non-intervening group (waiting list). Our findings support the differential efficacy of some HIV preventive intervention elements comparing others for women. In particular, the attitudinal discussion stands out followed by the informative talk and the role play. Contrarily, the fear induction component did not reveal relevant improvements. This study provides new evidence related to HIV prevention. Particularly, the higher efficacy of motivational components for these young Spanish women is revealed. PMID:24452498

Gil-Llario, María Dolores; Ballester-Arnal, Rafael; Giménez-García, Cristina; Salmerón-Sánchez, Pedro

2014-10-01

340

Unmasking Dashkayah: Storytelling and HIV Prevention.  

ERIC Educational Resources Information Center

American Indian stories are a form of medicine and can provide a model of how to deal effectively with life's challenges. Several stories are discussed that offer metaphors for living with an incurable condition such as AIDS and that provide a culturally sensitive means of discussing sexuality, high risk behaviors, and prevention. (Contains 25…

Tafoya, Terry

2000-01-01

341

Voluntary medical male circumcision: an HIV prevention priority for PEPFAR.  

PubMed

As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President's Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya's Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods-such as medical devices that remove the foreskin without injected anesthesia and/or sutures-are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all. PMID:22797745

Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

2012-08-15

342

Voluntary Medical Male Circumcision: An HIV Prevention Priority for PEPFAR  

PubMed Central

As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President’s Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya’s Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods—such as medical devices that remove the foreskin without injected anesthesia and/or sutures—are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all. PMID:22797745

Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C.; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

2013-01-01

343

MTV's "Staying Alive" Global Campaign Promoted Interpersonal Communication about HIV and Positive Beliefs about HIV Prevention  

ERIC Educational Resources Information Center

In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; Sao Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household…

Geary, Cynthia Waszak; Burke; Holly McClain; Castelnau, Laure; Neupane; Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

2007-01-01

344

Male circumcision for HIV prevention: Current research and programmatic issues  

PubMed Central

Randomized controlled trials in sub-Saharan Africa have shown that adult male circumcision reduces the risk of HIV acquisition in men by about 60%. In this paper we review recent data on the association of male circumcision and HIV/STI in men and women. This includes a summary of data showing some evidence of an effect of male circumcision against genital ulcer disease, HSV-2 infection, HPV and Trichomonas vaginalis, but not Chlamydia trachomatis or Neisseria gonorrhea in men. Longitudinal studies among HIV discordant couples suggest that male circumcision may provide some direct long-term benefit to women, which may start after complete wound-healing. Circumcision may also protect against HIV acquisition in men who have sex with men and practice unprotected anal intercourse (either exclusively or predominantly), although this data is not consistent. To date, there is little evidence from the few studies available of either unsafe practices or reported increases in risky behaviour, or adverse changes in sexual satisfaction and function. As countries in southern and eastern Africa scale up services, operational research will likely be useful to iteratively improve programme delivery and impact, while identifying the best methods of integrating safe male circumcision services into HIV prevention strategies and strengthening health systems. PMID:21042054

Weiss, Helen A; Dickson, Kim E; Agot, Kawango; Hankins, Catherine A

2014-01-01

345

Sharing the trousers: gender roles and relationships in an HIV-prevention trial in Zimbabwe  

Microsoft Academic Search

Male and female gender roles and inequalities are important in contributing to the disproportionate burden of HIV experienced by women in sub-Saharan Africa. Within the context of an HIV prevention trial, we aimed to describe and understand male partner influence on women's use of HIV-prevention methods. Our presumption was not that regressive gender norms prevailed – rather, that a wide

Elizabeth T. Montgomery; Agnes Chidanyika; Tsungai Chipato; Ariane van der Straten

2012-01-01

346

Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs  

ERIC Educational Resources Information Center

The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

2009-01-01

347

77 FR 23733 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment  

Federal Register 2010, 2011, 2012, 2013

...Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In accordance...activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health...

2012-04-20

348

"It's Crazy Being a Black, Gay Youth." Getting Information about HIV Prevention: A Pilot Study  

ERIC Educational Resources Information Center

Background: Access and adoption of HIV prevention information are important criteria for reducing HIV infection rates among men who have sex with men. Methods: Using focus group data, researchers sought to identify sources of HIV prevention information and barriers to adopting protective behaviors among young African American men who have sex with…

Voisin, Dexter R.; Bird, Jason D. P.; Shiu, Chen-Shi; Krieger, Cathy

2013-01-01

349

75 FR 39264 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment  

Federal Register 2010, 2011, 2012, 2013

...Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In accordance...activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health...

2010-07-08

350

Associations between Social Capital and HIV Stigma in Chennai, India: Considerations for Prevention Intervention Design  

ERIC Educational Resources Information Center

Stigma against persons living with HIV/AIDS (PLHA) is a barrier to seeking prevention education, HIV testing, and care. Social capital has been reported as an important factor influencing HIV prevention and social support upon infection. In the study, we explored the associations between social capital and stigma among men and women who are…

Sivaram, Sudha; Zelaya, Carla; Srikrishnan, A. K.; Latkin, Carl; Go, V. F.; Solomon, Suniti; Celentano, David

2009-01-01

351

Shared Communities, Structural Contexts, and HIV Risk: Prioritizing the HIV Risk and Prevention Needs of Black Heterosexual Men  

PubMed Central

Black heterosexual men (BHM) are seldom mentioned in HIV prevention research, policy, and interventions, despite evidence that heterosexual contact is becoming the leading exposure category for BHM. The disparate effect of HIV/AIDS on BHM; the debunked “down low” myth; the contexts of BHM's lives in terms of disproportionate poverty, unemployment, and incarceration; and a growing empirical base linking these factors to increased HIV risk, underscore the need to prioritize HIV risk and prevention initiatives for BHM. We highlighted the structural contexts of HIV risk for BHM, and four community-based approaches to address HIV risk and prevention for BHM: (1) men's health programs; (2) workforce and postincarceration release programs; (3) linkages to women's prevention programs; and (4) faith-based initiatives. PMID:22401513

Raj, Anita

2012-01-01

352

Protection Afforded by an HIV Vaccine Candidate in Macaques Depends on the Dose of SIVmac251 at Challenge Exposure  

PubMed Central

We used the simian immunodeficiency virus mac251 (SIVmac251) macaque model to study the effect of the dose of mucosal exposure on vaccine efficacy. We immunized macaques with a DNA prime followed by SIV gp120 protein immunization with ALVAC-SIV and gp120 in alum, and we challenged them with SIVmac251 at either a single high dose or at two repeated low-dose exposures to a 10-fold-lower dose. Infection was neither prevented nor modified following a single high-dose challenge of the immunized macaques. However, two exposures to a 10-fold-lower dose resulted in protection from SIVmac251 acquisition in 3 out of 12 macaques. The remaining animals that were infected had a modulated pathogenesis, significant downregulation of interferon responsive genes, and upregulation of genes involved in B- and T-cell responses. Thus, the choice of the experimental model greatly influences the vaccine efficacy of vaccines for human immunodeficiency virus (HIV). PMID:23325681

Vaccari, Monica; Keele, Brandon F.; Bosinger, Steven E.; Doster, Melvin N.; Ma, Zhong-Min; Pollara, Justin; Hryniewicz, Anna; Ferrari, Guido; Guan, Yongjun; Forthal, Donald N.; Venzon, David; Fenizia, Claudio; Morgan, Tia; Montefiori, David; Lifson, Jeffrey D.; Miller, Chris J.; Silvestri, Guido; Rosati, Margherita; Felber, Barbara K.; Pavlakis, George N.; Tartaglia, James

2013-01-01

353

Immune response to 2009 H1N1 vaccine in HIV-infected adults in Northern Thailand  

PubMed Central

Background: In late 2009, the Thai Ministry of Public Health provided two million doses of the monovalent pandemic influenza H1N1 2009 vaccine (Panenza® Sanofi Pasteur), which was the only vaccine formulation available in Thailand, to persons at risk of more severe manifestations of the disease including HIV infection. Several studies have shown poorer immune responses to the 2009 H1N1 vaccines in HIV-infected individuals. There are limited data in this population in resource-limited countries. Results: At day 28 post-vaccination, seroconversion was found in 32.0% (95%CI 24.5 - 40.2) of the HIV-infected group and 35.0% (95%CI 15.4- 59.2) of the healthy controls (p = 0.79). Seroprotection rate was observed in 33.3% (95%CI 25.8–41.6) and 35.0% (95%CI 15.4–59.2) of the HIV-infected group and the control group, respectively (p = 0.88). Among HIV-infected participants, the strongest factor associated with vaccine response was age 42 y or younger (p = 0.05). Methods: We evaluated the immunogenicity of a single, 15µg/0.5ml dose of a monovalent, non-adjuvanted 2009 H1N1 vaccine in 150 HIV-infected Thai adults and 20 healthy controls. Immunogenicity was measured by hemagglutination inhibition assay (HI) at baseline and 28 d after vaccination. Seroconversion was defined as 1) pre-vaccination HI titer < 1:10 and post-vaccination HI titer ? 1:40, or 2) pre-vaccination HI titer ? 1:10 and a minimum of 4-fold rise in post-vaccination HI titer. Seroprotection was defined as a post-vaccination HI titer of ? 1:40. Conclusions: A low seroconversion rate to the 2009 H1N1 vaccine in both study groups, corresponding with data from trials in the region, may suggest that the vaccine used in our study is not very immunogenic. Further studies on different vaccines, dosing, adjuvants, or schedule strategies may be needed to achieve effective immunization in HIV-infected population. PMID:22906932

Chotirosniramit, Nuntisa; Sugandhavesa, Patcharaphan; Aurpibul, Linda; Thetket, Sunida; Kosashunhanan, Natthapol; Supindham, Taweewat; Wongkulab, Panuwat; Kaewpoowat, Quanhathai; Chaiklang, Kanokporn; Kaewthip, Oranitcha; Sroysuwan, Piyathida; Wongthanee, Antika; Lerdsamran, Hatairat; Puthavathana, Pilaipan; Suparatpinyo, Khuanchai

2012-01-01

354

Epaxal: a virosomal vaccine to prevent hepatitis A infection.  

PubMed

Over the last few decades, different types of inactivated hepatitis A virus (HAV) vaccines have been developed: several aluminum-adjuvanted vaccines and an aluminum-free, virosome-formulated vaccine. Both types of vaccines are whole-virus preparations that are produced by growth of HAV strains in human diploid cell cultures and are subsequently inactivated with formaldehyde. This review summarizes all published papers on a virosome-formulated vaccine, Epaxal, based on formalin inactivated HAV (strain RG-SB) adsorbed to the surface of special liposomes (virosomes), that replace aluminum hydroxide as the adjuvant principle. A single injection of virosomal HAV vaccine is well tolerated and highly immunogenic, with 88-97% of seroprotection 2 weeks after a first dose. HAV virosomal vaccine can be administered concomitantly with other vaccines, without inducing antigenic competition. Direct comparison with aluminum-adsorbed vaccine has shown that the immunogenicity was similar, but fewer local reactions were reported with Epaxal. Recent studies in children have demonstrated that Epaxal Junior is also an excellent HAV vaccine for mass vaccination programs. PMID:18844588

Bovier, Patrick A

2008-10-01

355

Microbicides and other topical strategies to prevent vaginal transmission of HIV  

Microsoft Academic Search

The HIV epidemic is, by many criteria, the worst outbreak of infectious disease in history. The rate of new infections is now ?5 million per year, mainly in the developing world, and is increasing. Women are now substantially more at risk of infection with HIV than men. With no cure or effective vaccine in sight, a huge effort is required

Robin E. Offord; Oliver Hartley; Michael M. Lederman

2006-01-01

356

Community perspectives on care options for HIV prevention trial participants  

Microsoft Academic Search

There is on-going global debate and policy-setting concerning researchers’ obligations to meet the health needs of people participating in HIV prevention trials in resource-poor settings. The perspectives of local community stakeholders on this issue are poorly understood as most of what is presented on behalf of communities where research takes place is anecdotal commentary. Using qualitative methods (130 in-depth interviews

K. M. MacQueen; E. Namey; D. A. Chilongozi; S. P. Mtweve; M. Mlingo; N. Morar; C. Reid; A. Ristow; S. Sahay

2007-01-01

357

Drug users' willingness to encourage social, sexual, and drug network members to receive an HIV vaccine: a social network analysis.  

PubMed

This study examined feasibility of peer-based promotion of HIV vaccination and dyadic correlates to vaccine encouragement in risk- and non-risk networks of drug users (n = 433) in the US. Data were collected on HIV vaccine attitudes, risk compensation intentions, likelihood of encouraging vaccination, and recent (past 6 months) risk (i.e. involving sex and/or injecting drugs) and non-risk (i.e. involving co-usage of noninjected drugs and/or social support) relationships. Willingness to encourage HIV vaccination was reported in 521 and 555 risk- and non-risk relationships, respectively. However, 37 % expressed hesitancy, typically due to fear of side effects or social concerns. Encouragement was often motivated by perceived HIV risk, though 9 % were motivated by risk compensation intentions. In non-risk partnerships, encouragement was associated with drug co-usage, and in risk relationships, with perceived vaccine acceptability and encouragement by the partner. Network-based HIV vaccine promotion may be a successful strategy, but risk compensation intentions should be explored. PMID:24849621

Young, A M; DiClemente, R J; Halgin, D S; Sterk, C E; Havens, J R

2014-09-01

358

Where are the young men in HIV prevention efforts? Comments on HIV prevention programs and research from young men who sex with men in Los Angeles county.  

PubMed

Despite increasing rates of HIV infection among young men who have sex with men (YMSM), only a minority participate in formal HIV prevention efforts. Semi-structured mixed-methods interviews were conducted with a diverse sample of YMSM (N = 100, M(age) = 25.0 years) in Los Angeles, California, to identify facilitators and barriers to participation in HIV prevention programs. Summative content analyses were used to evaluate transcribed field notes from these interviews. Results showed that 28.0 % of all participants had previously attended an HIV prevention program, and that 21.3 % of those who were also asked if they had ever participated in any research pertaining to HIV prevention had done so. A significantly higher percentage of those who had participated in HIV prevention programs had been tested for HIV in the past 6 months compared to those who had not (p < .05). The most frequently mentioned barriers to participation in such a program were being too busy to attend (12.0 %), not perceiving themselves to be at risk for HIV infection (14.0 %), and believing that they already knew everything they needed to know about HIV transmission (23.0 %). YMSM suggested that future interventions should use technology (e.g., the Internet, mobile devices), engage their social networks, and highlight HIV prevention as a means for community connection. Collectively, these results provide some explanations for why YMSM account for a minority of HIV prevention program participants and offer possible directions for future HIV prevention efforts that target YMSM. PMID:23132515

Holloway, Ian W; Cederbaum, Julie A; Ajayi, Antonette; Shoptaw, Steven

2012-12-01

359

Where are the young men in HIV prevention efforts? Comments on HIV prevention programs and research from young men who have sex with men in Los Angeles County  

PubMed Central

Despite increasing rates of HIV infection among young men who have sex with men (YMSM), only a minority participate in formal HIV prevention efforts. Semi-structured mixed-methods interviews were conducted in a diverse sample of YMSM (N = 100, Mage = 25.0 years) in Los Angeles, California, to identify facilitators and barriers to participation in HIV prevention programs. Summative content analyses were used to evaluate transcribed field notes from these interviews. Results showed that 28.0% of all participants had previously attended an HIV prevention program, and that 21.3% of those who were also asked if they had ever participated in any research pertaining to HIV prevention had done so. A significantly higher percentage of those who had participated in HIV prevention programs had been tested for HIV in the past 6 months compared to those who had not (p < .05). The most frequently mentioned barriers to participation in such a program were being too busy to attend (12.0%), not perceiving themselves to be at risk for HIV infection (14.0%), and believing that they already knew everything they needed to know about HIV transmission (23.0%). YMSM suggested that future interventions should use technology (e.g., the Internet, mobile devices), engage their social networks, and highlight HIV prevention as a means for community connection. Collectively, these results provide some explanations for why YMSM account for a minority of HIV prevention program participants and offer possible directions for future HIV prevention efforts that target YMSM. PMID:23132515

Holloway, Ian W.; Cederbaum, Julie A.; Ajayi, Antonette; Shoptaw, Steven

2012-01-01

360

Adapting a Family-Based HIV Prevention Program for Homeless Youth and Their Families: The HIV Prevention Outreach for Parents and Early Adolescents Family Program  

Microsoft Academic Search

As rates of HIV infection increase in adolescents, it is important to provide prevention programs targeting this population. Homeless adolescents living with their families in shelters are at greater risk of participating in risky sexual behavior and incurring negative health outcomes. A family-based HIV-prevention pilot study was conducted with eight homeless families in a New York City shelter to explore

Taiwanna Messam; Mary M. McKay; Kosta Kalogerogiannis; Stacey Alicea

2010-01-01

361

Congenital rubella syndrome and autism spectrum disorder prevented by rubella vaccination - United States, 2001-2010  

PubMed Central

Background Congenital rubella syndrome (CRS) is associated with several negative outcomes, including autism spectrum disorders (ASDs). The objective of this study was to estimate the numbers of CRS and ASD cases prevented by rubella vaccination in the United States from 2001 through 2010. Methods Prevention estimates were calculated through simple mathematical modeling, with values of model parameters determined from published literature. Model parameters included pre-vaccine era CRS incidence, vaccine era CRS incidence, the number of live births per year, and the percentage of CRS cases presenting with an ASD. Results Based on our estimates, 16,600 CRS cases (range: 8300-62,250) were prevented by rubella vaccination from 2001 through 2010 in the United States. An estimated 1228 ASD cases were prevented by rubella vaccination in the United States during this time period. Simulating a slight expansion in ASD diagnostic criteria in recent decades, we estimate that a minimum of 830 ASD cases and a maximum of 6225 ASD cases were prevented. Conclusions We estimate that rubella vaccination prevented substantial numbers of CRS and ASD cases in the United States from 2001 through 2010. These findings provide additional incentive to maintain high measles-mumps-rubella (MMR) vaccination coverage. PMID:21592401

2011-01-01

362

75 FR 13550 - Office of Clinical and Preventive Services: National HIV Program  

Federal Register 2010, 2011, 2012, 2013

...adults as per 2006 Centers for Disease Control and Prevention (CDC...choose to bundle HIV tests with sexually transmitted diseases (STD) screening. II. Award...2010 Objectives, and other HIV disease control activities; (b)...

2010-03-22

363

Antibody-Mediated Fc? Receptor-Based Mechanisms of HIV Inhibition: Recent Findings and New Vaccination Strategies  

PubMed Central

The HIV/AIDS pandemic is one of the most devastating pandemics worldwide. Today, the major route of infection by HIV is sexual transmission. One of the most promising strategies for vaccination against HIV sexual infection is the development of a mucosal vaccine, which should be able to induce strong local and systemic protective immunity. It is believed that both humoral and cellular immune responses are needed for inducing a sterilizing protection against HIV. Recently, passive administration of monoclonal neutralizing antibodies in macaques infected by vaginal challenge demonstrated a crucial role of Fc?Rs in the protection afforded by these antibodies. This questioned about the role of innate and adaptive immune functions, including ADCC, ADCVI, phagocytosis of opsonized HIV particles and the production of inflammatory cytokines and chemokines, in the mechanism of HIV inhibition in vivo. Other monoclonal antibodies - non-neutralizing inhibitory antibodies - which recognize immunogenic epitopes, have been shown to display potent Fc?Rs-dependent inhibition of HIV replication in vitro. The potential role of these antibodies in protection against sexual transmission of HIV and their biological relevance for the development of an HIV vaccine therefore need to be determined. This review highlights the potential role of Fc?Rs-mediated innate and adaptive immune functions in the mechanism of HIV protection. PMID:21994593

Holl, Vincent; Peressin, Maryse; Moog, Christiane

2009-01-01

364

An evaluation of novel lipid-enveloped nanoparticles for adjuvant and antigen delivery for an HIV vaccine : stepping from laboratory into potential markets  

E-print Network

Enormous effort has been devoted to the development of a vaccine against human immunodeficiency virus (HIV). The purpose of this paper is to evaluate the technological and economical aspects of a potential vaccine designed ...

Khodami, Pantea

2011-01-01

365

Predictors of HIV-specific lymphocyte proliferative immune responses induced by therapeutic vaccination.  

PubMed

We treated a cohort of 38 HIV-infected individuals with a therapeutic vaccine (REMUNE, HIV-1 Immunogen) in an open label study. We then determined whether baseline parameters, such as CD4 cell count, viral load and IgG levels, were predictive of the magnitude of the HIV-specific lymphocyte proliferative responses (LPRs). We demonstrate herein that there is a significant enhancement from baseline for both HIV and p24 antigen-stimulated LPRs after immunization. Using a responder definition of a stimulation index of >5 on at least two post-immunization time-points, 29/38 (76%) responded to HIV-1 antigen while 27/38 (71%) responded to native p24 antigen. Viral load and total IgG were negatively correlated, while CD4 cell counts were positively associated with the magnitude of the HIV antigen LPR. In a multivariable analysis, baseline CD4 was the best predictor of HIV antigen LPR post-immunization. PMID:11985528

Moss, R B; Wallace, M R; Steigbigel, R T; Morrison, S A; Giermakowska, W K; Nardo, C J; Diveley, J P; Carlo, D J

2002-05-01

366

Predictors of HIV-specific lymphocyte proliferative immune responses induced by therapeutic vaccination  

PubMed Central

We treated a cohort of 38 HIV-infected individuals with a therapeutic vaccine (Remune, HIV-1 Immunogen) in an open label study. We then determined whether baseline parameters, such as CD4 cell count, viral load and IgG levels, were predictive of the magnitude of the HIV-specific lymphocyte proliferative responses (LPRs). We demonstrate herein that there is a significant enhancement from baseline for both HIV and p24 antigen-stimulated LPRs after immunization. Using a responder definition of a stimulation index of >5 on at least two post-immunization time-points, 29/38 (76%) responded to HIV-1 antigen while 27/38 (71%) responded to native p24 antigen. Viral load and total IgG were negatively correlated, while CD4 cell counts were positively associated with the magnitude of the HIV antigen LPR. In a multivariable analysis, baseline CD4 was the best predictor of HIV antigen LPR post-immunization. PMID:11985528

MOSS, R B; WALLACE, M R; STEIGBIGEL, R T; MORRISON, S A; GIERMAKOWSKA, W K; NARDO, C J; DIVELEY, J P; CARLO, D J

2002-01-01

367

Combination implementation for HIV prevention: moving from clinical trial evidence to population-level effects.  

PubMed

The promise of combination HIV prevention-the application of multiple HIV prevention interventions to maximise population-level effects-has never been greater. However, to succeed in achieving significant reductions in HIV incidence, an additional concept needs to be considered: combination implementation. Combination implementation for HIV prevention is the pragmatic, localised application of evidence-based strategies to enable high sustained uptake and quality of interventions for prevention of HIV. In this Review, we explore diverse implementation strategies including HIV testing and counselling models, task shifting, linkage to and retention in care, antiretroviral therapy support, behaviour change, demand creation, and structural interventions, and discusses how they could be used to complement HIV prevention efforts such as medical male circumcision and treatment as prevention. HIV prevention and treatment have arrived at a pivotal moment when combination efforts might result in substantial enough population-level effects to reverse the epidemic and drive towards elimination of HIV. Only through careful consideration of how to implement and operationalise HIV prevention interventions will the HIV community be able to move from clinical trial evidence to population-level effects. PMID:23257232

Chang, Larry W; Serwadda, David; Quinn, Thomas C; Wawer, Maria J; Gray, Ronald H; Reynolds, Steven J

2013-01-01

368

An Effective Vaccination Approach Augments anti-HIV Systemic and Vaginal Immunity in Mice with Decreased HIV-1 Susceptible ?4?7high CD4+ T Cells  

PubMed Central

HIV-1 preferentially infects activated CD4+ T cells expressing ?4?7 integrin and conventional vaccination approaches non-selectively induce immune responses including ?4?7high CD4+ T cells, suggesting that current candidate AIDS vaccines may produce more target cells for HIV-1 and paradoxically enhance HIV-1 infection. Thus it remains a challenge to selectively induce robust anti-HIV immunity without the unwanted HIV-1 susceptible ?4?7high CD4+ T cells. Here we describe a vaccination strategy that targets ALDH1a2, a retinoic acid producing enzyme in dendritic cells (DCs). Silencing ALDH1a2 in DCs enhanced the maturation and production of proinflammatory cytokines of DCs and promoted Th1/Th2 differentiation while suppressing Treg. ALDH1a2-silenced DCs effectively downregulated the expression of guthoming receptors ?4?7 and CCR9 on activated T and B lymphocytes. Consequently, intranasal immunization of a lentiviral vaccine encoding ALDH1a2 shRNA and HIV-1 gp140 redirected gp140-specific mucosal T cell and antibody responses from the gut to the vaginal tract, while dramatically enhancing systemic gp140-specific immune responses. We further demonstrated that silencing ALDH1a2 in human DCs resulted in downregulation of ?7 expression on activated autologous CD4+ T cells. Hence this study provides a unique and effective strategy to induce ?4?7low anti-HIV immune responses. PMID:23157585

Zhu, Wei; Shi, Guoping; Tang, Haijun; Lewis, Dorothy E; Song, Xiao-Tong

2013-01-01

369

Adapting effective narrative-based HIV-prevention interventions to increase minorities' engagement in HIV/AIDS services.  

PubMed

Disparities related to barriers to caring for HIV-positive and at-risk minorities continue to be a major public health problem. Adaptation of efficacious HIV-prevention interventions for use as health communication innovations is a promising approach for increasing minorities' utilization of HIV health and ancillary services. Role-model stories, a widely-used HIV-prevention strategy, employ culturally tailored narratives to depict experiences of an individual modeling health-risk reduction behaviors. This article describes the careful development of a contextually appropriate role model story focused on increasing minorities' engagement in HIV/AIDS health and related services. Findings from interviews with community members and focus groups with HIV-positive minorities indicated several barriers and facilitators related to engagement in HIV health care and disease management (e.g., patient-provider relationships) and guided the development of role-model story narratives. PMID:19415552

Berkley-Patton, Jannette; Goggin, Kathleen; Liston, Robin; Bradley-Ewing, Andrea; Neville, Sally

2009-04-01

370

Mental Health Treatment to Reduce HIV Transmission Risk Behavior: A Positive Prevention Model  

Microsoft Academic Search

Secondary HIV prevention, or “positive prevention,” is concerned with reducing HIV transmission risk behavior and optimizing\\u000a the health and quality of life of people living with HIV\\/AIDS (PLWHA). The association between mental health and HIV transmission\\u000a risk (i.e., sexual risk and poor medication adherence) is well established, although most of this evidence is observational.\\u000a Further, a number of efficacious mental

Kathleen J. Sikkema; Melissa H. Watt; Anya S. Drabkin; Christina S. Meade; Nathan B. Hansen; Brian W. Pence

2010-01-01

371

S. Blower, et al.: Forecasting the Future of HIV Epidemics: the Impact of Antiretroviral Therapies & Imperfect Vaccines AIDSREVIEWS  

E-print Network

S. Blower, et al.: Forecasting the Future of HIV Epidemics: the Impact of Antiretroviral Therapies & Imperfect Vaccines AIDSREVIEWS 113 Forecasting the Future of HIV Epidemics: the Impact of Antiretroviral of specific epidemic control strategies and to design epidemic control strategies. We review how models have

Blower, Sally

372

Prophylactic human papillomavirus vaccination and primary prevention of cervical cancer: issues and challenges.  

PubMed

Two prophylactic human papillomavirus (HPV) vaccines have been recently approved: one quadrivalent and the other a bivalent vaccine. When administered in a three-dose course to HPV-naive individuals, both vaccines exhibited excellent safety profiles and were highly efficacious against targeted clinical endpoints in large-scale international phase III clinical trials. Where coverage has been high for the appropriate target population, a reduction of HPV-related diseases with the shortest incubation periods has already been seen. By March 2012, universal HPV vaccination had been introduced into national vaccination programmes in more than 40 countries, but only in a few low-income and middle-income countries. With the growing market for HPV vaccines and competition between manufacturers, negotiated prices are already beginning to decline although they still remain out of reach of many countries. The great majority of countries are struggling to reach a level of coverage that will have the most impact on cervical cancer rates. Increasing coverage and improving completion of the HPV vaccine schedule, particularly of sexually naive females, is now the most important public-health issue in HPV vaccine efforts. A clear strategy for integrating primary (HPV vaccination) and secondary (screening) cervical cancer prevention must be agreed as soon as possible. Several second-generation prophylactic vaccines are being developed with the aim of resolving some of the limitations of the two current HPV prophylactic vaccines. PMID:22862799

Poljak, M

2012-10-01

373

Prevention of Symptomatic Seasonal Influenza in 2005-2006 by Inactivated and Live Attenuated Vaccines  

PubMed Central

Background The efficacy of influenza vaccines may vary annually. In 2004–2005, when antigenically drifted viruses were circulating, a randomized, placebo-controlled trial involving healthy adults showed that inactivated vaccine appeared to be efficacious, whereas live attenuated vaccine appeared to be less so. Methods In 2005–2006, we continued our trial, examining the absolute and relative efficacies of the live attenuated and inactivated vaccines in preventing laboratory-confirmed symptomatic influenza. Results A total of 2058 persons were vaccinated in October and November 2005. Studywide influenza activity was prolonged but of low intensity; type A (H3N2) virus was circulating, which was antigenically similar to the vaccine strain. The absolute efficacy of the inactivated vaccine was 16% (95% confidence interval [CI], ?171% to 70%) for the virus identification end point (virus isolation in cell culture or identification through polymerase chain reaction) and 54% (95% CI, 4%–77%) for the primary end point (virus isolation or increase in serum antibody titer). The absolute efficacies of the live attenuated vaccine for these end points were 8% (95% CI, ?194% to 67%) and 43% (95% CI, ?15% to 71%), respectively. Conclusions With serologic end points included, efficacy was demonstrated for the inactivated vaccine in a year with low influenza attack rates. The efficacy of the live attenuated vaccine was slightly less than that of the inactivated vaccine, but not statistically greater than that of the placebo. Trial registration ClinicalTrials.gov identifier: NCT00133523. PMID:18522501

Ohmit, Suzanne E.; Victor, John C.; Teich, Esther R.; Truscon, Rachel K.; Rotthoff, Judy R.; Newton, Duane W.; Campbell, Sarah A.; Boulton, Matthew L.; Monto, Arnold S.

2008-01-01

374

HIV/AIDS Review.  

PubMed

Many advances have been made in the prevention of HIV transmission and management of HIV/AIDS since the virus was discovered in the early 1980s. One of the most important discoveries has been antiretroviral treatment, which can halt the replication of HIV and ease symptoms, turning AIDS into a chronic condition instead of a rapidly terminal illness. Despite advances, HIV remains a major public health challenge. This article reviews the genus, life cycle, and transmission of HIV, as well as workplace issues surrounding the virus and the challenges of developing an HIV vaccine. PMID:23322863

Moss, Joseph Anthony

2013-01-01

375

Recombinant varicella vaccines induce neutralizing antibodies and cellular immune responses to SIV and reduce viral loads in immunized rhesus macaques  

Microsoft Academic Search

The development of an effective AIDS vaccine remains one of the highest priorities in HIV research. The live, attenuated varicella-zoster virus (VZV) Oka vaccine, safe and effective for prevention of chickenpox and zoster, also has potential as a recombinant vaccine against other pathogens, including human immunodeficiency virus (HIV). The simian varicella model, utilizing simian varicella virus (SVV), offers an approach

V. Traina-Dorge; B. Pahar; P. Marx; P. Kissinger; D. Montefiori; Y. Ou; W. L. Gray

2010-01-01

376

Common Features of Mucosal and Peripheral Antibody Responses Elicited by Candidate HIV-1 Vaccines in Rhesus Monkeys.  

PubMed

Human immunodeficiency virus type 1 (HIV-1) vaccines that elicit protective antibody responses at mucosal sites would be highly desirable. Here, we report that intramuscular immunization of candidate HIV-1 vaccine vectors and purified Env proteins elicited potent and durable humoral immune responses in colorectal mucosa in rhesus monkeys. The kinetics, isotypes, functionality, and epitope specificity of these mucosal antibody responses were similar to those of peripheral responses in serum. These data suggest a close immunological relationship between mucosal and systemic antibody responses following vaccination in primates. PMID:25210178

Li, Hualin; Stephenson, Kathryn E; Kang, Zi Han; Lavine, Christy L; Seaman, Michael S; Barouch, Dan H

2014-11-15

377

Addressing the Unique Needs of African American Women in HIV Prevention  

PubMed Central

African American women continue to be disproportionately affected by the HIV/AIDS epidemic, yet there are few effective HIV prevention interventions that are exclusively tailored to their lives and that address their risk factors. Using an ecological framework, we offer a comprehensive overview of the risk factors that are driving the HIV/AIDS epidemic among African American women and explicate the consequences of ignoring these factors in HIV prevention strategies. We also recommend ways to improve HIV prevention programs by taking into consideration the unique life experiences of adult African American women. PMID:19372518

Caldeira, Nathilee A.; Ruglass, Lesia M.; Gilbert, Louisa

2009-01-01

378

[HIV prevention in HIV-positive drug addicts. A methadone-supported model].  

PubMed

In Switzerland, an estimated 15-25% of intravenous drug users (IVDUs) are infected with human immunodeficiency virus (HIV). It has been suggested that reduction of HIV-transmission-prone behavior could be achieved in so-called "early intervention programs". Few public prevention programs have so far been targeted to HIV-infected IVDUs. Socially marginalized, jobless, street-based, HIV-infected IVDUs are those hardest to reach for education programs: it was the hypothesis that they can be motivated for HIV-prevention efforts by methadone-based comprehensive social and medical care. The program was established by integrating one additional social worker in an outpatient clinic for infectious diseases in St. Gallen, a city with a population of 70,000 inhabitants in eastern Switzerland. Access to the 29 clients of this study (10 women, 19 men) was facilitated by offering methadone treatment (follow-up 5 to 29 months). Abstinence from additional illegal drugs was not required. Methadone, plus social care and medical treatment was provided by a small team consisting of a social worker, a physician and a nurse. A gradual approach was chosen to establish a working relationship with clients. The first attempt was to satisfy basic medical needs, housing, and financial support as well as to strengthen relevant personal relationships. Once trusting cooperation was established, reduction of transmission-prone behavior was targeted. The results show that social performance can be greatly improved by integrated social, psychological and medical assistance: for the 16 initially homeless housing was found, 14 found a job and for all but 2 basic financial support was eventually guaranteed. Self-reported drug abuse was markedly reduced, as was transmission-prone behavior by prostitution, unsafe sex practices, needle sharing and improper disposal of used syringes. Breaking the isolation of socially marginalized IVDUs seems to be the important move to enhance their social responsibility as carriers of HIV. PMID:8272803

Oertle, D; Edelmann, R; Ostewalder, J; Vernazza, P L; Galeazzi, R L

1993-12-01

379

Ethical tradeoffs in trial design: case study of an HPV vaccine trial in HIV-infected adolescent girls in lower income settings.  

PubMed

The Declaration of Helsinki and the Council of the International Organization of Medical Sciences provide guidance on standards of care and prevention in clinical trials. In the current and increasingly challenging research environment, the ethical status of a trial design depends not only on protection of participants, but also on social value, feasibility, and scientific validity. Using the example of a study assessing efficacy of a vaccine to prevent human papilloma virus in HIV-1 infected adolescent girls in low resource countries without access to the vaccine, we compare several trial designs which rank lower on some criteria and higher on others, giving rise to difficult trade-offs. This case demonstrates the need for developing more nuanced guidance documents to help researchers balance these often conflicting criteria. PMID:23725055

Lindsey, J C; Shah, S K; Siberry, G K; Jean-Philippe, P; Levin, M J

2013-08-01

380

Impaired Generation of Hepatitis B Virus-specific Memory B Cells in HIV Infected Individuals Following Vaccination  

PubMed Central

Hepatitis B-specific memory B cell (HSMBC) frequencies were measured following hepatitis B vaccination in 15 HIV uninfected and 12 HIV infected adolescents. HSMBC were detected at significantly lower frequencies in HIV infected than in HIV uninfected individuals. The detection of HBsAb >10 mIU/ml at study week 28 was strongly associated with the detection of HSMBC and a direct correlation between HBsAb titers and HSMBC frequencies was observed. In HIV uninfected individuals, antibody titers >1000 mIU/ml were associated with higher HSMC frequencies. Lower HSMBC frequencies, reduced memory B cell (MBC) proliferation, and altered B cell phenotypes were measured in viremic HIV infected individuals compared with aviremic HIV infected or HIV uninfected individuals. PMID:20356567

Mehta, Nishaki; Cunningham, Coleen K.; Flynn, Patricia; Pepe, Joyce; Obaro, Stephen; Kapogiannis, Bill G.; Bethel, James; Luzuriaga, Katherine

2010-01-01

381

"Typhoid Mary" and "HIV Jane": responsibility, agency and disease prevention.  

PubMed

The construction of disease risks as knowable, calculable and preventable in dominant social science and public health discourses has fostered a certain kind of logic about individual risk and the responsibility for infection. Disease control measures that have developed out of this logic typically fail to recognise the socio-structural roots of many high-risk behaviours that are linked to the spread of infection. Instead, they hold the disease carrier responsible for managing his/her own risk of infection of others, and rely on constraining the agency of the carrier (e.g. by constraining movement, contact or occupation). In occupations associated with a high risk of infection, the idea of responsibility of the actor implicitly raises issues of "professional responsibility". Using the case of "Typhoid Mary" and a hypothetical case of "HIV Jane", this paper explores some of the problems with making sex workers responsible for the prevention of HIV transmission. It argues that for the notion of "responsibility" to make any sense, the HIV-positive person must be in a position to exercise responsibility, and for this they must have agency. PMID:14708397

Chan, Kit Yee; Reidpath, Daniel D

2003-11-01

382

HIV prevention in Latin America: reaching youth in Colombia.  

PubMed

The aim of this paper is to describe and evaluate a school-based peer education programme on HIV primary prevention implemented in urban marginal districts of three cities of Colombia from 1997 to 1999. Its main objective was to promote risk awareness and safe sexual behaviours among urban youth populations. Methodology included the collection of baseline information through qualitative methods (focus groups and in-depth interviews), a knowledge, attitudes and practices (KAP) survey, a health education intervention, and post-intervention data collection. Direct beneficiaries were adolescents 10 to 19 years of age, and secondary school teachers of 6th to 9th grades. Main strategies used were peer education and classroom sessions conducted by trained teachers. Short-term results suggest that the programme had a positive effect on knowledge and attitudes related to HIV/AIDS (as the mean knowledge summary indicator among adolescents and secondary school teachers increased 24% and 21%, respectively). The main outcome has been the development of a sex education programme, emphasizing the role of schools in the promotion of sexual and reproductive health. Mass education by a combination of interventions and events at school level, backed up by effective interpersonal communication such as peer education, classroom teaching and community actions are effective primary prevention strategies for HIV sexual transmission and should be more extensively considered. PMID:12655836

Perez, F; Dabis, F

2003-02-01

383

Preventing Mother-to-Child Transmission of HIV during Childbirth  

MedlinePLUS

... the risk of mother-to-child transmission of HIV reduced during childbirth? Pregnant women with HIV receive ... her health care providers. Do pregnant women with HIV all receive the same HIV medicines during childbirth? ...

384

Human Immunodeficiency Virus Vaccine Trials  

PubMed Central

More than 2 million AIDS-related deaths occurred globally in 2008, and more than 33 million people are living with HIV/AIDS. Despite promising advances in prevention, an estimated 2.7 million new HIV infections occurred in that year, so that for every two patients placed on combination antiretroviral treatment, five people became infected. The pandemic poses a formidable challenge to the development, progress, and stability of global society 30 years after it was recognized. Experimental preventive HIV-1 vaccines have been administered to more than 44,000 human volunteers in more than 187 separate trials since 1987. Only five candidate vaccine strategies have been advanced to efficacy testing. The recombinant glycoprotein (rgp)120 subunit vaccines, AIDSVAX B/B and AIDSVAX B/E, and the Merck Adenovirus serotype (Ad)5 viral-vector expressing HIV-1 Gag, Pol, and Nef failed to show a reduction in infection rate or lowering of postinfection viral set point. Most recently, a phase III trial that tested a heterologous prime-boost vaccine combination of ALVAC-HIV vCP1521 and bivalent rgp120 (AIDSVAX B/E) showed 31% efficacy in protection from infection among community-risk Thai participants. A fifth efficacy trial testing a DNA/recombinant(r) Ad5 prime-boost combination is currently under way. We review the clinical trials of HIV vaccines that have provided insight into human immunogenicity or efficacy in preventing HIV-1 infection. PMID:23209178

O’Connell, Robert J.; Kim, Jerome H.; Corey, Lawrence; Michael, Nelson L.

2012-01-01

385

HIV prevention with jail and prison inmates: Maryland's Prevention Case Management program.  

PubMed

Prevalence of HIV infection and AIDS cases is higher among inmates of correctional facilities than among the general population, especially for female inmates. This creates a strong need for effective HIV prevention with this population. Maryland's Prevention Case Management (PCM) program provides individual or group counseling to inmates nearing release to promote changes in risk behavior. Pretest and posttest surveys assess changes in perceived risk, condom attitudes, condom use self-efficacy, self-efficacy to reduce injection drug risk and other substance use risk, and behavioral intentions during participation in the program. Client contact logs, kept by counselors, document the number and duration of sessions, and the specific modules, completed by participants. Over a 4-year period, PCM records identified 2,610 participants in the program. Pre-intervention and postintervention data were available for 745 participants, with client contact log records available for 529 (71%) of these individuals. Significant, positive changes were found in self-reported condom attitudes, self-efficacy for condom use, self-efficacy for injection drug use risk, self-efficacy for other substance use risk, and intentions to practice safer sex post-release. Inmate populations are a crucial audience for HIV/AIDS testing, treatment, and prevention efforts. The Maryland PCM program has documented positive changes in participants' attitudes, self-efficacy, and intentions related to HIV risk, over a 4-year period. PMID:14626467

Bauserman, Robert L; Richardson, Damaris; Ward, Michael; Shea, Madeleine; Bowlin, Claudia; Tomoyasu, Naomi; Solomon, Liza

2003-10-01

386

Evidence-based HIV prevention in community settings: provider perspectives on evidence and effectiveness  

Microsoft Academic Search

As part of the efforts to expand evidence-based practice (EBP) in HIV prevention at the community level, the Centers for Disease Control and Prevention (CDC) created the Diffusion of Effective Behavioral Interventions (DEBI) program. Frontline service providers, who are charged with adopting and implementing these interventions, however, have resisted and criticized the dissemination of evidence-based HIV prevention interventions. Their failure

Jill Owczarzak

2012-01-01

387

Evidence-based HIV prevention in community settings: provider perspectives on evidence and effectiveness  

Microsoft Academic Search

As part of the efforts to expand evidence-based practice (EBP) in HIV prevention at the community level, the Centers for Disease Control and Prevention (CDC) created the Diffusion of Effective Behavioral Interventions (DEBI) program. Frontline service providers, who are charged with adopting and implementing these interventions, however, have resisted and criticized the dissemination of evidence-based HIV prevention interventions. Their failure

Jill Owczarzak

2011-01-01

388

Antiretroviral therapy for the prevention of HIV transmission: what will it take?  

PubMed

The evidence in support of use of antiretroviral therapy (ART) for prevention of human immunodeficiency virus (HIV) transmission is encouraging and has stimulated optimism for achieving a dramatic change in the trajectory of the HIV epidemic. Yet, there are substantial challenges that, if not addressed, could be the Achilles' heel for this concept. These challenges require strengthening every step of the HIV care continuum, including expansion of HIV testing to reach all those with HIV infection, effective linkage to and retention in care, timely initiation of ART, and high levels of treatment adherence with viral load suppression. Also important is the identification of individuals with acute HIV infection whose contribution to HIV transmission may be substantial. Implementation research is needed to identify strategies that address these challenges and to determine the efficacy of ART for prevention in key populations as well as to evaluate the effectiveness of combination strategies for HIV prevention at the population level. PMID:24429438

McNairy, Margaret L; El-Sadr, Wafaa M

2014-04-01

389

Pseudo-Mannosylated DC-SIGN Ligands as Potential Adjuvants for HIV Vaccines  

PubMed Central

The development of new and effective adjuvants may play a fundamental role in improving HIV vaccine efficacy. New classes of vaccine adjuvants activate innate immunity receptors, notably toll like receptors (TLRs). Adjuvants targeting the C-Type lectin receptor DC-SIGN may be alternative or complementary to adjuvants based on TRL activation. Herein we evaluate the ability of the glycomimetic DC-SIGN ligand Polyman 19 (PM 19) to modulate innate immune responses. Results showed that PM 19 alone, or in combination with TLR agonists, induces the expression of cytokines, ? chemokines and co-stimulatory molecules that may, in turn, modulate adaptive immunity and exert anti-viral effects. These results indicate that the suitability of this compound as a vaccine adjuvant should be further evaluated. PMID:24473338

Berzi, Angela; Varga, Norbert; Sattin, Sara; Antonazzo, Patrizio; Biasin, Mara; Cetin, Irene; Trabattoni, Daria; Bernardi, Anna; Clerici, Mario

2014-01-01

390

Pseudo-mannosylated DC-SIGN ligands as potential adjuvants for HIV vaccines.  

PubMed

The development of new and effective adjuvants may play a fundamental role in improving HIV vaccine efficacy. New classes of vaccine adjuvants activate innate immunity receptors, notably toll like receptors (TLRs). Adjuvants targeting the C-Type lectin receptor DC-SIGN may be alternative or complementary to adjuvants based on TRL activation. Herein we evaluate the ability of the glycomimetic DC-SIGN ligand Polyman 19 (PM 19) to modulate innate immune responses. Results showed that PM 19 alone, or in combination with TLR agonists, induces the expression of cytokines, ? chemokines and co-stimulatory molecules that may, in turn, modulate adaptive immunity and exert anti-viral effects. These results indicate that the suitability of this compound as a vaccine adjuvant should be further evaluated. PMID:24473338

Berzi, Angela; Varga, Norbert; Sattin, Sara; Antonazzo, Patrizio; Biasin, Mara; Cetin, Irene; Trabattoni, Daria; Bernardi, Anna; Clerici, Mario

2014-02-01

391

Generation and characterization of a preventive and therapeutic HPV DNA vaccine.  

PubMed

Cervical cancer is one of the most common cancers in women worldwide. Persistent infection with human papillomavirus (HPV) is considered to be the etiological factor for cervical cancer. Therefore, an effective vaccine against HPV infections may lead to the control of cervical cancer. An ideal HPV vaccine should aim to generate both humoral immune response to prevent new infections as well as cell-mediated immunity to eliminate established infection or HPV-related disease. In the current study, we have generated a potential preventive and therapeutic HPV DNA vaccine using human calreticulin (CRT) linked to HPV16 early proteins, E6 and E7 and the late protein L2 (hCRTE6E7L2). We found that vaccination with hCRTE6E7L2 DNA vaccine induced a potent E6/E7-specific CD8+ T cell immune response, resulting in a significant therapeutic effect against E6/E7 expressing tumor cells. In addition, vaccination with hCRTE6E7L2 DNA generated significant L2-specific neutralizing antibody responses, protecting against pseudovirion infection. Thus, the hCRTE6E7L2 DNA vaccines are capable of generating potent preventive and therapeutic effects in vaccinated mice. Our data has significant clinical implications. PMID:18096279

Kim, Daejin; Gambhira, Ratish; Karanam, Balasubramanyam; Monie, Archana; Hung, Chien-Fu; Roden, Richard; Wu, T-C

2008-01-17

392

Vaccines against poverty  

PubMed Central

With the 2010s declared the Decade of Vaccines, and Millennium Development Goals 4 and 5 focused on reducing diseases that are potentially vaccine preventable, now is an exciting time for vaccines against poverty, that is, vaccines against diseases that disproportionately affect low- and middle-income countries (LMICs). The Global Burden of Disease Study 2010 has helped better understand which vaccines are most needed. In 2012, US$1.3 billion was spent on research and development for new vaccines for neglected infectious diseases. However, the majority of this went to three diseases: HIV/AIDS, malaria, and tuberculosis, and not neglected diseases. Much of it went to basic research rather than development, with an ongoing decline in funding for product development partnerships. Further investment in vaccines against diarrheal diseases, hepatitis C, and group A Streptococcus could lead to a major health impact in LMICs, along with vaccines to prevent sepsis, particularly among mothers and neonates. The Advanced Market Commitment strategy of the Global Alliance for Vaccines and Immunisation (GAVI) Alliance is helping to implement vaccines against rotavirus and pneumococcus in LMICs, and the roll out of the MenAfriVac meningococcal A vaccine in the African Meningitis Belt represents a paradigm shift in vaccines against poverty: the development of a vaccine primarily targeted at LMICs. Global health vaccine institutes and increasing capacity of vaccine manufacturers in emerging economies are helping drive forward new vaccines for LMICs. Above all, partnership is needed between those developing and manufacturing LMIC vaccines and the scientists, health care professionals, and policy makers in LMICs where such vaccines will be implemented. PMID:25136089

MacLennan, Calman A.; Saul, Allan

2014-01-01

393

Rational design of HIV vaccine and microbicides: report of the EUROPRISE annual conference  

PubMed Central

EUROPRISE is a Network of Excellence sponsored from 2007 to 2011 by the European Commission within the 6th Framework Program. The Network encompasses a wide portfolio of activities ranging from an integrated research program in the field of HIV vaccines and microbicides to training, dissemination and advocacy. The research program covers the whole pipeline of vaccine and microbicide development from discovery to early clinical trials. The Network is composed of 58 partners representing more than 65 institutions from 13 European countries; it also includes three major pharmaceutical companies (GlaxoSmithKline, Novartis and Sanofi-Pasteur) involved in HIV microbicide and vaccine research. The Network displays a dedicated and informative web page: http://www.europrise.org. Finally, a distinguishing trait of EUROPRISE is its PhD School of students from across Europe, a unique example in the world of science aimed at spreading excellence through training. EUROPRISE held its second annual conference in Budapest in November, 2009. The conference had 143 participants and their presentations covered aspects of vaccine and microbicide research, development and discovery. Since training is a major task of the Network, the students of the EUROPRISE PhD program summarized certain presentations and their view of the conference in this paper. PMID:20659333

2010-01-01

394