GOOD AFTERNOON.
MY NAME IS MARY GLENSHAW,
DESIGNATED FEDERAL OFFICIAL OR
EXECUTIVE SECRETARY OF THE
ADVISORY COUNCIL.
OUR COUNCIL IS GOVERNED BY FACA
SETTING FORTH FORMATION AND USE
OF ADVISORY COMMITTEES.
IN THIS REGARD MY ROLE IS TO
PREPARE MEETING AGENDAS,
ORGANIZE MEETINGS, ATTEND AND
APPROVE COUNCIL AND SUBCOMMITTEE
MEETINGS, ADJOURN MEETING WHEN
DETERMINED TO BE IN THE PUBLIC
INTEREST.
AS PREVIOUS MEETINGS, WE'LL GO
OVER GENERAL GUIDELINES FOR
TODAY.
FIRST PLEASE STAY MUTED UNLESS
YOU'RE SPEAKING.
PLEASE KEEP YOUR CAMERA ON FOR
MOST OF THE MEETING, YOU'RE
WELCOME TO HIDE YOUR CAMERA IF
YOU NEED TO LEAVE MOMENTARILY.
WHEN YOU'D LIKE TO PARTICIPATE
IN DISCUSSIONS WE ASK YOU TO USE
THE "RAISE HAND" FEATURE, IF YOU
ARE ABLE TO.
DR. TURNBULL AND I WILL NOTE
THOSE WHO WANT TO SPEAK AND CALL
ON YOU IN TURN TO AVOID SPEAKING
OVER EACH OTHER.
PLEASE BE AWARE YOU NEED TO
LOWER YOUR HAND ONCE YOU'VE MADE
YOUR REMARKS.
FOR THIS MEETING THE ZOOM CHAT
MEET HAS BEEN DISABLED EXCEPT
FOR LOGISTICS MESSAGES TO THE
HOST.
IF YOU HAVE ISSUES OR CONCERNS
E-MAIL OARAFINFO@NIH.GOV.
OR YOU CAN TEXT ME ON MY CELL
PHONE.
FOR EVERYONE ON THE VIDEOCAST,
IF YOU'D LIKE TO SEE CLOSED
CAPTION FOR THE MEETINGS CLICK
ON THE C.C. ICON AT THE BOTTOM
RIGHT-HAND CORNER OF THE SCREEN.
I'LL NOW REMIND MEMBERS OF
POLICIES REGARDING CONFLICTS OF
INTEREST.
COUNCIL MEMBERS MAY NOT
PARTICIPATE IN THE REVIEW OR
DISCUSSION OF A SPECIFIC PROGRAM
OR PROJECT FOR WHICH THEY HAVE A
REAL OR APPARENT CONFLICT OF
INTEREST.
IF A PROGRAM OR PROJECT IS
DISCUSSED THAT PRESENTS A
CONFLICT YOU MUST EXCUSE
YOURSELF FROM THE ZOOM CALL.
SIGNAL ME AND WE'LL MOVE YOU
INTO A SEPARATE CASE.
AFTER THE MEETING SIGN THE
CONFLICT OF INTEREST FORM THAT
WE WILL BE SENDING YOU THIS
AFTERNOON, AND PLEASE E-MAIL IT
BACK TO VERIFY THAT NOTHING
TODAY POSED A CONFLICT FOR YOU.
BEFORE I MOVE FORWARD, I'M HAPPY
TO ANSWER QUESTIONS ABOUT
CONFLICTS OF INTEREST, IF THERE
ARE ANY.
OKAY.
HEARING NONE, PLEASE REMEMBER
TODAY'S MEETING IS OPEN TO THE
GENERAL PUBLIC AND IS CURRENTLY
RECORDED AND VIDEOCAST LIVE.
I'LL NOW TURN THE MEETING OVER
TO OUR CHAIR, DR. IVY TURNBULL,
TO BRING THE MEETING TO ORDER.
THANK YOU.
>> THANK YOU, DR. GLENSHAW.
GOOD AFTERNOON, EVERYONE.
THE 66th MEETING OF OFFICE OF
AIDS RESEARCH ADVISORY COUNCIL,
OARAC, IS NOW IN SESSION.
WELCOME, COUNCIL MEMBERS,
INVITED SPEAKERS AND GUESTS.
COLLEAGUES, WE'LL NOW CONDUCT
THE ROLL CALL.
STATE YOUR POSITION AND
INSTITUTION.
DR. GLENSHAW, PROCEED WITH THE
ROLL CALL.
>> THANK YOU VERY MUCH.
WE'LL START WITH OUR VOTING
MEMBERS, DR. OMAR GALARRAGA.
>> OMAR GAL RAGA DIRECTOR OF
HEALTH SERVICES DOCTORAL
PROGRAM, BROWN UNIVERSITY SCHOOL
OF PUBLIC HEALTH, PROVIDENCE,
RHODE ISLAND.
>> THANK YOU.
DR. LUIS MONTANER.
>> PROFESSOR OF IMMUNOLOGY AND
HIV CURE RAB AER TO.
>> THANK YOU.
DR. SHRUTI MEHTA I DON'T BELIEVE
HAS JOINED US, IS TRAVELING BUT
TRYING TO JOIN LATER.
DR. NAGHAVI?
>> I'M MOJGAN NAGHAVI, PROFESSOR
AT DEPARTMENT OF MICROBIOLOGY
AND IMMUNOLOGY, NORTHWESTERN
UNIVERSITY.
>> WELCOME.
DR. ANNE NEILAN.
>> GOOD AFTERNOON, INFECTIOUS
DISEASE PHYSICIAN AT
MASSACHUSETTS GENERAL HOSPITAL,
BOSTON.
DIRECT THE RESEARCH PROGRAM IN
ADOLESCENT HEALTH MEDICAL
PRACTICE EVALUATION CENTER,
ASSISTANT PROFESSOR OF
PEDIATRICS AND MEDICINE HARVARD
MEDICAL SCHOOL.
>> WE HAVE A VERY, VERY RECENTLY
JOINED NEW VOTING MEMBER, DR.
COURTNEY FLETCHER, TRYING TO
JOIN US LATER THIS MORNING, I'LL
INTRODUCE BRIEFLY.
DR. PHILADELPHIA - FLETCHER ISF
ANTI-VIRAL PHARMACOLOGY LAB AT
CENTER FOR DRUG DISCOVERY AT THE
UNIVERSITY OF NEBRASKA MEDICAL
CENTER, DR. FLETCHER HAS DEVOTED
HIS RESEARCH AND PRACTICE
INTERESTS TOWARDS CLINICAL
PHARMACOLOGY OF ANTI-VIRAL
AGENTS.
AND HE RECEIVED HIS DOCTOR OF
PHARMACY DEGREE FROM UNIVERSITY
OF MINNESOTA IN MINNEAPOLIS.
SO WE HOPE HE CAN JOIN US LATER
THIS MORNING.
OR THIS AFTERNOON.
I'LL NOW MOVE TO OUR EX
OFFICIOS, I DON'T BELIEVE SHE'S
JOINED YET BUT COLONEL JULIE AKE
WILL JOIN US LATER.
DR. VICKIE DAVEEY.
>> FROM THE V.A., DEPARTMENT OF
VETERANS AFFAIRS, IN THE U.S.
OFFICE OF RESEARCH AND
DEVELOPMENT.
>> WELCOME.
DR. DIEFFENBACH?
>> GOOD MORNING, DIRECTOR OF
DIVISION OF AIDS, NATIONAL
INSTITUTES OF ALLERGY,
INFECTIOUS DISEASE, IT'S A
PLEASURE TO BE HERE.
>> THANK YOU, WELCOME.
DR. JONATHAN MERMIN.
>> DIRECTOR OF NATIONAL CENTER
FOR HIV VIRAL HEPATITIS, STD AND
PREVENTION, AT THE CDC.
GREAT TO BE HERE.
>> GREAT TO SEE YOU.
I DON'T BELIEVE OUR ADVISORY
COUNCIL REPRESENTATIVES ARE HERE
WITH THE EXCEPTION OF DR. ELAINE
ABRAMS.
>> PROFESSOR OF PEDIATRICS AND
EPIDEMIOLOGY, COLUMBIA
UNIVERSITY.
>> THANK YOU FOR JOINING US
TODAY, DR. ABRAMS.
I KNOW THIS IS YOUR FIRST OARAC
MEETING.
NOW LEADERS AND SPEAKERS.
DR. FINZI.
>> GOOD AFTERNOON, I AM ACTING
DIRECTOR OF THE OFFICE OF AIDS
RESEARCH AND I AM ALSO THE
DIRECTOR OF THE BASIC SCIENCES
PROGRAM AT NIAID.
>> THANK YOU.
MS. RACHEL ANDERSON.
>> GOOD AFTERNOON, RACHEL
ANDERSON, SENIOR POLICY ADVISER
AT OAR.
>> THANK YOU.
AND BRETTA BIRD ABOUT JOIN US
LATER.
I'D LIKE TO WELCOME INVITED
GUESTS, MR. FRANCISCO RUIZ.
>> NICE TO MEET YOU.
>> NICE TO MEET YOU, MR. RUIZ IS
DIRECTOR OF THE WHITE HOUSE
OFFICE OF NATIONAL AIDS POLICY.
WE'RE VERY EXCITED FOR YOU TO
JOIN US TODAY.
DR. MARTINS?
>> I'M ASSOCIATE PROFESSOR IN
SCRIPPS INSTITUTE PART OF
UNIVERSITY OF FLORIDA NOW.
THANK YOU FOR THE INVITATION.
>> THANK YOU.
KIMBERLY CANADY-GRIFFITH WILL
JOIN US LATER, AND AND DR.
SHOKTUR WILL JOIN US LATER.
DR. TURNBULL, BACK TO YOU.
>> THANK YOU.
>> THE OARAC ADVISES INCLUDING
REVIEW OF NIH HIV/AIDS PROGRAMS,
I WILL NOW PROVIDE A BRIEF
OVERVIEW OF TODAY'S AGENDA,
WHICH WILL INCLUDE A REPORT FROM
THE ACTING OAR DIRECTOR, DR.
DIANA FINZI, AN UPDATE FROM DR.
RACHEL ANDERSON ON NIH STRATEGIC
PLAN FOR HIV AND HIV-RELATED
RESEARCH.
A PRESENTATION FROM
MR. FRANCISCO RUIZ, THE NEW
DIRECTOR OF THE WHITE HOUSE
OFFICE OF AIDS NATIONAL AIDS
POLICY.
A SPECIAL SEGMENT ON THE ISSUES
OF PERINATAL HIV RESEARCH AND
RESPONSES WHICH INCLUDES
PRESENTATION FROM DR. MAURICIO
MARTINS AND MS. KIMBERLY CANADY,
FOLLOWING THAT AN UPDATE FROM
THE RESEARCH COMMITTEE, WE'LL
HAVE AN UPDATE FROM NIH ADVISORY
COMMITTEE, FINALLY AN UPDATE
FROM ONE OF THE OAR HIV CLINICAL
GUIDELINES WORKING GROUPS.
THE AGENDA ALSO INCLUDES TIME
FOR REGISTERED PUBLIC COMMENT.
ANYONE INTERESTED IN TODAY
WISHING TO MAKE A PUBLIC COMMENT
SHOULD E-MAIL OARACINFO@NIH.GOV.
WITH YOUR NAME, AFFILIATION, AND
QUESTION OR COMMENT.
PLEASE VISIT THE NIH OAR WEBSITE
OR THE FEDERAL REGISTRY NOTICE
FOR MORE DETAIL.
NOW I INTRODUCE DR. DIANA FINZI,
ACTING NIH ASSOCIATE DIRECTOR OF
AIDS RESEARCH, ACTING DIRECTOR
OF OAR.
DR. FINZI, I TURN IT OVER TO
YOU.
>> THANK YOU, DR. TURNBULL.
SO, I WILL START BY LETTING YOU
KNOW THAT PERMANENT OAR DIRECTOR
SHOULD BE ANNOUNCED VERY SOON.
IN THE MEANTIME I WOULD LIKE TO
MENTION HOW GRATEFUL I HAVE BEEN
FOR THIS EXPERIENCE AS ACTING
DIRECTOR OF THE OFFICE OF AIDS
RESEARCH.
I'VE LEARNED SO MUCH ABOUT
PEOPLE HERE AND ABOUT YOU WHO
THE OAR FUNCTIONS AND THE
AMAZING BREADTH OF RESEARCH ON
HIV THAT IS COVERED BY THE OAR
AND THE NIH AS A WHOLE.
AND JUST A FEW HIGHLIGHTS WILL
INCLUDE PUBLISHING A NOTICE OF
INFORMATION AND SPECIAL NOSI
WITH THE OFFICE OF RESEARCH ON
WOMEN'S HEALTH, AND THAT
REAFFIRMS OUR SHARED COMMITMENT
TO ADVANCING SCIENCE ON HIV AND
WOMEN'S HEALTH.
WORKING ON VARIOUS DOCUMENTS,
INCLUDING PROFESSIONAL JUDGMENT,
THE STRATEGIC PLAN, THE OAR
BUDGET DOCUMENTS, AND EVEN
REALLY ON THE DAY-TO-DAY WORK
THAT THE OAR DOES IN APPROVING
FUNDING.
AND WE'VE ALSO PARTICIPATED, AND
I PERSONNEL HAVE PARTICIPATED,
IN MANY DIFFERENT ENGAGEMENTS
INCLUDING MEMBERS OF CONGRESS.
SO NOW JUST TO GIVE AN OVERVIEW,
FOR TODAY, TODAY WE WILL SHARE
SOME UPDATES ON OARAC, ON NIH,
AND OTHER LEADERSHIP
TRANSITIONS, FY 2026
PROFESSIONAL JUDGMENT, OAR
ENGAGEMENTS, AND ON THE
STRATEGIC PLAN.
AND I WILL CLOSE BY KICKING OFF
OUR DISCUSSION OF A VERY
IMPORTANT POPULATION TO US, AND
TO OUR WORK, THOSE WHO ACQUIRED
HIV PERINATALLY.
FIRST I WANTED TO SAY HAPPY
PRIDE.
NIH RECOGNIZES JUNE AS PRIDE
MONTH AND REAFFIRMS OUR
COMMITMENT TO UPLIFTING AND
CELEBRATING THE LIVED
EXPERIENCES OF OUR LGBTQIA+
PEOPLE, EMPLOYEES AND PEOPLE
EVERYWHERE.
YOU CAN LEARN MORE ABOUT ALL OF
OUR ACTIVITIES BY SCANNING THE
QR CODE HERE.
AND THEN NEXT SLIDE, I'M NOT
SURE IF WE HAVE COURTNEY HERE
YET OR NOT.
BUT I WANTED TO WELCOME
COURTNEY, AND WE LOOK FORWARD TO
HIS PARTICIPATION ON COUNCIL.
THEN MOVING TO A FEW TRANSITIONS
AT THE NIH LEADERSHIP LEVEL, NIH
WELCOMES DR. KATHLEEN NEUZIL AS
FOGARTY INTERNATIONAL NEWEST
DIRECTOR, AND SHE WILL BE THE
FIRST WOMAN TO HOLD THIS
POSITION, AND SHE COMES TO US
FROM THE UNIVERSITY OF MARYLAND,
WHERE SHE SERVED AS THE DIRECTOR
OF THE CENTER FOR VACCINE
DEVELOPMENT AND GLOBAL HEALTH.
AND WAS ALSO THE CHIEF OF THE
DIVISION OF GEOGRAPHIC MEDICINE
AT THE UNIVERSITY OF MARYLAND IN
BALTIMORE.
AND THEN LAST WEEK, DR. JOSHUA
GORDON DEPARTED FROM HIS
POSITION AT DIRECTOR OF THE
NATIONAL INSTITUTE OF MENTAL
HEALTH, TO RETURN TO COLUMBIA
UNIVERSITY, AS CHAIR OF THE
DEPARTMENT OF PSYCHIATRY AND
PSYCHIATRIST IN CHIEF OF THE NEW
YORK-PRESBYTERIAN HOSPITAL.
DR. GORDON WILL ALSO SERVE AS
THE DIRECTOR OF THE NEW YORK
STATE PSYCHIATRIC INSTITUTE.
AND FOLLOWING HIS DEPARTURE AND
WHILE NIH CONDUCTING A NATIONAL
SEARCH FOR A REPLACEMENT, THE
CURRENT NIMH DEPUTY DIRECTOR,
DR. SHELLY AVENEVOLI, WILL SERVE
AS ACTING DIRECTOR.
AND ONE TRANSITION TO NOTE FROM
OUTSIDE THE NIH, FRANCISCO RUIZ
HAS BEEN NAMED NEW DIRECTOR OF
THE WHITE HOUSE OFFICE OF
NATIONAL AIDS POLICY, ONAC, WE
LOOK FORWARD TO HEARING HIM
TALK.
MR. RUIZ IS A SEASONED PUBLIC
HEALTH EXPERT WELL KNOWN FOR
EXTENSIVE COLLABORATION WITH
COMMUNITY-BASED ORGANIZATIONS,
NATIONAL COALITIONS, AND
GOVERNMENT AGENCIES AT THE
LOCAL, STATE, FEDERAL LEVELS.
AS THE FIRST EVER LATINO SERVING
AS THE ONAC DIRECTOR HE BRINGS A
UNIQUE BLEND OF PROFESSIONAL
EXPERTISE AND PERSONAL
EXPERIENCE TO THIS VERY
IMPORTANT ROLE.
HE SUCCEEDS THE FORMER ONAC
DIRECTOR, HAROLD PHILLIPS, WHO
LED THE DEVELOPMENT OF THE
BIDEN-HARRIS ADMINISTRATION'S
NATIONAL HIV/AIDS STRATEGY AND
WORKED TIRELESSLY TO ILLUSTRATE
THE NEED FOR A NATIONAL PrEP
PROGRAM.
WE LOOK FORWARD TO WORKING WITH
MR. PHILLIPS IN HIS NEW ROLE AS
DEPUTY DIRECTOR OF PROGRAMS AT
NMAC.
NEXT I'LL PROVIDE AN UPDATE ON
THE PROFESSIONAL JUDGMENT
BUDGET, THE PJ.
OAR PREPARES A PROFESSIONAL
JUDGMENT BUDGET EVERY YEAR,
WHICH ESTIMATES THE FUNDS NEEDED
TO FULLY PURSUE SCIENTIFIC
OPPORTUNITIES LEADING TO THE
ENDS OF THE HIV PANDEMIC.
IT IS BASED ON CURRENT RESEARCH
OPPORTUNITIES, AND THE NIH
HIV/AIDS RESEARCH PRIORITIES.
IT IS REFERRED TO AS THE
PROFESSIONAL JUDGMENT BUDGET
BECAUSE IT REPRESENTS THE
PROFESSIONAL JUDGMENT OF OAR AS
TO THE HIV RESEARCH FUNDING
NEEDS AND IT IS PRESENTED
DIRECTLY TO THE PRESIDENT
WITHOUT MODIFICATION THAT IS --
THAT THERE USUALLY IS WITH THE
STANDARD FEDERAL BUDGET PROCESS.
THE PJ IS ONE OF TWO REQUIRED
DOCUMENTS THAT OAR PRODUCES
ANNUALLY.
THE OTHER BUDGET DOCUMENT IS THE
CONGRESSIONAL BUDGET
JUSTIFICATION, WHICH EXPLAINS
THE NIH HIV BUDGET TO CONGRESS.
WE EXPECT TO RELEASE THE NIH OAR
FY 26 PJ IN THE NEXT FEW WEEKS.
THE DOCUMENT WILL BE STRUCTURED
TO ALIGN WITH THE STRATEGIC
GOALS FEATURED IN THE NEXT
PROPOSED ITERATION OF THE NIH
STRATEGIC PLAN WHICH YOU'LL HEAR
MORE ABOUT LATER TODAY.
NOW TURNING NEXT TO THE
HIGHLIGHTS OF SOME OF THE OAR
ENGAGEMENT ACTIVITIES THAT TOOK
PLACE SINCE LAST MEETING AND TO
MENTION UPCOMING EVENTS, OAR HAS
BEEN VERY PRODUCTIVE.
THIS SLIDE HIGHLIGHTS FOUR
EVENTS THAT WERE EITHER LED OR
CO-SPONSORED BY THE OAR.
OAR AND THE OFFICE OF RESEARCH
ON WOMEN'S HEALTH CO-SPONSORED A
TWO-DAY VIRTUAL WORKSHOP IN
MARCH THAT REVIEWED THE STATE OF
THE SCIENCE, HIV AND WOMEN, TO
INFORM THE FUTURE RESEARCH
AGENDA.
IN EARLY APRIL OAR FEATURED A
TALK BY DR. SARA WEIBEL ON THE
LAST GIFT PROGRAM FOCUSING ON
ALTRUISM OF PEOPLE WHO DONATE
THEIR BODIES FOR SCIENTIFIC
DISCOVERY.
AND THIS WORK IS PARTICULARLY
IMPORTANT TO CURE RESEARCH WHERE
YOU CAN GET TISSUES AND SAMPLES
THAT ARE OTHERWISE VERY HARD TO
LOOK AT IN PEOPLE WHO HAVE BEEN
ON TREATMENT AND THIS IS HELPFUL
TO LOOK AT RESIDUAL VIRUS IN
PEOPLE WHO HAVE PASSED AWAY.
OAR ALSO SPONSORED A HYBRID
WORKSHOP AS PART OF THE 15th
INTERNATIONAL WORKSHOP ON HIV
AND WOMEN, AND APRIL 24 OAR HELD
ITS THIRD WORKSHOP FOR EARLY
CAREER INVESTIGATORS IN HIV IN
ITS EFFORTS TO PROVIDE RESOURCES
AND MENTORING TO THE NEXT
GENERATION OF HIV INVESTIGATORS,
AND THIS PARTICULAR WORKSHOP WAS
EXTREMELY WELL ATTENDED WITH
HUNDREDS OF EARLY INVESTIGATORS.
OKAY.
SO, OAR HAS ALSO PARTICIPATED IN
SEVERAL OTHER EVENTS IN THE PAST
FEW MONTHS.
CAPTAIN MARY GLENSHAW PRESENTED
AT AN OPENING PLENARY AT NMAC'S
SUMMIT.
I SPOKE AT NASEM'S CONFERENCE
AND HOW ADVOCACY INFLUENCED HIV
RESEARCH AND FUNDING AT THE NIH.
AND THEN DR. GLENSHAW ALSO SPOKE
AT PATCH'S 81th FULL COUNCIL
MEETING ON PROGRESS ON ENDING
THE HIV EPIDEMIC, SPOKE ON
VARIOUS AGENCY PERSPECTIVES.
NOW I WANT TO MENTION OAR IS
VERY GRATEFUL TO THE MANY HIV
NETWORKS FOR THEIR EFFORTS AND
RESEARCH, CARE, PREVENTION, AND
MANY OF THE -- ALL OF THESE
NETWORKS HAVE RECENTLY HELD
MEETINGS TO TALK ABOUT THEIR
WORK.
AND I WANTED ALSO TO QUICKLY
MENTION THAT THE NETWORK
RECOMPETITION HAS BEGUN.
THIS SLIDE YOU CAN SEE THE
TIMELINE, AND YOU'LL HEAR MUCH
MORE ABOUT THIS IN OUR NEXT
MEETING.
CARL DIEFFENBACH WILL GIVE AN
UPDATE OF WHERE WE ARE WITH THE
NETWORK RECOMPETITION IN
OCTOBER.
SO, MOVING ON, MOVING ALONG
BEFORE OUR NEXT OARAC MEETING
OAR IS LOOKING FORWARD TO MANY
ENGAGEMENTS, SOME OF WHICH ARE
SHOWN HERE.
OAR IS ALSO INVOLVED IN SEVERAL
COLLABORATIVE SESSIONS THAT WILL
TAKE PLACE AT THE UPCOMING AIDS
2012 IN MUNICH, INCLUDING WE
HAVE SESSIONS ON AGING, ON
CHILDREN AND ADOLESCENTS, WITH
PERINATAL HIV EXPOSURE, AND ON
RESERVOIRS AND FINDING A CURE
FOR HIV.
OAR CONTINUES TO WORK ON THE
NEXT STRATEGIC PLAN, AND YOU'LL
HEAR MORE ABOUT THIS VERY
SHORTLY.
BUT I WILL SAY THAT THIS
STRATEGIC PLAN AND THE PLAN
GUIDES THE LARGEST PUBLIC HEALTH
INVESTMENT IN HIV RESEARCH, AND
IS PART OF THE PROCESS OAR SEEKS
INPUT FROM ALL POSSIBLE
INTERESTED CONSTITUENTS,
INCLUDING RESEARCHERS,
HEALTHCARE PROFESSIONALS,
ADVOCATES, AND ADVOCACY HEALTH
ORGANIZATIONS, SCIENTIFIC AND
PROFESSIONAL ORGANIZATIONS,
PUBLIC HEALTH OFFICIALS,
GOVERNMENT AGENCIES, AND
COMMUNITY MEMBERS.
ON THE RIGHT-HAND SIDE OF THE
SLIDE YOU CAN SEE THERE'S SIX
FUNDAMENTAL SOURCES OF INPUT IN
THE DEVELOPMENT OF THIS
STRATEGIC PLAN.
AND, AGAIN, YOU'LL HEAR MUCH
MORE ABOUT THIS IN JUST A FEW
MINUTES.
AND NOW BEFORE I WRAP UP, I'D
LIKE TO PREVIEW OUR CONVERSATION
ON ISSUES RELATED TO PERINATAL
RESEARCH, AND THIS -- AND
MENTION THIS POPULATION IS SO
IMPORTANT TO OUR WORK AND GIVES
US ANOTHER KEY TOWARDS UNLOCKING
QUESTIONS ABOUT HIV LATENCY AND
PERSISTENCE.
LATER IN OUR PROGRAM, WE'LL HEAR
A BASIC AND TRANSLATIONAL
PERSPECTIVE FROM DR. MAURICEIO
MARTINS AND COMMUNITY
PERSPECTIVE FROM KIM CANADAY.
SO, PERINATAL ACQUISITION IS OF
COURSE LINKED TO LONG-TERM
SURVIVORSHIP.
THE PERCENTAGE OF OLDER ADULTS
LIVING WITH HIV IS INCREASING IN
ALL REGIONS OF THE WORLD.
AND PEOPLE IN THEIR 20s AND
30s WHO ARE DANDELIONS, A
UNIQUE POPULATION THAT LIVED
WITH HIV THEIR ENTIRE LIVES,
THOSE WHO A ACQUIRED AT YOUNG AE
ARE ALSO LONG TERM SURVIVORS,
ESPECIALLY IN THEIR 20s AND
30s.
WE ALSO KNOW THAT RATES OF
PERINATAL TRANSMISSION HAVE
DROPPED SIGNIFICANTLY BUT THERE
ARE MANY PEOPLE LIVING SINCE
BIRTH WITH HIV.
WITH SUCCESSIVE TREATMENT COME
QUESTIONS HOW HIV INTERACTS WITH
THE BODY AND WHILE ART CAN
SUPPRESS VIRAL REPLICATIONS
THERE'S STILL SIGNIFICANT
DIFFERENCES IN COMORBIDITIES AND
LIFE EXPECTANCY.
SOME AGE-RELATED COMORBIDITIES
OCCUR EARLIER IN PEOPLE WITH HIV
INFECTION THAN AMONG
HIV-INFECTED INDIVIDUALS --
UNINFECTED INDIVIDUALS.
IT'S, WITH THE SUCCESS OF
TREATMENT AND ART DESPITE GLOBAL
INVESTMENT NEARLY ONE-THIRD OF
THE 38 MILLION PEOPLE CURRENTLY
LIVING WITH HIV REMAIN
UNTREATED.
SO, TO ME, THESE ISSUES REALLY
HIGHLIGHT THE URGENT NEED FOR A
CURE.
SEVERAL DIFFERENT STRATEGIES ARE
BEING STUDIED, AND INTERESTINGLY
STUDIES ON PERINATALLY ACQUIRED
HIV ARE YIELDING VERY IMPORTANT
INFORMATION ON THE HIV
RESERVOIR.
I WANTED -- BEFORE MOVING ON, I
JUST WANTED TO QUICKLY REMIND
YOU ALL TO MARK YOUR CALENDAR
FOR OCTOBER 24, NEXT MEETING,
AND FOR MAKING THESE MEETINGS A
PRIORITY.
THIS AFTERNOON YOU'LL HEAR FROM
CAPTAIN MARY GLENSHAW AND DR.
NON-PROVIDING UPDATES OF THE
NEXT STRATEGIC PLAN AND MR. RUIZ
ABOUT ONAC.
DR. MARTIN AND MS. CANADAY WILL
PROVIDE INFORMATION ABOUT
SURVIVORSHIP, THE COUNCIL
MEETING, AND UPDATES FROM THE
NIH AIDS EXECUTIVE COMMITTEE,
AND DR. CORETTÉ BIRD, AND
CLINICAL GUIDELINES WORKING
GROUP OF OARAC.
I'D LIKE TO TAKE A MOMENT TO
REMEMBER DR. STEVE DOUGLAS WHO
PASSED AWAY MARCH 13, A DEAR
FRIEND OF MINE, ON EXPLORED THE
NEUROIMMUNOLOGY OF HIV, SPENT
MUCH OF HIS REMARKABLE CAREER AT
CHOP, CHILDREN'S HOSPITAL AT
PHILADELPHIA, AND AS PROFESSOR
OF PEDIATRICS AT PERLEMAN SCHOOL
OF MEDICINE AT UNIVERSITY OF
PENNSYLVANIA.
WE REALLY WILL MISS HIM.
I WANT TO END AND THANK YOU
AGAIN FOR YOUR ATTENTION, AND
WANT TO CLOSE WITH A QUICK PLUG
FOR NATIONAL HIV TESTING DAY,
NEXT WEEK, ON JUNE 27.
AN IMPORTANT DAY TO REMIND -- TO
GET AS MANY PEOPLE TESTED AS
POSSIBLE, AND OF COURSE
TREATMENT AND PREVENTION WHICH
ARE JUST VITAL TO OUR ENDING THE
HIV EPIDEMIC EFFORTS.
THANK YOU AGAIN.
AND I LOOK FORWARD TO THE REST
OF THIS MEETING.
DR. TURNBULL?
>> YES.
>> I TURN IT BACK OVER TO YOU.
>> THANK YOU, DR. FINZI.
THANK YOU SO MUCH FOR THE GREAT
UPDATE.
WE'LL HOLD QUESTIONS UNTIL THE
OPEN DISCUSSION PERIOD.
WE WILL NOW HEAR FROM SENIOR
POLICY ADVISER, DR. RACHEL
ANDERSON.
DR. ANDERSON, PLEASE BEGIN WHEN
YOU'RE READY.
>> THANKS, DR. TURNBULL.
AND I'M HERE TODAY TO SPEAK ON
BEHALF OF THE NIH OAR STRATEGIC
PLAN AND HIV RESEARCH PRIORITIES
WORKING GROUP TO GIVE AN UPDATE
ON THE STRATEGIC PLAN PROCESS.
LET'S GO TO THE NEXT SLIDE.
I'LL REVIEW WHERE WE ARE WITH
THE UPDATE PROCESS AND REMIND
YOU OF PROPOSED FRAMEWORK.
I WILL TALK ABOUT THE RFI
RELEASED THIS YEAR TO SOLICIT
PUBLIC FEED BACK, I WON'T BE
GOING INTO A LOT OF DETAIL ABOUT
THE RESPONSES THAT WE RECEIVED
BUT RATHER TALKING ABOUT HOW
THIS INFORMATION FROM THE RFI
RESPONSES ALONG WITH THE OTHER
SOURCES OF INFORMATION WILL
INFORM THE FUNDING PRIORITIES
OUTLINED IN THE NEW PLAN.
SO TO DO THAT I'LL PROVIDE SOME
ADDITIONAL INFORMATION ABOUT THE
STRUCTURE OF THE NEW PLAN,
INCLUDING GOALS AND OBJECTIVES,
AND FINALLY I'LL SHARE AN UPDATE
ON OAR TASK FORCES INCLUDING
NEXT STEPS.
LET'S GO TO THE NEXT SLIDE.
OKAY.
SO, AS WE DESCRIBED IN FEBRUARY
OAR OPTED TO RECONSIDER THE
STRUCTURE OF OUR STRATEGIC PLAN
IN ORDER TO LEVERAGE INCREASING
INTERSECTION OF SCIENTIFIC
APPROACHES.
SO WE'RE MOVING AWAY FROM THE
FIVE OVERARCHING PRIORITIES THAT
HAVE BEEN FEATURED IN THE
STRATEGIC PLAN FOR MANY YEARS
NOW.
THIS IS NOT TO ELIMINATE BUT TO
HIGHLIGHT, ALIGNING WITH NEW NIH
TEMPLATE FOR STRATEGIC PLANS,
AND WE LOOK TO THE STRUCTURE OF
THE MOST RECENT PROFESSIONAL
JUDGMENT BUDGET WHICH ALSO
FOLLOWS STAGES OF THE RESEARCH
CONTINUUM.
GOAL ONE IS TO ENHANCE DISCOVERY
AND ADVANCE HIV SCIENCE THROUGH
FUNDAMENTAL RESEARCH.
GOAL 2, TO ADVANCE THE
DEVELOPMENT AND ASSESSMENT OF
NOVEL INTERVENTIONS FOR HIV
PREVENTION, TREATMENT,
CO-MORBIDITIES, AND CURE.
GOAL 3 TO OPTIMIZE PUBLIC HEALTH
IMPACT OF HIV DISCOVERIES.
AND FINALLY, CAPACITY GOAL IS TO
BUILD RESEARCH WORKFORCE AND
INFRASTRUCTURE CAPACITY TO
ENHANCE THE SUSTAINABILITY OF
HIV SCIENTIFIC DISCOVERY.
WE'VE DRAFTED REVISED FRAMEWORK
AND WE'VE RECEIVED A LOT OF
DIFFERENT INPUT FROM INTERNAL
AND EXTERNAL SOURCES, THAT I'LL
TALK ABOUT IN JUST A MOMENT.
WE'RE CURRENTLY HERE PROCESSING
INPUT TO GENERATE COMBINED LIST
OF PROPOSED FUNDING PRIORITIES.
AND THESE ARE THE PRIORITIES
THAT WILL BE SHARED WITH THE OAR
TASK FORCES TO REVIEW AND USE AS
A BASIS FOR DEVELOPING
RECOMMENDATIONS.
SO THE TASK FORCE
RECOMMENDATIONS WILL INFORM THE
FINAL FUNDING PRIORITIES, AND
OAR'S STRATEGIC PLAN WORKING
GROUP WILL THEN START WRITING
THE PLAN.
OAR -- EXCUSE ME, AFTER OARAC
REVIEW AND NIH CLEARANCE THE
PLAN WILL BE PUBLISHED IN
ADVANCE OF FISCAL YEAR 26.
NEXT SLIDE.
THIS IS A SLIGHTLY MODIFIED
VERSION OF THE SLIDE DR. FINZI
SHOWED EARLIER, INFORMED BY
MULTIPLE SOURCES OF INPUT,
INCLUDING INTERNAL ANALYSIS AND
OTHER FEEDBACK FROM NIH SOURCES,
AS WELL AS EXTERNAL SOURCES SUCH
AS OAR LISTENING SITUATIONS
WORKSHOPS AND PUBLIC INPUT.
OARAC REMAINS AN IMPORTANT
SOURCE OF INPUT AS WELL.
I SPOKE ABOUT THIS IN FEBRUARY
AT OUR OARAC MEETING.
WE POSTED A PUBLIC RFI, REQUEST
FOR INFORMATION, THAT WAS OPEN
FROM FEBRUARY 12 THROUGH MARCH
28.
THIS RFI DESCRIBES THE NEW
FRAMEWORK AND INVITED
RESPONDENTS TO PROPOSE RESEARCH
PRIORITIES WITH POTENTIAL TO
ADVANCE HIV SCIENCE AND IMPACT
HIV-ASSOCIATED PUBLIC HEALTH
ACROSS THE FOUR GOALS.
WE ALSO INCLUDED AN OPTION TO
PROVIDE FEEDBACK ON THE
FRAMEWORK ITSELF.
IN RESPONSE TO THE RFI, WE HEARD
FROM 205 RESPONDENTS, AND THIS
INCLUDES 52 RESPONSES SUBMITTED
ON THE BEHALF OF ORGANIZATIONS.
RESPONDENTS HAD THE OPTION TO
SELF-IDENTIFY THEIR SECTOR, AND
SO THIS FIGURE IS SHOWING HOW
THE 205 RESPONDENTS IDENTIFIED.
AS YOU CAN SEE, JUST OVER 40% OF
OUR RESPONDENTS REPRESENTED
ACADEMIC SECTOR BUT WE ALSO HAD
GOOD REPRESENTATION FROM HEALTH
CARE, ADVOCACY, GOVERNMENT, AND
NON-GOVERNMENT ORGANIZATIONS.
JUST FOR YOUR AWARENESS OF THE
ORGANIZATIONS THAT SUBMITTED
COORDINATED RESPONSES, ABOUT
HALF IDENTIFIED AS NGOs,
COMMUNITY-BASED ORGANIZATIONS,
OR ADVOCACY ORGANIZATIONS.
NEXT SLIDE.
OUR RESPONDENTS HAD THE OPTION
TO DISCLOSE GEOGRAPHIC LOCATION,
SO 65% OF OUR RESPONDENTS WERE
FROM THE UNITED STATES.
10% FROM AFRICA.
WE ALSO RECEIVED A FEW OTHER
RESPONSES FROM OTHER COUNTRIES
IN NORTH AMERICA, SOUTH AMERICA,
EUROPE, ASIA.
20% OF RESPONDENTS DID NOT
DISCLOSE A LOCATION.
I WANTED TO NOTE THAT AS WELL.
NEXT SLIDE.
WHEN WE LOOK AT THE BREAKDOWN OF
REPRESENTATION ACROSS THE UNITED
STATES, BACK ONE SLIDE PLEASE.
THANK YOU.
MOST OF THE RESPONSES CAME FROM
THE SOUTH.
WE RECEIVED OTHER RESPONSES
ROUGHLY DIVIDED EQUALLY ACROSS
THE WEST, MIDWEST, NORTHEAST.
AGAIN, I'M NOT GOING TO TALK
ABOUT SPECIFIC FEEDBACK TODAY
BUT RATHER DESCRIBE HOW THAT
INFORMATION WILL BE USED TO
INFORM THE FUNDING PRIORITIES
THAT THE NEW PLAN WILL
HIGHLIGHT.
NOW WE CAN GO TO THE NEXT SLIDE.
GREAT.
SO IN FEBRUARY, WE DESCRIBED THE
STRATEGIC PLAN STRUCTURE, EACH
OF THE FOUR GOALS WILL INCLUDE
FOUR OBJECTIVES THAT BROADLY
REFLECT DIFFERENT RESEARCH
AREAS.
WITHIN THESE OBJECTIVES,
SPECIFIC FUNDING PRIORITIES WILL
BE DESIGNATED.
CLICK THROUGH ONE TIME PLEASE.
SO THIS APPROACH WILL ENSURE OUR
STRATEGIC PLAN REFLECTS THE
BREADTH OF HIV RESEARCH WHILE
ALSO SPECIFYING TOPICS THAT WILL
BE PRIORITIZED FOR FUNDING.
SO TODAY I'LL SHARE WITH YOU THE
BROAD OBJECTIVES THAT COMPRISE
EACH GOAL.
AND THESE OBJECTIVES REFLECT
INPUT FROM OAR STAFF AND FROM
THE NIH REPRESENTATIVES ON THE
NIH AIDS EXECUTIVE COMMITTEE,
WHILE ALSO GENERALLY ALIGNING
WITH OUR PREVIOUS STRATEGIC
PLANS.
AND I WANTED TO TAKE A MOMENT TO
NOTE HERE THAT WE DID RECEIVE
SOME COMMENTS IN RESPONSE TO THE
RFI THAT EMPHASIZED SEVERAL
UNDERLYING PRINCIPLES THAT WE
SHOULD BE MINDFUL OF WHEN
UPDATING THE PLAN.
SO I WANTED TO AFFIRM HERE THAT
THE GOALS, OBJECTIVES, FUNDING
PRIORITIES WILL REFLECT
PRINCIPLES SUCH AS
INCLUSIVENESS, AND THAT'S
INCLUSIVENESS OF SCIENTIFIC
DISCIPLINES, INCLUSIVENESS OF
DIFFERENT RESEARCH TOPICS, AND
INCLUSIVENESS OF DIFFERENT
POPULATIONS AND SETTINGS.
THE PLAN WILL ALSO ADDRESS
HEALTH DISPARITIES AND PROMOTE
ENGAGEMENT IN ETHICAL RESEARCH
PRACTICES, AND THE PLAN WILL
ALSO BE MINDFUL OF THE
IMPORTANCE OF CHOICE AND VALUE
OF COMMUNITY VOICES.
NEXT SLIDE.
FOR OUR OARAC MEMBERS, I'LL
REMIND YOU, YOU DID RECEIVE A
MORE DETAILED DESCRIPTION OF
EACH OBJECTIVE WITH YOUR MEETING
BRIEFING MATERIALS, SO IN THIS
PRESENTATION I'LL MOVE PRETTY
QUICKLY THROUGH THIS LIST JUST
TO PROVIDE A SENSE OF THE BROAD
RESEARCH THAT WILL BE REFLECTED
IN THE PLAN.
SO STARTING WITH GOAL NUMBER 1,
THE OBJECTIVES INCLUDE HIV
BIOLOGY, VIROLOGY, IMMUNOLOGY
AND PATHOGENESIS OF HIV
ASSOCIATED COMORBIDITIES,
CO-INFECTIONS, COMPLICATIONS.
EPIDEMIOLOGIC ASPECTS OF HIV
INFECTION, CO-INFECTIONS, AND
COMORBIDITIES.
AND BEHAVIORAL AND SOCIAL
FACTORS AND PROCESSES.
FOR GOAL 2, OBJECTIVES INCLUDE
PRE-CLINICAL AND TRANSLATIONAL
RESEARCH, CLINICAL TRIALS AND
OTHER INTERVENTION STUDIES OF
PROMISING HIV PREVENTION
TREATMENT COMORBIDITY AND CURE
STRATEGIES.
AS WELL AS NEW AND INTEGRATED
MODELS OF HIV PREVENTION,
TREATMENT, CARE, COMORBIDITIES,
AND CURE RESEARCH AND SERVICES.
GOAL 3 INCLUDES FOCUSING ON
IMPLEMENTATION SCIENCE AND
TRANSLATIONAL RESEARCH,
COMMUNITY ENGAGED AND COMMUNITY
LED RESEARCH, DISSEMINATION AND
COMMUNICATION OF HIV SCIENCE.
FINALLY, GOAL 4 OBJECTIVES
INCLUDE WORKFORCE CAPACITY
STRENGTHENING, RESEARCH
INFRASTRUCTURE AND CAPACITY, AND
METHODS AND TECHNOLOGIES FOR HIV
RESEARCH.
SO, AS OAR HAS GATHERED INPUT
FROM DIFFERENT SOURCES OUR TEAM
HAS BEEN BUSY EXTRACTING IDEAS
TO GENERATE ROBUST LIST OF
PROPOSED FUNDING PRIORITIES.
NEXT SLIDE.
THAT'S WHERE THE OAR TASK FORCES
COME IN.
AS EARLY AS NEXT WEEK OAR WILL
SECOND OUT INVITATIONS FOR
MEMBERSHIP IN THREE TASK FORCES
CHARGED WITH REFINING THIS
INITIAL LIST OF FUNDING
PRIORITIES.
SO EACH TASK FORCE WILL INCLUDE
OARAC MEMBERS IN ADDITION TO
EXTERNAL SUBJECT MATTER EXPERTS,
THOSE EXPERTS WILL INCLUDE
RESEARCHERS, PRACTITIONERS, AS
WELL AS OTHER MEMBERS OF THE HIV
COMMUNITY WITH LIVED EXPERIENCE.
SO BETWEEN NOW AND OCTOBER, THE
TASK FORCES WILL REVIEW THE
FRAMEWORK WITH GOALS,
OBJECTIVES, LIST OF PROPOSED
FUNDING PRIORITIES GENERATED
FROM THESE MULTIPLE SOURCES OF
INPUT, AND AT THE OCTOBER OARAC
MEETING EACH TASK FORCE WILL
REPORT OUT THEIR RECOMMENDATIONS
FOR FUNDING PRIORITIES.
I'LL CLOSE TODAY WITH A RECAP OF
THE PROCESS AND ANTICIPATED
TIMELINE SO WE'RE STILL IN THE
PHASE OF CONVENING AND ENGAGING,
LATER THIS YEAR AFTER RECEIVING
THE TASK FORCE RECOMMENDATIONS
OAR WILL FINALIZE FUNDING
PRIORITIES AND START WRITING THE
PLAN.
AND PLAN DEVELOPMENT WILL
CONTINUE THROUGH THE MIDDLE OF
NEXT YEAR, AND THAT TIMELINE
WILL INCLUDE OARAC REVIEW AND
NIH CLEARANCE OF THE PLAN.
FINALLY, WE'RE AIMING TO LAUNCH
AND PROMOTE THE PLAN BEFORE THE
START OF FISCAL YEAR 2026.
AND WITH THAT I WANT TO TAKE A
BRIEF MOMENT TO ACKNOWLEDGE
EFFORTS OF MY COLLEAGUES, NAMED
ON THE NEXT SLIDE, WHO SUPPORTED
THIS EFFORT.
SO WITH THAT, WE HAVE TIME FOR
DISCUSSION.
THANK YOU.
>> DR. TURNBULL, I THINK YOU'RE
ON MUTE.
>> OKAY.
I ALWAYS FORGET THAT.
AS DR. ANDERSON JUST MENTIONED,
WE NOW HAVE TIME FOR DISCUSSION.
OARAC MEMBERS, PLEASE USE YOUR
RAISE HAND FUNCTION, IF YOU HAVE
A QUESTION OR COMMENT.
DR. MONTANER.
>> YES, THANK YOU FOR THAT
OVERVIEW OF THE STRATEGIC PLAN
TIMELINE.
EXPAND ON THE TASK FORCE
MEMBERSHIP, HOW MANY INDIVIDUALS
DOES THAT USUALLY ENTAIL AND
WHAT IS THE STRIKING BALANCE
OBJECTIVE BETWEEN INTRAMURAL AND
EXTRAMURAL AND COMMUNITY AND/OR
INDUSTRY, IS THERE ANY KIND OF
FRAMEWORK THAT IS IN PLACE FOR
MEMBERSHIP?
>> SURE.
I CAN PROVIDE A LITTLE BIT OF
DETAIL THERE.
AGAIN, AS THE FINAL LISTS ARE
BEING REVIEWED FOR INVITATIONS
TO GO OUT NEXT WEEK, I CAN SAY
THAT THREE TASK FORCES ARE
ENVISIONED WITH A LITTLE BIT OF
SPECIALIZATION OF AREAS OF
EXPERTISE IN ORDER TO OFFER A
DISTINCT LENS ON HIV RESEARCH,
SO WE WILL HAVE A BASIC
BIOMEDICAL FOCUSED TASK FORCE, A
SEPARATE TASK FORCE FOCUSING ON
BEHAVIORAL AND SOCIAL SCIENCES
RESEARCH, AND THE THIRD TASK
FORCE WILL CONCENTRATE CLINICAL
AND INTERVENTION RESEARCH AS AN
AREA OF EXPERTISE.
MEMBERS OF THE COMMUNITY WILL BE
INCLUDED IN ALL OF THE TASK
FORCES, ALL OF THE TASK FORCES
WILL ADDRESS THE WORKFORCE AND
CAPACITY ISSUES, SO THE
INVITATION PROCESS IS SORT OF
WORKING TO BALANCE DIFFERENT
SECTORS WITHIN THESE ROUGHLY
SPECIALIZED TASK FORCES, AND
THERE WAS ANOTHER PART OF YOUR
QUESTION.
OH, THE NUMBER, THE NUMBER.
I THINK WE'RE AIMING TO HAVE
ABOUT TEN MEMBERS ON EACH TASK
FORCE.
>> I WOULD JUST ENCOURAGE THAT
YOU KIND OF TASK THE TASK FORCE
TO NOT BE INSULAR.
FOR EXAMPLE, SOCIAL SCIENCE WORK
INTERFACE WAS CLINICAL AND
PRE-CLINICAL WORK, SO TO THE
EXTENT THAT YOU COULD FOSTER
SORT OF HAVING INSIGHT ACROSS
ALL THREE OBJECTIVES FOR THE
TASK FORCE, NOT NECESSARILY
FOCUS ON ONE SPECIFIC AREA,
BECAUSE AS WE MOVE FORWARD A LOT
OF THESE AREAS, YOU KNOW, ARE
EMPOWERED BY SYNERGY AS OPPOSED
TO SILOING INTO SPECIFIC
BUCKETS.
>> SURE, I APPRECIATE THAT
COMMENT AND WE COULD HAVE
EXPLORE OPPORTUNITIES TO HAVE
AS
IT TASK FORCES WORK TOGETHER.
SO THANK YOU.
>> DR. NEILAN?
>> THANKS FOR THAT OVERVIEW.
I KNOW YOU ARE NOT PLANNING TO
GO INTO DETAILS OF THE FEEDBACK
YOU RECEIVED ON RFA TODAY.
WONDERING IF YOU COULD SPEAK TO
HOW THE DISTRIBUTION OF THE
FEEDBACK DIFFERED OR WAS SIMILAR
TO PRIOR SOLICITATIONS FOR PRIOR
STRATEGIC PLANS.
>> I ACTUALLY CAN SPEAK TO THAT.
SO, THIS YEAR, OUR PROMOTIONAL
EFFORTS DR. -- DID RESULT IN
BROADER REPRESENTATION OF
RESPONDENTS.
FOR THE LAST STRATEGIC PLAN RFI
ABOUT 80% OF THE RESPONSES WERE
FROM ACADEMIC -- FROM PEOPLE
REPRESENTING ACADEMIC
INSTITUTIONS.
OR INDIVIDUALS FROM THE ACADEMIC
SECTOR.
AND WE DID RECEIVE RESPONSES
FROM MANY OTHER SECTORS THIS
TIME.
SO THERE WAS I THINK MORE
DIVERSITY IN THE RESPONDENTS
THIS TIME.
>> CAN I MAKE A COMMENT?
I FOUND THIS IMPRESSIVE AND
FOUGHTFUL.
MY QUESTION IS A BIT ON THE META
SIDE, WHICH IS THESE ALL MAKE
SENSE BUT WE HAVE A RAPIDLY
CHANGING SCIENTIFIC ENVIRONMENT,
INCLUDING, YOU KNOW, POTENTIAL
SIX MONTHS INJECTION FOR PrEP,
AND LONG ACTING AGENTS THAT
ALMOST CERTAINLILY WILL BE
SEVERAL MONTHS, EITHER ORAL OR
INJECTABLE, FOR TREATMENT.
I'M WONDERING IF THAT INFLUENCES
THE DISTRIBUTION OF RESOURCES
AMONG THESE TOPICS THAT HAVE
PICKED, IN OTHER WORDS, WE MAY
BE HEARING LESS ABOUT
OPPORTUNISTIC INFECTION AND MORE
ABOUT ACCESS TO TREATMENT,
TREATMENT ADHERENCE, OTHER
THINGS WE MAY HAVE HAD IN THE
MIXTURE BUT HOW IS OAR DEALING
WITH DISTRIBUTION OF RESOURCES
THAT ARE PROVIDED TO NIH TO DO
RESEARCH?
>> MAYBE I CAN PROVIDE
CONCEPTUAL COMMENTS AND THEN SEE
IF ANY MY COLLEAGUES WOULD LIKE
TO WEIGH IN SPECIFICALLY ON THE
TOPICAL ISSUES THAT YOU RAISE.
YOU KNOW, AS FAR AS IDENTIFYING
NEW PRIORITIES AND TRYING TO
STEER THE SHIP OF THE RESEARCH
THAT IS PROPOSED IN THE
APPLICATIONS THAT COME IN, YOU
KNOW, IT'S SLOW TO CHANGE SOURCE
A LITTLE BIT.
AND ANY GIVEN YEAR WE'RE STILL
FUNDING A LOT OF RESEARCH THAT
INITIATED IN PREVIOUS YEARS, SO,
YOU KNOW, THE HOPE IS THAT WE
ARE STIMULATING INVESTIGATORS TO
SUBMIT APPLICATIONS FOR THESE
TOPICS THAT ARE HIGHLIGHTED IN
THE PLAN, RECOGNIZING IT WILL
TAKE SOME TIME TO CHANGE THE
RESEARCH LANDSCAPE.
AND I ALSO THINK THAT, WELL, ONE
THING I DIDN'T SPEAK TO
SPECIFICALLY IN MY PRESENTATION
TODAY IS THAT WE DO INTEND FOR
THE PLAN TO BE REVIEWED
ANNUALLY.
SO AS NEW OPPORTUNITIES COME UP,
WE WILL HAVE THE OPPORTUNITY TO
ADJUST, AND HIGHLIGHT NEW
FUNDING OPPORTUNITIES IN ORDER
TO BE RESPONSIVE TO EMERGENT
AREAS OF RESEARCH.
DID ANYONE ELSE FROM OAR WANT TO
ADD TO MY COMMENTS?
>> I LOST CONNECTION FOR A
MOMENT BUT WILL BE HAPPY TO
RESPOND BUT I'M JUST CATCHING
UP.
I WILL RESPOND OFFLINE.
THANK YOU.
>> THANK YOU.
>> THAT WAS A GREAT OVERVIEW OF
THE STRATEGIC PLAN.
I WAS PLEASED TO SEE THERE'S
MORE EMPHASIS ON IMPLEMENTATION
SCIENCE AND DISSEMINATION
EFFORTS, SEEMS TO ME THAT THE
PLAN IS VERY HIGH LEVEL.
IS THE ROLE OF THE TASK FORCE
THEN TO BECOME A BIT MORE
SPECIFIC, IS THIS GREATER
EMPHASIS IN IMPLEMENTATION
SCIENCE GOING TO TRANSLATE IN
MORE REQUESTS FOR PROPOSALS IN
THAT AREA OR SOME OTHER
STRATEGIC NUDGING SO AS YOU WERE
SAYING RACHEL THAT THERE'S GOING
TO HAVE TO BE NEW SCIENCE THAT
MOVES INTO THIS NEW AREA, HOW
SPECIFICALLY ARE WE GOING TO GET
THERE, IS THAT THE ROLE OF THE
TASK FORCE OR HOW ARE YOU GOING
TO GET THERE?
>> SURE.
I APPRECIATE THE QUESTION.
AND YOU'RE RIGHT, THAT AS OF
RIGHT NOW THE PLAN AND WHAT
YOU'VE SEEN, IT IS VERY HIGH
LEVEL AND DOESN'T GET INTO THE
DETAILS.
THAT IS EXACTLY THE ROLE OF THE
TASK FORCES.
SO, WHAT WE'VE BEEN GOING IS
COMPILING ALL OF THE DIFFERENT
SOURCES OF INPUT WE'VE RECEIVED,
NOT ONLY FROM THE RFI BUT WHAT
WE'VE BEEN HEARING AT WORKSHOPS,
LISTENING SESSIONS, AND
INTEGRATING THAT INTO
ESSENTIALLY A LIST OF THINGS
THAT COULD BE PRIORITIES.
SO IT'S A REALLY ROBUST LIST
THAT COVERS A LOT OF TOPICS.
IT'S PROBABLY TOO MANY TOPICS TO
TRULY CALL PRIORITIES RIGHT NOW.
AND SO HANDING OVER THESE MORE
SPECIFIC THREE RESEARCH AREAS TO
THE TASK FORCES TO DELIBERATE
AND REALLY LOOK AT THEM AND SEE
WHICH ONES SHOULD BE INCLUDED
AND HELP US REFINE THE LIST
USING YOUR SUBJECT MATTER
EXPERTISE AND EXAMINING THE
OPPORTUNITIES FOR THE RESEARCH
FIELD.
SO, THERE ARE PARTS OF THIS THAT
HAVEN'T BEEN WORKED OUT YET BUT
THE TASK FORCES WILL RECOMMEND
MORE SPECIFIC FUNDING
PRIORITIES.
AND AS ALWAYS WITH HOW THE PLAN
IS IMPLEMENTED, YOU KNOW, A LOT
OF THIS WILL DEPEND ON THE
APPLICATIONS THAT ARE RECEIVED
AND THE INITIATIVES THAT THE
I.C.s SUPPORT FOR HIV
APPLICATIONS.
SO, YOU KNOW, WE CERTAINLY -- WE
HOPE TO STIR UP NEW INTEREST
IN -- OR ENHANCED INTEREST IN
THESE AREAS TO EXPAND.
THANK YOU.
>> GREAT.
DR. NAGHAVI?
>> FOLLOWING UP ON ALL THE
INDIVIDUAL COMMENTS BE INCLUDED
IN THE TASK FORCE FOR
CONSIDERATION OR ARE THERE ONLY
LIKE THE ONES THAT HAVE OVERLAP?
I MEAN, IF SOMEONE, ONE SINGLE
INDIVIDUAL, AS AN OUT-OF-BOX
IDEA WOULD THAT BE INCLUDED FOR
CONSIDERATION?
>> WE ARE PLANNING TO BE VERY
INCLUSIVE WITH THE MATERIALS
THAT WE SHARE WITH THE TASK
FORCES TO CONSIDER.
SO, EACH TASK FORCE WILL RECEIVE
OUR KIND OF HIGH LEVEL LIST OF
WHAT WE'VE PULLED OUT OF ALL OF
THESE SOURCES BUT THE TASK
FORCES WILL ALSO RECEIVE THE
SOURCE MATERIAL ITSELF, SO
EVERYTHING.
EVERYTHING YOU COULD POSSIBLY
WANT, I THINK.
>> THANK YOU.
>> DR. GALARRAGA, DID YOU HAVE
ADDITIONAL COMMENT OR QUESTION
FOR DR. ANDERSON?
>> NO, I DIDN'T.
I RAISED -- I LOWERED MY HAND
ALREADY.
THANK YOU.
>> OKAY.
ALL RIGHT.
ARE THERE ANY MORE COMMENTS OR
QUESTIONS?
OKAY.
SEEING NONE, I'D LIKE TO THANK
OUR PRESENTERS AND OARAC MEMBERS
FOR THEIR DISCUSSION.
AND I'M GOING TO MOVE FORWARD
WITH THE NEXT PRESENTER.
I'M PLEASED TO INTRODUCE OUR
NEXT PRESENTER, DR. FRANCISCO
RUIZ, IN THIS ROLE FRANCISCO
LEADS EFFORTS TO IMPLEMENT THE
NATION'S STRATEGY TO ADDRESSING
HIV, WORKING CLOSELY WITH
GOVERNMENT AGENCIES AT ALL
LEVELS, COMMUNITY-BASED
ORGANIZATIONS, HEALTHCARE
PROVIDERS, AND MANY OTHER
ENTITIES TO COORDINATE A
COMPREHENSIVE RESPONSE TO THE
HIV EPIDEMIC.
MR. RUIZ, I WILL TURN IT OVER TO
YOU.
>> THANK YOU SO MUCH, EVERYONE.
MY SLIDES WILL APPEAR MAGICALLY
SOMEHOW.
BUT I'LL GET STARTED.
I WANT TO THANK EVERYONE, OAR IN
PARTICULAR FOR THE INVITATION TO
JOIN YOU.
AND THESE PAST TWO MONTHS IN THE
NEW ROLE I'VE HAD THE PRIVILEGE
OF ENGAGING IN INSIGHTFUL AND
MEANINGFUL CONVERSATION WAS
FEDERAL COLLEAGUES, NATIONAL,
LOCAL PARTNERS, MOST IMPORTANTLY
PEOPLE WITH HIV.
ARE MY SLIDES SHOWING?
I WANT TO MAKE SURE THAT --
HAPPY TO SHARE MY DESKTOP.
PERFECT, OKAY.
KEEP GOING.
SO CONVERSATIONS I HAVE HEARD
FROM COMMUNITY PEOPLE WITH HIV
ABOUT THE WORK THAT YOU WANT TO
DO, SHARE KEY AREAS I'VE
IDENTIFIED IN COLLABORATION AS I
SAID IN CONVERSATION WITH FOLKS
CENTERING SCIENCE, ACCELERATING
PROGRESS, ADVANCING HEALTH
EQUITY.
>> EXCUSE ME, MR. RUIZ.
THOSE WERE THE WRONG SLIDES.
DID WE GET THE RIGHT SLIDES UP
FOR FRANCISCO'S PRESENTATION?
THOSE ARE DR. MARTIN'S SLIDES WE
WERE LOOKING AT.
>> YEAH, YOU CAN PROCEED AND WE
WILL PULL THEM UP AS YOU GO.
>> PERFECT.
I COULD ALSO SHARE MY SCREEN IF
IT'S EASIER.
WHATEVER WORKS ON YOUR END.
SO THERE WE GO.
>> THERE WE GO.
THANK YOU.
>> ALL RIGHT.
SO IF YOU GO TO THE NEXT SLIDE.
AWESOME.
WE'LL DISP THE CURRENT STATE AND
WORK THAT LIES AHEAD, LAY
FOUNDATION FOR APPROACH AN
COMMITMENT.
WE'LL THEN EXPLORE THE FOCUS
AREAS FOR ONAP INCLUDING CALL TO
ACTION.
NEXT SLIDE.
SO LAST MONTH CDC RELEASED
THROUGH NEW HIV SURVEILLANCE
REPORTS, GLAD TO SEE DR. MERMIN
ON THE CALL.
I'M CONFIDENT YOU ALREADY
REVIEWED THE REPORT.
LET'S DELVE INTO FINDINGS TO
GROUND OUR PROGRESS AND GUIDE
OUR FUTURE EFFORTS.
NEXT SLIDE.
THE OVERALL NUMBER OF NEW
INFECTIONS INCREASED 12% IN 2022
COMPARED TO 2018 WHICH MEANS
WE'RE GOING IN THE RIGHT
DIRECTION, REDUCTION
DEMONSTRATES EFFECTIVENESS OF
CURRENT STRATEGIES AND POTENTIAL
FOR FUTURE PROGRESS.
IN 2020 THERE WERE 31,800 NEW
INFECTIONS, AT YEAR END, 22,
1.2 MILLION PERSONS LIVING WITH
HIV OF WHICH 87 HAD RECEIVED A
DIAGNOSIS.
HIGHLIGHT POPULATIONS WITH
NOTABLE CHANGES IN 2022 COMPARED
TO 2018.
NEXT SLIDE.
2022 NEW INFECTION DECREASED 18%
AMONG BLACK PERSONS.
YOU SEE BY AGE, FINISH INCIDENCE
DECREASED 30% IN 2022 AMONG
PERSONS AGED 13 TO 24, THE
LARGEST NUMBER OF INFECTIONS
AMONG PERSONS 25-34, EACH YEAR.
40% OF INFECTIONS IN 2022.
NEXT SLIDE.
IN 2022 NEW INFECTIONED DECREAE
THE 16%, EACH YEAR LATINO MALES
HAD HIGHER ESTIMATED NUMBER OF
NEW INFECTIONS, NO CHANGE AMONG
FEMALE OR ETHNIC POPULATIONS,
47% OF NEW INFECTION AMONGST
FEMALES WERE AMONG BLACK
FEMALES.
NEXT SLIDE.
NEW INFECTION DECREASED 20%
AMONG WHITE, MSM, 16% AMONG
BLACK MSM.
IN 2022, 39%, WE MUST ENSURE
PROGRESS AMONG ALL COMMUNITIES.
BY REGION NEW INFECTION
INCREASED 16% IN THE SOUTH, 49%
OF INFECTIONS IN 2022.
NEXT SLIDE.
THE STATE OF HIV IN THE UNITED
STATES, I WILL DIVE INTO SOME
ONAP PRIORITIES.
I WANT TO SHARE BEFORE THAT SOME
VALUES ENVISIONED, ENSURING
EFFORTS ARE ROOTED IN NEEDS OF
PEOPLE WITH AND
DISPROPORTIONATELY IMPACTED BY
HIV.
THIS DECISION-MAKING PROCESS AND
POLICY DEVELOPMENT, WE CAN
FOSTER ENVIRONMENT THAT
PRIORITIZEs WELL-BEING OF ALL
INDIVIDUALS REGARDLESS OF
BACKGROUND OR CIRCUMSTANCES.
AS YOU SEE THE EQUITY, BY
FOCUSING ON EQUITY WORK TO
ELIMINATE DISPARITIES.
THIS COMMITMENT IS ABOUT
FAIRNESS, ABOUT HELPING TO
ELIMINATE THE GAP IN HEALTH
OUTCOMES ACROSS DIFFERENT
COMMUNITIES.
NUMBER 2, ACCOUNTABILITY.
WE'LL TRACK PROGRESS WITH
TRANSPARENCY ENSURING THAT OUR
EFFORTS ARE MEASURABLE AND OPEN
TO PUBLIC REVIEW.
THIS WILL HELP BUILD TRUST AND
DEMONSTRATE COMMITMENT TO
ACHIEVING OUR GOALS.
AND THIRD IS INNOVATION, TO
DRIVE US TO ADOPT CUTTING EDGE
SOLUTIONS TO BE EFFECTIVE AND
FORWARD THINKING.
INCLUSIVITY IS THE NEXT VALUE,
SHAKING OUR STRATEGIES.
AS A CONGRESSWOMAN SAID THE
PEOPLE CLOSEES TO THE PAIN
SHOULD BE CLOSEST TO THE POWER,
THIS HELPS CREATE MORE
EMPATHETIC POLICIES, THIS VALUE
RECENTERS COMMITMENT MADE IN
1983 AT DENVER PRINCIPLES, THE
IMPORTANCE OF MEANFUL
INVOLVEMENT OF PEOPLE WITH HIV.
ACCESSIBILITY WILL GUARANTEE
EVERYONE HAS RESOURCES BREAKING
DOWN BARRIERS TO CARE AND
SUPPORT.
ADAPTABILITY, RESPONDING SWIFTLY
TO EMERGING CHALLENGES AS
SCIENCE EMERGE, WE MUST BE
ADAPTABLE, FLEXIBLE TO CHANGE,
ADDRESS DEVELOPMENTS.
AND LAST BUT NOT LEAST
COLLABORATION.
COLLABORATION WILL AMPLIFY
IMPACT, BRING TOGETHER A BROAD
COLLECTION OF PARTNERS, MUST
ELIMINATE US VERSUS THEM
MENTALITY, WE MUST WORK AS ONE
UNIFIED FORCE TOWARDS OUR COMMON
GOALS.
THE INTENT IN DEVELOPING THESE
VALUES TO INTEGRATE SCIENCE WITH
HUMANITY.
SO IT'S CRUCIAL TO REMEMBER THAT
WHAT DRIVES US IS THE LIVES AND
HOPES AND DREAMS OF EVERY
INDIVIDUAL WE SERVE.
LET'S DISCUSS ONAP PRIORITIES,
STRAIGHTFORWARD.
THEY FOCUS ON THREE KEY AREAS,
UPDATING POLICY, BASED ON LATEST
SCIENTIFIC EVIDENCE.
ACCELERATING PROGRESS, PROMOTING
HEALTH EQUITY FOR ALL AMERICANS.
AS YOU SEE HERE ON THE STRATEGY,
I WANT TO REGROUND US.
IT'S HARD TO PUT ALL THESE
ELEMENTS ON ONE SLIDE BUT I DID
MY BEST.
AS YOU KNOW, THESE DOCUMENTS
WERE RELEASED IN THE FIRST YEAR
OF THE BIDEN-HARRISS
ADMINISTRATION BY MY
PREDECESSORS, TO STRENGTHEN THE
WHOLE-OF-GOVERNMENT APPROACH.
THE DOCUMENTS HAVE OUR -- ONE
VISION, FOUR GOALS.
THE GOALS ARE SUPPORTED BY 21
OBJECTIVES, FURTHER ENRICHED BY
78 STRATEGIES.
STRATEGY LAYS OUT EIGHT
INDICATORS, TO TRACK PROGRESS
TOWARDS NATIONAL HIV GOALS,
FEDERAL IMPLEMENTATION PLAN
CENTERS HHS AND NINE FEDERAL
DEPARTMENTS, 38 0 ACTION ITEMS,
INTRODUCING FIVE NEW STRATEGY
INDICATORS FOCUSED ON QUALITY OF
LIFE AMONG PEOPLE WITH HIV, AND
THOSE ARE SELF-RATED HEALTH
STATUS, MENTAL HEALTH, HUNGER,
UM EMPLOYMENT, UNSTABLE HOUSING.
NEXT SLIDE YOU SEE BUILT ON THE
SHOULDERS OF MANY, THE
PRIORITIES AND FOCUS AREAS, SO
THE FIRST BEING MODERNIZING
POLICIES BASED ON SCIENCE.
FIRST SHRINE SORT OF LEARNS INTO
SCIENCE, MANY POLICIES ARE
OUTDATE AND CONTRIBUTE TO
STIGMATIZATION, SO MODERNIZING
ARE REALLY IMPORTANT.
WE'VE SEEN PROGRESS, LAST YEAR
THE FDA UPDATED INDIVIDUAL RISK
ASSESSMENT FOR BLOOD DONATION,
ELIMINATED BLANKET EXCLUSION OF
GENDER -- BASED ON GENDER AND
SEXUAL ORIENTATION.
WE SUE THE UPDATE OF THE
POLICIES BASED, CHANGING MEDICAL
STANDARDS TO ACCEPT APPLICANTS
LIVING WITH CHRONIC HEPATITIS B
AND HIV.
YOU SEE REVIEWING EXISTING OTHER
EXISTING EMPLOYMENT POLICIES,
ENSURING EQUITABLE ACCESS FOR
PEOPLE AROUND ORGAN TRANSPLANT
AND CLINICAL TRIALS, UPDATING
CURRICULA, MAKING SURE THEY ARE
ACCURATE AND INCLUSIVE,
MODERNIZING LAWS TO REFLECT
CURRENT SCIENCE AND REDUCE
STIGMA.
NEXT IS ACCELERATING PROGRESS IN
OUR HIV RESPONSE.
WE'VE MADE INCREDIBLE STRIDES,
REGARDLESS OF RACE MUST HAVE
INDIVIDUAL CHOICES.
LARGER SOCIETAL FACTORS NEED TO
BE ADDRESSED.
NEXT SLIDE YOU SEE SOME OF THOSE
PRIORITY AREAS UNDER THIS SORT
OF BUCKET, LOOKING AT BUILDING
INTO MOMENTUM WE HAVE, IGNITING
NEW ONES, STRENGTHENING
COLLABORATION, BY SOUGHING DATA
CONNECTION OR CROSS-AGENCY
LOOKING AT CO-HOSTING COMMUNITY
ENGAGEMENT ACTIVITIES.
CROSS-POLLINATING T.A. RESOURCES
AND TRAINING.
SO A LOT OF THESE OPPORTUNITIES
ARE THINGS THAT ARE ALREADY IN
MOTION, WORKING ACROSS AGENCIES
TO DO THAT MORE.
LOOKING AT VIRAL SUPPRESSION
ENHANCING EFFORTS TO INCREASE
VIRAL SUPPRESSION RATES THROUGH
TAILORED INTERVENTIONS.
ACCESS TO ARTs.
LOOKING AT INTERCONNECTED
EPIDEMICS, ADAPTING HOLISTIC
RESPONSES, STREAMLINE
TRANSLATION OF HIV RESEARCH INTO
EFFECTIVE PROGRAMS AND POLICIES.
LASTLY CONTINUE TO LAY THE
GROUND WORK FOR CONGRESSIONAL
CHAMPIONS ON HIV.
NEXT SLIDE.
NEXT IS FOCUSING ON AS I
MENTIONED EQUITY, ONE OF THE
CORNERSTONES IN OUR VALUES,
MAKING SURE WE ADDRESS THE
NUMBER OF OLDER ADULTS LIVING
WITH HIV, SO THE NEXT SLIDE YOU
SEE SOME PRIORITIES UNDER
EQUITY, CONTINUING EFFORTS
ACROSS FEDERAL GOVERNMENT TO
STRENGTHEN EXISTING PROGRAMS AND
ASSESSING GAPS AND SERVICES.
NEXT SLIDE.
PrEP ACCESS EXPANSION TO
COLLABORATE ACROSS FEDERAL
AGENCIES TO INCREASE PrEP
ACCESSIBILITY AND AFFORDABILITY.
EXPANDING POLICIES AND
PARTNERSHIPS.
SUPPORT AND RETAIN CURRENT
WORKFORCE, DEVELOPING INCENTIVE
TO ATTRACT TALENT, FOSTERING
DIVERSITY AND INCLUSION IN THE
WORKFORCE.
ELEVATING INVOLVEMENT OF
BUSINESSES, FAITH-BASED
INSTITUTIONS, SOCIAL
ORGANIZATIONS TO LEVERAGE
INFLUENCE, EXPERTISE AND
PLATFORMS FOR THE WORK THAT WE
DO.
NEXT SLIDE, YOU SEE SORT OF THE
ADMINISTRATION CALL TO ACTION IS
SIMPLE.
AND THE CALL TO ACTION IS TO
JOIN US IN THIS.
MANY OF YOU HAVE BEEN DOING THIS
WORK FOR MANY YEARS SO WE WANT
TO HAVE YOU RECOMMIT TO THIS
WORK, AND CONTINUE TO MOVE
FORWARD IN SOME OF THE ACTIONS
THAT WE'VE SEEN SOME PROGRESS
IN.
SO THE NEXT SLIDE YOU'LL SEE
THESE PAST TWO MONTHS HAVE BEEN
BUSY AND BEAUTIFUL.
I'VE HAD THE OPPORTUNITY TO
SPEAK WITH MANY DOING THE WORK,
AND THOSE RECEIVING SERVICES.
PAST TWO MONTHS REMINDED ME IT'S
ABOUT THE SCIENCE THAT DRIVES US
AND HUMANITY THAT INSPIRES US.
LET'S MAKE SURE EVERY PERSON IS
SEEN, HEARD, SUPPORTED, IN OUR
COLLECTIVE RESPONSE.
THANK YOU FOR YOUR DEDICATION
AND PARTNERSHIP.
AND LET'S MOVE FORWARD WITH A
PURPOSE.
I WENT FAST BUT WE'LL MAKE SURE
THE SLIDES ARE AVAILABLE TO
FOLKS.
AND THEN I'LL STOP THERE AND SEE
IF THERE'S ANY QUESTIONS.
>> THANK YOU FOR YOUR
PRESENTATION, MR. RUIZ.
I WOULD LIKE TO JUST REMIND
OARAC MEMBERS TO RAISE YOUR
HANDS, WITH THE RAISE-HAND
FUNCTION, IF YOU HAVE ANY
QUESTIONS OR COMMENTS.
>> THANK YOU FOR YOUR
PRESENTATIONS, EXCITING TO HAVE
YOU LEADING THIS OFFICE AND
EFFORT.
ONE COMMENT AND TWO QUESTIONS.
IS IT YOUR INTERPRETATION THAT
THE DECREASES IN INFECTION ARE
NOT REALLY POLARIZED TO ANY
PARTICULAR AGE GROUP, IT'S A
UNIFORM DECREASE ACROSS ALL AGE
GROUPS BASED ON THE DATA YOU THE
SHOWED, IS THAT A CORRECT
INTERPRETATION OF THE
INFORMATION?
>> OVERALL I THINK, AS I SAY
THERE'S BEEN A 12% DECREASE
SINCE 2022.
SOME COMMUNITIES AS MENTIONED
HAVE SEEN MORE OF A DRASTIC
INCREASE BUT NOT CONSISTENT
ACROSS COMMUNITIES.
>> AGE-WISE, SEEMS TO BE STABLE,
THE AGE, FROM THE AGE GROUPINGS.
THAT'S RELATED TO MY FIRST
QUESTION, HISPANIC INCREASE, IS
THAT MORE DIAGNOSIS OR MORE
INFECTIONS?
BECAUSE THAT'S THE ONLY GROUP
THAT CONSISTENTLY WENT OPPOSITE
THAN THE OTHER GROUPS, SO WHAT'S
HAPPENING THERE?
>> I THINK I DON'T KNOW IF
MR. MERMIN WANTS TO JUMP IN.
>> THE FIRST QUESTION, MAJOR
DECREASES OVER THE PAST FEW
YEARS IN HIV INCIDENCE HAS BEEN
IN YOUNGER AND YOUNG-ISH PEOPLE.
SO PARTICULARLY THE YOUNGISH
POPULATION, OVER A LONGER PERIOD
OF TIME WE'VE SEEN DECREASES IN
YOUNG AFRICAN AMERICAN GAY MEN
WHO USED TO HAVE THE HIGHEST
INCIDENCE RATE, THIS IS
INCIDENCE RATE, LIKE NUMBER OF
NEW INFECTION PER POPULATION OF
ANY POPULATION, ALMOST 50
PASADENA - 50% DECREASE IN THE
PAST TEN YEARS, DECREASE IN
YOUNGISH PEOPLE, INCREASE
BETWEEN 20 AND 35 TO 40 AND 45 A
LITTLE BIT, THAT'S DECREASING,
SO WHAT'S HAPPENED IS ALMOST ALL
POPULATIONS MOST OF THE EFFECT
HAS BEEN SEEN IN YOUNGER
POPULATIONS.
THERE'S BEEN A STARTING IN SOME
POPULATIONS IN MID-RANGES, AND
WHAT'S -- BUT HISPANIC/LATINO
POPULATIONS HAVE NOT FOLLOWED
THIS, AS FRANCISCO HIGHLIGHTED
THAT TREND.
THE SECOND QUESTION, WE DON'T
REALLY KNOW, OUR CASE
SURVEILLANCE FORM DOES NOT
COLLECT INFORMATION ABOUT HOW
LONG PEOPLE HAVE BEEN IN THE
UNITED STATES AND OTHER FACTORS,
AND SO WE ARE -- IT'S AN
OUTSTANDING QUESTION OF GREAT
INTEREST.
STILL WE HAVE THE NEED AND
OPPORTUNITY IN THE FEDERAL
GOVERNMENT TO BE ABLE TO DO A
BETTER JOB WITH OUR PARTNERS, TO
PROVIDE PREVENTION AND CARE
SERVICES TO HISPANIC AND LATINOS
IN THE UNITED STATES AND SHOULD
TAKE THAT ON WITH RELISH.
THE QUESTION DETERMINING HOW
MUCH OF NEW DIAGNOSES ARE NEW
INFECTIONS, ESTIMATED NEW
INFECTIONS ARE INCIDENTS IS
SOMETHING WE'RE INTERESTED IN
LOOKING IN MORE DEPTH WITH
FRANCISCO'S GUIDANCE.
>> THANK YOU.
ONE MORE QUESTION, MR. RUIZ.
REGARDING THE FEDERAL OVERSIGHT
AS YOU MENTIONED, INCLUSIVITY
AND ACCESS, WHAT ARE YOUR VIEWS
ON THE STATE LEGISLATIONS
AGAINST DIVERSITY AND EQUITY
COLLECTION OF DATA RELATIVE TO
HAVING LESS TOOLS TO KIND OF
MONITOR DIVERSITY WITHIN SOME
ACADEMIC ENVIRONMENTS, AND I
KNOW SOME STATES HAVE
LEGISLATION, SOME DON'T, BUT
IT'S AN EMERGING KIND OF TREND.
MY QUESTION IS MORE GENERAL.
DO YOU THINK THAT THESE WILL
HAVE AN IMPACT ON FEDERAL
EFFORTS FOR COLLECTION OF DATA?
OR IN RELATION TO ACCESS?
OR HOW -- WHAT ARE YOUR THOUGHTS
REGARDING THIS EMERGING AREA?
>> YEAH, I THINK WE'VE SEEN A
LOT OF ANTI--- A LOT OF THINGS
HAPPENING IN DIFFERENT PARTS OF
THE COUNTRY.
I THINK THAT'S SOMETHING THAT'S
ALARMING TO THE ADMINISTRATION.
SO THERE'S A LOT OF TEAMS
THINKING ABOUT THAT.
NOT OBVIOUSLY WITHIN HIV BUT
LARGER IN TERMS OF EDUCATION AND
EMPLOYMENT, SOMETHING WE NEED TO
KEEP AND EYE ON.
THERE'S BEEN SOME CONVERSATIONS
AT PACHA, THE PRESIDENTIAL
ADVISORY COUNCIL ON HIV AND
AIDS, THINKING ABOUT WHAT THEY
CAN DO AS THAT BODY OF FOLKS
AROUND THE COUNTRY, AS RELATES
TO THE WORK THAT WE DO IN HIV, I
KNOW THERE'S A LOT OF INTEREST,
MAKE SURE -- THAT'S MORE THE
INCLUSIVITY PART MAKING SURE
PEOPLE DO WHAT WE CAN DO FROM
THE ADMINISTRATION, PEOPLE WITH
LIVING WITH HIV AND/OR
DISPROPORTIONATELY IMPACTED BY
HIV ARE GIVEN OPPORTUNITIES TO
HAVE A CONVERSATION AT THE
TABLE, ONE THING I'M PASSIONATE
ABOUT.
I THINK AT THE LOCAL LEVEL,
OBVIOUSLY THERE'S A LOT OF OTHER
THINGS.
THAT'S A LOT OF WHERE THE
LEGISLATION HAPPENS, AND SOME
OTHER RESTRICTIONS AND
CHALLENGES, AND SO I KNOW WE'RE
MONITORING THAT AND WORKING WITH
THE OFFICE OF INTERAGENCY
AFFAIRS DOES A LOT OF THAT WORK.
IN THE TWO MONTHS I'VE BEEN IN
THIS ROLE, IDENTIFYING WHO ARE
THE PLAYERS ACROSS THE AGENCY,
AND SO IT'S ONE OF THOSE THINGS
I'M LEARNING THE PROCESS IN THE
NEXT -- IN THE PAST TWO MONTHS,
BUT THAT'S SOMETHING THAT I'M
DEFINITELY LOOKING AT, AGAIN,
NOT JUST FROM THE ACCESS TO
SERVICES BUT ALSO WHAT ARE THE
OTHER THINGS THAT NEGATE ONE'S
IDENTITY, WHAT DOES THAT DO FOR
ENABLING THEM TO SEEK OUT
TESTING BEHAVIORS, SEEK OUT
TESTING OR CARE IF THEY TEST
POSITIVE.
THEY DEFINITELY HAVE DIRECT AND
INDIRECT IMPLICATIONS.
>> THANK YOU.
>> DR. GALARRAGA?
THANK YOU, THAT WAS A GREAT
PRESENTATION.
I WANT TO FOLLOW UP ON THE ISSUE
OF HISPANIC LATIN X INCIDENCE
RATE WHICH SEEMS SO HIGH, VERY
PRICING.
39%, THAT'S ALMOST DOUBLE THE
EXPECTED, I SUPPOSE, ONE-TO-ONE
LATIN X, HISPANIC POPULATION IN
THE UNITED STATES, AROUND 18%,
STUDENTS, MORE THAN DOUBLES, THE
ONLY ONE THAT HAS NOT COME DOWN,
THE ONE THAT IS HAVE INCREASED.
THE POINT WE MADE, THE ISSUE OF
AGE AND MAYBE COUNTRY OF ORIGIN
WHICH MAY BE RELATED TO TIME IN
THE U.S., BUT I THINK FROM AN
IMPLEMENTATION SCIENCE AND
HEALTH SERVICES RESEARCH POINT
OF VIEW WE NEED A LOT MORE
INFORMATION, RIGHT?
WE NEED THROUGH THE BASIC
THINGS, YOU KNOW, INSURANCE,
RIGHT?
HEALTH INSURANCE, NO ACCESS TO
PRIMARY CARE PROVIDER AND
CONTINUITY OF PRIMARY CARE
PROVIDER, IN TERMS OF REFERRALS
TO PrEP AND OF COURSE ACCESS
TO PrEP.
IT JUST SEEMS VERY WORRISOME,
SOMETHING THAT WE NEED TO KNOW A
LOT MORE IN ORDER TO REVERSE
THAT TREND.
>> YEAH, AND I THINK JUST TO
CLARIFY, I THINK THAT PERCENTAGE
OF LATINOS IN THE U.S. IS
COMPRISE - COMPREHENSIVE.
19% IS MALE AND FEMALE.
ONE THING I POINTED OUT IN,
WE'VE SEEN A DECREASE IN BLACK
AFRICAN AMERICAN MSM, A LOT OF
EMPHASIS RIGHTFULLY SO BY THE
GOVERNMENT, PRIVATE SECTOR,
PROVEN TO BE EFFECTIVE.
WHEN YOU INVEST MONEY IN A
COMMUNITY AND DEVELOP TAILORED
INTERVENTIONS YOU SEE THIS
DECREASE THAT WE'VE BEEN SEEING
IN SOME OF THE COMMUNITIES AND I
THINK THAT HAS SOMETHING THAT I
THINK WE NEED TO REVISIT HOW WE
CAN DO SIMILAR FOR THIS
POPULATION, I THINK THAT WE TEND
TO RECEIVE -- YOU PUT MONEY
WHERE THERE'S A NEED, AND YOU
GET THE OUTCOME, MAYBE NOT AS
FAST AS YOU WANT BUT WE SEE
OUTCOMES SO THAT'S SOMETHING
THAT I'M PLANNING TO PUT
TOGETHER A CONVENING TO TALK
ABOUT WHAT THAT LOOKS LIKE.
HOW CAN WE LEARN?
IT'S NOT ABOUT FORGETTING THE
COMMUNITY, BECAUSE OBJECTSLY
WE'RE NOT FORGETTING WHAT WE
NEAT TO GET FOR AFRICAN
AMERICANS, BLACK MSM OR AFRICAN
AMERICAN WOMEN BUT MAKING SURE
WE LEARN FROM OUR -- FROM THE
WORK IN THESE COMMUNITIES TO
HELP INFORM THE WORK THAT NEEDS
TO HAPPEN IN HISPANIC LATINO, SO
100%, IT'S MORE THAN JUST AN
ORAL SWAB OR PILL.
IT'S HOW DO WE PROVIDE SPACE FOR
FOLKS TO HAVE ACCESS TO THESE
SERVICES.
HOW DO WE MAKE SURE THAT THEY
FEEL ENABLED TO SORT OF GO INTO
AND GET THAT TEST, SO THERE'S A
LOT OF OTHER THINGS, YOU KNOW,
AND THE NEEDS IN NEW YORK
DIFFERENT THAN THE SOUTH, RIGHT?
THERE'S A LOT OF AS I MENTIONED
A LOT OF IMMIGRATION,
ANTI-IMMIGRATION SENTIMENT
HAPPENING SO WE NEED TO ALSO
ADDRESS THAT AND WHAT
IMPLICATIONS THOSE POLICIES HAVE
ON HEALTH-SEEKING BEHAVIORS.
>> IT WOULD BE GREAT TO SEE SOME
SORT OF REPORT WITH BEST
PRACTICES AND THERE'S SOME YOU
KNOW GOOD NEWS FROM SOME
COMMUNITIES THAT HAVE BEEN ABLE
TO NOT BE PART OF THE
UNFORTUNATE TREND AND TURN
THINGS AROUND.
YEAH, THANK YOU.
>> PROFESSOR GALARRAGA, TO
CLARIFY, STILL AFRICAN AMERICANS
HAVE THE HIGHEST RATE OF NEW HIV
INFECTIONS PER POPULATION, UP BY
RACE AND ETHNICITY IN THE UNITED
STATES.
BUT BECAUSE THERE ARE MORE
HISPANIC AND LATINOS IN AMERICA,
EVEN THOUGH AT LOWER RATE, THE
ABSOLUTE NUMBER OF NEW
INFECTIONS THEREFORE PROPORTION
OF NEW CASES ARE ACTUALLY HIGHER
IN LATINOS.
SO IT'S OUR KIND OF EQUITY
NUMBERS ISSUE WE DEAL WITH IN
PUBLIC HEALTH ALL THE TIME.
>> YEAH, BUT I THINK IT'S
TERRIBLE, RIGHT?
EACH NEW INFECTION IS ONE TOO
MANY IN MY OPINION, RIGHT?
SO IF YOU JUST DO ONE-TO-ONE TO
THE PROPORTION OF POPULATION AND
SAY 50-50 MALE FEMALE WHICH I
UNDERSTAND, MAJORITY ARE MEN
THAT HAVE SEX WITH MEN IS WHAT I
ASSUME BUT IN MY HEAD
SIMPLE-MINDED ECONOMIST HERE
DOING 18, 19% OF HISPANIC AND
LATINX POPULATION, AS A
PROPORTION OF NEW INFECTIONS, IF
IT WAS ONE-TO-ONE YOU SHOULD
EXPECT NO MORE THAN THAT AND
WE'RE SEEING DOUBLE, IN MY HEAD.
SEEMS LIKE A LOT.
DISPROPORTIONATELY AFFECTING THE
LATIN X HISPANIC POPULATION.
ONE INFECTION IS ONE TOO MANY.
I DON'T WISH NEW INFECTIONS ON
ANYBODY, ON ANY GROUP.
BUT IT SEEMS LIKE SOMETHING IS
NOT RIGHT WITH THE
HISPANIC/LATINX POPULATIONS, AS
FRANCISCO POINTS OUT SOME
COMMUNITIES ARE DOING THE RIGHT
THING AND WE SHOULD HIGHLIGHT
THOSE SO IN ADDITION TO AGE,
COUNTRY OF ORIGIN, THERE'S SO
MANY OTHER THINGS THAT WE NEED
INFORMATION, RIGHT?
IS THAT AN ISSUE ACCESS TO
HEALTH INSURANCE, PrEP,
PRIMARY CARE AND CONTINUING CARE
PROVIDERS.
THIS MAY BE AGAIN POLITICAL
ISSUE, AND POLITICAL ECONOMY
ISSUE.
THERE'S ISSUES OF TABOO AND
THERE'S ISSUES OF WHAT YOU
DISCUSS IN CERTAIN COMMUNITIES.
AND DISCRIMINATION.
I WAS DOING THE SIMPLE PATH IN
MY HEAD.
>> THE PRIORITIES UNDER THE LAST
SECTION WORKING WITH FOLKS,
NON-TRADITIONAL PARTNERS, IF YOU
WILL, I THINK OFTENTIMES IN HIV
WE KIND OF GUY IN THE SAME
CIRCUIT, TALK TO SAME PARTNERS,
SAME CONFERENCES AT MEETINGS.
ONE THING I WANT TO PRIORITIZE
IS GOING TO ORGANIZATIONS THAT
MAYBE DON'T HAVE HIV AS A FUNDED
CENTER TOPIC.
WE NEED TO FIGURE OUT WHY THE
FOLKS NOT GOING TO THE HIV
MEETINGS AND CONFERENCES ARE
ATTENDING INSTAGRAM LIVES, HOW
DO WE REACH PEOPLE, NATIONAL
URBAN LEAGUE, HBCUS, NAACP.
ONE OF MY GOAL IS TO ENGAGE
CONTINUING TO LEAN INTO HISTORY
OF A LOT OF THESE SPACES AND
ORGANIZATIONS, ALSO BRINGING
CONVERSATION ABOUT HIV EDUCATION
TO PLACES THAT ARE HAPPENING.
THAT'S GOING -- HOPEFULLY WE'LL
SEE RESULTS THERE.
A LOT OF PARTNERS THAT CDC FOR
EXAMPLE AND DR. MERMIN'S SHOP IS
DOING THAT AS WELL, A LOT OF
PARTNER ENGAGEMENT HAPPENING
OVER THERE.
>> THANK YOU.
>> ARE THERE ANY OTHER
QUESTIONS?
I WOULD LIKE TO ADD A COMMENT.
FRANCISCO, ONE OF THE THINGS I
HAVE TO SAY OVER MY WORK WITH
THIS FIELD FOR SEVERAL YEARS,
THE OFFICE OF AIDS POLICY.
STRATEGIES ARE HUGE, THEY
SOMETIMES FEEL UNWIELDY, RIGHT?
WHAT HAPPENS WITH THE COMMUNITY
IS THAT THEY GET LOST IN THE
SENSE THEY NEVER REALLY KNOW
WHAT GOES ON, WHAT THE RESULTS
ARE.
SO, I GUESS MY COMMENT OR MY
QUESTION TO YOU IS HAVE YOU
THOUGHT ABOUT OR ARE THERE
THOUGHTS ABOUT HOW TO ACTUALLY
BEGIN, MAYBE IT'S THROUGH A
PROGRESS REPORT, THAT INFORMS US
OF THE STRATEGY WITH THE
UNWIELDY STRATEGY TO IMPLEMENT
ACROSS THE COUNTRY.
>> A HUNDRED PERCENT.
I THINK A STRATEGY IS ONLY AS
GOOD AS PEOPLE ACTUALLY USING
IT.
ALSO MEASURING SUCCESS.
THAT'S ONE OF THE THINGS, THE
CURRENT STRATEGY GOES TO 2025,
WHICH MEANS THIS IS THE TIME TO
START THINK ABOUT THE NEXT
ITERATION, ALSO THE TIME TO
THINK ABOUT THE IMPACT STORIES,
WHAT HAVE WE DONE SINCE 2021,
RELEASED THE LAST STRATEGY,
THAT'S SOMETHING THAT I'M
COMMITTED TO DO WITH OUR FEDERL
PARTNERS, TO TELL A STORY TO
LEARN FROM EACH OTHER TO BUILD
MOMENTUM AT THE HIGHEST LEVELS
OF GOVERNMENT, SO THAT WE HAVE
THAT SUPPORT.
BUT ALSO TO BRING VISIBILITY AND
AWARENESS IN OUR COMMUNITIES.
WE CAN HAVE STRATEGY BUT IT'S
MORE THAN JUST SORT OF A
PUBLICATION THAT WE SEND OUT VIA
E-MAIL AND WEBSITE.
I'M ALL FOR PRINTING THINGS,
HAVING THAT DOCUMENT ON THE
DESK, WHAT AM I DOING TODAY TO
HELP ADVANCE SOME OF THIS, AND
SO I'M HOPEFUL TO HAVE
DISCUSSIONS IN THE COMING MONTHS
WITH FEDERAL PARTNERS.
>> THANK YOU.
DR. NEILAN?
>> THANKS FOR THE ENERGY YOU
BRING.
I HOPE THAT LIST INCLUDES
ORGANIZATIONS THAT ENGAGE YOUTH
AND YOUNGEST INDIVIDUALS, I'M
THINKING OF NEW DIAGNOSES IN
CLINIC, INDIVIDUAL WHO NEVER
HEARD OF PrEP WHO IS 22, THE
OLDER BUCKET, OR 26, BUT STILL
UNDER THE CARE OF OF A PEDIATRN
WHO MAY NOT BE PRESCRIBING
PrEP, I ENCOURAGE YOU TO THINK
ABOUT MINORS WHO ARE -- THERE'S
SO MUCH HETEROGENEITY IN ACCESS
BECAUSE OF DIFFERENCES IN STATE
LAWS AS YOU ARE DEVELOPING YOUR
PLANS.
THANK YOU.
>> ABSOLUTELY.
ALSO ENGAGING INTERDISCIPLINARY
FOLKS, LOOKING AT SOCIAL
WORKERS, NURSES, PHARMACISTS,
OUTLIED TRADITIONAL ROLE.
BRINGING YOUNG FOLKS TO THE
TABLE, RIGHT?
OFTENTIMES WE SPEAK ON THEIR
BEHALF BUT I THINK IT'S
IMPORTANT TO BRING THEM TO THE
TABLE AND SEE, HEY, WHAT DO YOU
THINK IS INNOVATIVE, WHAT DO YOU
THINK YOU WANT TO SEE AND GIVE
THEM THE MIC, FOR SURE.
THANK YOU.
>> ONE MORE THING.
ON THE HEELS OF DR. NEILAN'S
QUESTION OR COMMENT, IN TERMS OF
LIKE THE YOUTH AND YOUNG PEOPLE,
MAKING SURE THEY HAVE A VOICE AT
THE AVAILABLE, WE'VE GOT TO BE
TALKING ABOUT VERY SPECIFIC
COHORT OF THE POPULATION LATER
ON THIS AFTERNOON, AND THOSE ARE
ALL OF THE INDIVIDUALS WITH
PERINATALLY ACQUIRED HIV, THOSE
YOUNG PEOPLE ARE NOW IN THEIR
30s, SOME OF THEM TO BE 40.
SO WHAT IS THE STRATEGIES, IS
THERE A MECHANISM INCLUSIVE OF
THAT COHORT OF THE POPULATION
INTO THIS STRATEGY?
>> ABSOLUTELY.
WHEN WE TALK ABOUT HIV AND
AGING, IT'S NOT JUST WHO ARE
50+, 60+, IT'S ABOUT THOSE WHO
ARE AGING WITH HIV, ALL THEIR
LIVES, MOST OF THEIR LIVES LIVED
WITH HIV.
THAT'S THE CONVERSATION WE NEED
TO HAVE.
I HEARD EARLIER TODAY
CONVERSATIONS AROUND THAT, AND I
THINK MORE WORK NEEDS TO BE DONE
TO LOOK AT POTENTIAL GAPS AND
BRINGING IN THE PRINCIPLES
MAKING SURE THEY SPEAK AND THEY
ARE PART OF THE DECISION IN
TERMS OF POLICIES BEING FORMED.
ONE OF MY COMMITMENTS IS MAKING
SURE IN ANY CONVENINGS WE HAVE
THOSE LIVING WITH HIV AND THOSE
IMPACTED, THAT'S MY COMMITMENT
TO THE WORK.
>> THANK YOU.
ANY OTHER QUESTIONS OR COMMENTS
FOR MR. RUIZ?
SEEING NONE, WE WILL NOW TAKE A
BREAK.
WE WILL RESTART PROMPTLY AT
1:45.
WELCOME BACK FROM BREAK,
EVERYONE.
WE WILL NOW BEGIN THE SEGMENT ON
ISSUES IN PERINATAL HIV RESEARCH
AND RESPONSE.
FIRST PRESENTER IS DR. MAURICIO
MARTINS, ASSOCIATE PROFESSOR AT
SCRIPPS INSTITUTE FOR BIOMEDICAL
INTERVENTION AND TECHNOLOGY, A
BRANCH OF THE UNIVERSITY OF
FLORIDA LOCATED IN UPPER,
FLORIDA.
IN HIS LAB HIS WORK ON
DEVELOPMENT OF INTERVENTION WITH
FOCUS ON GENE THERAPIES FOR
PROMOTING IN VIVO EXPRESSION OF
HIV BIOLOGICS IN DIFFERENT
POPULATIONS.
I WILL TURN IT OVER TO YOU.
>> THANK YOU FOR THE
INTRODUCTION.
IT'S A GREAT HONOR TO BE HERE.
THANK YOU FOR THE INVITATION AS
WELL.
SO MY GROUP WORK HAS BEEN
WORKING WITH DELIVERY, I'M GOING
TO BEGIN WITH A BRIEF OVERVIEW
OF STATISTICS THAT EMPHASIZE THE
SEVERITY OF THE EPIDEMIC.
2022, 39 MILLION PEOPLE LIVING
IN THE VIRUS.
SAME YEAR, 1.3 MILLION PEOPLE
GAME NEWLY INFECTED, TWO NEW
INFECTIONS PER MINUTE.
SAME YEAR, ABOUT 6 MILLION AND
30,000 PERSONS UNFORTUNATELY
SUCCUMBED TO HIV-RELATED CAUSES
LEADING TO ABOUT A DEATH PER
MINUTE.
SO, WE TAKE THESE MATTERS
SERIOUSLY IN THE LAB, WORKING TO
REDUCE THESE NUMBERS, HOPEFULLY
BRING THEM DOWN TO ZERO.
WE'RE EXPLORING VARIOUS
TECHNOLOGIES INCLUDING LARGE
LANGUAGE MODELS THAT HAVE BEEN
DESIGNED RECENTLY.
AND ONE OF THEM IS ChatGPT,
QUITE USEFUL AND INACCURATE AT
TIMES, WE'RE STILL EXPLORING
POTENTIALS THAT THIS TECHNOLOGY
OFFERED.
IN PREPARING FOR THIS
PRESENTATION I ASKED ChatGPT
THE FOLLOWING QUESTION.
HOW WOULD YOU DESCRIBE THE
DISTRIBUTION OF PEOPLE LIVING
WITH HIV ACROSS THE GLOBE.
GEOGRAPHICALLY UNEVEN, HIGHLY
CONCENTRATED IN SPECIFIC
REGIONS, QUITE ACCURATE.
LET ME SHOW YOU WHY.
THIS IS A WORLD MAP WITH EVERY
COUNTRY DISPLAYED BY DIFFERENT
SHADES, CORRESPONDENTING TO
CONTINENT.
IF WE CHANGE THE SIZE OF EACH
COUNTRY TO REFLECT ITS HIV
PREFERENCE WE SEE SOMETHING
QUITE DIFFERENT.
SOMETHING THAT IS GEOGRAPHICALLY
UNEVEN, HIGHLY CONCENTRATED IN
SPECIFIC REGIONS AS DESCRIBED BY
ChatGPT.
OF COURSE, UNFORTUNATELY, MOST
OF THE INFECTIONS ARE IN REGIONS
OF THE WORLD WITH NOT READY
ACCESS TO SOME PREVENTIONS FOR
COMBATING THE EPIDEMIC.
GLOBAL PREFERENCE OF PEDIATRIC
HIV INFECTIONS REFLECT THIS IS
DISTRIBUTION AS WELL, WITH
1.5 MILLION CHILDREN LIVING WITH
HIV IN 2022, 90% IN 21 COUNTRIS
IN AFRICA.
WHEN ART IS AVAILABLE, AND
IMPLEMENTED, ART CAN PREVENT
VERTICAL HIV TRANSMISSION WITH
CAVEATS.
THE FIRST ONE BEING UNDIAGNOSED
WITH CURRENT INFECTION, WOMEN
BECAME MORE SUSCEPTIBLE IN LATE
PREGNANCY AND POSTPARTUM PERIOD,
AND THERAPY CAN BE TOXIC TO
CHILDREN, ESPECIALLY INFANTS,
POTENTIAL FOR ACQUISITION OF
DRUG RESISTANCE.
POOR ADHERENCE IS A MAJOR
PROBLEM.
IF YOU DON'T TAKE MEDICATIONS,
YOU DON'T SUPPRESS THE VIRUS,
MORE LIKELY TO TRANSMIT TO YOUR
CHILD.
OF COURSE, STIGMA WHICH DESERVES
A TOPIC OF ITS OWN.
OUR INCREASED UNDERSTANDING OF
HIV TRANSMISSION HOW TO BLOCK IT
WITH THE SCALEUP OF THERAPY
PREVENTED THOUSANDS OF PEDIATRIC
INFECTIONS AND DEATHS.
WE'VE SEEN GAINS BY REDUCTIONS
OF INFECTION AND DEATH BUT THE
STATE OF THE CARE IS UNLIKELY TO
END PEDIATRIC HIV INFECTION IN
MY VIEW, WE NEED SOMETHING ELSE.
AND MY GROUP AND MANY OTHERS
HAVE BEEN VERY -- HAVE BEEN
WORKING WITH BROADLY
NEUTRALIZING ANTIBODIES, THOSE
THESE ARE MONOCLONAL ANTIBODIES
THAT CAR -- TARGET COULD BE
SERVED REGIONS MAKING THEM
EFFECTIVE AGAINST A LARGE SWATH
OF CIRCULATING HIV ISOLATES,
MANY ADVANTAGES FOR USING THIS
APPROACH ESPECIALLY IN CHILDREN.
MOLECULES ARE SAFE, INCLUDING
INFANTS, EVIDENCE FROM ANIMAL
MODELS SHOW PRE AND POST
EXPOSURE CAN PREVENT IN INFANT
MACAQUES AND NOW EVIDENCE IN
CHILDREN WITH HIV.
IT REQUIRES REPEATED INFUSIONS
AND IN THE CASE OF PROPHYLAXIS
THE VISION HERE IS THAT YOU
RECEIVE REGULAR INFUSION WITH
THESE MOLECULES.
WHICH CAN PREVENT -- PROTECT
RECIPIENT FROM INFECTION UPON
HIV EXPOSURES BUT ONCE YOU --
ONCE LEVELS OF ANTIBODIES
DECREASE TO A CERTAIN LEVEL, OR
IF YOU STOP RECEIVING THESE
INFUSIONS YOU THEN BECOME
SUSCEPTIBLE AGAIN, BECOME
INFECTED.
bNAbS HAVE BEEN USED IN
PEOPLE LIVING WITH HIV, WHERE
PEOPLE HARBOR VIRUSES SENSITIVE
TO bNAbS WE SEE CONTROL OF
VIREMIA AFTER STOPPING BUT ONCE
THE ANTIBODIES FELL BELOW
THERAPEUTIC LEVELS THE VIRUS
CAME BACK AND THE JARGON HERE IS
VIRUS REBOUND.
THIS IS VERY ENCOURAGING BUT
THERE'S A MAIN CAVEAT, SINCE
REPEATED DOSING FACES CHALLENGES
TO BROAD SCALE IMPLEMENTATION.
BUT THEN WHAT IF bNAbS COULD
BE PRODUCED BY HOST CELLS,
OBVIATING THE NEED FOR REPEAT
ADMINISTRATIONS, AND THIS IS
WHAT WE HOPE TO ACHIEVE WITH AAV
VECTOR DELIVERY OF MOLECULES.
THE VISION IS THAT A SINGLE DOE
WOULD PRE-CIVIL IN REDUCTION IN
VIVO, IN THE CASE OF
PROPHYLAXIS, IN THE CASE OF
THERAPY A SINGLE DOSE OF THESE
PERHAPS DURING THE TIME OF ART
INITIATION COULD RESULT IN
PRODUCTION OF MOLECULES ALLOWING
RECIPIENT TO STOP TAKING THERAPY
AND REMAIN AVIREMIC FOLLOWING
TREATMENT INTERRUPTION.
SEEMS PERTINENT TO TALK ABOUT
WHAT AAV IS, STANDS FOR
ADENOASSOCIATED VIRUS,
DISCOVERED IN 1967, A CELL
CULTURE CONTAMINANT, HENCE THE
NAME, ADENO-ASSOCIATED, BUT IT'S
DIFFERENT.
IT'S PARVO VIRUS, A MEMBER OF
DEPENDOPARVOWVIRUS, CANNOT
REPLICATE ON ITS OWN.
THE AAV GENOME WAS CLONED IN THE
1980s, LEADING TO DEVELOP OF
GENETIC SYSTEMS.
IT'S SIMPLE, THE WILDTYPE AAV
HAS TWO GENES, IN VECTORS BOTH
AAV GENES ARE REMOVED AND PLACED
BY TRANSGENE EXPRESSION
CASSETTE.
IN THE END, THE ONLY PROTEIN
EXPRESSED FROM AN AAV VECTOR IS
TRANSGENE PRODUCT.
WHICH SIMPLICITY CONTRIBUTES TO
SAFETY OF THIS APPROACH, LOW
IMMUNOGENICITY, LOW CYTOTOXICITY
COMPARED TO OTHER VIRAL VECTORS
USED.
THERE ARE MANY ADVANTAGES BUT I
ONLY WISH TO EMPHASIZE FOLLOWING
AAV TRANSDUCTION IT'S
NON-INTEGRATING, PERSISTING AS
LONG AS THE TRANSDUCED CELL
LIVES, HOPING TO ACHIEVE DURABLE
EXPRESSION OF bNAbS,
TARGETING SKELETAL MUSCLE
BECAUSE MYOCYTES ARE ABUNDANT
AND DISPLAY LITTLE TURNOVER.
GENE EXPRESSION CAN PERSIST IN
SKELETAL MUSCLE FOR YEARS,
POSSIBLY EVEN DECADES.
SO, HOW DO WE APPLY THIS IN THE
CONTEXT OF PERINATAL HIV
RESEARCH ESPECIALLY IN CASES FOR
PREVENTING INFECTION IN INFANTS?
OUR HYPOTHESIS AAV bNAb
INOCULATION AT BIRTH RESULTS IN
EXPRESSION THROUGHOUT INFANCY,
PREVENTING VERTICAL TRANSMISSION
THROUGH BREASTFEEDING.
CHILD BIRTH IS ONE OF THE MOST
CONSISTENT TIMES OF INTERACTION
IN THE DYAD SO TREATING BREAKS
WITH AAV VECTORS AT THIS TIME
COULD GRANT DURABLE IMMUNITY
EVEN IF LOST TO FOLLOW-UP.
THE WAY WE ADDRESS THIS IN MY
GROUP IS THROUGH USE OF
NON-HUMAN PRIMATE MODEL, A
PEDIATRIC NON-HUMAN PRIMATE, OF
HIV/AIDS.
WE SELECTED NEWBORN RHESUS
MACAQUES FROM CALIFORNIA CENTER
AND TREATED WITH AAV VECTORS,
SELECTED TWO bNAbS OR
MOLECULES, ONE OF THE MOST
CONSERVED REGIONS OF THE
ENVELOPE.
MOLECULES WERE THE bNAbS IN
MULTIPLE CLINICAL TRIALS, AND
ECD 4-IG WHICH MIMICS GRANTING
EXCEPTIONAL BREAD THAT.
WE TREATED A TOTAL OF THREE
GROUPS WITH, ONE RECEIVED AN
INJECTION, WITHIN 24 HOURS OF
BIRTH.
GROUP 2 RECEIVED INTRAVENOUS
DOSE OF AAV8, AND FOUR WEEKS
LATER ANIMALS RECEIVED THE SAME
DOSE DELIVERED INTRAMUSCULARLY.
GROUP 3 A DOSE AGAIN WITHIN 24
HOURS OF BIRTH.
WE ALSO SELECTED SIX CONTROL
MACAQUES WHICH SERVED AS
CONTROLS FOR SUBSEQUENT ORAL
SHIFT CHALLENGES WE SUBJECT
THESE ANIMALS TO.
I MUST EMPHASIZE THE
INOCULATIONS WITH SAFE, WELL
TOLERATED, ANIMALS GAINED
WEIGHT, WHICH WAS WITHIN
EXPECTED.
WE TRACKED EXPRESSION OF
MOLECULES IN ALL GROUPS OVER
TIME.
SHOWN IS THE SERUM
CONCENTRATIONS IN GROUP 1, 2,
SERUM CONCENTRATION IN GROUP 3,
ALL ANIMALS EXCEPT FOR ONE IN
GROUP 3 DEVELOPED PERSISTENT
EXPRESSION OF RESPECTIVE
bNAbS OR bNAb MOLECULES
OVER TIME.
ONE OF THE ANIMALS IN GROUP 3,
THE ONE THAT FAILED TO DEVELOP
PERSISTENT EXPRESSION, HAD TO BE
EXCLUDED FROM THE STUDY DUE TO
REASONS UNRELATED TO
INOCULATION.
WE ALSO CONFIRMED THAT THE
MOLECULES PRODUCED IN VIVO IN
THESE ANIMALS DISPLAYED
ANTI-VIRAL ACTIVITY SHOWN HERE
ARE THE ID 80 NEUTRALIZATION
TITERS, MOLECULES WERE PRODUCED,
FUNCTIONALLY ACTIVE.
AND THE RESULTS OF THE ORAL SHIV
CHALLENGE PHASE, EXPOSING
ANIMALS ORALLY TO ESCALATING
DOSES OF A SIMEON HIV CLONE,
SHIV 88 TO MIMIC CHILDHOOD
TRANSMISSION IN BREASTFEEDING.
SHOWN IS THE RATE IN THE CONTROL
GROUPS, ALL ANIMALS BECAME
INFECTED BY THE 12th ORAL
EXPOSURE.
AND THEN ON TOP OF THIS CURVE WE
HAVE THE GROUP 1 RATE OF
ACQUISITION, WITH ONLY ONE
ANIMAL BECOMING INFECTED, ONLY
AFTER THEY WERE EXPOSED TO
UNDILUTED VIERS WHICH -- VIRUSY
HIGH DOSE OF VIRUS.
OTHER THAN THAT, THE ANIMALS
WERE COMPLETELY PROTECTED.
WE KEPT THESE ANIMALS ALIVE
AFTER THE ORAL SHIV CHALLENGE
PHASE AND MONITORED
CONCENTRATIONS OVER TIME.
TWO GROUP 3 ANIMALS CONTINUED TO
SEE CONTINUOUS UNINTERRUPTED
EXPRESSION OVER TIME FOR UP TO
THREE YEARS.
AFTER RECEIVING SINGLE DOSE OF
THE VECTOR AT BIRTH.
WE CONTINUED TO MONITOR FOR
EXPRESSION IN THE TWO ANIMALS
FROM ONE AND TWO OVER TIME AND
SAW UNINTERRUPTED EXPRESSION FOR
UP TO FOUR YEARS.
JUST TO SUMMARIZE THE FIRST
PART, NEONATAL DELIVERY ENCODING
HIV BIOLOGICS IS SAFE AND
CONFERS DURABLE HIV IMMUNITY IN
INFANT MACAQUES.
IN VIVO PRODUCTION LASTED FOR
THREE TO FOUR YEARS WITHOUT
REDOSING, MORE THAN ENOUGH TO
COVER THE BREASTFEEDING PERIOD
IN MOST REGIONS OF THE WORLD.
IN ADDITION TO PROPHYLAXIS,
WE'RE ALSO USING, TESTING THIS
APPROACH FOR TREATING PERINATAL
HIV INFECTION AND USING A
SIMILAR NON-HUMAN PRIMATE MODEL
VERTICAL TRANSMISSION.
SO HERE WE ENROLLED TEN INFANT
RHESUS MACAQUES, ORALLY INFECTED
WITH DIFFERENT TYPE OF SHIV.
ONE WEEK LATER, THESE ANIMALS
STARTED ANTIRETROVIRAL THERAPY
AND RECEIVED TWO AAA FACTORS,
AND A NEW bNAb WHICH TARGETS
A DIFFERENT REGION.
WE INFECTED SIX CONTROL ANIMALS
IN PARALLEL, PLACED ON
ANTIRETROVIRAL, THEY DID NOT
RECEIVE ANY AAV VECTORS.
LET'S LOOK AT THE RESULTS FROM
THE ANTIRETROVIRAL PHASE.
SHOWING THE DATA AS INDIVIDUAL
GRAPHS FOR EACH ANIMAL,
INDICATING IN THE CONTROL GROUP,
IN THE CASE OF THE CONTROL
MONKEY, WE'RE LOOKING AT PLASMA
VIRAL LOADS AS RED CIRCUMSTANCE
ALSO, PLOTTED AGAINST LEFT
Y-AXIS, SHADED AREA CORRESPONDS
TO PERIOD OF ANTIRETROVIRAL IN
ALL ANIMALS.
AND THE POINT HERE IS THAT THE
ANTIRETROVIRAL THERAPY PHASE
SUPPRESSED VIREMIA IN ALL SIX
CONTROL ANIMALS AND DID SO TOO
IN ALL TEN EXPERIMENTAL ANIMALS.
THE GRAPH, A RIGHT Y-AXIS THAT
INDICATES SERUM CONCENTRATIONS
OF EACH MOLECULE DELIVERED BY
AAV VECTORS, THE CD4 IG HAD
GREEN CIRCLES, THE POINT IS THAT
ALL EXPERIMENTAL ANIMALS
DEVELOPED PERSISTENT EXPRESSION,
FOR REASONS I DON'T HAVE TIME TO
TALK ABOUT, EXPRESSION WAS MORE
VARIABLE.
WHAT HAPPENS TO THE VIRUS WHEN
WE INTERRUPTED ART?
WELL, THE VIRUS COMES BACK
QUICKLY IN ALL SIX CONTROL
ANIMALS.
AND EXPRESSION OF AT LEAST ONE
MOLECULE IS MAINTAINED BY ALL
TEN EXPERIMENTAL MACAQUES.
AND WE WERE VERY ENCOURAGED TO
SEE NO REBOUND, NO VIRUS, NO
VIREMIA, IN A TOTAL OF SEVEN
AAV-TREATED MACAQUES.
WE ANALYZED MORE THAN 225 PLASMA
SAMPLES, FROM SEVEN AAV TREATED
INFANTS, NO EVIDENCE OF VIRUS.
THERE WAS ONE CASE IN LATE VERY
SMALL BREAKTHROUGH IN ONE
EXPERIMENTAL ANIMAL, BUT VIRAL
LOADS WERE CONTROLLED
EVENTUALLY.
AND THE TWO LAST EXPERIMENTAL
ANIMALS BECAME VIREMIC SHORTLY
AFTER THE ANTIRETROVIRAL
THERAPY, THE END OF THE PHASE,
BUT THESE WERE CAPABLE OF
REGAINING CONTROL WHICH
COINCIDED WITH A DECREASE IN
CONCENTRATION.
WHEN WE ANALYZED RATE OF REBOUND
BETWEEN THE TWO GROUPS WE SEE
STATISTICALLY SIGNIFICANT
DIFFERENCE BETWEEN CONTROL GROUP
AND EXPERIMENTAL GROUP.
WE SEE THAT EARLY ART INITIATION
AND AAV bNAb THERAPY CAN
PREVENT VIRUS REBOUND IN
SHIV-INFECTED INFANT MACAQUES
TREATED ONE WEEK POST INFECTION,
ENCOURAGING BUT MADE US WONDER
THAT THE LENGTH OF TIME THAT THE
VIRUS HAD TO REPLICATE, TOO
SHORT, ONLY SEVEN DAYS, WHICH
MAY HAVE CREATED ANT
ARTIFICIALLY SMALL RESERVOIR
THAT COULD MADE IT EASIER
PERHAPS FOR THE INTERVENTION WE
USED TO BE EFFECTIVE SO WITH
THIS IN MIND WE ASKED WHETHER
THE SAME APPROACH WOULD WORK IN
ANIMALS HARBORING LARGER
RESERVOIRS.
AND WE DID -- TO CREATE A LARGER
RESERVOIR IN THE SYSTEM WE
CONDUCTED A VERY SIMILAR
EXPERIMENT BUT INSTEAD OF
INITIATING ANTIRETROVIRAL
THERAPY SEVEN DAYS AFTER
INFECTION, AND DELIVERING THE
VECTORS AT THE SAME TIME WE
WAITED LONGER.
WE DID SO AT WEEK THREE POST
INFECTION.
THERE WAS ADDITIONAL TWO WEEKS
OF TIME FOR THE VIRUS TO
REPLICATE UNCHECKED IN BOTH
EXPERIMENTAL AND CONTROL
ANIMALS.
AND WE WERE ABLE TO SUPPRESS
VIREMIA DURING THE 30 WEEKS OF
ANTIRETROVIRAL THERAPY, AND SAW
REBOUND IN ALL CONTROL ANIMALS
AGAIN LIKE THE FIRST EXPERIMENT.
WE ALSO SO PERSISTENT
COMPRESSION OF BIOLOGICS AND
DURABLE CONTROL OF VIREMIA IN
FIVE OF THE SIX EXPERIMENTAL
ANIMALS EVEN WHEN THESE MACAQUES
HAD LARGER RESERVOIRS CREATED BY
STARTING THE THERAPY AT WEEK 3
INSTEAD OF WEEK 7.
AND ONCE AGAIN STATISTICALLY
SIGNIFICANT.
TO SUMMARIZE THE SECOND PARTY
EARLY ANTIRETROVIRAL THERAPY CAN
SUBSTANTIALLY DELAY REQUIRES WE
BOUND.
THIS APPROACH WORKS WHEN
INTERVENTIONS ARE GIVEN ONE OR
THREE WEEKS POST SHIV INFECTION
AND REQUIRES CONTROLS EXPRESSION
OF bNAbS.
I WANT TO HIGHLIGHT UNIQUE
FEATURES OF AAA VECTORED
DELIVERY OF bNAbS.
IT DOES NOT REQUIRE PATIENT
ADHERENCE BECAUSE OF LONGER-TERM
EXPRESSION OF MOLECULES, WE CAN
POTENTIALLY TREAT AND TREAT
INFANT OR CHILD LIVING WITH HIV
ONCE AND NOT WORRY HOPEFULLY
ABOUT COMPLIANCE TO MEDICATIONS.
AAV EXPRESSED bNAbS ARE LESS
IMMUNOGENIC, WE SEE THE
TOLERANCE IMMUNE SIS FEMME IN
EARLY LIFE MAKES INFANTS IDEAL
SUBJECTS TO RECEIVE THESE
MOLECULES, THIS INTERVENTION,
BECAUSE THEY ARE LESS LIKELY TO
DEVELOP POST-IMMUNE RESPONSES
TARGETING AAV-ENCODED bNAbS
THAT CURB THEIR EXPRESSION.
ALSO EAST OF ADMINISTRATION, IT
ONLY TOOK TWO OR FOUR
INTRAMUSCULAR INJECTIONS GIVEN
AT THE SAME TIME TO ACHIEVE
PERSISTENT EXPRESSION OF
MOLECULES.
AGAIN, INTRAMUSCULAR INJECTIONS
DO NOT REQUIRE ADVANCED MEDICAL
TRAINING TO DELIVER, SO THIS
MAKES IT EASY TO DEPLOY THESE
INTERVENTIONS IN REMOTE AREAS OF
THE GLOBE WHERE THE HIV EPIDEMIC
IS CONCENTRATED.
THE VECTORS ARE STABLE ACROSS
TEMPERATURES, ACROSS pHs,
REGARDLESS OF EXPOSURE TO HUMAN
SERUM OR NOT AGAIN MAKING IT
CRITICAL FOR IMPLEMENTING THESE
TYPES OF THERAPIES IN REGIONS
WHERE A COLD CHAIN CANNOT BE
RELIABLY MAINTAINED.
COST EFFECTIVENESS, YES, AAV
GENE THERAPIES ARE EXPENSED BUT
DOSED BY BODY MASS, TARGETING
INFANTS WHICH WEIGH LESS WE CAN
GET GAINS IN COST HERE.
FINALLY, AGAIN, I DIDN'T HAVE
TIME TO TALK ABOUT THIS,
bNAb EXPRESSION LASTS FOR
YEARS AND IN OUR TIME MODEL
LASTS UNTIL ANIMALS BECOME
SEXUALLY MATURE, ADOLESCENCE,
WITH A SINGLE NEONATAL DOSE OF
THERAPY THEY ARE PROTECTED
AGAINST CHALLENGE WITH SHIV IN
MODELS DESIGNED TO MIMIC SEXUAL
TRANSMISSION OF HIV.
SO, WITH ONE FELL SWOOP IF WE
CAN TARGET THESE POPULATIONS AT
RISK AT BIRTH, ONE OF THE MOST
CONSISTENT TIMES OF INTERACTION
WITH HEALTH CARE PROVIDERS, WE
COULD POTENTIALLY PREVENT
INFECTION IN INFANCY AND LATER
ADOLESCENCE.
THERE ARE LIMITATIONS, TO BE
OPEN ABOUT THEM, DIVERSITY OF
HIV ISOLATES SIMPLY IS DIFFICULT
TO DESCRIBE, IT'S OVERWHELMING.
IT'S MUCH MORE, MUCH GREATER
THAN DIVERSITY OR LACK OF
DIVERSITY USED IN THE SHIV
CHALLENGE MODELS IN THE STUDY.
THIS LEADS TO BE CONSIDERED
CAREFULLY SO PROPER MODEL FOR
CLINICAL TRIALS.
COST, EQUITABLE ACCESS, GENE
THERAPIES ARE COST PROHIBITIVELY
NOW, MAYBE BECAUSE THEY ARE
NOVEL INTERVENTIONS, BUT WE
WOULD REQUIRE PUBLIC/PRIVATE
PARTNERSHIPS TO DEPLOY
INTERVENTIONS TO REGIONS WHERE
MOST NEEDED AND FINALLY AAV IS
ENDEMIC IN THE HUMAN POPULATION
SO MANY INDIVIDUALS CARRY
ALREADY ANTIBODIES THAT CAN
NEUTRALIZE THE AAV THERAPY
VECTORS.
THE MESSAGE IS THAT WITH PROPER
INVESTMENT AAV DELIVERY OF
BIOLOGICS MAY HOLD KEY TO
ACHIEVING SUSTAINED IN CHILDREN
IN A PRACTICAL AND SCALABLE WAY.
I THANK MY GROUP AND OTHERS
INVOLVED IN THIS STUDY, SPECIAL
THANKS TO THE NIH FOR GRANT
SUPPORT AND ALSO MY COLLEAGUES
FROM PAVE LABORATORY, AND I
WOULD BE HAPPY TO TAKE QUESTIONS
NOW.
THANK YOU VERY MUCH FOR YOUR
ATTENTION.
>> THANK YOU, DR. MARTINS, FOR
YOUR PRESENTATION.
OARAC MEMBERS, PLEASE HOLD YOUR
QUESTIONS UNTIL AFTER OUR NEXT
PRESENTER.
IT'S A PRIVILEGE TO INTRODUCE
KIMBERLY CANADY-GRIFFITH, A
TESTAMENT TO THE WORK IN THIS
COUNTRY REGARDING PERINATAL HIV
INFECTION.
HOWEVER, THERE IS MUCH TO LEARN
AND MUCH TO BE LEARNED FROM THE
LIVED EXPERIENCE OF PERSONS WHO
ACQUIRED HIV DURING INFANCY.
KIM BRINGS A LIFETIME OF
EXPERIENCE AS AN ADVOCATE, AND
EDUCATOR, IN ADDRESSING THE
UNIQUE NEEDS OF THIS PARTICULAR
COHORT OF POPULATION.
KIM, OVER TO YOU.
>> THANK YOU, IVY.
I APPRECIATE IT SO MUCH.
WHEW, THE FORGOTTEN PIECES OF
THE EPIDEMIC.
SO, FIRST I WANT TO SAY THANK
YOU FOR HAVING ME.
I ALSO WANTED TO TAKE A MOMENT
ON THE SIDE, YOU SEE THE PICTURE
OF ME AND THREE OTHER PEOPLE, I
AM ONE OF FOUR WHO ARE HIV
POSITIVE.
EVERY TIME I HAVE AN
ACCOMPLISHMENT, GRADUATED FROM
SCHOOL, YOU CAN JUST WAKE UP AND
CHOOSE TO LIVE.
MY OLDEST SISTER NEXT TO ME, I
WAS NUMBER TWO, SHE ALWAYS TELLS
ME THE DOCTORS SAID YOU WASN'T
GOING TO LIVE PAST AGE OF ONE,
NOW LOOK AT YOU.
FOR ME, IT'S A REALLY LONG TIME,
I HAD THAT FEELING THAT I WASN'T
GOING MAKE IT, AND SHE WAS ONE
OF MY BIGGEST SUPPORTERS, IS ONE
OF MY BIGGEST SUPPORTERS TO
REMIND ME EVERY DAY.
NEXT SLIDE.
CHILDHOOD, THE TIMELINE OF MY
LIFE, ALSO BRIEF HISTORY,
EVERYBODY HAS EXPERIENCE OR HAS
LIVED THROUGH, I WANTED TO PUT
THIS UP HERE SO THAT WAY YOU CAN
SEE HOW THE HIV EPIDEMIC
PROGRESSED AS MUCH AS I
PROGRESSED, BEING THE AGE OF 36.
ACTUALLY I'M 37.
I DON'T EVEN KNOW HOW OLD I AM.
1986.
RIGHT BEFORE IT, BEGINNING OF
THIS EPIDEMIC, HIV/AIDS
PROGRAMS, AIDS SERVICE, I'M FROM
NEW YORK, ONE OF THE CITIES THAT
ACTUALLY HAD SOME FUNDING.
ALSO I WAS BORN DECEMBER 7,
1986, TO A MOM WHO DIDN'T KNOW
SHE WAS HIV POSITIVE AT THE
TIME.
SHE FOUND OUT SHE WAS POSITIVE
AFTER SHE GAVE BIRTH TO ME.
WHICH WAS A SAD THING, THAT AT
THAT TIME THAT'S HOW MANY
MOTHERS FOUND OUT OF THEIR HIV
STATUS.
MY MOM DIDN'T UNDERSTAND HOW SHE
COULD GIVE BIRTH TO BABY WHO HAS
A VIRUS, SHE DIDN'T UNDERSTAND
HOW SHE GOT IT.
AT THAT TIME THERE WASN'T THAT
MUCH INFORMATION, THAT WAS 1986
COMPARED TO 2024.
SAD REALITY SHE COULDN'T GRASP
WITH HER DIAGNOSIS AND MINE AS
WELL, ESPECIALLY WITH DOCTORS
LETTING HER NO, I WASN'T GOING
TO MAKE IT PAST ONE, AND TO MAKE
ARRANGEMENTS FOR ME TO PASS ON.
GROWING UP I WASN'T LIVING WITH
MY MOM.
SHE GAVE ME STRAIGHT TO MY
GRANDMOTHER AT THE HOSPITAL.
AND JUST LIKE A LOT OF PEERS WE
WERE BABIES WHO DIDN'T LIVE WITH
PARENTS, LIVED IN FOSTER CARE,
MY GRAND HAD KINSHIP WITH ME,
1989, IT WAS SOMETHING I CAN SAY
THAT CHANGED MY LIFE, LIVING
WITH MY SISTERS, TYPICAL
HOUSEHOLD WITH EVERYBODY IN THE
HOME.
AND THAT REALLY WAS THE SUPPORT
I DIDN'T KNOW I NEEDED AND
DIDN'T REALIZE A LOT OF MY
FRIENDS DIDN'T HAVE AT THAT
TIME.
NEXT SLIDE.
MY ADOLESCENT YEARS WAS
SOMETHING THAT CHANGED MY LIFE
IN A DIFFERENT WAY.
GROWING UP, FOR ME 10 WAS A BIG
DEAL.
WAY BEFORE I WOULD GO TO THE
DOCTOR I WANT TO SAY EVERY SIX
WEEKS.
THEN I WENT TO THE DOCTOR BY
1996, GOING ABOUT EVERY TWO
MONTHS.
BY THE TIME AGE 12 I WAS GOING
EVERY THREE MONTHS.
WE DON'T TALK ABOUT THE PAST,
HOW OFT WEAN GO TO THE DOCTOR,
HOW WE WERE HAVING 30 TO 40
DIFFERENT VIALS OF BLOOD TAKEN
FROM US.
I REMEMBER ALL OF IT.
I REMEMBER HAVING TO TALK TO
EVERYBODY AT THE DOCTOR, BUT NOT
UNDERSTANDING WHY I WAS WITH SO
MANY PEOPLE.
MY GRANDMOTHER DIDN'T TELL ME I
WAS LIVING WITH HIV UNTIL AFTER
BOTH MY PARENTS PASSED AWAY.
SO 1996, THE LAST DAY OF SCHOOL,
FOURTH GRADE, MY FATHER PASSED
AWAY.
THREE MONTHS LATER, LABOR DAY,
MY MOM PASSED AWAY, GOING TO HER
FUNERAL FIRST DAY OF FIFTH
GRADE.
TWO WEEKS BEFORE MY FRIEND'S
BIRTHDAY, TWO WEEKS LATER, I WAS
TOLD I WAS LIVING WITH HIV.
AS A 9-YEAR-OLD ABOUT TO BE 10 I
WAS SOMEBODY WHO I WANTED --
WARRANTED A BIRTHDAY PARTY,
DIDN'T UNDERSTAND THE
COMPLICATIONS, STILL DIDN'T
UNDERSTAND AT THAT TIME WHY MY
PARENTS WASN'T ABLE TO TAKE CARE
OF ME.
TRYING TO EXPLAIN WHAT HIV WAS
AT THAT TIME, AND UNDERSTANDING
WHAT THAT WAS LIKE IN YOUR BODY
AS A 9-YEAR-OLD WHEN ALL YOU
WANTED WAS A 10-YEAR-OLD
BIRTHDAY PARTY WAS SOMETHING
THAT WAS HARD TO FOLLOW
ESPECIALLY AT THAT TIME, MY MOM,
SHE WASN'T ABLE TO GET BURIED,
WAS CREMATED, DIDN'T EVEN GET TO
SEE HER ONE LAST TIME.
THAT WAS SOMETHING THAT REALLY
TOOK A TOLL ON ME AS A CHILD,
TRYING TO UNDERSTAND MY STATUS,
UNDERSTAND WHAT WAS HAPPENING,
AND THEN ALSO TRYING TO LIVE,
HOW COULD YOU GIVE AT THAT TIME,
LIKE HOW COULD YOU KEEP GOING
WHEN EVERYTHING AROUND YOU FELT
LIKE DESPAIR.
EVEN THOUGH I WAS MADE AWARE OF
MY STATUS I DIDN'T, AGAIN, LIKE
I SAID I DIDN'T UNDERSTAND,
DIDN'T KNOW WHAT WAS GOING ON.
AND IT TOOK ME A COUPLE YEARS
BEFORE I FULLY GRASPED I WAS
LIVING WITH HIV.
AT THAT TIME EVEN GOING TO THE
CLINIC AND SEEING OTHER KIDS
DIDN'T KNOW UNTIL AFTER I WAS
TOLD I WAS LIVING WITH HIV THAT
OTHER KIDS WERE HIV POSITIVE AS
WELL.
AND THOSE WHO KNOW WASN'T
ALLOWED TO TELL WHAT YOUR STATUS
WAS BECAUSE THEIR PARENTS DIDN'T
TELL THEM.
BY THAT TIME WE LOOKED
DIFFERENT, NOW YOU'RE THE KID
GOING TO THE DOCTOR ALL THE
TIME, MISSING SCHOOL, NOW YOU
SEE ALL THE OTHER CHILDREN AND
IT BECAME A LITTLE CLIQUE, TO
THE POINT WHERE I WANTED TO FIND
MY PEOPLE, WANTED TO FIND THOSE
WHO WERE LIVING WITH HIV, BECAME
VERY EMOTIONAL, VERY DEPRESSED
JUST WANTED TO FIND SOMETHING
WHO LOOKED LIKE MY.
MY SISTERS WERE NEGATIVE.
I GREW UP IN A RELIGIOUS
HOUSEHOLD, MY GRANDMOTHER WAS --
SHE JUST WANTED ME TO BE HAPPY,
SO I STARTED GOING TO HIV CAMPS,
THAT'S WHAT CHANGED MY LIFE TO
ACTUALLY ACCEPT WHO I AM AS A
PERSON, LIVING WITH HIV, AND TO
WANT TO CHANGE AND DO MORE.
EVEN THOUGH I WENT TO CAMP
THINGS, I WENT TO GROUP, I STILL
FELT ALONE BECAUSE EVEN THOUGH
I'M MAKING THESE FRIENDS, THEY
KEEP PASSING AWAY.
AND THAT WAS SOMETHING THAT I
DIDN'T KNOW HOW TO COPE WITH.
BECAUSE IN ONE PART, I WAS TOLD
I AM NON-PROGRESSIVE, HIV WAS
DIFFERENT, HOW THEY EXPLAINED TO
ME.
HIV IS LIKE A TURTLE, SLOW
MOVING, AND IT DOESN'T CHANGE AS
RAPIDLY AS EVERYBODY ELSE IS.
YOU'RE OKAY NOW, YOU KNOW, THE
COAST IS KIND OF CLEAR.
THAT'S WHAT I HAD IN MY HEAD
LIKE 15 AND 16
BOTTOM DATES, BUT I KEPT GOING
TO FUNERALS, DIDN'T UNDERSTAND
WHY THIS WAS MY LIFE, WHY DO WE
HAVE TO KEEP DYING, WHAT AM I
MISSING, HOW IS HIV PROGRESSING
IN THE WORLD WITH ALL THESE
MEDICAL ADVANCES, MEDICATION IS
OUT, BUT WE STILL KEEP PASSING
AWAY?
SO, NEXT SLIDE.
I HAVE TO KEEP TRYING TO FIGURE
IT OUT, WHICH SOME DAYS IT'S SO
HARD.
EVEN RIGHT NOW.
AS A YOUNG ADULT, 2006, THAT WAS
ONE OF THE HARDEST TIMES FOR ME.
IT SHOULD HAVE BEEN ONE OF THE
GREATEST TIMES BECAUSE I CHOSE
MYSELF, I CHOSE TO DISCLOSE MY
STATUS HONESTLY TO THE WORLD.
I WAS SECRETLY DOING HIV WORK IN
SCHOOL, IN HIGH SCHOOL, AND IT
WAS SOMETHING THAT I WANTED
TO -- I WAS LIVING A DOUBLE
LIFE.
I HAD HIV POSITIVE KIM WAS WHO
WAS AN ACTIVIST, ADVOCATE.
AND THE OTHER HAND, I WAS A
REGULAR PERSON WHO WANTED TO BE
THE CHICK THAT LIVES IN THE
PROJECT THAT JUST WANTED TO KEEP
GOING, WANTED TO HAVE A NORMAL
LIFE.
I WAS STRUGGLING WITH THESE TWO
WORDS AND IN 2006 DECIDED TO
COMBINE INTO ONE.
AND WHEN MY GRANDMOTHER WAS
SOMEBODY WHO SAW HOW RYAN WHITE
WAS, HOW THINGS PLAYED OUT, SHE
WAS SCARED THAT THAT WOULD HAVE
BEEN MY LIFE IF I CHOSE TO BE
OPEN WITH IT.
AND I BEGGED PLEASE LET ME BE
OPEN, I HAVE NOTHING TO BE
ASHAMED OF, I WANT TO EDUCATE
AND DO MORE THAN WHAT I'M DOING.
SHE GAVE ME HER BLESSING.
TWO WEEKS LATER SHE GAVE ME HER
BLESSING, SHE PASSED AWAY.
AND IT CRIPPLED ME BECAUSE I
WANTED TO HONOR HER AND THE
OTHER PART I WANTED TO HONOR
MYSELF, BUT I CHOSE TO HONOR
HER, I CHOSE TO TAKE THAT
BLESSING AND KEEP GOING AND GOT
DIFFERENT OPPORTUNITIES,
SOMETHING SHE BEGGED ME TO DO,
TO CONTINUE.
, CONTINUE WITH SCHOOL.
I HAD TO DROP OUT TO TAKE CARE
OF HER.
THE SECOND TIME I CAME OUT
OPENLY AS POSITIVE.
THE SCHOOL WASN'T RECEPTIVE.
THIS IS IN 2006.
MY NEIGHBORHOOD, SOME PEOPLE
WERE RECEPTIVE, OTHERS WERE
TRYING TO UNDERSTAND, I KNOW, I
HAVE MY SISTERS BUT I'M A
19-YEAR-OLD WHO HAS TO LEARN HOW
TO PAY BILLS, WHO IS TRYING TO
UNDERSTAND WHY IS ALL MY FRIENDS
PASSING AWAY, AND NOW I HAVE TO
FIGURE OUT HOW DO YOU EVEN PAY
RENT?
WHAT IS THIS?
THIS IS SOMETHING THAT I DIDN'T
THINK THAT WOULD EVEN HAPPEN.
LIKE EVERY YEAR I HAD TO -- I
WAS IN DISBELIEF, THIS IS A NEW
PART OF ADULTHOOD THAT I NEVER
THOUGHT THAT I WOULD BE ABLE TO
REACH.
AND THAT WAS LIVING A LONG TIME,
FOR TRYING TO UNDERSTAND HOW DID
I EVEN GET HERE.
THE WORLD IS TELLING ME I SHOULD
HAVE PASSED AWAY.
NOT ONLY BECAUSE I'M LIVING WITH
HIV BUT BECAUSE I'M A BLACK
WOMAN THAT LIVES IN THE HOOD.
THAT LIVES IN BROOKLYN,
RESOURCES ARE SCARCE, I'M
SUPPOSED TO BE UNEDUCATED,
SUPPOSED TO NOT HAVE ANY KIND OF
HOPE COMING FROM A DRUNK
ADDICTED MOM AND MAJORITY OF MY
FAMILY WHO DABBLE IN DRUGS, MY
ENVIRONMENT ALONE SHOULD HAVE
HAD ME CRIPPLED.
ALSO WITH MY HIV STATUS, I
SHOULDN'T BE ABLE TO BE THIS
PERSON THAT I AM RIGHT NOW.
SO I HAD TO FIND THAT INNER
STRENGTH.
A LOT WAS I WAS IN THE RIGHT
PLACE AT THE RIGHT TIME.
I ALWAYS HAD PEOPLE WHO BELIEVED
IN ME, SAW SOMETHING I DIDN'T
SEE IN MYSELF, SOMETIMES STILL
STRUGGLE TO SEE.
I GOT OFFERED TO BE PART OF
UNICEF, TRAVELED TO AFRICA, THAT
WAS SOMETHING THAT I NEVER
THOUGHT, ONE, JUST TO GO TO
AFRICA, I LIVE IN THE HOOD,
GOING TO AFRICA WAS LIFE
CHANGING.
AND THEN ALSO TO SEE WHAT HIV
LOOKS LIKE OUT THERE COMPARED TO
WHAT IT LOOKS LIKE HERE, TO GIVE
THEM HOPE THAT IT CAN BE BETTER,
CHANGED MY VIEW OF WHAT HIV
LOOKS LIKE.
I WAS SOMEBODY WHO DROPPED OUT
OF HIGH SCHOOL, NEEDED TO GET A
GED, OBTAINED IT, AND STARTED
WORKING HEAD ON WITH IT.
AS I WAS DOING THIS, I GOT TIRED
OF MORE FRIENDS PASSED AWAY.
I WENT TO OVER 50 FUNERALS BY
THIS TIME.
I HAD REPORTED -- I HAD A BOX
THAT RECORDED WHAT MY FUNERAL
WOULD LOOK LIKE.
I JUST TOLD THIS TO MY HUSBAND.
I HAD PICKED OUT THE PERFECT
FONT OF MY OBITUARY, PICTURES OF
WHAT I WANTED, PLANNED OUT MY
FUNERAL SINCE THE AGE OF 14,
I'VE BEEN HOLDING ON TO THAT
UNTIL MAYBE FOUR OR FIVE -- NO,
SIX YEARS AGO.
AND ONE THING THAT I NEVER
THOUGHT THAT I WOULD BE ABLE TO
SEE IS EVEN THE FACT OF HAVING A
BABY, GETTING MARRIED, I WAS
TOLD FOR SO LONG NOBODY WOULD
LOVE US.
I HEARD STORIES OF PEOPLE NOT
ONLY GETTING ABUSED BECAUSE OF
THE STATUS, PEOPLE TAKING
ADVANTAGE OF THEM, BUT ALSO OF
THE FACT OF A LOT OF US LOOK AT
US AS THE STIGMA OF LIVING WITH
HIV, FEELING YOU'RE NOT WORTHY,
UNDERSTANDING -- TRYING TO
UNDERSTAND FOR YOURSELF THAT YOU
ARE THAT PERSON THAT DESERVES
LIFE.
MOVE TO THE NEXT SLIDE.
OVERCOMING VERSUS GIVING UP, I
WAS STRUGGLING WHAT TO SAY ON
THIS SLIDE.
I FELT THIS IS IMPORTANT BUT
BEFORE THEN I WAS SOMEBODY WHO
STRUGGLED WITH MY CONFIDENCE
BECAUSE -- AND STRUGGLES TO EVEN
WANT TO CONTINUE TO DO THIS
WORK.
THIS WORK IS TIRING, STRESSFUL.
I'VE BEEN ADVOCATING SINCE AGE
OF 13, TALKING TO DOCTORS,
TALKING TO PEOPLE, AND I NEVER
GOT TO SEE US, THOSE LIVING WITH
HIV SINCE BIRTH, IN THE FRONT.
AND IT SEEMS LIKE AFTER FUNDING
DISAPPEARED PEOPLE STOPPED
TALKING ABOUT US.
WE WASN'T IMPORTANT.
WHEN WE WERE -- WE WERE THE
EXAMPLE OF WHAT IT WAS AT THAT
TIME, EARLIER IN THE EPIDEMIC,
OF WHAT HIV WAS.
YOU KNOW, WE GOT TO A POINT
WHERE WE STARTED LIVING AND
PEOPLE JUST KIND OF IGNORED US.
AND I WANTED MY LIFE BACK, TO BE
THE PERSON WHO COULD NOT ONLY BE
PROUD OF WHO I AM AND DO THIS
WORK FOR THOSE WHO COULDN'T DO
THE WORK, I WANTED TO DO IT FOR
MYSELF, NOT JUST FOR MY FRIENDS
THAT PASSED AWAY.
AND I HAD CHOSEN TO DO THAT.
NEXT SLIDE.
THAT'S WHAT A LOT OF US HAVE,
NOT TO GIVE UP.
THIS IS ME NOW.
I HAVE A 13-YEAR-OLD TODAY,
PROBABLY WHY I'M TIRED AND
DISHEVELED, I CAME BACK FROM MY
SON'S GRADUATION, AGAIN I WANTED
TO EMPHASIZE MY SON IS 14, HIV
NEGATIVE.
THAT'S SOMETHING I NEVER THOUGHT
I WOULD BE ABLE TO SEE.
I NEVER THOUGHT THAT I WOULD BE
MARRIED TO SOMEBODY WHO ACCEPTS
ME, NOT BECAUSE OF FEELING BAD
FOR ME, BECAUSE I HAVE HIV, BUT
BECAUSE HE SEES ME, FOR A CHILD
TO BE HEALTHY, FOR US TO --
13,000 OF US RIGHT NOW, LIFETIME
SURVIVORS, A HUGE NUMBER FOR US.
WE'RE STILL HERE.
BUT I HAVE OUR OWN BUSINESS,
EVERY DAY IT'S EASIER TO KNOW
THAT I HAVE A PURPOSE, BUT IT'S
STILL HARD BECAUSE PEOPLE ARE
STILL DYING, AND NOBODY IS
TALKING ABOUT THAT.
WE TALK ABOUT IT FOR FIVE
MINUTES AND IT DISAPPEARS.
NOTHING ELSE HAPPENS.
NEXT SLIDE.
THIS IS ME AGAIN WITH ME, MY
FAMILY, THIS IS ME WITH THE HIV
CAMPAIGN WHERE I'VE BEEN A
SPOKESPERSON FOR ABOUT 12 YEARS.
WE ARE EDUCATING THOSE THAT LIVE
WITH HIV TO STAY ON TREATMENT,
WHATEVER TREATMENT LOOKS LIKE
FOR YOU, EDUCATE OTHERS, MY SON
HAS A FOOTBALL BANQUET, PART OF
MY NORMAL LIFE, I'M NOT TALKING
ABOUT ME LIVING WITH HIV, AND
THE WELL PROJECT, THAT HELPS
WOMEN LIVING WITH HIV, THE
WEBSITE THE WELLPROJECT.ORG.
NEXT SLIDE.
SO DANDELION MOVEMENT, TAKING
OWNERSHIP, NOT WANTING TO GIVE
UP, I WASN'T THE ONLY ONE.
VALENCIA WILLIAMS AND ANTOINETTE
JONES WERE CO-FOUNDERS.
LAST YEAR EVERYBODY HAS BEEN
HEARING, WE WANTED A NAME THAT
WE CAN OPENED BY US, WE CREATED.
BASED OFF OF A POEM, WE CAME UP
WITH THIS NAME DANDELIONS FOR
ALL OF US.
TWO YEARS AGO, MAYBE THREE YEARS
AGO, CAME ONE THE NAME LIFETIME
SURVIVORS, WE'VE BEEN TELLING
EVERYBODY THIS IS WHO WE ARE.
CALL US BY THAT NAME.
AND TIFFANY PASSED AWAY LAST
YEAR, INTEGRAL AT THE INCEPTION
OF THE MOVEMENT, PEOPLE BORN
POSITIVE, NOT JUST A NAME FOR
EVERYBODY TO USE AS A RESEARCHER
BUT FOR A MOVEMENT THAT YOU CAN
SUPPORT AS WELL.
THAT'S FOR US, BY US.
NEXT SLIDE.
WHAT IS CURRENTLY IMPLEMENTED
AND REQUIRES IMPROVEMENT?
TIME RIGHT NOW I WANTED TO
HIGHLIGHT BREASTFEEDING
ADVANCES, GUIDELINES FOR CHANGE.
THE PROJECT, A LOT OF PEOPLE
HAVE BEEN PART OF THE
BREASTFEEDING ADVANCES, AND
ESPECIALLY I WANTED TO SHOUT OUT
WHO WAS A BIG PART OF THIS.
NEXT SLIDE, WHAT NEEDS TO
HAPPEN.
THERE'S NOTHING SPECIFIC TO LIFE
STIME SURVIVORS AND OUR
CHILDREN, ALSO THERE NEEDS TO BE
FUNDING -- I WOULD LOVE FUNDING
NAMED AFTER HYDEIA BROADBENT WHO
RECENTLY PASSED AWAY THIS YEAR,
A HIT IN OUR COMMUNITY.
AND WE KEEP TAKING THESE HITS,
OVER AND OVER AND OVER AGAIN.
AND I HOPE THAT WE CAN START
LISTENING TO WHAT'S HAPPENING.
AND WHAT ELSE NEEDS TO BE DONE?
ACKNOWLEDGMENT.
RIGHT NOW, JUST BY HAVING ME
HERE IS A HUGE STEP.
AND EVERYTHING IS A HUGE STEP.
BEFORE THIS YEAR, BEFORE ALL OF
US WENT ON THAT STAGE AT USC
LAST YEAR YOU HEARD ANYBODY
TALKING ABOUT LIFETIME
SURVIVORS, THERE WAS WHISPERS,
WHAT CAN I DO, AND IT
DISAPPEARED.
RIGHT NOW THIS IS WHERE WE
STARTED.
EVEN TO SOMETHING AS RECOGNIZING
LONG-TERM SURVIVORS, YES, WE'RE
LIFETIME SURVIVORS.
WE'VE HAD IT FOR A LIFETIME.
BUT THERE'S MANY CASES WHERE WE
ARE IN SPACES, WHERE PEOPLE ARE
SAYING BECAUSE OF OUR AGE,
BECAUSE WE'RE YOUNG, THEY DO NOT
LOOK AT US AS A LONGTIME EVEN
THOUGH WE'RE LIVING WITH THE
VIRUS OUR WHOLE LIFE.
FUNDING FOR PROGRAMS FOR
LIFETIME SURVIVORS FOR
PROTECTION, WE DON'T FEEL
PROTECTED.
WHEN IT COMES TO GROUP THERAPY,
A LOT IS GONE.
WE DON'T HAVE THE RESEARCH, AND
I DON'T EVEN KNOW -- NEXT SLIDE,
WE CAN GO OVER THE RESEARCH FOR
LIFETIME SURVIVORS, WHAT'S
MISSING.
THERE IS A FEW PIECES OF
RESEARCH THAT'S AROUND US, BUT
NOT A LOT.
MAYBE TWO, THESE TWO RIGHT HERE.
SOME ARE UP COMING BUT HIV OUT
FOR OVER 40 YEARS, I'M ABOUT TO
BE 38 IN DECEMBER, THIS IS ALL
THE RESEARCH OUT RIGHT NOW, AND
RIGHT NOW AS FAR AS THE FACT
THAT WE'RE GRIEVING EVERY DAY OF
THE LOSSES, I'M HOLDING MY
BREATH.
EVERY TIME WE HAVE A LOSS OF
SOMEBODY IN OUR COMMUNITY, IT'S
A HIT.
SOMETHING WHERE I FEEL THE
RESPONSIBILITY WAS DROPPED.
LIKE THE PRIORITY OF WHO WE WERE
DROPPED THE BALL A LONG TIME
AGO.
AND WHY SHOULD YOU CARE ABOUT
US?
IT'S THE PUBLIC'S
RESPONSIBILITY.
AGAIN, WE WERE THE BABIES.
NOW WE'RE GOING TO BE IN ANOTHER
TEN YEARS THE NEXT GENERATION
THAT'S GOING TO BE AGING WITH
HIV, WE'VE BEEN AGING WITH HIV
BUT PAST THE STANDARD OF WHAT
PEOPLE WOULD LIKE TO ACTUALLY
ACKNOWLEDGE OF AGING WITH HIV,
THOSE OVER 50, THAT WILL BE US
IN THE NEXT TEN YEARS.
WILL THERE BE RESEARCH, WILL
ANYBODY CARE FOR US.
WE'RE NEVER PRIORITIZED.
WE HAVEN'T BEEN PRIORITIZED IN
THE WAY WE SHOULD HAVE BEEN
PRIORITIZED.
THAT'S SOMETHING THAT NEEDS TO
CHANGE MOVING FORWARD.
NEXT SLIDE.
THANK YOU.
I DIDN'T WANT TO -- I KNOW THE
TIME IS GEARING UP, I DIDN'T
WANT TO FOCUS ON CERTAIN THINGS
BUT I DID WANT TO SAY I
SHOULDN'T HAVE BEEN 50 PEOPLE IN
MY LIFE, THOSE WHO ARE BORN
POSITIVE, IT'S A SAD NUMBER.
MY EXPERIENCE OF CHANGE, WHO I
AM, HOW I DO THIS WORK, HOW I
SHOW UP FOR MY PEOPLE, IT'S VERY
HARD TO TELL MY STORY BECAUSE
I'M PAST THAT IN MY LIFE, AND TO
OPEN UP THE SPACE FOR A PART OF
ME WHERE IT'S VULNERABLE,
BECAUSE I FEEL THAT I'M A
STRONGER PERSON NOW THAN WHEN I
WAS 19, 20, REALLY IN THE HEAT
OF IT.
EVEN AT THAT TIME I FELT LIKE
NOBODY HEARD ME.
I HOPE THAT AFTER THIS
PRESENTATION SOMEBODY IN THIS
ROOM, ON THIS CALL, HEARD THIS,
THIS IS A MATTER THAT SHOULDN'T
BE FORGOTTEN.
WE SHOULDN'T BE FORGOTTEN IN THE
EPIDEMIC.
THANK YOU FOR LISTENING.
I THINK IT'S TIME FOR QUESTIONS
>> I THANK YOU BOTH.
THANK YOU BOTH FOR YOUR
INSIGHTFUL AND POWERFUL
PRESENTATIONS.
WE NOW HAVE TIME FOR OPEN
DISCUSSION REGARDING THIS ISSUE.
DR. GLENSHAW AND I ARE GOING TO
MODERATE THIS DISCUSSION.
STARTING WITH THE MEMBERS ON THE
ZOOM CALL.
SO PLEASE RAISE YOUR HAND WHEN
YOU WANT TO PARTICIPATE.
DR. MONTANER?
>> I THANK DR. MARTINS AND
MS. CANADY FOR IMPRESSIVE AND
INSIGHTFUL PRESENTATIONS THAT
LEAVES A LOT FOR US TO THINK
ABOUT.
DR. MARTINS, THE DATA YOU SHOWED
IS REALLY INCREDIBLE, INCREDIBLY
ENCOURAGING FOR THE STRATEGY
OVERALL AND THE IMPRESSIVE
CONTROL THAT YOU HAVE
DOCUMENTED.
I WANTED TO LEARN MORE ABOUT HOW
YOU ANTICIPATE THIS MOVING
FORWARD.
FIRST QUESTION IS, YOU MENTIONED
THERE WAS HIGH LEVEL OF IMMUNITY
IN THE ADULTS, SO DO YOU
ANTICIPATE THIS STRATEGY WOULD
SORT OF HOLD CLAUSTRUM UNTIL
UNTIL BREAST FEEDING AND RESUME,
HAVE SUME,
HAVE TO MANAGE THE BREASTFEEDING
IN RELATION TO IMMUNITY?
>> REGARDING BREASTFEEDING AND
PREEXISTING IMMUNITY, THERE ARE
TWO COMPONENTS THAT MUST BE
DIFFERENTIATED, YES, AND WE TALK
ABOUT PREEXISTING IMMUNITY INTO
AAV, AND BABIES, THEY CAN BE
BORN WITH MATERNAL ANTIBODIES
THAT TARGET THE AAV VECTOR WHICH
CAN INTERFERE WITH THIS APPROACH
BUT AS MATERNAL ANTIBODIES WANE
OVER TIME WE BELIEVE THIS IS
STILL TO BE IDENTIFIED, THERE
MAY BE A SWEET SPOT, WINDOW OF
OPPORTUNITY, WHERE WHEN THE
MATERNAL ANTIBODIES HAVE CLEARED
FROM THE BABY'S CIRCULATION
ALLOWING THEN THIS CHILD TO
RECEIVE THE VECTORS WITHOUT
INTERFERENCE, AN ONGOING AREA OF
EXPLORATION IN MY LAB, WE HOPE
TO HAVE DATA SOON.
THE OTHER ASPECT, WHEN HOSTS
REACT TO THE AAV ENCODED
bNAb, YES, THESE RESPONSES
WITH SIGNIFICANTLY LESS COMMON
IN INFANTS THAN ADULTS WHICH I
BELIEVE COULD MAKE THIS
PARTICULARLY USEFUL FOR TREATING
PEDIATRIC HIV INFECTIONS.
>> WITH REGARDS TO CONTROL IN
THOSE CASES WHERE YOU TREATED
AFTER INFECTION, DID YOU -- HAVE
YOU HAD OPPORTUNITY TO DEPLETE
CD8 OR CONFIRM THIS IS ANTIBODY
MEDIATED CONTROL AND WHEN IT
COMMENTS TO THE WORD CONTROL ARE
YOU ALSO ABLE TO REDUCE
PERSISTENT VIRUS OR DO YOU
INTERPRET THIS TO BE A LONG-TERM
CONTROL SCENARIO?
>> YES, WE HAVE PERFORMED CD8
DEPLETIONS, WE HAVE SEEN NO
REBOUND IN CONTEXT OF CD 8
DEPLETIONS, PERFORMED IgG
DEPLETIONS USING ANTIBODY, AND
THEREFORE ACCELERATES
CATABOLISM.
AS ANTIBODIES GO DOWN WE SEE
VIRUS RECORD ESSENCE, ACCURACY
DEPENDS ON PERSISTENT EXPRESSION
OF MOLECULES WHICH ADDRESSED
YOUR SECOND QUESTION, THAT THIS
IS PROBABLY SOMETHING -- THIS IS
ONGOING CONTROL OF THE VIRUS.
HOWEVER, WE MUST REMEMBER THAT
ANTIBODIES DIFFER FROM
ANTIRETROVIRAL DRUGS, FUNCTION
IN FC COMPONENTS THAT ENABLE
THEM TO KILL HIV CELLS, WE'RE
EXPLAINING TO EXPLORE OVER TIME
TO SEE IF WE CAN EFFECT
SIGNIFICANT REDUCTION IN
RESERVOIRS THROUGH FCF FUNCTIONS
DESCRIBED.
>> TO MISS CANADAY.
THANK YOU FOR SHARING YOUR LIFE
EXPERIENCE.
WE HEAR YOU WELL.
THE REASON YOU'RE HERE, IT IS AN
IMPORTANT GROUP OF PEOPLE THAT
NEED TO BE INCLUDED IN THE
PLANNING AND IN THE FUTURE
INTERVENTIONS THAT HOPEFULLY
WOULD COME OUT OF THE STRATEGIC
PLAN THAT WE JUST DISCUSSED IS
GOING TO BE CRAFTED AS WELL AS
INCREASING AMOUNT OF ATTENTION
IN RESEARCH AROUND PERINATAL
INFECTION, JUST AS YOU HEARD
FROM ONE OF THE LABORATORIES
FOCUSED ON PERINATAL, AND SO
LASTLY I WANT TO SAY THAT YOU'RE
INCREDIBLY, YOU KNOW, COURAGEOUS
AND BRAVE TO SHARE YOUR STORY
AND YOU REALLY SPEAK VOLUMES OF
TAKING DOWN THE STIGMA AND BEING
AN EXAMPLE FOR OTHERS TO LOOK AT
YOUR LIFE EXPERIENCE AND FEEL
EMPOWERED BY YOUR STORY SO THANK
YOU FOR SHARING IT AND I HOPE
MANY MORE PEOPLE GET TO HEAR
YOU.
>> THANK YOU.
>> DR. ABRAMS.
>> YES, THANKS SO MUCH.
AND KIMBERLY, I WANT TO ALSO
EXPRESS MY APPRECIATION FOR YOUR
STORY, FOR YOUR WILLINGNESS TO
GET OUT THERE AFTER ALL THESE
YEARS AND SHARE WITH US.
I KNOW THAT THERE ARE LOTS OF --
SIMILAR CONVERSATIONS ARE TAKING
PLACE IN DIFFERENT SPACES,
THERE'S A LAB AT HOWARD
UNIVERSITY, WHERE YOUNG PEOPLE
WITH PERINATAL INFECTION ARE
TALKING ABOUT THESE THINGS, THE
AIDS INSTITUTE IN NEW YORK.
I WAS WANTED TO BOTH ENCOURAGE
YOU AND ASK YOUR OPINION ABOUT
HOW DO WE HARNESS THESE
CONVERSATIONS TO BEGIN TO INFORM
A RESEARCH AGENDA PARTICULARLY
IN THE CONTEXT OF WHERE WE ARE
TODAY IN THIS MEETING, BECAUSE
THERE ARE DEFINITELY CARE
OBJECTIVES BUT I THINK THERE'S A
CLEAR SET OF RESEARCH QUESTIONS
THAT NEED TO BE ADDRESSED, AND
UNDERSTAND TO KNOW THOSE
QUESTIONS FROM THE COMMUNITY
POINT OF VIEW.
>> THANK YOU AGAIN FOR HAVING
ME.
THANK YOU FOR ASKING THAT
QUESTION.
I THINK ONE OF THE THINGS THAT
CAN BE DONE IS ME BEING THE
CONNECTION, THE NETWORK YOU'RE
AFFILIATED WITH, REACHING OUT TO
THOSE HOSPITALS REACHING OUT TO
THESE PEOPLE, IF THOSE WHO ARE
BORN POSITIVE IF THEY COULD BE
WILLING TO COME TOGETHER AND BE
OPEN TO HAVING THESE
CONVERSATIONS, I THINK PART IS
PEOPLE ASK THE QUESTION, ANSWER
THE QUESTIONS FOR US, VERSUS
HAVING US AT THE TABLE.
SO IF Y'ALL CAN COME TOGETHER
AND GET THOSE DIFFERENT GROUPS
THAT ARE ALREADY DOING THE WORK
TO ACTUALLY COME TOGETHER AND
THEN YOU WOULD HAVE DIFFERENT
PEOPLE WHO ARE LIVING WITH HIV,
BORN WITH IT, TO ACTUALLY TRY TO
ASK RESEARCH QUESTIONS OF WHAT'S
NEEDED.
I KNOW A STUDY THAT'S COMING OUT
SOON, USING NETWORKS AND
REACHING OUT, HEY, WE WANT TO
REACH OUT TO THIS POPULATION, WE
WANT TO DO THIS FOCUS GROUP, DO
THIS RESEARCH, AND THEY ARE NOT
JUST TALKING TO THEMSELVES.
THEY ARE TALKING TO PEOPLE IN
DIFFERENT STATES.
MAYBE THAT COULD BE A GOOD START
MOVING FORWARD.
>> ONE QUESTION FOR DR. MARTINS.
THERE'S A LOT OF ONGOING
DISCUSSION IN THE PERINATAL
PREVENTION ARENA AROUND USING
bNAbS FOR PERINATAL
PREVENTION.
AND I'M JUST WONDERING FROM YOUR
POINT OF VIEW WHAT EVIDENCE OF
EFFICACY DO WE NEED, EITHER
ADULTS OR IN CHILDREN, BEFORE WE
CAN MOVE FORWARD WITH SOME OF
THESE TECHNOLOGIES OR GENE
THERAPY?
WE DON'T HAVE PK STUDIES, WE
KNOW THESE ARE -- bNAbS PER
SE ARE SAFE. BUT IN HUMANS,
CHILDREN, WE HAVE NO EFFICACY.
>> YES, AND YOU'RE SPEAKING
SPECIFICALLY ABOUT PROPHYLAXIS,
RIGHT?
>> YES, PREVENTION.
NOT FOR TREATMENT AT ALL OR
REMISSION.
>> RIGHT.
YOU KNOW, I MUST SAY, I HOPED
THAT SOME OF THE COMPANIES THAT
HAVE LICENSED THESE BROADLY
NEUTRALIZING ANTIBODIES WOULD BE
MORE OPEN AND EXCITED ABOUT
USING THESE MOLECULES FOR
TESTING IN PEDIATRIC
POPULATIONS.
AND AS OF YET, I -- WE ARE
ACTUALLY IN COLLABORATION TO USE
N 6 FOR ONGOING HP STUDIES, IN
THE CONTEXT OF THERAPY.
AND I GUESS WHAT I'M TRYING TO
SAY IS IF ONLY THERE WERE MORE
INTEREST FROM THE PRIVATE SECTOR
ABOUT THESE LONG-ACTING
STRATEGIES FOR, YOU KNOW,
CHILDREN, I SUSPECT, I MIGHT BE
WRONG, THAT THEY ARE WAITING FOR
MORE DATA TO BE PERFORMED IN
OLDER AGE GROUPS, PERHAPS GOING
DOWN THE -- MAYBE FROM ADULTS,
ADOLESCENTS, THEN OLDER CHILDREN
BEFORE IT CAN BE TESTED IN
INFANTS.
AND IF THIS IS THE CASE, WELL, I
GUESS, YOU KNOW, WE'RE -- IN MY
VIEW, THESE THERAPIES ARE READY
TO BE TESTED.
WE WOULD HAVE LARGE AMOUNT OF
SAFETY DATA, LARGE AMOUNT OF
CLINICAL EFFICACY DATA, AND I
SHARE YOUR CONFUSION SOMETIMES
ON WHY THIS IS NOT MOVING
FASTER.
I WISH IT WERE.
>> THANKS.
>> DR. NAGHAVI.
>> THANK YOU FOR SHARING YOUR
STORY, KIMBERLY.
COMING FROM MYSELF AS A
SCIENTIST, THIS IS NOT SOMETHING
WE HEAR ON A DAY-TO-DAY BASIS.
IT REALLY GIVES US SOMETHING TO
THINK ABOUT.
THANK YOU FOR BEING YOU.
AND DR. MARTINS, JUST WONDERING
IF YOU COULD GIVE US SOME
INSIGHTS ON WHAT THE RESERVOIRS
MIGHT BE IN THIS PEDIATRIC
INFECTIONS, IF THERE ARE UNIQUE
COMPOSITIONS OF ITS RESES AS
OPPOSED LIKE THEY ARE NAIVE
CDCELLS, WHETHER THAT SHOULD BE
CONSIDERED IN THIS ERADICATION
STRATEGY?
>> THANK YOU FOR THE QUESTION.
WE'RE MONITORING RESERVOIR
LEVELS IN OUR NHP STUDIES
THROUGH THIS ASSET DEVELOPED AT
JOHNS HOPKINS UNIVERSITY, IPDA
ASSAY.
AND WE SEE A DECLINE IN LEVELS
OF VIRUSES THAT AT LEAST DURING
THE PERIOD OF ANTIRETROVIRAL
THERAPY RESEMBLES DECLINE OF THE
CONTROL GROUP, SO DURING THE 30
WEEKS OF ANTIRETROVIRAL THERAPY
WE STUDY, WHICH IS VERY SHORT,
WE DID NOT OBSERVE AN
ACCELERATION IN DECAY RATE OF
MOLECULES.
LONGER STUDIES, HOPEFULLY LAST
MORE THAN A YEAR, ALSO USING
ANTIBODIES THAT ARE MORE
EFFECTIVE AT ELIMINATING
INFECTED CELLS.
THERE WAS ONE DETAIL I DID NOT
EXPLORE AS MUCH PERHAPS AS I
SHOULD HAVE THAT THE ANTIBODIES
I USED IN OUR ONGOING STUDIES
WERE OF THE IgG 2 SUBCLASS,
WHICH ARE NOT SO RAPID, SO FAST
AT KILLING AFFECTED CELLS IN
MACAQUES COMPARED TO IGG1
SUBCLASS, IN THE NEXT STUDIES
WE'LL USE IGG1 SUBCLASS TO AC
SET RATE DECLINED KINETICS, WITH
HOPES OF REDUCING OR ELIMINATE
IT.
>> THANK YOU.
IT'S A VERY POWERFUL TECHNIQUE.
>> THANK YOU VERY MUCH.
>> DR. FINZI?
>> THANK YOU.
I WANTED TO THANK YOU BOTH.
I HAVE A QUESTION FOR DR.
MARTINS.
WHEN YOU THINK OF YOUR METHOD
AND SUSTAINING THE LEVELS THAT
WOULD BE NEEDED AND THE TYPES OF
ANTIBODIES, DO YOU ENVISION
USING VARIOUS DIFFERENT
ANTIBODIES OVER TIME OR HOW
WOULD YOU SUSTAIN THE LEVEL
NEEDED TO KEEP CONTROL OVER
LONGER TIMES?
AND ALSO, MONITORING FOR
DEVELOPMENT OF RESISTANCE?
>> YES, SO IN MY VIEW WE SHOULD
BE USING COMBINATIONS OF
MOLECULES TO REALLY EXPAND THE
BREADTH OF NEUTRALIZATION AND
FUNCTION IN THESE ANIMALS.
I THINK WE ONLY USED TWO
MOLECULES IN OUR STUDIES BECAUSE
THOSE WERE THE REAGENTS
AVAILABLE.
ONE MOLECULE ACTUALLY DISPLACED
VERY IMPRESSIVE BREADTH, CDIG 4
MOLECULE, WE HOPE TO MAKE IT
MORE EFFECTIVE MOVING FORWARD
BUT FROM THE STANDPOINT OF A
CLINICAL TRIAL I WOULD CERTAINLY
ADVOCATE FOR USING AT LEAST
THREE MOLECULES TARGETING
DIFFERENT SITES OF THE ENVELOPE
PROTEIN.
AND IN TERMS OF SUSTAINING THE
LEVELS, THIS IS A VERY GOOD
QUESTION ACTUALLY BECAUSE THESE
AAV GENOMES THAT WE DELIVER TO
THE MUSCLE CELLS OF BABIES THEY
ARE NOT SUPPOSED TO DIVIDE OVER
TIME.
SO EVENTUALLY AS CHILDREN GROW
OVER YEARS WE EXPECT, WE HAVEN'T
SEEN THIS YET BECAUSE IT TAKE
YEARS, BUT WE PREDICT AS BLOOD
VOLUMES INCREASE, LEVELS MAY GET
DILUTED REQUIRES PERHAPS A BOOST
AND UNKNOWN AMOUNT OF TIME.
WHEN THAT TIME COMES WE HAVE THE
TECHNIQUES AT LEAST TO REMOVE
ANTIBODIES WHICH WOULD HOPEFULLY
ALLOW FOR READMINISTRATION TO
BOOST CONCENTRATION OF VIRUS
REBOUND LATER IN LIFE.
>> RIGHT.
THANK YOU.
THANK YOU VERY MUCH.
AND MS. CANADY, I WANTED TO ECHO
WHAT OTHER PEOPLE HAVE SAID.
I MEAN, WHAT AN AMAZING STORY.
AND I ALSO HAVE BEEN WORKING ON
HIV, AT LEAST WORKING ON HIV FOR
OVER 30 YEARS, AND THINKING
ABOUT IT SINCE BEFORE YOU WERE
BORN.
AND TO HEAR YOUR STORY REALLY IS
AMAZING AS A RESEARCHER AND
HEARTWARMING AS JUST A PERSON
WHO HAS KNOWN ABOUT HIV FROM THE
SCIENTIFIC SIDE FOR SO MANY
YEARS AND ALSO AS A MOM.
JUST AMAZING.
KEEP IT UP.
IF WE CAN ENCOURAGE YOU IN ANY
WAY, LET US KNOW.
AND WE DID HEAR YOUR STORY.
>> DR. GALARRAGA?
>> THANK YOU.
EXCUSE ME.
KIM, THANK YOU SO MUCH FOR
SHARING YOUR PERSONAL STORY.
IT IS AGAIN VERY UNUSUAL FOR US
TO HEAR THAT.
I DO A LOT OF NUMBERS AND A LOT
OF STATISTICS, I LOOK AT
PROGRAMS, LIKE IN KENYA, WE HAVE
200,000 PEOPLE IN TREATMENT,
15,000 NEW CASES OF HIV PER
YEAR, THOSE DON'T MEAN ANYTHING,
RIGHT?
ONCE YOU SEE NUMBERS, NUMBERS,
NUMBERS.
THEN I SEE YOUR FACE, WOW,
THERE'S HOPE, THERE'S A
STRENGTH.
AND THERE'S RESILIENCE OF HUMANS
AND IT'S JUST AMAZING.
THANK YOU.
IF I MAY, I MEAN, AGAIN, JUST IN
THE SPIRIT OF ENCOURAGING YOU, I
HOPE YOU CAN, YOU KNOW, WRITE
YOUR STORY IN A BOOK OR I MEAN I
HOPE THAT YOUR STORY BECOMES A
MOVIE.
I HOPE THAT -- I'M SURE YOU KNOW
YOU'RE YOUNGER SO I HOPE YOU
HAVE A VERY ACTIVE INSTAGRAM
YOUNGER PAGE, SO THE YOUNGER
GENERATIONS HEAR YOUR MESSAGE
AND ARE INSPIRED BY YOUR
RESILIENCE AND YOUR TOUGHNESS.
I THINK THAT'S VERY MOVING.
I HAVE A SUGGESTION ALSO.
YOUR WORK SEEMS AMAZING,
MAURICIO, A GAME CHANGER.
SOME OF THE PRICES OF THE DRUGS,
YOU KNOW, AAV DRUGS, AS MANY
PEOPLE KNOW ARE STAGGERING, HALF
A MILLION FOR SOME OF THE
SHOTS,
HOW CAN THIS BE?
WE LIVE IN A MARKET WHERE IT'S
SUPPLY AND DEMAND.
REALLY THE U.S. IS WHATEVER THE
MARKET WILL BEAR.
AND THAT'S REALLY UNFORTUNATE.
AND SO YOU ALREADY SPOKE THAT
YOU'RE IN CONVERSATIONS WITH
SOME OF THE DRUG MANUFACTURERS,
BUT I ASSUME THAT AGAIN HAVING
BEEN WORKING IN THIS AREA FOR
OVER 20 YEARS AT THIS POINT,
OVER 25 YEARS, I'VE SEEN A LOT
OF CHANGES.
AND SO I JUST DON'T THINK
REGULAR CHANNELS ARE GOING TO BE
WHAT GETS THIS TO THE MARKET,
RIGHT?
IT ALMOST SEEMS SOMETHING LIKE
ADVANCED PURCHASE COMMITMENT IS
NEEDED, SAYING PEPFAR OR W.H.O.
IS COMMITTED TO BUYING, I DON'T
KNOW, HALF A MILLION OF THESE OR
100,000 EVERY YEAR, WILLING TO
PUT A BUNCH OF MONEY TO MAKE IT
INTERESTING FOR THE COMPANIES TO
REALLY DEVELOP THIS.
OTHERWISE THERE'S NOT GOING TO
BE THE MARKET BECAUSE
UNFORTUNATELY AS YOU SHOWED THE
MAP, WHERE THE MOST NEED IS IS
NOT WHERE THE MONEY IS.
THE BUSINESS OPPORTUNITY.
AND SO I THINK THAT SORT OF
MULTI-TRADITIONAL CHANNELS IS
WHAT'S GOING TO WORK HERE.
AND YOU HAVE YOUR OWN VIEWS OF
COURSE BUT THAT'S MY OPINION
BASED ON WHAT I'VE SEEN IN THE
MARKET, HOW THE MARKET WORKS THE
LAST 20, 30 YEARS.
>> YOU MAKE VERY GOOD POINTS.
I THINK MY NUMBER ONE PRIORITY,
WE NEED TO ADDRESS THIS IN A
STEP-WISE FASHION.
MY PRIORITY NOW, THOSE OF MY
COLLEAGUES, TO CONDUCT FIRST
CLINICAL TRIAL TO DEMONSTRATE
SAFETY.
AND WE'RE WORKING WITH ACTUALLY
BILL AND MELINDA GATES NETWORK,
BUT, YES, I HEAR YOU.
I ALSO SHARE THESE CONCERNS.
BUT I ALSO WANT TO MAKE SURE
THAT WE ARE NOT -- THAT THE
EXCITEMENT AND THE PRIORITY FOR
THIS INFORMATION IS NOT DAMPEND
BY THE CURRENT PRICE TAG.
EARLIER IN THE EPIDEMIC PEOPLE
WERE HAVING CONVERSATIONS ABOUT
COST, DEPLOYING THIS TO REGIONS
WITH THE HIGHEST NUMBERS OF
INFECTIONS.
NOWADAYS THROUGH GENERICS AND
AGREEMENTS, A PERSON CAN HAVE
ACCESS TO A FULL YEAR OF
ANTI-RETRO VIRALS FOR LESS THAN
$100, THERE'S A PART FORWARD BUT
DOESN'T MEAN THE PATH NOW TO
THEN IS GOING TO BE EASY AND I
HOPE WE CAN HAVE THIS IN PLACE
WITH THE W.H.O. AS YOU DESCRIBED
AND DRUG COMPANIES, I'M A BENCH
SCIENTIST BY TRAINING.
>> YEAH, NO, I FULLY HEAR YOU.
IT'S SUPPLY AND DEMAND,
PHARMACEUTICAL COMPANY CAN MAKE
HALF A MILLION DOLLARS SELLING
ONE SHOT, HALF MILLION, OR HALF
MILLION SHOTS AT ONE DOLLAR,
RIGHT?
HOW DO YOU TRANSFER THAT TO GO
LOW- AND MIDDLE-INCOME
COUNTRIES, SUB-SAHARAN AFRICA,
TO BE HONEST, UNICEF, W.H.O.,
PEPFAR, COMMITTED TO USING X TO
THE FIRST PHARMACEUTICAL THAT
DOES IT.
I'M PROBABLY -- YOU SHOULD
PARTNER WITH SOMETHING THAT HAS
MORE EXPERIENCE, OBVIOUSLY
YOU'RE AN EXPERT IN THE BENCH
SCIENCE, OTHERS HAVE TO DEAL
WITH MARKETING ISSUES THAT ARE
COMPLEX.
BUT IT'S VERY IMPRESSIVE.
>> GREAT POINTS.
I HEAR YOU.
>> FINAL QUESTION FROM DR.
MONTANER.
>> THANK YOU.
MISS CANADY, IN YOUR STORY YOU
REFERRING TO THE CONTINUITY OF
DEATH IN YOUR COMMUNITY PEOPLE
LIVING WITH HIV.
I WANTED TO EXPAND A LITTLE BIT.
WE TALKED ABOUT IMPLEMENTATION
SCIENCE, HOW BEST TO ADDRESS
HEALTH DISPARITIES WITH PEOPLE
THAT DON'T HAVE ADEQUATE SUPPORT
FOR HEALTH INFRASTRUCTURE OR
FOLLOW-UPS.
SO IS THIS THE MAIN REASON THAT
YOU WOULD ASSIGN TO THIS
CONTINUAL DEATHS, IN AN ERA
WHERE THERE IS ANTIRETROVIRAL
THERAPY OR IS THERE MORE TO
THIS?
IF YOU CAN DIRECT YOUR COMMENTS
AROUND IMPLEMENTATION GAPS OR
AREAS THAT YOU THINK THAT
STRATEGIC PLAN SHOULD FOCUS ON
AS TRYING TO TRY TO BETTER
ADDRESS HEALTH DISPARITIES,
IMPLEMENTING PROGRAMS THAT CAN
MAKE ANTIRETROVIRAL THERAPY MORE
ACCESSIBLE.
>> WITH A LOT OF MY FRIENDS, A
LOT WAS IMPLEMENTATION WOULD
REALLY BE HELPFUL FOR BETTER
STRATEGIC PLANNING WHEN IT COMES
TO TRANSITIONING FROM PEDIATRIC
CARE TO ADULT CARE.
THAT'S WHY A LOT OF US GET LOST.
WHEN -- EARLIER ON A LOT OF BULK
OF PASSING OF MY FRIENDS WERE
EARLY TEENAGERS, SO THIS IS THE
TIMELINE, 1996 TO MAYBE 2006 TO
2010.
MEDICATION WAS THERE.
WE WERE YOUNG.
I WAS ONE OF THE LUCKY OR
BLESSED ONES, I WASN'T ON
MEDICATION UNTIL 30, THAT WAS MY
CHOICE.
THAT'S GOING WITH STIGMA AND ME
FEELING I'M 30, WHY AM I STILL
HERE?
I SHOULD BE ON MEDICATION, EVEN
THOUGH MY NUMBERS SAY I'M GOOD.
LET'S SEE WHAT HAPPENS.
A LOT OF FRIENDS WERE ON
MEDICATION OFF AND ON SINCE AGE
7, AGE 8, NOT BEING TOLD ABOUT
THE MEDICATION BECAUSE WE DIDN'T
KNOW WE WERE POSITIVE.
SO NOT TAKING MEDICATION
PRESCRIBED.
BY THE TIME THEY WERE TAKING THE
MEDICATION, THEY WERE ON
EXPERIMENTAL DRUGS, THEIR BODIES
SUFFERED FROM DYSTROPHY OR ORGAN
FAILURE.
BECAUSE THE MEDICATION WAS HUGE,
DISGUSTING, THEY DIDN'T KNOW HOW
TO SWALLOW, NOBODY WOULD ASSIST
THEM ON HOW TO TAKE THE
MEDICATION, WHAT THAT LOOKED
LIKE.
THE IMPORTANCE BECAUSE WE WERE
CHILDREN.
BY THE TIME WE BECAME
ADOLESCENT, OUR BODIES GAVE OUT.
FOR A LOT OF THEM, MEDICATION
WASN'T WORKING.
BY THE TIME THAT A LOT OF US
WANTED TOKING BACK ON IT, TRY TO
GET ON THOSE, THEY WERE
RESISTANT AND MEDICATION WASN'T
WORKING.
THE BODY ALREADY TOOK THE TOLL.
FOR A LOT, THE BULK WAS BECAUSE
OF THAT.
FOR THOSE WHO PASSED AWAY ON A
LOT IS MENTAL HEALTH SERVICES
WASN'T THERE TO TALK ABOUT WHAT
IT LOOKS LIKE TO CONTINUE TO BE
HIV POSITIVE GROWING UP.
THEY PREPARED US FOR DEATH SO
MUCH, WE WEREN'T PREPARED FOR
LIFE.
THAT SOUNDS INSANE.
WHY WOULD YOU DIG THIS UP, YEA,
YOU'RE RESILIENT, YOU SHOULD BE
HAPPY YOU'RE ALIVE BUT THERE'S
THE PROGRAMS DISAPPEARED FOR US
TO WANT TO BE ALIVE.
AND WE FELT ALONE.
AND THEN ACCESS -- BEING ADULT
AND ACCESSING CARE TRYING TO
LIVE A NORMAL LIFE DOESN'T
EQUATE BECAUSE I'M TRYING TO BE
IN A RELATIONSHIP, NOT SPEAKING
FOR MYSELF BUT BEING IN A
RELATIONSHIP AND LIVING WITH
SOMEBODY BECAUSE A LOT OF US
HAVE LIVED WITH OUR GRANDPARENTS
WHO PASSED AWAY.
WE'VE SEEN THEM PASS AWAY
BEFORE -- WE OUTLIVED THE
PARENTS, THE FOSTER CARE SYSTEM,
NOW NAVIGATING WITH THAT
MEDICAL, THE CO-PAYMENT FOR
MEDICATION, WANT TO LIVE LIFE,
BUT BECAUSE WE CAN'T AFFORD $300
FOR A CO-PAYMENT, I'D RATHER NOT
BE ON MEDICATION.
AND NOBODY IS TALKING ABOUT THE
RESOURCES TO EVEN COMPENSATE
THAT.
OKAY, YOU DON'T HAVE TO --
THERE'S DIFFERENT PROGRAMS OUT
THERE TO ASSIST YOU WHERE WE CAN
PAY FOR THE CO-PAYS, BUT NOBODY
IS TALKING ABOUT.
TRANSITIONING OUT OF PEDIATRIC
CARE, THEY ARE RUSHING YOU OUT,
TALKING AT YOU AND NOT WITH YOU.
TRYING TO COME UP WITH ACTUAL
GAME PLAN.
IF YOU EXPERIENCED PEDIATRIC
CARE IT'S A WHOLESOME LOVING
ENVIRONMENT, FOR A LOT OF US, I
DON'T WANT TO GO TO CARE BECAUSE
NOW I'M NOBODY, I'M A NUMBER.
IT'S THE WAY PEOPLE ARE TRAINED.
THEY ARE NOT TRAINED PROPERLY
HOW TO TALK TO PEOPLE LIVING
WITH HIV, AND ESPECIALLY THIS
POPULATION ON THE AMOUNT OF
STUFF THAT'S HAPPENING.
THE HISTORY PART WHAT WE'VE BEEN
THROUGH AS CHILDREN, GOING TO
DOCTOR CONTINUOUSLY AS CHILDREN,
TRYING TO DIFFERENT MEDICATIONS,
IN AND OUT OF THE SYSTEM, LOSING
PARENTS, BEING AN ADULT, TRYING
TO NAVIGATE WHAT THAT LOOKS
LIKE, A LOT OF PEOPLE THAT THIS
IS NOT BEING TAUGHT HOW TO
ACTUALLY CARE FOR US.
I WOULD SAY THE CARE PART,
TRANSITION PART PEDIATRIC TO
ADULT CARE, MORE PROGRAMS
INITIATED FOR ART, WHEN
EMOTIONAL ASPECTS ARE NOW STILL
BEING ALIVE, WHAT THAT LOOKS
LIKE.
>> THANK YOU.
>> WE COULD HAVE THIS
CONVERSATION FOREVER.
I WANT TO ADD SOMETHING TOO WHAT
KIM SAID AS WELL AS TO RESPOND
TO YOU, ALSO TO DR. MONTANER,
ONE THING WE HAVEN'T LOOKED AT
OVER THE COURSE OF THE
TRANSITION FROM PEDIATRIC CARE
TO ADOLESCENT TO ADULT CARE,
MANY PATIENTS WHO HAVE BEEN ON
DRUGS FOR A LONG TIME, NOT
DRUGS, THEY HAVE LOTS OF
CO-MORBIDITIES.
COMORBIDITIES ARE FRIGHTENING,
YOUNG WOMEN AND MEN HAVE HEART
DISEASE, HYPERTENSIVE.
AND IT'S THOSE KINDS OF THINGS
VERY OFTEN NECESSARILY HIV,
SOMETHING ELSE THAT KILLS THEM.
WE HAVEN'T FOCUSED ON WHAT
SPECIFIC AREAS ARE BUT WITH KIM
HERE AND WITH DR. MARTINS'
RESEARCH WE DO HAVE THE
OPPORTUNITY TO DO THAT.
THANK YOU ALL FOR SUCH AN
INSIGHTFUL CONVERSATION.
NOW I WANT TO MOVE FORWARD WITH
THE AGENDA SO WE CAN NOW HEAR A
BRIEF UPDATE FROM NIAID AIDS
RESEARCH ADVISORY COMMITTEE, DR.
ELAINE ABRAMS.
THE FLOOR IS YOURS.
>> JUST NEED MY SLIDES.
GREAT.
AND I WILL SAY THIS IS A LITTLE
BIT LIKE A GOLDILOCKS MOMENT, AS
I HOPE I'M NOT TOO LONG OR TOO
SHORT.
THIS IS MY FIRST OPPORTUNITY TO
JOIN THIS MEETING.
BEAR WITH ME.
SO I'M GOING TO REPORT BACK ON
THE NIAID COUNCIL ARAC MEETING
OF JUNE 3.
NEXT SLIDE PLEASE.
THE MEETING STARTED WITH THE
DIRECTOR DR. CARL DIEFFENBACH'S
REPORT.
I'LL GO THROUGH THE HIGHLIGHTS
OF WHAT HE SHARED WITH US.
NEXT PLEASE.
HE INTRODUCED NEW ARAC MEMBERS
INCLUDING DR. GRACE ALDROVANDI,
DR. SHAH, DR. GEBO, TIMOTHY
HENRICH, DR. LANDOVIT DIS
DR. LUVU.
NEXT PLEASE.
HE ALSO INTRODUCED THE NEW OR
UPDATED NIAID HIV LANGUAGE GUIDE
AND RELATED MATERIALS WHICH
COULD ALL BE FOUND AT THIS
WEBSITE.
NIAID IS MAKING EVERY EFFORT TO
ELIMINATE USE OF STIGMATIZING
TERMINOLOGY AND ADVANCE THE USE
OF PERSON FIRST INCLUSIVE AND
RESPECTFUL LANGUAGE.
AND I'M SURE EVERYBODY IS
FAMILIAR WITH THIS GUIDE.
IT'S BEEN ESSENTIAL TO
RESEARCHERS AS WELL AS TO THE
COMMUNITY TO GET US ALL ON BOARD
TO USING THIS PERSON-FIRST
RESPECTFUL LANGUAGE.
HE SPENT SOME TIME REVIEWING
BUDGETARY ISSUES.
POINTING OUT THAT THE 2024, FY
24 ENACTED BUDGET, WAS FLAT
LINED, UNCHANGED, COMPARED WITH
FY 2023 AUTHOR NIAID IN
PARTICULAR.
IT'S HIGHLIGHTED IN YELLOW HERE.
R01 PAYLINE ESTABLISHED
INVESTIGATORS AT THE 10th
PERCENTILE.
NEW P.I.s AT 14th
PERCENTILE.
NON-COMPETING AT 100%, COMPETING
GRANTS WILL BE FUNDED AT 90% OF
APPROVED FUNDING.
NO ADJUSTMENTS TO FELLOWSHIP
TRAINING, CAREER DEVELOPMENT,
SMALL BUSINESS AWARDS.
COMPETING RESEARCH INITIATIVES
MAY HAVE UP TO 20% CUT, OVERALL
ESTIMATED SUCCESS RATE IS
16-20%.
NEXT PLEASE.
FINALLY HE REVIEWED THE HEARING
AIDS CLINICAL TRIALS NETWORK
RECOMPETITION TIMELINE, THE
PROCESS HAS ALREADY BEEN
LAUNCHED THIS SPRING WITH
NETWORK PRESENTATIONS TO
STRATEGIC WORKING GROUP, WE'LL
HAVE PRELIMINARY DISCUSSIONS
WITH ARAC AND OTHER ADVISORY
COMMITTEES IN THE FALL, CAN
EXPECT THE RFAs TO BE
PUBLISHED IN JANUARY 2026.
AND GRANTS WILL BE DUE IN THE
FALL OF 2026.
ALL OF THE NETWORKS ARE ALREADY
DEEP INTO INTERNAL CONVERSATIONS
ABOUT THEIR PROCESSES.
IN ADDITION TO DIRECTOR'S
REPORT, PRIMARY ACTIVITIES
DURING MEETING WERE TO APPROVE
THE REVIEW AND APPROVE THE NEW
CONCEPTS.
THERE WERE SEVEN CONCEPTS
PRESENTED AND APPROVED AT THIS
MEETING.
LISTED HERE.
NEXT SLIDE PLEASE.
THERE WERE A LOT OF DISCUSSIONS
DURING THIS MEETING ABOUT THE
MARTIN DELANEY COLLABORATORIES,
THIS IS THE FIRST OF THREE
COLLABORATORY CONCEPTS, THIS ONE
IS A REISSUE FOR FIVE-YEAR AWARD
FROM NIAID WITH MULTIPLE
INSTITUTES OF POTENTIAL
PARTNERS, THE INTENT IS TO
ACCELERATE INNOVATIVE DYNAMIC
AND COLLABORATIVE BASIC AND
TRANSLATIONAL AND CLINICAL
RESEARCH, BROAD PARTNERSHIP
ACROSS ACADEMIA, TO ACHIEVE
ERADICATION OF HIV.
NEXT SLIDE PLEASE.
THE INITIATIVE SEEKS AND HAS
BEEN SEEKING OVER TIME TO
ADDRESS MAJOR OBSTACLES TO CURE
AND REMISSION IN PEOPLE LIVING
WITH HIV, WITH THE GOAL TO
EXTEND UNDERSTANDING OF BASIC
BIOLOGY AND DYNAMICS OF
PERSISTENT RESERVOIRS, DEVELOP
IMPROVED ASSAYS, METHODOLOGY,
EXPEDITE RESEARCH AND PROGRESS,
TO DESIGN, DEVELOP, TEST
THERAPEUTIC STRATEGIES ACHIEVING
LONG-TERM REMISSION OR
ERADICATION, WHEN YOU CAN SEE
THE SETUP OF THE COLLABORATORIES
IN THIS FIGURE.
NEXT PLEASE.
THE SECOND CONCEPT PARALLELS THE
FIRST FOR ANOTHER MARTIN DELANEY
COLLABORATORY.
THIS ONE IS SPECIFICALLY FOCUSED
ON PEDIATRIC HIV RESEARCH, ON
THE CURRENT COLLABORATORY WAS
JUST DISCUSSED, LAST SESSION.
THERE WOULD BE ONE AWARD ALSO A
REISSUE, AND THE PURPOSE IS ALSO
TO ACCELERATE RESEARCH TO
ADDRESS MAJOR OBSTACLES IN HIV
ERADICATION, LONG-TERM ART-FREE
CONTROL.
BUT FOR PEDIATRIC HIV CURE
RESEARCHERS FOCUSING ON
CHILDREN.
NEXT SLIDE PLEASE.
YOU CAN SEE THE STRUCTURE OF
THIS COLLABORATORY, IN THIS
FIGURE.
THIS IS THE FIRST PEDIATRIC MDC.
AND RESEARCH FOCI ON BASIC
SCIENCE, CONTROL OF REBOUND,
ERADICATION, ASSAY DEVELOPMENT.
THIS PROGRAM IS SPECIFICALLY
FOCUSED ON PEOPLE LIVING WITH
HIV, UNDER 18 YEARS OF AGE.
THE GOALS PARALLEL NON-PEDIATRIC
OR ADULT COLLABORATORIES.
THE FINAL MARTIN DELANEY
COLLABORATORY CONCEPT WAS FOR A
NEW AWARD TO ESTABLISH A
COORDINATION CENTER.
FACILITATE COMMUNICATION,
COLLABORATION, COORDINATION,
AMONG THE INDIVIDUAL MDCS AND
KEY STAKEHOLDERS, SUPPORTING A
COORDINATION CENTER THAT WOULD
PROVIDE ADMINISTRATIVE,
SCIENTIFIC, TECHNICAL AND
MANAGEMENT SUPPORT TO ENHANCE
THE COLLABORATIVE AND
COOPERATIVE INTERDISCIPLINARY
ENVIRONMENT.
AND THIS IS REALLY THE VISION
FOR THE COORDINATION CENTER
SUPPORT.
YOU CAN SEE THE COLLABORATORIES,
THE JEWELS, AND THE COORDINATION
CENTER WOULD PROVIDE
COORDINATION BETWEEN THE
COLLABORATORIES, WITH THE NIH
PROGRAM TEAM, AND ALL OF THE
COMMUNITY AND SCIENTIFIC
CONSULTANTS.
ALSO LIKELY SUPPORT SOME EARLY
CROSS-CUTTING EARLY INVESTIGATOR
FELLOWSHIPS OR SCHOLARSHIPS.
WE WENT FROM COLLABORATORIES TO
TALK ABOUT ANOTHER FLAGSHIP
PROGRAM, THE IEDEA NETWORK OR
PROGRAM, INTERNATIONAL
EPIDEMIOLOGY DATABASES TO
EVALUATE AIDS.
THIS IS A U01 MECHANISM, LIMITED
COMPETITION AND REISSUE,
OBJECTIVE TO CONTINUE
INTERNATIONAL EPIDEMIOLOGY
PROGRAM FOCUSED ON CLINICAL
EFFECTIVENESS ACROSS NIH'S
CURRENT PROGRAMS TO UNDERSTAND
THE CHANGING HIV EPIDEMIC
GLOBALLY.
AND THIS IS -- HAS MULTIPLE
INSTITUTES THAT OVER TIME HAVE
PARTICIPATED AND CONTINUE TO
PARTICIPATE IN THIS PROGRAM.
NEXT SLIDE PLEASE.
SO, THERE ARE CURRENTLY SEVEN
REGIONAL DATA CENTER AWARDS THAT
COVER 7 REGIONS, 44 COUNTRIES,
388 SITES, OVER 2 MILLION
PEOPLE, CLOSE TO A QUARTER OF A
MILLION CHILDREN.
AND OVERALL, SUPPORT DATA
COLLECTION, AGGREGATION,
QUALITY, DEVELOP NOVEL DATA
CORRECTION, CONDUCT RESEARCH IN
COLLABORATION WITH CLINICS, WITH
EACH OTHER, IN-COUNTRY PARTNERS,
HUGE INVESTMENT IN TRAINING
INVESTIGATORS AND SERVES AS
PLATFORM FOR OTHER RESEARCH.
IT WILL BRING TOGETHER CLINICAL
AND RESEARCH DATA WITHIN THE
REGIONS AND COLLABORATION
GLOBALLY, TO MONITOR AND GUIDE
RESPONSE WITH KEY QUESTIONS
AROUND LONG-TERM IMPACT OF HIV
AND TREATMENT, EPIDEMIOLOGY OF
COMMON INFECTION, HEALTH CARE
UTILIZATION, ULTIMATELY COMPARE
BETWEEN REGIONS.
AND IMPRESSIVE NUMBER OF PAPERS
AND YOUNG INVESTIGATORS
PARTICULARLY FROM LOW- AND
MIDDLE-INCOME COUNTRIES THAT
HAVE LAUNCHED THEIR CAREERS.
WE THEN LOOKED AT CONSORTIA FOR
HIV/AIDS VACCINE DEVELOPMENT AND
IMMUNOLOGY, CHAVDI, THE UM 1
MECHANISM, TO ESTABLISH A
COORDINATED MULTI-DISCIPLINARY
EFFORT FOCUSED ON PRE-CLINICAL
VACCINE DISCOVERY, CLINICAL
VACCINE MANUFACTURE, AND
ULTIMATELY ACHIEVE PROOF OF
CONCEPT OF VACCINE INDUCTION OF
bNAbS TO THREE DIFFERENT
bNAb TARGETS AND INCLUSION OF
OTHER COOPERATIVE IMMUNE
RESPONSES.
YOU CAN SEE IT FITS INTO THE
VACCINE RESEARCH PROGRAM,
HIGHLIGHTED ABOVE THE RED LINE,
YOU'LL SEE THE PROGRAM EXTENDS
FROM DISCOVERY PRE-CLINICAL TO
TRANSLATIONAL, MANUFACTURING,
ALL THE WAY TO CLINICAL RESEARCH
NEXT PLEASE.
NEXT CONCEPT WAS THE LAST
PROGRAM, ADVANCING TRANSLATION
OF LONG ACTING STRATEGIES FOR
HIV AND HIV-ASSOCIATED
CO-INFECTION.
AND THIS IS A NEW GRANT, R61,
R33, OBJECTIVE IS TO SUPPORT
PRE-CLINICAL ACTIVITIES FOR THE
DEVELOPMENT OF SAFE AND
EFFECTIVE LONG ACTING SUSTAINED
RELEASED TECHNOLOGIES FOR
PREVENTION, TREATMENT OF HIV AND
ASSOCIATED TB AND HEPATITIS AND
TO ULTIMATELY ENABLE SUBMISSION
OF IND APPLICATIONS TO THE FDA,
REALLY TO FACILITATE THE
TRANSITION OF THE INNOVATIVE
LONG ACTING LOW-RELEASE
TECHNOLOGIES, FROM R&D TO IND.
NEXT PLEASE.
IN THIS FIGURE YOU SEE THE
OVERALL PROGRAM FROM LONG ACTING
RELEASE DEVELOPMENT TO CLINICAL
TRIALS, AND IN YELLOW THE AT
LAST PROGRAM INTENDED TO FIT, IN
THE MIDDLE IT'S A TRANSITION
FROM THOSE DEVELOPMENT TO TRIAL.
THE PROGRAM INITIATIVES AND
RESOURCES ARE BEING PROVIDED TO
OVERCOME THIS TRANSLATIONAL GAP,
AND FACILITATE ADVANCEMENT OF
THESE INNOVATIVE TECHNOLOGIES.
THE PURPOSE IS TO SUPPORT AND
ULTIMATELY ENABLE SUBMISSION OF
A NEW INVESTIGATIONAL DRUG TO
THE FDA, THE FIRST PHASE WOULD
SUPPORT RESEARCH THAT
DEMONSTRATED SIGNIFICANT
PRELIMINARY DATA THAT HASN'T
ADVANCED TO THE LEVEL OF
CLINICAL TRANSLATION.
AND THE SECOND PHASE WOULD
SUPPORT RESEARCH THAT'S IN THE
FINAL STAGE OF PRE-CLINICAL
DEVELOPMENT WITH POTENTIAL FOR
IND SUBMISSION.
LAST, THE VQ ARKS VIRAL QUALITY
ASSURANCE PROGRAM, VQA, TO
PROVIDE A COMPREHENSIVE QUALITY
ASSESSMENT PROGRAM FOR DAIDS
LABS PERFORMING VIROLOGYOLOGIC
ASSAYS IN SUPPORT OF
NIAID-SPONSORED MULTI-SITE
CLINICAL STUDIES.
NEXT PLEASE.
THE VQA PROGRAM WAS ESTABLISHED
IN 1988, PROVIDES QUALITY
ASSURANCE AND PROFICIENCY
TESTING FOR VIROLOGIC-BASED
ASSAYS FOR HIV AND OTHER
PATHOGENS, CONDUCTED AT
NIAID-SUPPORTED LABS.
AND IT'S REALLY CONSIDERED
CRITICAL TO THE SCIENTIFIC
INTEGRITY OF ONGOING AND FUTURE
NIAID-FUNDED STUDIES.
THOSE ARE THE SEVEN CONCEPTS
APPROVED AND REVIEWED.
THE NEXT COUNCIL ARAC MEETING IS
SEPTEMBER 9.
I WANT TO REMIND EVERYBODY THAT
OUR MEETINGS ARE RECORDED,
PUBLICLY POSTED ON THE NIH
VIDEOCAST WEBSITE.
THANK YOU VERY MUCH FOR ALLOWING
ME TO REPORT BACK.
>> THANK YOU, DR. ABRAMS.
NEXT UPDATE WILL BE FROM MISS
CORETTÉ BYRD WITH INFORMATION
FROM THE NIH AIDS EXECUTIVE
COMMITTEE.
YOU HAVE THE FLOOR, MISS BYRD.
>> GOOD AFTERNOON.
HAPPY FIRST DAY OF SUMMER.
TODAY I WILL PROVIDE A BRIEF
OVERVIEW OF A FEW OTHER RECENTLY
CLEARED HIV CONCEPTS, AND
REISSUED CONCEPTS AS WELL AS
SCIENTIFIC ADVANCES FROM OUR
PARTNER INSTITUTES, CENTERS,
OFFICES AT NIH SINCE OUR LAST
MEETING IN FEBRUARY.
THIS IS A SUMMARY OF ALL NEW AND
REISSUED CLEARED CONCEPTS FOR
MARCH THROUGH END OF THIS MONTH.
AS YOU CAN SEE THERE ARE SEVEN
NEW AND TWO REISSUED CONCEPTS.
TOTAL OF NINE FOR THIS PERIOD.
NATIONAL CANCER INSTITUTE HAS
TWO NEW CONCEPTS, NATIONAL
INSTITUTE OF ALCOHOL ABUSE AND
ALCOHOLISM HAS ONE NEW CLEARED
CONCEPT.
NCI THE FIRST CONCEPT SOCIAL
DETERMINANTS OF HEALTH AND
QUALITY OF CARE CONTRIBUTORS TO
CANCER DISPARITIES IN PEOPLE
WITH HIV, AIMS TO INCREASE NCI
RESEARCH PORTFOLIO,
INVESTIGATING CANCER DISPARITIES
IN PEOPLE WITH HIV.
AND ADVANCE UNDERSTANDING OF
WHICH SOCIAL DETERMINANTS OF
HEALTH ARE IMPORTANT AND HOW
THEY INTERSECT WITH CANCER CARE,
INEQUALITY, TO CONTRIBUTE TO
DISPARITIES IN PEOPLE WITH HIV
AND CANCER.
EXPECTATION THE RESEARCH MAY
INFORM FUTURE INTERVENTIONS.
THE CONFLUENCE OF CANCER AND HIV
STIGMA IN HIV-POSITIVE
INDIVIDUALS DIAGNOSED WITH
CANCER AIMS TO INFLUENCE AMONG
PEOPLE WITH HIV DIAGNOSED WITH
CANCER.
ASSESS IMPACT OF THESE TWO
CONVERGING STIGMAS ON CANCER
OUTCOMES AMONG PEOPLE WITH HIV,
WITH CANCER, SUPPORT
EXPERIMENTAL MEDICINE APPROACHES
THAT LEVERAGE STIGMA REDUCTION,
TO ELUCIDATE MECHANISMS OF
STIGMA CONTRIBUTING TO NEGATIVE
OUTCOMES AND PROMOTE RESEARCH,
FOCUS ON REGIONS IN WHICH HIV
CANCER BURDEN IS ELEVATED.
THE ALCOHOL-HIV/AIDS PROGRAM
PROJECT COMORBIDITIES,
CO-INFECTIONS, COMPLICATIONS
RESEARCH, INTERVENTION AND
CROSS-CUTTING FOUNDATIONAL
RESEARCH WILL SOLICIT
APPLICATIONS FOR HUMAN STUDIES
THAT WILL ADVANCE OPERATIONS OR
IMPLEMENTATION RESEARCH IN THE
CONTEXT OF ALCOHOL AND HIV/AIDS
BY FACILITATING DEVELOPMENT OF A
BROADER SYSTEMS APPROACH FOR
MONITORING COMPLEX HIV AND
ALCOHOL-RELATED MORBIDITY AND
MORTALITY.
AS WELL AS INTERVENTION TO
REDUCE IMPACT OF ALCOHOL ON HIV
DISEASE PROGRESSION AND
TRANSMISSION.
RESEARCH FUNDED UNDER THIS
ANNOUNCEMENT WILL SERVE AS
FOUNDATION FOR NEXT GENERATION
OF INTERVENTION STUDIES, TO
ADDRESS ALCOHOL USE FROM
TRANSMISSION TO TREATMENT OF
HIV.
LISTED ARE THE FOUR NEWLY
CLEARED CONCEPTS FROM NATIONAL
INSTITUTE ON DRUG ABUSE.
THE FIRST FUNDAMENTAL RESEARCH
INTO MECHANISMS THAT CONTRIBUTE
TO HIV-ASSOCIATED PAIN IN THE
CONTEXT OF SUBSTANCE USE
DISORDER IS NOTICE OF FUNDING
OPPORTUNITY THAT SUPPORTS BASIC
RESEARCH INTO MECHANISMS OF
PAIN, MODIFICATION OF PAIN AS A
CHRONIC CONDITION IN THE CONTEXT
OF HIV INFECTION.
WITH SPECIAL EMPHASIS ON
IDENTIFICATION OF TARGETS FOR
THERAPEUTIC INTERVENTION TO
REDUCE RISK OF ANALGESIC
MEDICATION ESCALATION AND
TOLERANCE UNDER LONG-TERM USE.
THE SECOND CONCEPT IN VIVO
RESEARCH ON EFFECTS OF
METHAMPHETAMINE USE ON HIV
INFECTION, EXPRESSION, AND
PERSISTENCE, PROMOTES RESEARCH
INTO THE COMPLEX INTERACTIONS
BETWEEN METH USE AND HIV DISEASE
BIOLOGY IN VIVO.
THIS INITIATIVE SUPPORTS METH
RELEVANT MECHANISTIC STUDIES
CONNECTING RESEARCH OUTCOMES
WITH IN VIVO MODELS OF HIV IN
CLINICAL STUDIES, IN PEOPLE WITH
HIV ACROSS THE HUMAN LIFESPAN.
CLINICAL RESEARCH ON
HIV-ASSOCIATED PAIN IN THE
CONTEXT OF SUBSTANCE USE
DISORDERS SEEKS TO UNDERSTAND
MECHANISM AND FACTORS ASSOCIATED
WITH PAIN IN PEOPLE WITH HIV AND
SUBSTANCE USE DISORDER.
EVEN FURTHER, THIS OPPORTUNITY
SEEKS TO LEARN MORE ABOUT SAFE
AND EFFECTIVE TREATMENTS WITH
THIS POPULATION.
AND LASTLY, EFFECTS OF HIV ON
DRUG-SEEKING AND IMPULSIVE
BEHAVIOR, EFFECTS ON
DRUG-SEEKING BEHAVIOR AND
IMPULSIVITY ON INFECTION.
REISSUANCE BOTH NATIONAL HEART,
LUNG AND BLOOD INSTITUTE AND
NATIONAL INSTITUTE OF CHILD
HEALTH DEVELOPMENT HAVE ONE,
RENEWAL OF MACS/WIHS COHORT
STUDY FOR SEVEN YEARS VIA
COOPERATIVE AGREEMENT MECHANISM,
KEY AREAS OF SCIENCE WILL BE
EXPANDED IN RESPONSE TO BOTH
EVOLVING HIV KNOWLEDGE BASE AND
AGING OF THE COHORT.
NICHD EARLY IMMUNE SYSTEM
DEVELOPMENT AND ONTOGENY WILL
FOCUS ON UNDERSTANDING THE
DEVELOPMENT OF ADAPTIVE IMMUNE
SYSTEM AND HOW IMMUNE FACTORS
ARE MODULATED BY HIV AND
EXPOSURE TO HIV AND
ANTIRETROVIRALS.
WE'VE RECEIVED NOTIFICATION OF
23 ADVANCES PUBLICATIONS, I'M
NOT GOING OVER EACH BUT I WANT
TO JUST PROVIDE A SNAPSHOT OF A
FEW OF THOSE PUBLICATIONS ON
THIS SLIDE AND ON THE NEXT
SLIDE.
YOU ALL WERE PROVIDED MORE
INFORMATION ABOUT THESE
PUBLICATIONS IN YOUR BRIEFING
MATERIALS FOR YOU TO READ AT
YOUR LEISURE.
AND WITH THAT I THANK YOU FOR
YOUR TIME AND I WILL TURN IT
BACK OVER TO DR. TURNBULL.
>> THANK YOU.
FINAL UPDATE FOR TODAY WILL COME
FROM THE HIV CLINICAL GUIDELINES
WORKING GROUP OF OARAC.
INCLUDING GUIDELINES AND PANEL
UPDATES.
DR. NAHIDA CHVMENTRAKHTOURA WILL
PROVIDE AN UPDATE ON THE
GUIDELINES.
OVER TO YOU.
>> THANK YOU.
I'M PRESENTING ON BEHALF OF DR.
HASRA, THE EXECUTIVE SECRETARY
FOR PEDIATRIC GUIDELINES.
THANK YOU.
NEXT SLIDE PLEASE.
THESE GUIDELINES WILL BE UPDATED
THIS MONTH, SECTION UPDATES ARE
BEING FINALIZED AND SHOULD BE
LIVE IN A COUPLE OF WEEKS.
NEXT SLIDE PLEASE.
SO, WE PRESENTED PERINATAL
GUIDELINES AT LAST OARAC, THERE
WERE THREE SECTIONS DEVELOPED IN
COLLABORATION WITH THE PEDIATRIC
PANEL, AND THOSE WILL BE PLANNED
TO BE PUBLISHED IN THIS CYCLE SO
INFANT FEEDING FOR INDIVIDUALS
WITH HIV DIAGNOSIS OF HIV
INFECTION AND INFANTS AND
CHILDREN AND THEN THE
ANTIRETROVIRAL MANAGEMENT WITH
PERINATAL HIV EXPOSURE WILL BE
UPDATED IN THIS UPCOMING CYCLE.
NEXT SLIDE.
AND THEY WELCOMED SEVERAL NEW
MEMBERS IN THIS CYCLE, DR. AZIZ
FROM RUSH UNIVERSITY, DR.
DIRAJILAL-FARGO FROM LURIE AND
DR. GRIFFITH FROM JOHNS HOPKINS
UNIVERSITY, DR. ANDERSON FROM
UNIVERSITY OF COLORADO, DR.
ETHEL WELD, FROM JOHNS HOPKINS.
AND DR. BYRD FROM CDC
REPRESENTING THE ADULT AND
PEDIATRIC INFECTIOUS DISEASE.
AND THEY HAVE SEVERAL RETIRING
OR MEMBERS WHO RESIGNED,
INDIVIDUALS THAT WERE SELECTED
WERE REPLACING SPECIALISTS THAT
HAD EITHER RESIGNED OR AGAIN
RETIRED FOR THE 2023 CYCLE.
SPECIFIC GUIDELINES, SECTIONS
THAT WILL BE REVISED THROUGHOUT
GUIDELINES TO INCORPORATE
UPDATED TEXT AND REFERENCES FOR
CLINICAL LABORATORY MONITORING
OF PEDIATRIC INFECTIONS UPDATED
UPDATES TO ADDRESS RECOMMENDED
BASELINE SCREENING TESTS FOR
CO-INFECTION AND OPPORTUNISTIC
INFECTIONS.
AND NEW DATA REAFFIRMED
ADDITIONAL EVIDENCE TO SUPPORT
NEURODEVELOPMENTAL AND IMMUNE
BENEFITS ASSOCIATED WITH EARLY
INITIATION OF ART.
THAT WILL BE HIGHLIGHTED.
NEXT SLIDE.
WHAT TO START SECTION WAS
RECOMMENDATIONS FOR INITIAL ART
PRESENTED, NOW DISCUSSED BY AGE
GROUP SO BIRTH TO LESS THAN 30
DAYS, 30 DAYS UP TO 2 YEARS, 2
YEARS AND ABOVE TO 12 YEARS, AND
12 YEARS AND ABOVE RATHER THAN
BY ARV DRUG CLASS SO THEY ADDED
A CONTENT ADDRESSING PRACTICAL
CONSIDERATIONS IN THE DRUG
REGIMEN SELECTION AND
IMPLEMENTATION FOR INITIAL ART,
NEW TABLES TO SUMMARIZE FACTORS
TO CONSIDER IN REGIMEN
SELECTION, AND ADVANTAGES AND
DISADVANTAGES OF REGIMENS
RECOMMENDED FOR INFANTS FROM
BIRTH TO LESS THAN 30 DAYS OF
AGE.
ALSO UPDATES TO REFERRED AND
ALTERNATIVE ART REGIMENS AND
ARVs THAT WERE SUMMARIZED AND
UPDATED IN THE VARIOUS TABLES,
TABLE 8, TABLE B.
NEXT WERE PANEL RECOMMENDED
RECOMMENDATION AROUND
BICTEGRAVIR IN INFANTS AND
CHILDREN AGED 30 DAYS AND ABOVE
AND WEIGHING ABOVE 3 KILOGRAMS
OR ABOVE WHENEVER POSSIBLE.
CHANGES TO ABACAVIR FOR INFANTS
LESS THAN 30 DAYS TO AVOID
DELAYS WITH HLA TESTING PRIOR TO
USE.
NEXT SLIDE.
UPDATES WERE INCLUDED FOR
ADHERENCE TO ANTIRETROVIRAL
THERAPY, PANEL RECOMMENDS
DISCUSSING OPTION OF LONG ACTING
INJECTABLE THERAPY TO SUPPORT
ADHERENCE WITH ELIGIBLE PATIENTS
AND CAREGIVERS.
MANAGEMENT OF CHILDREN RECEIVING
ART TO INCORPORATE IN LINE WITH
APPROVAL AND RECOMMENDATION, AND
PANEL RECOMMENDATIONS HAVE BEEN
UPDATED TO UNDERSCORE THAT
TREATMENT INTERRUPTION IS NOT
RECOMMENDED AS STRATEGY TO
CONFIRM DIAGNOSIS AND/OR ASSESS
REEMISSION OR CURE IN CLINICAL
SETTINGS AND CONTENT ABOUT
MITIGATING UNPLANNED
INTERRUPTION TO TREATMENT,
THAT'S BEEN EXPANDED.
AND PEDIATRIC DRUG SESSION FIXED
DOSE SECTION HAS NOW FDA
APPROVAL DOSING FOR INFANTS, AND
CHILDREN AGE 3 MONTHS AND ABOVE,
AND WEIGHING 6 KILOGRAMS OR
ABOVE TO LESS THAN 25 KILOGRAMS,
FDC D TY/LAMIVUDINE IS NOW
APPROVED, 25 KILOGRAMS OR ABOVE.
AND THEN THE ORAL SOLUTION NO
LONGER AVAILABLE SO
100-MILLIGRAM PACKETS ARE
AVAILABLE FOR CHILDREN NOT ABLE
TO SWALLOW PILLS AND VARIOUS
DOSING ADJUSTED.
THIS MAY BE THE LAST SLIDE.
YES.
THANK YOU VERY MUCH.
I'M HAPPY TO TAKE QUESTIONS BUT
ALSO HAPPY THAT DR. ELAINE
ABRAMS WHO IS ON THE PERINATAL
COMMITTEE CAN ANSWER QUESTIONS
RELATED TO PEDIATRIC AND NOT
PERINATAL.
THANK YOU.
AND ANYTHING TO ADD, ELAINE,
THAT I MAY HAVE MISSED?
THANK YOU.
BACK TO YOU IF THERE ARE NO
QUESTIONS, DR. TURNBULL.
>> THANK YOU SO MUCH.
AS WE BEGIN TO CLOSE, REMINDER
THAT THIS HAS BEEN -- THIS TIME
HAS BEEN ALLOTTED FOR PUBLIC
COMMENT.
DR. GLENSHAW, HAVE YOU RECEIVED
ANY COMMENTS FOR TODAY'S
MEETING?
>> YES, I HAVE TWO.
>> OKAY.
>> IF YOU COULD PUT THE FIRST
ONE ON THE SCREEN.
THIS WAS RECEIVED FROM THE WELL
PROJECT, FOR TODAY'S MEETING.
WE WILL SHOW IT ON THE SCREEN
BUT ALSO READ IT OUT LOUD.
FROM THE WELL PROJECT, TODAY,
JUNE 20, 2024.
THE WELL PROJECT IS A NON-PROFIT
ORGANIZATION WHOSE MISSION IS TO
CHANGE THE COURSE OF THE HEARING
AIDS PANDEMIC THROUGH A UNIQUE
AND COMPREHENSIVE FOCUS ON WOMEN
AND GIRLS ACROSS THE GENDER
SPECTRUM.
THE WELL PROJECT ENVISIONS A
WORLD IN WHICH WOMEN HAVE THE
INFORMATION, SUPPORT, TOOLS THEY
NEED TO ADVOCATE FOR THEIR
HEALTH AND WELL-BEING AND TO
LIVE FREE FROM STIGMA.
WE UNAPOLL JET REALLY FOCUS ON
THE UNIQUE INTERSECTIONAL NEEDS
OF WOMEN ACROSS THE GENDER
SPECTRUM LIVING WITH AND
VULNERABLE TO HIV, CENTERING
BLACK WOMEN AND OTHER WOMEN OF
COLOR.
OUR HIGHLY RESPONSIVE
PROGRAMMING AIMS TO IMPROVE
AGENCY, HEALTH, AND WELLNESS
AMONG WOMEN LIVING WITH AND
VULNERABLE TO HIV BY ADVANCING
WOMEN-SPECIFIC HIV EDUCATION,
SUPPORT, RESEARCH, AND POLICY;
AND ADDRESS THE MOST URGENT GAPS
IDENTIFIED BY OUR DIVERTS
COMMUNITY OF STAKEHOLDERS.
WHILE WE ADDRESS ISSUES WITH
HIV, WE'VE HIGHLIGHTED SEVERAL
PRIORITIES.
FIRST ENSURE THAT WOMEN AND
OTHER BIRTHING PARENTS LIVING
WITH HIV CAN EXPERIENCE THEIR
FUNDAMENTAL RIGHTS TO MAKE
INFORMED, SUPPORTED, UNCOERCED
INFANT-FEEDING DECISIONS.
DOING SO WILL REQUIRE RESEARCH
TO ADDRESS KNOWLEDGE GAPS AND
DISSEMINATION OF EVIDENCE-BASED
INFORMATION TO BOTH PARENTS
LIVING WITH HIV AND HEALTHCARE
PROVIDERS THAT AFFIRMS SHARED
DECISION-MAKING AND BODILY
AUTONOMY AND ADDRESSES RECENT
GUIDELINE UPDATES.
SECOND, INTEGRATE SEXUAL AND
REPRODUCTIVE HEALTH INCLUDING
SEX POSITIVITY AND PLEASURE,
INTO WOMEN-FOLKED HIV CARE,
PREVENTION, EDUCATION EFFORTS.
THIS APPROACH TO WOMEN'S OVERALL
WELLNESS SHOULD BE HOLISTIC,
ADDRESSING BIOMEDICAL,
BEHAVIORAL, SOCIAL AS
SECRETARIES OF HEALTH, AND SHIFT
THE LANGUAGE OF RISK AROUND
VULNERABLE TO HIV TO A FRAMEWORK
THAT PRIORITIZES AGENCY.
THIRD, ADDRESS GAPS IN RESEARCH,
PROGRAMMING, AND CARE FOR WOMEN
AGING WITH HIV ACROSS THE
LIFESPAN, INCLUDING LIFETIME
SURVIVORS, WOMEN WHO ACQUIRED
HIV AT BIRTH OR IN INFANCY.
THIS AGENDA SHOULD INCLUDE
RESEARCH ON EFFECT IT'S OF
LONG-TERM HIV TREATMENT ON
ACCELERATED AGING AMONG WOMEN
AND PRIOR TIDES UNIQUE MENTAL
HEALTH NEEDS OF OLDER WOMEN AND
LIFETIME SURVIVORS.
FOURTH, ATTEND TO THE
BIOMEDICAL, BEHAVIORAL, AND
SOCIAL ASPECTS OF HIV IN WOMEN'S
LIVES THROUGH RESEARCH.
PARTNER WITH COMMUNITY TO ENSURE
TRULY MEANINGFUL AND EQUITABLE
ENGAGEMENT OF ALL RELEVANT
POPULATIONS OF WOMEN IN HIV
RESEARCH INCLUDING BLACK WOMEN
AND OTHER WOMEN OF COLOR, WOMEN
AND OTHER BIRTHING PARENTS WHO
ARE PREGNANT OR LACTATING, WOMEN
OF TRANS EXPERIENCE, LIFE
SOMETIME TIME SURVIVORS, WOMEN
WHO USE DRUGS, AND SEX WORKERS.
IN CLOSING THEY STATE ENSURING
THAT HIV AGENDA ADDRESSES NEEDS
OF WOMEN LIVING WITH AND
VULNERABLE TO HIV REQUIRES
CONCERTED PARTNERSHIPS THAT
CENTER THE LIVES AND EXPERIENCES
OF DIVERSE POPULATIONS OF WOMEN
ACROSS ALL HIV STAKEHOLDERS.
THE SECOND PUBLIC COMMENT IS
FROM A PROFESSOR AT THE STATE
UNIVERSITY COLLEGE OF NEW YORK
AT BUFFALO.
AND SHE STATES, TODAY'S OARAC
MEETING HAD INSITES THAT ARE
AVAILABLE ESPECIALLY PRIORITIES
OF OAR.
OUR COMMITMENT IS COMMENDABLE.
SHE REFERENCES WHERE SHE AND I
MET, AT THE HIV PREVENTION --
MEDICAL PREVENTION SUMMIT
RECENTLY IN SEATTLE, AND SHE
STATES AFRICAN AMERICAN
IMMIGRANTS OFTEN FACE UNIQUE
CHALLENGES AND BARRIERS IN
ACCESSING HIV PREVENTION AND
CARE SERVICES, THESE CAN INCLUDE
CULTURAL STIGMA, LANGUAGE
DIFFERENCE, LIMITED ACCESS TO
HEALTH CARE RESOURCES.
AS WE CONTINUE DISCUSSIONS IT IS
CRUCIAL TO INCLUDE AFRICAN
AMERICAN IMMIGRANTS IN THE
CONVERSATION TO ENSURE --
AFRICAN IMMIGRANTS IN THE
CONVERSATION.
THEY ARE DEVELOPING STRATEGIES
TO INCREASE HIV TESTING AND
PrEP AMONG UNDERREPRESENTED
POPULATIONS, PARTICULARLY
AFRICAN IMMIGRANTS, PRELIMINARY
FINDINGS INDICATE WILLINGNESS TO
ADOPT PrEP FOR HIV PREVENTION.
AND I BELIEVE THAT CONCLUDES ALL
OF THE PUBLIC COMMENTS.
THANK YOU.
>> I THANK YOU, DR. GLENSHAW.
I THINK WE'RE NOW TO THE PORTION
TO TALK ABOUT THE OARAC MEMBERS
TO RETURN THEIR CONFLICT OF
INTEREST FORMS.
DO YOU WANT TO TAKE THAT?
>> SURE, YES.
THANK YOU.
FOR VOTING MEMBERS KINDLY CHECK
YOUR E-MAIL AND PLEASE SIGN AND
RETURN THE FORMS THAT WE SENT
YOU TODAY.
>> OUR NEXT OARAC MEETING PLEASE
NOTE IS SCHEDULED FOR OCTOBER
24, 2024.
>> IT WILL BE A VIRTUAL MEETING
AT THIS POINT.
>> IF YOU COULD GIVE US A
CLOSING STATEMENT WE CAN
CONCLUDE TODAY'S MEETING.
>> SO, I WANTED TO END BY
THANKING ALL OF THE SPEAKERS SO
MUCH.
REALLY, WHAT A WONDERFUL SET OF
PRESENTATIONS.
AND ON ALL TOPICS.
SO VERY HEARTFELT THANK YOU TO
ALL OF THE SPEAKERS AND ALSO TO
DR. IVY TURNBULL.
THANK YOU FOR YOUR WORK AS CHAIR
PERSON ON THIS COMMITTEE.
WE LOOK FORWARD TO -- THANK YOU
ALSO TO MARY FOR YOUR WORK ON
THIS.
SO, TAKE CARE, EVERYONE.
AGAIN, THANK YOU ALL SO MUCH.
WE LOOK FORWARD TO SEEING YOU
AGAIN AT THE NEXT MEETING IN
OCTOBER.
>> THANK YOU, EVERYONE.
THANK YOU ALSO FOR THE KIND
WORDS, DR. FINZI'S.
TODAY'S MEETING IS NOW
ADJOURNED.
THANK YOU ALL FOR ATTENDING.