Moving HIV Science into Policy and Practice: IAS Conference on HIV Science

Between July 18 and 21, the Office of AIDS Research (OAR) participated in the 11th International AIDS Society (IAS) Conference on HIV Science (IAS 2021). Conducted in alternate years, the conference features cutting-edge basic, clinical, and operational HIV/AIDS research. Although it was virtual, this year’s conference was a big success.

Major conference themes included long acting pre-exposure prophylaxis (PrEP) regimens and HIV vaccine development for HIV prevention; characterization of the viral reservoir to achieve an HIV cure; and HIV treatment approaches using broadly neutralizing antibodies and gene-editing. The conference highlighted the importance of a holistic HIV treatment and patient-centered care; the impact of social determinants of health, stigma, and discrimination; the effect of aging on HIV outcomes; and the HIV/AIDS risk of underserved communities in the United States and around the world.

NIH’s participation was robust and stimulated critical conversations on lessons learned from the HIV and COVID-19 pandemics that can be used to sustain investment in HIV research and meet targets during uncertain COVID times.

• Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), spoke at the Opening Session about the concurrent HIV and COVID-19 pandemics, and how the mRNA HIV vaccine platform was quickly adapted to develop the COVID-19 vaccine.
• The NIH was central in the IAS 2021 HIV Cure & Gene Therapy Forum, a joint effort with the National Institute of Mental Health (NIMH), and the Basic Sciences Program in the NIAID Division of AIDS. NIH Director Dr. Francis Collins participated in the Forum and contributed his expertise on gene-based therapy for HIV and other health conditions.
• NIH OAR and NIMH senior science staff and researchers representing six study teams supported through NIMH and NIAID presented their work at a symposium where they highlighted methods and measurements in social determinants of health that are crucial for HIV control. They stressed the importance of integration of social theories, innovative research designs and measurement, and community engagement.
• The symposium NIH Center Research Partnerships: Implementation Science to End the HIV Epidemic in the United States outlined activities by the NIH-funded Implementation Science Coordination, Consultation, and Collaboration Initiative (ISC3I) during the first year and a half of the Ending the HIV Epidemic in the U.S. (EHE) initiative. These projects used implementation science to evaluate evidence-based HIV interventions that increase equitable delivery among historically underserved populations.
• Conference attendees agreed that new technologies are essential to define the composition and dynamics of viral reservoirs, and to continue developing gene-editing techniques that focus on genomic targets that might be used to cure HIV using gene therapy. This last therapeutic approach may come with a high price tag, but creative strategies might allow the deployment of new therapies in areas with the greatest need.

On Friday, July 30, the Center for Strategic and International Studies (CSIS) hosted a panel discussion titled Reflections on the 2021 IAS Conference on HIV Science. The conversation was moderated by J. Stephen Morrison, Senior Vice President and Director of the CSIS Global Health Policy, and Dr. Jennifer Kates, Senior Vice President and Director of Global Health & HIV Policy at the Kaiser Family Foundation. I was pleased to participate on the panel with distinguished colleagues Dr. Chris Beyrer, Desmond M. Tutu Professor in Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health, and Dr. Adeeba Kamarulzaman, IAS President and Dean of the Faculty of Medicine and Professor of Medicine and Infectious Diseases at the University of Malaya in Kuala Lumpur.

Panelists summarized the impact of COVID-19 on HIV outcomes: Basic and clinical research for HIV and other diseases had to be put on hold during the COVID surge to protect laboratory personnel, leverage laboratory resources toward coronavirus testing, and develop and produce a massive number of doses of COVID vaccines. The COVID-19 pandemic underscored staggering global and national health disparities, a problem well known to the HIV community.

Conference reports from around the world brought some relief. Countries and communities pivoted existing human and material HIV resources in two critical directions: to support COVID-19 efforts and to maintain critical support to individuals who needed PrEP, HIV diagnosis, and to continue established HIV treatment protocols during the COVID lockdown. Overall, the UNAIDS HIV targets for 2020 were not met.

Looking into the future, there are many unknowns. Support to international HIV programs has been steady for the past few decades. However, it is reasonable to wonder how the current global economic crisis and supply chain bottlenecks experienced during the COVID-19 pandemic will impact the ability of some countries to support their national HIV programs.

The NIH OAR will continue to do its part to support the substantial and ongoing commitment of the U.S. federal government to reach HIV epidemic control worldwide through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and domestically through the EHE initiative.

To learn more, I encourage you to watch the video of the CSIS event mentioned above and—beginning mid-September, when content will be available to the public—visit the IAS website.

Maureen M. Goodenow, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health