On Tuesday, June 14 and Wednesday, June 15, I had the opportunity to attend The HIV Prevention Trials Network 2016 Annual Meeting in Arlington, VA. The HIV Prevention Trials Network (HPTN) is a worldwide collaborative clinical trials network that brings together investigators, ethicists, community and other partners to develop and test the safety and efficacy of interventions designed to prevent the acquisition and transmission of HIV. I attended a number of plenary sessions that brought the research, challenges, and risks that surround preventing and treating HIV to my immediate attention. The first plenary session that I attended was a modelling plenary moderated by Dr. Deborah Donnell. Dr. Donnell is a principal investigator of the Statistical and Data Management Center for the HPTN. She also oversees statistical design and analysis as well as data management operations of the Statistical Center for HIV/AIDS Research and Prevention. She is also a Principal Staff Scientist in the Vaccine and Infectious Disease Division, Fred Hutchison Cancer Research Center and an affiliate associate professor at the University of Washington in the Department of Global Health. Overall, I enjoyed this session because it provided me with an understanding of how studies are designed and conducted in order to estimate the impact of interventions and how populations at risk are affected.

Dr. Marie-Claude Boily introduced the HPTN Modelling Centre, which is a collaborative effort between the HIV Trials Prevention Network and the Imperial College London.  Dr. Boily also informed the audience of the steps taken to analyze clinical trials from a mathematical point of view using different scenarios. When designing the clinical trial, the investigator must first calculate the expected size of the study based on HIV incidence of the population where the intervention will be tested. During the clinical trial, it is necessary to test the efficacy of the intervention. Lastly, it is critical to inform public health decisions that need to be made regarding next steps to take based upon the results of the trial. I enjoyed Dr. Boily’s discussion because it provided me with a broader view of how these HIV clinical trials must be conducted in the most effective and efficient way. I was also able to better understand the specific clinical trials that were discussed later on throughout the sessions that preceded hers.

The next presentation was from Dr. Kate Mitchell and she discussed Modelling HIV Transmission and Treatment for US Men Who Have Sex with Men (MSM) to Estimate the Impact of HPTN 078 on HIV Incidence. HPTN 078 is a protocol number for research study that is called Enhancing Recruitment, Linkage to Care and Treatment for HIV-Infected MSM In the United States. I thought her presentation was interesting because it addressed the need to target at risk populations such as African American MSM because there is a higher HIV prevalence within that population, compared to Caucasian MSM. I also appreciated that the research that Dr. Mitchell conducted had a plan and an expected outcome that was clearly laid out.  The purpose of this study was to “develop and assess the efficacy of an integrated strategy that includes feasible and scalable interventions to identify, recruit, link to care, retain in care, attain, and maintain viral suppression among HIV-infected men who have sex with men (MSM) in the U.S. “ In Dr. Mitchell’s initial analysis, the question she sought to answer was what level of viral suppression must be achieved in order to reduce HIV incidence among Baltimore MSM by 20% in 5-10 years?

This is the chart that she displayed and according to the results, over 40% of the viral load must be suppressed in order to reduce HIV incidence by 20% in Baltimore MSM. This model provided a glimpse of the work that needs to be done in order to get a step closer to eradicating HIV. Dr. Mitchell also addressed what the next steps are in this study which includes estimating how much individual intervention components- HIV testing, linkage to care, ART initiation and retention in care- need to increase in order to achieve this reduction in HIV incidence. Also, estimating the predicted impact upon HIV incidence of meeting UNAIDS and CDC targets for diagnosis, treatment and viral suppression will be important.

On Wednesday, June 17^th, one particular part of the plenary was led by Dr. Linda-Gail Bekker, who discussed HIV-Positive Adolescents and Issues of Disclosure of HIV Status to Sexual Partners. I was very interested in hearing about how disclosure affects the HIV epidemic. Those that are HIV + may not feel comfortable disclosing their status out of fear that they will be rejected by their loved ones and communities. There is a huge stigma surrounding HIV infection and it is difficult to talk about. However, these barriers must be broken down in order to adequately address the issue at hand. This is exactly what Dr. Linda-Gail emphasized in her discussion as well as the importance of supporting those who may be in need of help with disclosing their status. Some of the benefits of disclosure include having better relationships,  people are more likely to get ART, gives a boost of self-esteem and increases the feeling of cohesion and support. People who are HIV+ are more likely to receive the treatment, care and support that they need by speaking up, however, it is also a matter of making these people feel safe with disclosing their status. This plenary session helped me become more aware of the needs of the HIV+ population and the risks and challenges that come along with their personal lives.

In closing, I truly enjoyed attending the HPTN Annual Meeting. HPTN is doing some amazing work regarding the treatment and prevention of HIV in populations across the globe. Having the opportunity to hear from so many experts about the strategies of treating and eradicating HIV in the near future was an opportunity of a lifetime. Interning at the Forum has provided me with the opportunity to be exposed to top of the line research on HIV Prevention. I hope to continue to attend meetings similar to this one because I believe it will help me grow and advance as a public health professional in the future.