Scientific Program

Day 1

KEYNOTE SPEAKERS
  • Matrix protein gene variants of two serotypes of vesicular stomatitis virus are ideal viral vectors for prime-boost therapeutic HIV vaccines

    The University of Western Ontario
    Canada
    Biography

    Dr. Chil-Yong (Yong) Kang, PhD, DSc, FRSC, is a molecular virologist and Professor of Virology in the Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry at the University of Western Ontario in Canada (1992-Present). He carried out his postgraduate studies at McMaster University where he received a Ph.D. in virology under the supervision of Professor Ludvik Prevec (1968-1971) and his postdoctoral training under Professor Howard Temin at the University of Wisconsin-Madison (1971-1974). Dr. Kang went on to serve as a Professor of Virology in the Department of Microbiology at the University of Texas, Southwestern Medical School in Dallas, Texas (1974-1982), Professor and Chairman of the Department of Microbiology and Immunology at the University of Ottawa, Faculty of Medicine (1982-1992), and Dean of Science at the University of Western Ontario (1992-1999). Dr. Kang has received numerous prizes such as the Award of Excellence of the University of Ottawa (1991), Gold Medal for Ilchun Lecture (1998), Ho-Am Prize in Medicine (1999), the Order of Korea in Science and Technology (2002), the McMaster University Distinguished Alumni Award for 2007, the Lifetime Achievement Award from University of Western Ontario (2009), the Queen Elizabeth II Diamond Jubilee Medal (2012), selected as a Korean-Canadian Diaspora to Canadian Society by Canadian Government (2013) and the Scientist of the Year Award from the Korean Federation of Science and Technology (2013). Dr. Kang was elected as a Life-time Fellow of the Royal Society of Canada Academy of Science (1993) and an elected Life-time Member of the Korean Academy of Science and Technology (1997). He continues to serve as a grant selection committee member for various federal granting agencies in Canada and the United States. He is a member of the Board of Directors of numerous research institutions and foundations. Dr. Kang also serves as a reviewer for the Journal of Virology, Journal of Infectious Diseases, Virus Research, Virology, Journal of Biological Chemistry, Journal of Human Virology and Retrovirology, and Canadian Medical Association Journal.

    Abstract

    There have been numerous attempts to develop therapeutic vaccines to clear virus-infected cells by activating viral protein-specific cytotoxic T lymphocytes using many different recombinant viral vectors. The vesicular stomatitis virus (VSV), one of the rhabdoviruses, offers an ideal system for prime-boost vaccine vectors. In order to induce the maximum immune responses, the priming recombinant viral vector should be antigenically distinct from the boosting vector to maximize the boost effect since a priming vaccine vector will induce neutralizing antibodies which will neutralize the boosting vaccine vector should one uses the same vector for the prime-boost vaccinations. Here, we report robust T-cell immune responses and humoral immune responses when two antigenically distinct genetically modified VSV vectors are used for prime-boost immunization. To examine the CD8+ T cell and B cell adaptive immune responses against the proteins expressed from the genetically modified M gene variants of rVSV vectors, we generated rVSVs with HIV-1 gag, env and pol genes. From the various vaccination regimens tested in animals, priming with rVSVInd(GML)-gag, rVSVInd(GML)-pol, and rVSVInd(GML)-env followed with rVSVNJ(GMM)-gag, rVSVNJ(GMM)-pol, and rVSVNJ(GMM)-env boosting induced the strongest CD8+ cytotoxic T cell immune responses against the HIV-1 Gag, Pol, and Env proteins. The same vaccination regimen also induced strong humoral immune responses against the HIV-1 Gag protein and Env protein. Increasing vaccine doses up to 109 PFU induced stronger humoral immune responses against the HIV-1 Gag protein and Env protein. Our results demonstrated that rVSVInd(GML) priming following with rVSVNJ(GMM) boosting is the best for optimum adaptive CD8+ T cell as well as humoral immune responses. Our results showed that genetically modified dual serotype VSV vectors with HIV gene inserts are safe and highly efficient in inducing robust adaptive immune responses. This rVSV-HIV vaccine is an excellent candidate as therapeutic vaccine to treat HIV-positive patients.

  • HIV/STI prevention interventions for sex workers in different settings in Singapore: Impact, challenges and lessons learned from two decades of research

    National University of Singapore
    Singapore
    Biography

    Mee-Lian Wong is Associate Professor of Public Health at the NUS Saw Swee Hock School of Public Health, National University of Singapore (NUS). She received her MBBS and MPH from the University of Malaya and her Doctor of Medicine from the National University of Singapore. Her current research interests include health promotion, behavioral change and prevention of sexually-transmitted infections (STIs) and HIV among adolescents, heterosexual men and sex workers in Singapore and Cambodia. She has devoted 24 years to research in the development and evaluation of STI/HIV/AIDS programs and behavioral interventions for sex workers. She has published more than 100 papers on STI/prevention and health promotion. Her research on HIV/STI prevention has earned her many awards, including (i) the Wilf Howe Memorial Prize 2008, Faculty of Occupational Health Physicians, United Kingdom, for outstanding intervention/research project on STI prevention among sex workers with demonstrable health benefits, (ii) Red Ribbon Award, Singapore 2014 for her invaluable research contributions in HIV prevention and control (iii) National Skin Centre (NSC) Distinguished Friend Award 2009, for significant contributions to the Department of STI Control, NSC in translational research in HIV/STI prevention and Control (iv) SEAMEO-JASPER award, second best research on women and health for her research study “Women and Sexually transmitted Diseases: A Sustainable Intervention to Increase Condom Use and Reduce Gonorrhea among Sex Workers in Singapore, 1996 and (v) the Rockefeller Foundation’s (US) Reflections on Development Fellowship award, 1989 for her research on Women in Health and Community Development. She is also visiting consultant to the Department of STI Control, National Skin Center, Singapore. Mee Lian has previously served as Assistant Dean of Preclinical Education at the Yong Loo School of Medicine, National University of Singapore; and Program Director of the National Preventive Medicine Residency Program, Singapore.

    Abstract

    Male patronage of female sex workers has been reported as the main mode of transmission of HIV and Sexually Transmitted Infections (STIs) in Asia. In Singapore, sex workers operate from diverse settings ranging from licensed brothels, to streets and entertainment establishments. A survey of licensed brothel-based sex workers in Singapore in 1992 found that 40% tested positive for STIs. Only 45% used condoms consistently with their clients because they could not persuade them to use condoms. I collaborated with the Department of STI Control (DSC), and we developed an intervention, using behavioral and work environment strategies to get health staff to motivate the sex workers to use condoms, develop their condom negotiation skills and mobilize support from brothel owners for condom use. Evaluation of the intervention, using a quasi-experimental design, showed a statistically significant increase in condom use with a corresponding decline in STIs. The intervention program was scaled up to all brothel-based sex workers in which they were required to attend STIs/HIV talks and skills development sessions on condom use and negotiation at the DSC Clinic. Program activities for brothel management included HIV/STI talks and mandatory display of posters on 100% condom use. Free condoms were given to all clients in the brothels. The program led to a sustained increase in condom use to more than 90% with a corresponding decline in STIs from 40 per 1000 person months to less than 1 per 1000 person-months among the sex workers. In recent years, globalization and wide income disparities across countries in Asia led to an influx of women from the region to work in entertainment establishments in Singapore. Our survey on entertainment establishments in Singapore in 2008 found that 70% of entertainment establishments provided sexual services. Almost all (>90%) of the female entertainment workers came from Asia and some came on short term social visit passes. Condom use with clients was low (<50%) among them. We faced more challenges in designing interventions for this group than for brothel-based workers because of their geographic mobility, illegal and hidden nature of their work, their lack of access to STI/HIV screening and treatment, and the influence of alcohol on condom use. We collaborated with non-governmental organizations and developed outreach peer-led sessions on condom negotiation and alcohol consumption. Free condoms and STI screening were also provided. At 6-week follow-up, the intervention group was more likely than the control group to report consistent condom use with paid partners (75% vs. 42%; adjusted risk ratio [aRR] 1?78; 95% CI: 1?73 – 1?84). There was also a corresponding significant decline in STI incidence (8?2 % vs. 13.5%, p<0.05). Given the heterogeneity of sex work, we need to develop context-specific and culturally appropriate multilevel interventions that address structural and behavioral barriers to condom use. It is crucial to address the social and structural influences on condom use among foreign sex workers in Singapore by working with relevant stakeholders and by using community empowerment strategies.

  • Botswana HIV/AIDS counselor’s perceptions of their role, and Clients’ Perceptions of the counseling experience; results from a programmatic effort.

    Indiana University
    USA
    Biography

    Dr. Rex Stockton is the Class of 1969 Chancellor’s Professor in the Department of Counseling and Educational Psychology, affiliate faculty member in African studies and Research Fellow, Rural Center for AIDS/STD Prevention at Indiana University. He has held a wide variety of academic, administrative and professional responsibilities. For over a decade in collaboration with African colleagues, he has lead a project related to the social emotional aspects of having HIV/AIDS. He has focused on counselor training and research related to the prevention of HIV/AIDS and counselling interventions in Sub-Saharan Africa. Dr. Stockton has received several major research awards for his work. For example, he is a recipient of the American Counseling Association’s Extended Research Award and the Association for Specialists in Group Work Eminent Career Award. Most recently, he received APA’s Division 49, the Arthur Teicher Award. Dr. Stockton is a recipient of the Burton W. Gorman Teaching Award at Indiana University. In addition to his research efforts, Dr. Stockton has conducted many workshops, nationally and internationally. As well as his consulting, instructional and research activities, Dr. Stockton has held numerous offices and committee assignments in professional societies. He is a Fellow of both the American Psychological Association and American Counselling Association and Diplomate of the American Board of Professional Psychology.

    Abstract

    This presentation reports on a study of counselor’s perceptions of HIV/AIDS in Botswana, as well as clients who have received HIV/AIDS counseling. HIV/AIDS has presented one of the greatest global health challenges in recent history. Mental health concerns can exacerbate the progression and transmission of HIV/AIDS. Thus counseling can play an important role in addressing these issues. Due to the hyper-geometric increased of AIDS, countries including Botswana, had been hard-pressed to provide well-trained counselors for AIDS clients. Results of a programmatic effort to examine the utilization of Botswana HIV/AIDS counselors and their perceptions of professional identity, practice and training issues, as well as the perceptions of clients who have received counseling are discussed.

  • HIV Stigmatization in Chinese Media Discourse and Responses from People Living with HIV in China

    Central michigan university
    USA
    Biography

    Ren teaches skills and lecture courses in public relations, including PR principles and practices, PR research methods, PR writing, PR case studies and PR campaigns. He has worked for 10 years in the PR industry, including five years at Weber Shandwick Beijing serving as a senior consultant and later account supervisor for clients with a global presence. His major clients included Pfizer, Bayer Healthcare, Merck, P&G, Norvatis, Nestle, BMS, L’Oreal, IKEA, Electrolux, Intel, Ericsson, Juniper Networks and NVIDIA. His research concentration is health communication and mass media processes and effects. His research has consistently focused on strategic health communication approaches to prevent disease and reduce disease-related stigma, particularly HIV/AIDS stigma.

    Abstract

    Mass media plays a crucial role in influencing people’s perceptions of certain illnesses and diseases, including HIV/AIDS. Despite the positive role media play in reduce stigma, literature also documented that media could reinforce HIV stigma in media discourse. In China, serious HIV stigmatization has been identified in newspaper coverage of HIV/AIDS. We conducted two quantitative content analysis studies to examine Chinese newspaper articles about HIV/AIDS published in each of the eight Chinese news outlets one week before and one week after World AIDS Day every other year from 2000 to 2010. After the two studies, we conducted study three to explore how people living with HIV (PLHIV) in China responded to HIV stigmatization in media discourse. Study one showed that Chinese media play two distinct roles in HIV/AIDS reporting. On one hand, Chinese media played an advocacy role by promoting anti-stigma efforts. Nearly one out of every five of these news stories addressed HIV/AIDS stigma by reporting stigma stories experienced by PLWHA or by promoting anti-stigma efforts. One the other hand, study one showed that nearly one out of every three HIV/AIDS news stories contained either overtly or covertly stigmatizing language. The content of these articles indicate that the Chinese media frame HIV/AIDS in stigmatizing terms, even when they discuss anti-stigma efforts. The journalists’ selection of metaphors, photos, and terminology serves to further demonize the disease rather than disseminating current medical knowledge about the transmission and treatment of the disease. In addition to overtly stigmatizing language, covertly stigmatizing content was present in more than 10% of all articles included in the study. Study two extends previous research by exploring how HIV transmission was portrayed in Chinese media discourse, particularly how the media framed HIV transmission for people living with HIV (PLHIV) and affected groups. The results suggest that Chinese newspaper articles label PLHIV and stereotype certain social groups to reinforce an “us versus them” dichotomy. Chinese media promote two different views of PLHIV that are dependent on the manner in which people contracted HIV. Individuals who contracted HIV through socially acceptable means (e.g., blood transfusion) were worthy of being featured. In contrast, individuals who contracted HIV through socially unacceptable means (e.g., intravenous drug use) were less likely to be identified as individuals and were instead devalued as nondescript members of a deviant and dangerous group. This dichotomy reinforces HIV stigmatization and will mitigate China’s anti-stigma efforts. Study three is a continuation of the first two content analysis studies. Given that it is unknown how PLHIV in China responded to the media’s stigmatizing practice, our study three, using a rare opportunity for access, interviewed individuals living with HIV in China, and explored their perspectives on HIV stigmatization in media. Perspectives from PLHIV confirmed the notion that Chinese media tend to reinforce the dichotomous relationship of health moral us and diseased immoral them. Specifically, this study found that PLHIV reported that media stories about HIV/AIDS tended to stereotype and overstate threats to the non -affected population, caused PLHIV to curtail their own media consumption, and acted as barriers to seeking adequate healthcare. Stigmatizing news stories may interfere with anti-stigma efforts and creating barriers to better health policies in China. Overall, the findings provide health communication experts and anti-stigma advocates new evidence of HIV stigmatization in the media context.

  • HIV/AIDS in Cameroon: Rising gender issues in policy-making matters

    PRESBYTERIAN GENERAL HOSPITAL
    Cameroon
    Biography

    Eseme nnorge divine currently works at Presbyterian general hospital, Cameroon.

    Abstract

    This literature review investigated gender differentials in HIV/AIDS in Cameroon and to which extent gender was taken into account in the country’s current policy on HIV/AIDS. The review found that in Cameroon women were at increased risk of being infected with HIV/AIDS compared to men and that apart from biological vulnerability, Socio-cultural as well as economic factors accounted for those differences. In addition, the review found that at the policy level, the government has drawn up plans to reduce the high prevalence of HIV/AIDS among women. However, although the current policy acknowledged the need for tackling gender differentials in HIV/AIDS transmission; little has been done at the level of implementation. The current policy needs to be implemented in a more effective manner and a multi-sectorial approach should be explored in order to curb the current trend of the feminization of HIV/AIDS in Cameroon.

  • Are Sexually Transmitted Infections the neglected orphan in our response to HIV/AIDS, STI and TB (HAST) in South Africa?

    The Human Sciences Research Council
    South Africa
    Biography

    Professor Geoff Setswe is a Deputy Executive Director in the HIV/AIDS, STI & TB Programme. He holds a Doctor of Public Health (DrPH) degree from the University of Limpopo, and obtained a Masters of Public Health (MPH) from Temple University in Philadelphia, USA (1998). His doctorate focused on behavioural interventions for reducing HIV risk among employees. The study provides policy makers and implementers with evidence of behavioural interventions that work to reduce HIV risk among employees in various workplaces. He worked for the HSRC as Chief Research Specialist and Research Director from 2006 to 2010. Before rejoining the HSRC in December 2013, he was a Professor of public health at Monash University, Australia and founding Head of the School of Health Sciences at Monash South Africa from 2010 to 2013. Prof. Setswe is an expert on the social aspects of HIV and AIDS and on the development of research programs to reduce HIV transmission and the impact of AIDS. He has been principal investigator on more than 12 research projects in HIV/AIDS and public health in the past 8 years. His research interests are in the behavioural and social aspects of HIV/AIDS/TB/STI, AIDS/TB policy, epidemiology and general public health issues where he has almost 90 publications (50 journal articles, eight books/book chapters and 31 technical reports) and more than 60 conference presentations.

    Abstract

    Introduction: Every day more than 1 million people are newly infected with STIs that can lead to morbidity, mortality, and an increased risk of HIV acquisition. STIs account for a high proportion of incident HIV infections and are also responsible for a high proportion of adverse pregnancy outcomes. The monitoring of STI prevalence is crucial for the evaluation of STI treatment programs, and can also provide an indirect measure of change in sexual behaviour. There is currently no national approach for monitoring the prevalence of STIs except for HIV and HSV-2. This is despite the fact that STIs accounted for approximately 14% of all new HIV infections in South Africa in 2010 with an estimated 4 million people receiving treatment for STI’s every year. Design and Methods: A purposive and targeted search was used to obtain literature from all sources available in the public domain and the grey literature. Information was extracted using an abstraction tool. We conducted a quantitative review of data on STIs. Findings and Discussion: There is a lack of recent data on the extent of STI as the last national survey on STI in the South African public health sector was conducted in 2003 (SANAC, 2014). Johnson et al (2005) said lack of consistency between sentinel surveys precludes a rigorous analysis of trends in STI prevalence. “The last national survey on the quality of STI treatment in the South African public health sector was conducted in 2003” (SANAC, 2014: 57). The proportion of new HIV infections in adults that were attributable to curable STIs reduced from 39% in 1990 to 14% in 2010, while the proportion of new infections attributable to genital herpes increased*. Monitoring of syphilis was discontinued in 2011 - this limited the possibility of tracking rapid changes in sexual behaviour for which syphilis is an indicator. The latest data available on HSV-2 was from the 2012 antenatal survey which found a prevalence of 55.8% among pregnant women in four provinces (KZN, Gauteng, WC and NC). This was the first time HSV-2 prevalence was measured nationally and trend data is therefore not available. Eventhough modelled estimates for females aged 15-49 in 2005 were 54.4%, there were no alarm bells raised for these staggering statistics. Conclusion and Recommendations: There is a considerable need for more research to more accurately map the variations in STI rates, as well as the risk factors underpinning STI spread. This work would benefit from more accurate population-based STI incidence and prevalence data. There is a need for more nationally representative STI prevalence studies in South Africa and more periodic cross sectional studies that can be used to monitor prevalence trends and the success of STI treatment initiatives (Johnson et al, 2005: 291). To maximize HIV prevention efforts in South Africa, public health officials should consider testing for other STIs when they test for HIV. Prepare a National STI strategy to ensure STIs are no longer neglected in our response.

  • Precision Medicine in the HIV Aging Population

    University of Houston
    USA
    Biography

    Dr. Crutchley graduated from Duke University in 2001. He then received his doctorate of Pharmacy from the University of North Carolina at Chapel Hill. Dr. Crutchley continued his education further by completing his PGY-1 Pharmacy Practice Residency at the University of Texas at Tyler and his PGY-2 HIV Specialty Residency at the State University of New York at Buffalo. Since then, he has also completed a STAR Health Disparities Fellowship through the University at North Texas Health Science Center at Fort Worth. Dr. Crutchley is currently working as a Clinical Associate Professor at the University of Houston, College of Pharmacy. He works as a HIV clinical pharmacist at Therapeutic Concepts (private adult HIV clinic) and the Retrovirology Clinic at Texas Children’s Hospital with HIV-infected children and adolescents. Dr. Crutchley established a new and innovative PGY-2 HIV Ambulatory Care/Clinical Pharmacogenetics Residency Program at the University of Houston. His research interests include complimentary alternative medicine and pharmacogenetic approaches used to improve the quality of life and lifespan of HIV-infected patients.

    Abstract

    Increased availability of one pill-once daily antiretroviral therapy (ART) combinations with greater potency and tolerability has created a dynamic shift in prescribing patterns towards simplification to these newer therapies. In this presentation, we will identify common one pill-once daily ART combinations and most current recommendations for treatment of HIV. In an era of ART simplification encouraged by an armamentarium of better therapies, the HIV aging population is increasing. Given these trends, the prevalence of comorbidities is also increasing in the HIV aging population. One example includes the large HIV Dutch ATHENA cohort projecting a significantly increased prevalence in both the number of comorbidities (especially, cardiovascular disease) and concomitant medications used to treat these comorbidities by 2030. Consequences of polypharmacy include increased pill burden, costs, drug-drug interactions, and adverse effects. In this presentation we will briefly discuss current and future polypharmacy trends in an aging HIV population. Studies show that adherence to ART is improved if HIV patients are taking fewer medications on a daily basis. Although many strategies exist to reduce polypharmacy to ensure sustainable success on ART, one excellent measure may include precision medicine. In this presentation, we will describe specific examples of how using this personalized healthcare approach can serve importantly in guiding choices in both ART and management of common comorbidities in the HIV aging population. Finally, we will conclude with factors affecting clinical uptake of pharmacogenetic testing and discuss future implications.

  • In their own words: Racial/ethnic and gender differences in sources and preferences for HIV prevention information among young adults

    The university of Chicago
    USA
    Biography

    Dexter R. Voisin is a Professor in the School of Social Service Administration and a Faculty Affiliate at the Center for the Study of Race, Culture, and Politics and the Center for Health and the Social Sciences. His fields of special interest include community violence exposure, adolescent sexual risk behaviors, the role of gender in adapting to risks, international HIV prevention, and social work practice. Professor Voisin has authored more than 100 peer reviewed publications in such journals as AIDS, AIDS Care, AIDS and Behavior, AIDS Education and Prevention, the American Journal of Orthopsychiatry, the American Journal of Public Health, Behavioral Medicine, Children and Youth Services Review, Journal of Epidemiology & Community Health, Journal of Adolescence, among others. Due to his expertise on adolescent sexuality, trauma exposure, and international HIV prevention, he is highly sought after as a peer reviewer and has reviewed articles for various academic journals across many disciplines. His scholarship is recognized as being one of highest cited among Black scholars in top Schools of Social Work. Voisin was appointed a Visiting Professor (summers 2004, 2005, 2007) at the Center for AIDS Prevention Studies in the Department of Medicine at the University of California, San Francisco. In 2010, he was appointed co-editor of the Journal of HIV/AIDS and Social Services. He was also appointed a consulting editor for Social Work: Journal of the National Association of Social Workers (2003-2008), the Journal of HIV/AIDS Education and Prevention (2004-2007), the Journal of HIV/ AIDS and Social Services (2003 to 2010). In 2012 he was appointed to the editorial boards of the Journal of Adolescent Health, BMC Public Health, and in 2013 Social Work Research. In 2010, he was appointed to the Illinois Statewide Committee for Juvenile Justice Programs, Disproportionate Minority Contact Subcommittee and in 2013 to the Illinois African American Family Commission by the Office of Governor Pat Quinn.

    Abstract

    Aims: The purpose of this study was to examine where young adults were obtaining their HIV prevention information, and determine if there were consumption preferences based on gender and race/ethnicity. Methods: We conducted a series of race/ethnic and gender-concordant 2-hour focus groups, and qualitative analyses identified common domains. Sixty adolescents attended 6 focus groups. Results: Findings revealed that primary informational sources were television and advertisements, educational settings, community health care centers, and family and friends. However, television commercials and advertisements were viewed as an ineffective approach, with mistrust of the “mainstream” media being very high for Black males. Recommendations centered on the need for more realistic scenarios related to living with HIV by other adolescents, greater parental involvement with HIV education, especially for minority youth, and the use of social media. Conclusion: Special attention should be given to the importance of social media for adolescents, and how the fear of HIV-related stigma influences HIV information consumption patterns among males.

  • Children and Youth Voices about Sex and AIDS and Implications for Life Skills Education: Experiences in KwaZulu-Natal in South Africa

    Livingstone Hospital
    South Africa
    Biography

    Thabisile Buthelezi is a qualified nurse, midwife, teacher, and Adult Basic Education Practitioner. She works as an Associate Professor in the School of Education, at the University of KwaZulu-Natal in South Africa. Her teaching and research interests are on Life skills-based and sexuality education, HIV/AIDS in curricula, Education and Society, Language Education, Gender and culture, African languages and social aspects.

    Abstract

    Abstract : The HIV/AIDS epidemic and the complex socio-cultural factors that fuel HIV transmission among many societies in the world have led to governments adopting the multi-pronged and multi-sectorial approaches to deal with the phenomenon (Buthelezi, 2013). In education, the curriculum is identified as an area where HIV/AIDS and sexuality knowledge that is integrated within life skills education is incorporated (World Bank, 2002; Kelly, 2000). In South Africa, the life skills and HIV/AIDS education is included in the National Curriculum policy for schools. The paper foregrounds the primary and secondary school learners’ voices, which articulate their experiences of the rural context. METHODS The project, Ixopo duty-bearers’ Project Number One , was done in the Ixopo rural area of KwaZulu-Natal in South Africa. The qualitative framework was used, and 84 learners (54 primary and 30 high school learners) participated. Having cleared all ethical procedures that helped consolidate trust between the two schools involved in the project and the NGO working in the area, I embarked on the data production process. The qualitative approach; specifically, the arts-based and participatory methodologies were used. The learner participants, aged between 8-19 years wrote stories of their lives through drawings, and textual narratives in dialogue journals. Data from the dialogue journals were analysed qualitatively through open and axial coding, patterning, re-coding, and categorisation until the themes emerged. RESULTS AND DISCUSSION Together the learners expressed narratives of worry, mainly about AIDS related deaths, TB, poverty, sex, and teenage pregnancy that are common in their context. After completing her life story, one learner wrote in big letters, “The earth is death” (FP11-13years). This four-word metaphor accurately captures the contents of almost all dialogue journals, which described in detail the learners’ experiences, where the death of family members due to AIDS related conditions is common. When parents die, children experience poverty and abuses including sexual abuses by the remaining relatives. Adult-adult and adult-child sex is prevalent in the community. Learners themselves engage in transactional sex to survive. Then, learners live to worry about getting pregnant. The absence of relevant support for learners affected and infected by HIV/AIDS leads to depression among learners who, as a result, see death as an option. In the learners’ voices, this is reflected as “I just think of taking the rope and kill myself to have peace.” or “I wish I should drink poisoned water” or “I wish my dead mother comes and fetches me.” Poverty and the ineffective delivery of life skills education exacerbate depression and hopelessness. CONCLUSION Problems and challenges facing children in the area are complex; however, theoretically a person is not a subject of his/her environment. In an environment of anti-child culture (van Greunen, 1993), education, particularly life skills education becomes a mediating factor between the child and his/her environment (Buthelezi, 2007). Consequently, the child develops his/her full potential and engages with the environment on personal, cognitive, psychological, socio-economic and constitutional levels, assumes responsibilities for their lives and make the most of life’s opportunities.

  • Combination antiretroviral (cARV) loaded nanoparticles: A potential alternative future for HIV patients.

    Creighton University
    USA
    Biography

    Post doctoral researcher at Creighton university.

    Abstract

    Globally, an estimated 37 million people are living with human immunodeficiency virus (HIV)-1. In the United States, > 1.2 million people living with HIV and the most worrisome issue is that among these people, it is estimated that 13 % are unaware of their clinical status, leading to unacceptably high HIV transmission rate. Joint United Nations Programme on HIV/AIDS (UNAIDS) reported the use of antiretroviral drugs (ARVs) has resulted in about 45% drop in death caused by HIV/acquired immune deficiency syndrome (HIV/AIDS). Still (2015 report), about 2.1 million new infections have been reported worldwide, mainly due to high HIV transmission rate and patient’s non-adherence to ARVs. Therefore, the focus during formulating novel effective therapeutics should not only be to improve the quality of life of HIV/AIDS infected people but also to reduces the possibility of infection transmission. The cARVs has enhances the live expectancy of HIV patients, which was once considered to be a uniformly fatal disease. However, daily oral therapy is mandatory to achieve the goal of a nondetectable plasma viral load (pVL) along with a highly motivated, adherent patient. Therefore, cARV therapy faces major challenges including adherence, a daily large oral dose, with associated drug side effects, and economics. Here, cARV nanomedicine could be a potential alternative. Various surveys on HIV-infected patients reflects that they are enthusiastic about long-acting parenteral nanomedicines. Thus, researchers are actively developing long-acting nanomedicines for HIV-1 prevention/treatment. To improve patient lifestyle and control the epidemic, HIV/AIDS therapeutics research goals for developing new ARV drugs are: potent, non-toxic or with few side effects, small dosages to ensure better adherence, and long-term viral load maintenance. High HIV/AIDS prevalence in areas of underdeveloped and developing countries, therefore cARV should be inexpensive as well as readily accessible to resource-limited countries. To fulfill above prerequisite, we are formulating cARVs encapsulated polymeric nanoparticle (NPs) as nanodrug delivery system, that shows slow drug release and protects drugs from systemic clearance. Therefore, we predict use of cARV NPs will lead to monthly dosing, that potentially could overcome the adherence burden in the HIV patient. We are the first to report the use of PLGA encapsulated cARV drugs (i.e. TAF+EVG and/ FTC) NPs for prevention/treatment of HIV in a humanized mouse model.

  • ACUTE HCV AND HAV IN MEN HAVING SEX WITH MEN: AN EMERGING EPIDEMIC IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY

    Dipartimento di Medicina Specialistica Unità Operativa Malattie Infettive
    Italy
    Biography

    Antonio Mastroianni, M.D, graduated and specialized in Infectious and Tropical Diseases at the University of Bologna. July 1996–May 2017 working as a medical physician specialist in Infectious Diseases & Tropical Diseases with a “High degree in antibiotic and antifungal treatment” at Infectious Diseases Unit of the “G.B.Morgagni – L. Pierantoni”, Hospital,Forlì, Italy. June 2017 Director of Infectious Diseases Unit "Annunziata" Hospital, Cosenza, Italy. Master of Tropical Medicine (University of Siena), Master of Diagnostic Pathways and Management of Sexually Transmitted Infections (Bologna, ECCMID), Master of Sepsis & Septic Shock (Univeristy of Milan), Master of Hospital Infections (University of Milan-Bicocca), Master of Tuberculosis (University of Brescia), Master of Pediatric Infections (University of Florence), Master of Infections in Pregnancy (University of Brescia). Mastroianni has authored more than 150 peer reviewed publications in indexed Journals as Clinical Infectious Diseases, AIDS, AIDS Care, Journal of Chemotherapy, Clinical Microbiology & Infection, Europen Journal of Clinical Microbiology & Infectious Diseases, Journal of Infection.

    Abstract

    Men who have sex with men (MSM) are at risk for acquiring hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) and must be vaccinated at an early age to prevent acquisition of HAV and HBV. Acute HCV and acute HAV infection are frequently a missed or delayed diagnosis bc largely asymptomatic. Fewer than 20% of patients have characteristic symptoms and unexplained elevations in transaminases may be the only laboratory finding. HCV has been traditionally known to be transmitted parenterally and HAV through fecal-oral transmission from person-to-person contact, while not efficiently transmitted through sexual contact. Since 2000, epidemics of acute HCV infection in HIV?infected MSM have been reported, predominantly in Western Europe, Australia, and the United States. Certain sexual risk behaviors have been hypothesized to be associated with the acquisition of acute HCV infection in this population: unprotected anal intercourse, fisting, enema use, bleeding during intercourse. Group sex practices and unsafe sexual partices were all associated with acute HCV infection in recent different studies. HAV outbreaks occurred among MSM throughout the world in the 1990s and sexual activity is probably the major mode of transmission among homosexual and bisexual men. Acute HAV infection may have an impact on HIV viral load. The interactions between HIV and HAV may prolong the HAV viremia compared with non-HIV-infected individuals which may result in a prolonged duration of risk of HAV transmission to others, and may also increase the risk of HIV transmission. Some studies suggest that acute hepatitis A may increase HIV-1 viral load that may not return to baseline after infection is resolved. MSM are at increased risk for HAV infection, and risk factors include high number of sexual partners and sexual practices involving oro-anal contact, however limited data suggest low rates of HAV vaccination in this population, particularly among young MSM. HIV-infected MSM who do not participate in intravenous drug use have essentially the same rate of hcv infection as the general population, however, in the last few years, there have been a number of reports of acute HCV infection due to sexual transmission in the HIV-infected MSM in urban centers in Europe and in the US. Health-care workers often do not ask about risk behaviors during health-care visits, resulting in missed opportunities to vaccinate persons in high-risk groups against HAV and HBV infection. Reciprocal interactions between HIV and HCV or HAV can increase risk of morbidity and mortality in HIV disease and/or worsened the natural course of the hepatitis viruses. Healthcare workers should maintain a high grade of clinical suspicion to identify the transmission risk factors for prevention of reinfection, to recognize HAV and HCV in the acute stage of infection to preventing liver related morbidity and mortality in patients with HIV infection and to decrease the risk of HCV transmission to susceptible hosts. The prevention of HAV and HCV infections in the setting of co-infection with HIV is critical because of reciprocal interactions between the viruses that can lead to an increase risk of morbidity and mortality.

Day 2

KEYNOTE SPEAKERS
  • Gaps in HIV Epidemic, Prevention and Control: The Role of Academic Centers

    Michigan state university
    USA
    Biography

    Dr. Reza Nassiri is a Professor of Clinical Pharmacology, Professor of Family and Community Medicine, and lecturer in Global Health, Infectious Diseases and Tropical Medicine at Michigan State University College of Osteopathic Medicine. His research interests focuses on Clinical Pharmacology of HIV/AIDS & TB, prevention and control of infectious diseases, neglected tropical diseases, community health, global health, and socio-ethical determinants of health. Prof. Nassiri works on international public health issues and has expertise in global health education, research, policy and governance. He has made contributions in various fields of medical sciences including clinical investigation and health education. One the basis of his extensive experience and expertise in HIV/AIDS and TB, he developed Clinical Research Programs in Brazil, South Africa, Haiti, Dominican Republic and Mexico. The core foci of such programs are socio-cultural, bio-ethical determinant of HIV/AIDS and TB prevention, control and intervention.

    Abstract

    AIDS remains a public health and social problems threatening global population. There are approximately 36.7 million people currently living with HIV and tens of millions of people have died of AIDS-related complications since the beginning of the epidemic. The greatest prevalence and incidence remains in Eastern and southern Africa with 19 million (52%) affected. While new cases have been reported in all regions of the world, approximately two-thirds are in sub-Saharan Africa, with 46% of new cases in Eastern and Southern Africa. In the endemic regions outside the western countries, many people living with HIV or at risk for HIV do not have access to prevention, care, and treatment. In addition to affecting the health of individuals, HIV impacts households, communities, and the development and economic growth of nations. The number of people newly infected with HIV, especially children, and the number of AIDS-related deaths have declined over the years. The number of people with HIV receiving treatment increased to more than 18 million in 2016. However, gaps exist. While studies show declines in new infections among adults observed earlier in the epidemic, incidence is now rising in some areas of the world particularly in China and India. HIV epidemic has led to a resurgence of tuberculosis (TB), particularly in Africa. TB is a leading cause of death for people with HIV worldwide. In 2015, approximately 11% of new TB cases occurred in people living with HIV. Interestingly, between 2004 and 2014 TB deaths in people living with HIV declined by 32%, largely due to the scale up of joint HIV/TB services (The Global HIV/AIDS Epidemic, Kaiser Family Foundation. January 2017). From our experience of HIV preventive work in the Dominican Republic, effective prevention strategies include behavior change programs, condom use, HIV testing, blood supply safety, harm reduction efforts for injecting drug users, and male circumcision (WHO and CDC recommendations). Additionally, recent research has shown that providing HIV treatment to people with HIV significantly reduces the risk of transmission to their HIV-negative partners. Pre-exposure antiretroviral prophylaxis (PrEP) has also been shown to be an effective HIV prevention strategy in individuals at high risk for HIV infection. Additionally, in 2016, the U.N. Political Declaration on HIV/AIDS stated PrEP research and development should be accelerated. Numerous studies suggest that prevention should be based upon “evidenced-based knowledge of epidemic” directed to tailor the prevention and control measures to the local context and epidemiology. On World AIDS Day 2014, UNAIDS set targets for 2020 aimed at ending the epidemic by 2030.These goals and targets were reiterated in UNAIDS’ 2016-2021 strategy, which also aligns with the Sustainable Development Goals (SDGs). The U.N. charter members pledged committed to ending the AIDS epidemic by 2030. To reach this target within the SDGs is the central challenge facing the United Nations General Assembly High-Level Meeting on Ending AIDS which was held from 8 to 10 June 2016. In the United States, new HIV infections are becoming rare. When they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have access to quality, life-extending care, free from stigma and discrimination. The Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia has dramatically impacted the regional response to the epidemic. The monitoring process of the Declaration has provided valuable insight on the progress of HIV prevention and control by countries and where improvements in national programs must be made to reduce the number of new infections and improve the quality of life for people living with HIV. The collaboration between government and civil society has proven to be essential element of sustainable response to HIV epidemic, monitoring, prevention and control (European Center for Disease Prevention and Control, Dublin Declaration Monitoring – 2016 progress). In conclusion, while numerous socioeconomic and policy making factors play crucial role in understanding HIV epidemic, prevention and control, the key stakeholders are encouraged to work together as a team. Community-academic partnerships will gain increasing prominence in solving HIV-related matters.

  • Combatting HIV/AIDS at the School Level: Lessons Learned form a Pilot in Ugandan Schools

    Iowa State University
    USA
    Biography

    Linda Serra Hagedorn is Associate Dean of Undergraduate Programs, International Programs, Student Services, Diversity, and Community in the College of Human Sciences and Professor in the School of Education at Iowa State University. She is a prominent researcher in the area of community college student success with over 200 publications and presentations. As the Director of International Programs at Iowa State, she is also highly involved in international education. Dr. Hagedorn has extensive international experience beginning with her initial work in Vietnam as a Fulbright Specialist at AnGiang University (2003). She subsequently has been a researcher and collaborator in China, Indonesia, Russia, Korea, Spain and Vietnam. She is on the advisory board of international universities in both China and Iran. As the past president of the Association for the Study of Higher Education (ASHE) and Vice President of the American Educational Research Association (AERA), Dr. Hagedorn has a rich history of leadership.

    Abstract

    It is commonly agreed that to annihilate the level of HIV infection, prevention instruction must take place at an early age. Schools are the obvious and easy target when designing to reach young people. However, while many countries have adopted an education series and support initiatives, the problem persists. This presentation will highlight a study within Uganda specifically targeting Head Teachers. Using ordinal logistic and Rasch scaling, this study utilized the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) data to predict the strength and direction of the associations between school and community-based initiatives and the perceived risk of HIV infection reported by headteachers. Findings indicate community and school-based HIV/AIDS awareness and school based HIV/AIDS support significantly predict the odds of perceived risk of HIV/AIDS infection. Socio-demographic and contextual factors confound some of the associations. The presentation will explore the ways that the education sector can play a bigger role through the education of its faculty and administrators in addition to students.

  • Generative dialogues regarding the couples experience of living with HIV

    Mount Royal University
    Canada
    Biography

    Patricia Miller is an Assistant Professor at Mount Royal University, within the faculty of Child & Youth Studies and Social Work. She continues to consult and research within the larger HIV community, within the province of Alberta. She is dually registered as a Social Worker and Psychologist, while running a private practice within the city of Calgary, Alberta.

    Abstract

    The research project is grounded in post-modern feminist theory in order to rigorously investigate the politics of interpretation, representation and language that has given meaning to the social-relational experiences of couples living with HIV. It was completed through qualitative research, specifically a participatory action research methodology. As per a PAR methodology, a series of initial gatherings did focus on inviting diverse couples that have identified themselves as living with HIV and wanting to create a new understanding of the needs of the HIV couples community. These initial gathering did allow couples to dialectically develop their agenda and story for further action. These dialogues were documented in field notes and facilitated through a semi-structured group format. The second phase will consist of constructing and developing a community of support while engaging actions, agreed upon by the couples themselves for the worthwhile purpose of empowerment of the persons and community itself. The final phase of the research project is an on going action component that allows for full immersion and engagement in action research that has significant heuristic value as it formats a diverse and concise process for a couple peer support model of engagement and community building. This validates the initial needs of the couples that sought to identify issues of concern and develop practice solutions from within their community. METHODS: It will be completed through qualitative research, specifically a participatory action research methodology. As per a PAR methodology, a series of initial gatherings will focus on inviting diverse couples that have identified themselves as living with HIV and wanting to create a new understanding of the needs of the HIV couples community. RESULTS: A thorough discussion of the emerging themes for couples living with HIV, will be presented and discussed regarding living well with the HIV virus. The results will bring forth a better understanding of a peer support model of support for the HIV community.

  • Genetically modified and killed whole-HIV vaccine is safe and stimulates anti-HIV antibody responses in human

    The University of Western Ontario
    Canada
    Biography

    Dr. Chil-Yong (Yong) Kang received his Ph.D. from McMaster University in Canada in 1971 and his D.Sc. degrees from McMaster University and from Carleton University. He took his three year postdoctoral training at the University of Wisconsin, Madison, USA. He has served as a Professor of Microbiology at the University of Texas, Southwestern Medical School in Dallas, Professor and Chairman of the Department of Microbiology and Immunology at University of Ottawa, Faculty of Medicine, Dean of Science at the University of Western Ontario, and currently is serving as Professor of Virology in the Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry at the University of Western Ontario. His research in molecular virology includes the development of antiviral therapeutic agents and efficacious vaccines against various human viral diseases. He has published 297 scientific papers in fields of virology, medicine, and molecular biology. He holds nine international patents. Dr. Kang has received numerous prizes including Ho-Am Prize in Medicine in 1999 and Queen Elizabeth II Diamond Jubilee Medal of the Governor General of Canada in 2012. Dr. Kang is an elected Life-time Fellow of the Royal Society of Canada, Academy of Science and an elected Life-time Member of the Korean Academy of Science and Technology.

    Abstract

    Development of efficacious vaccine to prevent HIV infection has been one of major tasks in the last three decades. We report here an evaluation of the safety and the immunogenicity of a genetically modified and killed whole-HIV-1 vaccine designated as SAV001. HIV-1 Clade B NL4-3 was genetically modified by deleting the nef and vpu genes and substituted the coding sequence for the Env signal peptide with that of honeybee melittin signal peptide in order to generate a replication efficient and attenuated HIV-1. This genetically modified virus (gmHIV-1NL4-3) was propagated in the human T cell line, A3.01, followed by virus purification and inactivation by aldrithiol-2 and ?-irradiation. Thirty-three HIV-1 positive volunteers receiving cART were recruited for this observer-blinded, placebo-controlled phase I human clinical trial to assess the safety and immunogenicity. The humoral immune responses were assessed by standard antibody ELISA and by neutralization assay of HIV-1. We found SAV001 was well tolerated with no serious adverse events. HIV-1NL4-3-specific PCR showed no evidence of vaccine virus replication in vitro and in the participants receiving SAV001 vaccine. Furthermore, SAV001 with adjuvant significantly increased the pre-existing antibody response to HIV-1 proteins. Antibodies in the plasma from these vaccinations were also found to recognize HIV-1 envelope protein on the surface of infected cells as well as showed an enhancement of broadly neutralizing antibodies inhibiting tier I and II of HIV-1 A, B, and D subtypes. Our results indicate that the killed whole-HIV vaccine is completely safe and may trigger appropriate immune responses to prevent HIV infection. This killed whole-HIV vaccine strategy may pave the way to develop an effective HIV vaccine.

  • Assessment of Sex-Related Behaviours, Human Immunodeficiency Virus (HIV) Knowledge and Sexually Transmitted Infections (STIs) among Men of Reproductive Age in Cameroon

    PRESBYTERIAN GENERAL HOSPITAL
    Cameroon
    Biography

    Divine Ngakokibang Nsangon is the Community Outreach Coordinator for Presbyterian General Hospital Kumba, Southwest Region, Cameroon, where he covers projects and Workshops Regional wide. He holds B.S. and M.S. degrees in Biochemistry from the University of Buea in the Southwest Region. Divine Ngakokibang Nsangon is a registered professional Outreach Coordinator in 5 Divisions in the Southwest Region and has more than 5 years 8 months of experience in Outreach Coordinating and project management. He is a trustee of the Presbyterian Church in Cameroon and former co-chair the HIV/AIDS Sensitization Project of the Presbyterian General Hospital (2013-2015). He is also a member of the Solidarity Health Foundation and past chair of the sensitization of people living with AIDS committee (2015-2016).

    Abstract

    Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), are among the major public health challenges in Cameroon. This paper determined the effect of men’s sex-related behaviors and HIV knowledge on reported STIs. The data came from the 2012 Cameroon’s Demographic and Health Survey (DHS) that were collected from 7191 respondents in 2012. Descriptive and logistic regression methods were used for data analysis. Results showed that majority of the respondents were aware of STIs and Acquired Immune Deficiency Syndrome (AIDS), while 3.96% reported STIs. Also, 49.45% of the men had no wife, while 75.58% and 84.58% noted that condoms and keeping of one partner could be used to prevent HIV transmission, respectively. Wrong impressions that mosquito bites and sharing of food could lead to HIV infection were held by 31.94% and 12.44% of the men, respectively. Among those that reported STIs, 33.33%, 30.18% and 13.33% respectively used condom during sex with most recent partner, second to most recent partner and third to most recent partner, compared to 24.69%, 15.04% and 4.17% among those that did not report STIs. Logistic regression results showed that probability of STI increased significantly (p < 0.05) with condom use with third most recent partners, being married, wrong knowledge that mosquito bites cause HIV and being away for more than one month, while it significantly reduced (p < 0.05) with number of children, knowledge that having one partner prevents STIs. It was concluded that policy initiatives and programmes to enhance right sexual knowledge and behavior among men would go a long way in reducing STI incidence in Cameroon.

  • Interventions to Reduce HIV/AIDS Stigma: What Have We Learned?

    PRESBYTERIAN GENERAL HOSPITAL
    Cameroon
    Biography

    QUINTA BIH is a native of Bamenda Town and has lived in Kumba, Southwest Region since 1990. Since 2008, Quinta has been a Clinical Nurse for Presbyterian General Hospital and she is responsible for the clinical expert, consultant, educator and researcher program at the Presbyterian General Hospital. Her bi-cultural background and focus on community collaboration has led her to a number of volunteer opportunities and community leadership roles. Quinta received her Bachelor of Science in Nursing at University of Buea.

    Abstract

    This article reviews 22 studies that test a variety of interventions to decrease AIDS stigma in Cameroon. This article assesses published studies that met stringent evaluation criteria in order to draw lessons for future development of interventions to combat stigma. The target group, setting, type of intervention, measures, and scale of these studies varied tremendously. The majority (14) of the studies aimed to increase tolerance of persons living with HIV/AIDS (PLHA) among the general population. The remaining studies tested interventions to increase willingness to treat PLHA among health care providers or improve coping strategies for dealing with AIDS stigma among PLHA or at-risk groups. Results suggest some stigma reduction interventions appear to work, at least on a small scale and in the short term, but many gaps remain especially in relation to scale and duration of impact and in terms of gendered impact of stigma reduction interventions.

  • Monitoring and Managing HIV/AIDS in India

    Tajen University(Yanpu)
    Taiwan
    Biography

    Govindasamy Agoramoorthy is Distinguished Research Professor at College of Pharmacy and Health Care, Tajen University, Taiwan. His research includes multidisciplinary aspects of health sciences. He has carried out field research in Asia, Africa, and South America over three decades. Between 1989 and 1993, he served as Visiting Scientist at Smithsonian Institution, Washington, DC. He is currently Research Advisor at SVYASA Yoga University in India. Professor Agoramoorthy authored 25 books, 60 book chapters, and 250 scientific articles in peer-reviewed journals with impact factor.

    Abstract

    India holds third rank in AIDS prevalence with over 2 million cases. The country’s first case of HIV/AIDS was reported in 1986, and since then the virus has spread across the nation. Both the serotypes one and two occur in India, and the sub-type HIV-1 C is the most common. The disease spread mainly due to sexual transmission. Statistics show that <5% of people in India use condoms for birth control, since the culture dictates that women undergo sterilization or take birth pills. Prostitution plays a key role in disease spreading among heterosexuals in major towns and cities. The National AIDS Control Organization has managed to contain the disease from going out of control. But, healthcare experts are concerned that India does not spend enough funds to monitor and manage the diseases effectively. Therefore, the government must spend more budget allocation to go all out to combat the diseases from further spreading.

  • Recent advances in the Drug discovery of anti- HIV/AIDS agents

    Texas A&M University
    USA
    Biography

    Hamed I. Ali is an Assistant Professor of Pharmaceutical Sciences, Texas A & M Rangel College of Pharmacy, USA

    Abstract

    HIV and AIDS remain a persistent problem for the United States. In 2015, 39,513 people were diagnosed with HIV. Since the beginning of the epidemic, nearly 675,000 people with AIDS in the United States have died, and even today, nearly 13,000 people with AIDS in the United States die each year. While great progress has been made in preventing and treating HIV, but challenges remain. These challenges include the current drug resistance and toxicity and unresponsiveness of the treatment to suppress HIV replication in all patients. These challenges incite searching for novel anti-HIV drugs and a new strategy to control the multiple-target viral replication. Likely, the HIV replication cycle offers multiple receptor sites for chemotherapeutic intervention, including the proteases, integrase, reverse transcriptase, cellular ATPase DDX3, viral envelope glycoprotein (gp120), transmembrane glycoprotein (gp41), and viral co-receptors (CXCR4 and CCR5) as a valid anti-HIV targets. Therefore, the use of chemotherapy to suppress replication of HIV has tremendously improved the treatment of AIDS in the last decades. Dual chemotherapy such as cabotegravir and rilpivirine or dolutegravir plus lamivudine which have opened the door to a new treatment paradigm in HIV therapeutics. Furthermore, cell or gene therapy by allogeneic stem cell transplantation have had a resurgence of interest to control the HIV virus which may point towards a future drug-free therapy for HIV-1 infection. The application of the computer-aided drug design (CADD) has become one of the core technologies in the current discovery of the anti-HIV inhibitors. Accordingly, the cost of drug development was reduced by up to 50% and the ADMET properties of the potential anti-HIV inhibitors become feasible. Structural-based drug design plays a significant role in the current success of discovery of highly selective inhibitors of protease (PR), reverse transcriptase (RT) and/or integrase (IN) of the pol gene of HIV-1. In recent years, computer-based approaches are widely and effectively applied in virtual screening and de novo design of protein–protein interaction inhibitors (PPI) for the discovery of highly active antiretroviral therapy (HAART) against HIV/AIDS. Furthermore, the application of simulation to drug design incorporated with experimental techniques has developed considerable numbers of novel fusion inhibitors, reverse transcriptase inhibitors (RTI), integrase inhibitors (II), and protease inhibitors (PI). Furthermore, the Nanosystems (liposomes, nanoparticles, niosomes, polymeric micelles, and dendrimers) used for HIV therapeutics offer some unique advantage like enhancement of bioavailability, water solubility, stability, and targeting ability of ARV drugs. Currently, the main attention is paid on vaccines are made from deactivated versions of HIV so that HIV can fight with HIV or any other vaccines approaches. The rapid emergence of drug-resistant HIV-1 mutants and serious adverse effects have highlighted the need for further discovery of new drugs and new targets. The problem of drug resistance development due to mutations in HIV-1 proteins targeted by antiviral drugs could be overcome by the development of specific DEAD-box RNA helicase/ATPase DDX3 inhibitors as effective anti-HIV agents.

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