TAG: "AIDS/HIV"

Putting the spotlight on global health


UC Irvine professor Brandon Brown is spreading the word about global health.

UC Irvine professor Brandon Brown (right)

UC Irvine professor Brandon Brown (right)

By Katherine Tam

Every few months, UC Irvine professor Brandon Brown returns to Epicentro Salud, a gay men’s community-based clinic in Lima, Peru, to help the staff brainstorm ways to encourage local men to get tested for HIV.

The stigma around homosexuality often deters the gay community from proactively getting tested in Lima, but Brown and clinic leaders have been working to change that these last three years. With Brown’s help, the clinic landed a USAID grant in October 2011 that provided funds to train HIV counselors and bought vital clinic and laboratory equipment.

“Epicentro staff did a lot of outreach to get started. We recruited on Facebook, on the streets, at bars, and were active in the gay pride parade,” Brown said. “We’re seeing more people visiting the center than ever. It’s a big asset for gay men and transgendered individuals in Peru.”

Whether it’s battling HIV stigma in Peru, finding new tools to diagnose malaria in Thailand, or improving sanitation in Kenya, Brown has made it his mission to spotlight the importance of global health and spread the word about the myriad opportunities here and around the globe that people can make a difference.

“Global health is an exciting field and there are lots of ways to get involved,” said Brown, who teaches global health, public health ethics, honors research, and epidemiology. “It’s easy for people to be comfortable in the bubble they’re in. But even if you’re studying say math, you can still be educated on things outside your area of expertise.”

That’s why two years ago, Brown launched a new initiative to put global health on more people’s radar at UC Irvine.

The initiative, Global Health Research Education and Translation (GHREAT),brings together researchers to collaborate on projects, and encourages students to get involved in global health. GHREAT offers courses students can take to earn a global health certificate. In addition, it also offers a global health mentorship program, seminar series and global health job opportunities.

Brown leads GHREAT on his own time and does not receive a salary for it. Neither do the motivated students and faculty who collaborate with him.

So far, students who have participated in GHREAT have become involved in a variety of projects here and abroad: studying how sanitation interventions can prevent contamination of the water supply in Kenya; investigating mental health issues of Iraqi refugees; identifying perceptions of genital warts in Peru; and producing a photo series chronicling the experiences of people living with HIV.

“I don’t think I could have asked for a better mentor,” said Karen Munoz, who graduated in May with a bachelor’s degree in public health and will seek a master’s degree in the same field this fall. “He’s always willing to help, especially when it’s a student’s passion and has to do with global health.”

Munoz credits Brown with her ability to successfully secure a grant from the Undergraduate Research Opportunities Program for her project, which focuses on access to health care among low-income women in Southern California for early detection of the human papillomavirus and cervical cancer.

“When we were applying for grants for our projects, he helped us revise our papers and showed us examples of his so we learned what to do,” Munoz said. “Many of us had never applied for a grant before.”

UC Irvine professor Brandon Brown (center) works closely with the staff at Epicentro in Lima, Peru to help gay men in the community.

UC Irvine professor Brandon Brown (center) works closely with the staff at Epicentro in Lima, Peru, to help gay men in the community.

When he’s not teaching at UC Irvine or spearheading GHREAT, Brown continues to work on global health projects. In addition to weekly Skype calls, he returns to Peru during the year to continue his collaborations with Epicentro.

Jerome Galea, founder of Epicentro, said the grant Brown helped secure early on was instrumental in getting the clinic off the ground.

“Probably if it weren’t for Brandon, Epicentro would not have a clinic today,” Galea wrote via email. “I’ve worked with Brandon for about 10 years and have found myself looking for projects to do with him – even though we’re on different continents – since he’s one of those people that you know you’ll have a great work experience with.”

Brown is working simultaneously on three research projects, including a study on syphilis among gay men in Peru that could lead to better treatment. And he has partnered with a UC San Diego team to research cervical cancer prevention among female sex workers in Tijuana, Mexico.

He hopes more students will take an interest in global health, whether they choose it as their major or not. Eventually, he plans to ask the university to establish an organized research unit in global health, which would provide more funding for projects, synergize global health efforts, help support student travel, and make researchers less dependent on grants.

“Few know what’s possible in global health and how to get involved,” Brown said. “Making more people aware could mean a big difference for all of us globally.”

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Combo of social media, behavior psychology leads to HIV testing


Technique developed at UCLA may apply to other diseases, prevention efforts.

Sean Young, UCLA

Sean Young, UCLA

Can social media be used to create sustainable changes in health behavior?

A UCLA study published Sept. 3 in the peer-reviewed journal Annals of Internal Medicine demonstrates that an approach that combines behavioral science with social media and online communities can lead to improved health behaviors among men at risk of HIV infection.

The evidence-based approach not only led to increased HIV testing and encouraged significant behavioral change among high-risk groups but also proved to be one of the best HIV-prevention and testing approaches on the Internet, according to the study’s lead investigator, Sean D. Young, an assistant professor of family medicine and director of innovation at the Center for Behavior and Addiction Medicine at the David Geffen School of Medicine at UCLA.

And it’s not only applicable to HIV prevention efforts, he noted.

“We found similar effects for general health and well-being,” said Young, who is also a member of the UCLA AIDS Institute. “Because our approach combines behavioral psychology with social technologies, these methods might be used to change health behaviors across a variety of diseases.”

In an earlier study, published in February and also led by Young, researchers found that social media could be useful in HIV- and STD-prevention efforts by increasing conversations about HIV prevention.

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UC awarded $21M in stem cell grants


Diseases targeted include prostate cancer, autism, ALS and AIDS/HIV.

Alysson Muotri, UC San DIego

Alysson Muotri, UC San DIego

The University of California and its affiliates received seven grants totaling more than $21 million in the latest round of funding from the state’s stem cell agency.

Prostate cancer, autism, ALS and AIDS/HIV are among the diseases targeted by the California Institute for Regenerative Medicine, whose governing board awarded a total of more than $40 million in funding for this round.

Overall, CIRM’s governing board has awarded more than $1.8 billion in stem cell grants, with half of the total going to the University of California or UC-affiliated institutions.

CIRM Early Translation Awards IV:

  • UC Irvine: $4.3 million: Magdalene Seiler
  • UCLA: $13 million: Donald Kohn, Gerald Lipshutz, Robert Reiter, Jerome Zack
  • UC San Diego: $1.8 million: Alysson Muotri
  • UCSF-affiliated J. David Gladstone Institutes: $2.3 million: Steven Finkbeiner

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New intervention reduces risky sex among bisexual African-American men


Holistic approach takes into account cultural considerations.

Nina Harawa, UCLA

Nina Harawa, UCLA

A culturally tailored HIV prevention program developed and tested by investigators at UCLA and the Charles R. Drew University of Medicine and Science has been shown to significantly reduce unprotected sex among bisexual black men.

The innovative approach, called Men of African American Legacy Empowering Self, or MAALES, is described in an article in the peer-reviewed journal AIDS.

The rate of HIV/AIDS among African-Americans is significantly higher than it is among any other ethnic or racial group. (According to the Centers for Disease Control and Prevention, African-Americans accounted for an estimated 44 percent of new U.S. HIV diagnoses in 2010.) Among men who have sex with men, black men account for the largest estimated number of HIV infections. Yet there are few interventions available to reduce those rates, said the study’s principal investigator, Nina Harawa, adjunct assistant professor of epidemiology at UCLA and associate professor of research at the Charles R. Drew University of Science and Medicine.

MAALES takes a holistic approach to minimizing behaviors that could put men at risk for HIV, engaging participants in small-group discussions about popular media, exercises such as negotiating condom use with sexual partners and activities to improve the participants’ knowledge of sexual health. Importantly, the intervention is also culturally relevant, addressing participants’ shared legacies, including social expectations of African-American men, historical discrimination and disenfranchisement, and societal impacts on individual health and sexual decision-making.

“When we first set out in 2004 to develop an intervention for behaviorally bisexual African-American men, the gap between documented need and services was staggering,” Harawa said. “Up to that point, just one prevention intervention tailored for African-American men who had sex with men had been developed and no interventions designed for behaviorally bisexual men of any race or ethnicity had been published.”

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UC Berkeley names public health dean


Gates Foundation senior fellow, AIDS expert Stefano Bertozzi to lead school.

Stefano Bertozzi

Stefano Bertozzi

Dr. Stefano Bertozzi, a prominent global health scientist, AIDS expert and health economist, has been named dean of the School of Public Health at the University of California, Berkeley, effective Sept.1.

Bertozzi, 53, is currently a senior fellow at the Bill & Melinda Gates Foundation, where he has directed the HIV and tuberculosis programs and led a team that manages the foundation’s portfolio of grants in HIV vaccine development, biomedical prevention research, diagnostics, and strategies for introduction and scaling-up of interventions. He oversaw the development of a new initiative in efficiency and effectiveness, and represented the private foundation’s constituency on the board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. He also serves on the scientific advisory boards for the President’s Emergency Plan for AIDS Relief, the National Institute of Health’s Office of AIDS Research and the World Health Organization.

“Stefano Bertozzi’s extensive experience confronting and engaging complex global health challenges, combined with his expert academic credentials, make him uniquely suited to lead UC Berkeley’s School of Public Health,” said UC Berkeley Chancellor Nicholas Dirks, who officially began his tenure on June 3. “His passion, commitment and accomplishments will help ensure that faculty, students and staff have the leadership they need. I look forward to working with him as the school becomes ever more central to the mission of UC Berkeley in the years ahead.”

Prior to joining the Gates Foundation, Bertozzi worked at the Mexican National Institute of Public Health as director of its Center for Evaluation Research and Surveys. He led economics and statistics teams that conducted impact evaluations of large health and social programs in Mexico, as well as in Africa, Asia and Latin America. He also led the institute’s AIDS/Sexually Transmitted Infections research group.

Bertozzi is considered a bold choice to lead the school through a period of great change in public and global health.

“During our nationwide search for the new dean, Dr. Bertozzi emerged early as a clear leader,” said George Breslauer, UC Berkeley’s executive vice chancellor and provost. “We were impressed with his breadth of experience – from teaching to research to program evaluation – as well as his progressive ideas about the role higher education can play in the evolving field of public health. I am confident that he will prove to be a transformative dean.”

Bertozzi has also held positions with UNAIDS and the World Bank. His research has covered a diverse range of projects in health economics and policy, focusing on the economic aspects of HIV/AIDS and on the health impact of large social programs.

He holds a bachelor’s degree in biology and a Ph.D. in health policy and management from the Massachusetts Institute of Technology. He earned his medical degree at UC San Diego, and trained in internal medicine at UC San Francisco. Bertozzi has lived and worked in developing countries in Africa, Asia and Latin America, and speaks English, French, Spanish and Italian.

“This is an extraordinary time,” said Bertozzi. “The world of public health, both in the U.S. and globally, is changing dramatically because of new tools and technologies. We are interconnected like we’ve never been before. It’s hard to think of a school of public health that’s more centrally located than UC Berkeley’s when it comes to innovation. We are well positioned to take advantage of the Bay Area’s leadership in transformations that are happening in technology, as well as those that are happening in the biomedical sciences.”

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Women who suffered severe sexual trauma as kids benefit most from intervention


UCLA-led study suggests that such interventions should be tailored to individuals’ experience.

Semel Institute for Neuroscience and Human Behavior at UCLAA UCLA-led study of HIV-positive women who were sexually abused as children has found that the more severe their past trauma, the greater their improvement in an intervention program designed to ease their psychological suffering.

The study, conducted by researchers at UCLA’s Collaborative Center for Culture, Trauma and Mental Health Disparities, suggests that such interventions should be tailored to individuals’ experience and that a “one size fits all” approach may not be enough to successfully reduce women’s depression, post-traumatic stress and anxiety symptoms.

“This study shows that those who suffer early and severe trauma can improve their psychological symptoms,” said primary investigator Dorothy Chin, an associate research psychologist at the Semel Institute for Neuroscience and Human Behavior at UCLA. ”Indeed, those who improve the most are those who suffered the most trauma.”

The research findings are published in the peer-reviewed journal Psychological Trauma: Theory, Research, Practice and Policy.

For the study, researchers used data on women who had participated in the Healing Our Women program, a clinical trial testing an HIV/trauma intervention for HIV-positive women who had suffered sexual abuse as children. Previous research demonstrated that this program was successful at reducing psychological distress among these women. The question for the current study was: Who benefited the most?

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Marital status reduces risk of death from HIV/AIDS for men


UC Riverside sociologist finds higher mortality rates for women of color.

Augustine Kposowa, UC Riverside

Augustine Kposowa, UC Riverside

At the height of the AIDS epidemic in the 1980s  men who were married were significantly less likely to die of HIV/AIDS than their divorced or otherwise single counterparts, according to a UC Riverside analysis of new mortality data for that era.

For women, marital status had little impact on who was more likely to die of the disease. But race proved to be a significant risk factor, with African-American women nine times more likely to die of HIV/AIDS and Latinas seven times more likely to die of the disease than white women. Those mortality rates were considerably higher than those for men of color compared to white men.

The study by UCR sociology professor Augustine Kposowa — “Marital status and HIV/AIDS mortality: evidence from the U.S. National Longitudinal Mortality Study” — is the first to examine the effects of marital status on deaths of individuals with HIV/AIDS. It appears in the International Journal of Infectious Diseases, the official publication of the International Society for Infectious Diseases.

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Intestinal bacteria may fuel inflammation, worsen HIV disease


HIV-infected people have different gut microbiome than people who are uninfected.

Intestinal bacteriaChanges in intestinal bacteria may help explain why successfully treated HIV patients nonetheless experience life-shortening chronic diseases earlier than those who are uninfected, according to a new study led by UC San Francisco.

These changes in gut bacteria may perpetuate inflammation initially triggered by the body’s immune response to HIV, researchers reported.

Their study was published online today (July 10) in the journal Science Translational Medicine.

The new findings support recent research pointing to such persistent inflammation is a possible cause of the early onset of common chronic diseases found in HIV patients, who now can live for decades without immune system destruction and death due to infection thanks to lifelong treatment with antiretroviral drugs. Likewise, in the general population, ongoing inflammation has been linked in some studies to chronic conditions, such as heart disease, dementia and obesity.

Studies have shown that inflammation is induced by HIV in both treated and untreated patients, and is associated with – and possibly causes – disease in both, according to Joseph M. McCune, M.D., Ph.D., chief of the Division of Experimental Medicine at UCSF and a senior author of the study. McCune has been investigating the causes of chronic inflammation in HIV-infected patients and has treated patients with HIV for more than three decades.

“We want to understand what allows the virus to persist in patients who have HIV disease, even after treatment,” he said. “In this study, we see that bacteria in the gut may play a role.”

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Team science plays a key part in quest for HIV cure


UCSF doctors deliver lecture detailing importance of collaboration.

Steven Deeks, UC San Francisco

In a lecture that represents one of the top recognitions that researchers can receive from their peers, two veteran UCSF doctors who have been battling the AIDS epidemic for decades retraced past efforts and described their ongoing quest for a cure for HIV.

Steven Deeks, M.D., and Mike McCune, M.D., Ph.D., are joint recipients of the UCSF Academic Senate’s Third Annual Faculty Research Lecture – Translational Science. On June 18 in Genentech Hall on the Mission Bay campus, they talked about “Team Science and the HIV Cure.”

“This team has consistently demonstrated elegant and creative work focused on the mechanisms and consequences of immune dysfunction in HIV-infected patients,” said Janet Myers, Ph.D., M.P.H., vice chair of the Academic Senate’s Committee on Research.

Mike McCune, UC San Francisco

Paul Volberding, M.D., director of the Center for AIDS Research at UCSF, introduced Deeks and McCune. Together, he said, the two have done remarkable things, including exploring the role of the thymus, effects of treatment discontinuation, viral fitness, the overall concept of HIV and aging, and the role of immune activation and microbial translocation.

Of the three large grants in the United States that are centered on finding a cure for HIV, one is being led by Deeks and McCune, Volberding said.

In short, Deeks and McCune are among UCSF’s legendary leaders working on the frontlines of the field since its emergence more than three decades ago.

Their lectures, 45 minutes apiece, made it clear how their work has shifted the focus from HIV itself to how the immune system responds to the virus.

“Each of us has walked through this epidemic. We’ve seen the high points and the low points,” said McCune, chief of UCSF’s Division of Experimental Medicine, who stressed that getting rid of HIV will happen only with a group of people working together in a collegial and collaborative way.

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Program improves life for rual women in India living with HIV/AIDS


Lay women trained as social health activists to assist women who have HIV/AIDS.

UCLA's Adey Nyamathi (center) with program participants

A multidisciplinary team of researchers from UCLA and India has found that a new type of intervention program, in which lay women in the rural Indian province of Andra Pradesh were trained as social health activists to assist women who have HIV/AIDS, significantly improved patients’ adherence to antiretroviral therapy and boosted their immune-cell counts and nutrition levels.

The lay women were trained by the research team to serve as accredited social health activists, or ASHA, and their work was overseen by rural nurses and physicians. These ASHA then provided counseling and support to the women with HIV/AIDS, as well as assistance aimed at removing the barriers they face in accessing health care and treatment.

“For rural women living with AIDS in India, stigma, financial constraints and transportation challenges continue to exist, making lifesaving antiretroviral therapy difficult to obtain,” said lead researcher Adey Nyamathi, distinguished professor and associate dean of international research and scholarly activities at the UCLA School of Nursing.

In India, 2.47 million people are affected with HIV/AIDS, and more than half are women. The epidemic is shifting from urban to rural areas, and the rice-producing Andhra Pradesh district in southeastern India is at the epicenter; this area has the highest total number of HIV/AIDS cases of all states in the country, with nearly 20 percent of the population infected.

For the intervention study, women with HIV/AIDS in Andra Pradesh were randomly selected to participate either in the intervention, called AHSA-LIFE (AL), or in a control group.

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New strategies aim to keep high-risk youth free of HIV infection


UC’s California HIV/AIDS Research Program funds three projects to help curb HIV.

Studies funded by UC’s California HIV/AIDS Research Program hope to curb HIV in the state by engaging people at high risk in innovative prevention efforts in their communities.

Last year, Grant Lindsey visited Oakland’s Downtown Youth Clinic for the first time, accompanying his partner who was being treated there for HIV. Lindsey is not HIV-positive, but this was a new relationship, and he was there to offer help and encouragement.

“I really wanted to support my partner, and I wanted to get educated for myself,” he said. “I wanted to get up to date as far as HIV and safe sex were concerned.”

While at the clinic, Lindsey was tested for HIV. He also talked with the clinic director and medical staff about his new relationship, and he got answers to questions that had been worrying him.

Soon, he was volunteering for a new study to test an HIV prevention pill (Truvada), which has been found to protect uninfected persons against the virus. This prevention pill is part of a new strategy called PrEP (pre-exposure prophylaxis) that includes taking the daily antiretroviral medication, Truvada, which was approved last year by the FDA. Truvada is provided for the study by its maker, Gilead Sciences, Inc.

This bold research, which is funded by UC’s California HIV/AIDS Research Program (CHRP), engages people at high risk for HIV infection in an innovative new biomedical prevention effort in their communities. The study in Oakland and other East Bay cities is one of three PrEP research projects funded by CHRP to help curb HIV in California. The combined effort is the largest PrEP demonstration project in the U.S. (See “Combining a prevention pill with community treatment programs“)

“I didn’t know anything about this,” said Lindsey. “It’s amazing. HIV is still rampant, and not enough people are talking about it.”

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UCTV: HIV: Past present and future — Mini Medical School for the public presented by UCSF Osher Center for Integrative Medicine

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Cross-border connections


UC San Diego chancellor visits Tijuana to learn about industry, health care and education.

Health Frontiers in Tijuana Clinic

From touring the production floor of one of Mexico’s best places to work to witnessing a student-run free health clinic in action, UC San Diego Chancellor Pradeep K. Khosla’s visit to Tijuana, Mexico, Friday offered him an introduction to the bustling metropolis just across the border from San Diego. The one-day tour included visits to Hospital Angeles Tijuana, the Health Frontiers in Tijuana Clinic, the Business Innovation and Technology Center, El Florido Parque Industrial, and the Culinary Art School.

“I’m pleased to have the opportunity to meet with our community partners in Tijuana and learn more about this region and cross-border issues,” said Khosla. “My goal is to strengthen the existing partnerships between UC San Diego and our neighboring country, and pursue other opportunities for collaboration. Our teamwork is vital for the economic and social growth and prosperity of our regions, and we look forward to the ongoing exchange of ideas.”

Accompanying Khosla in Tijuana were Mary Walshok, associate vice chancellor for Public Programs at UC San Diego; Juan Lasheras, interim dean of the Jacobs School of Engineering; Alberto Díaz-Cayeros, director of the university’s Center for U.S.-Mexican Studies; and James Clark, director general of the Mexico Business Center at the San Diego Regional Chamber of Commerce, who helped arrange the trip.

The day began with a visit to Hospital Angeles Tijuana, Mexico’s largest private hospital network and a top-tier facility for medical care. In a series of brief presentations, Khosla was introduced to the hospital’s breadth of services, novel technology and leading-edge research. Representatives from UC San Diego and Hospital Tijuana discussed where there may be opportunities for future collaboration, from research and clinical trials to training students.

Next on the tour was a visit to a different side of healthcare in Tijuana: a student-run free clinic in one of the city’s poorest districts. About a dozen patients, many homeless, gathered in the alley in front of the Health Frontiers in Tijuana (HFiT) Clinic, waiting to be seen.

The HFiT Clinic is a collaborative project of UC San Diego and the Universidad Autónomo de Baja California. Students from both sides of the border are mentored by faculty at the clinic to provide free care for underserved populations in Tijuana. Faculty and students also collaborate on a number of research projects focusing on HIV and STD prevention, substance abuse, policing practices and sex trafficking.

“There is an intense need for health services here,” said Steffanie Strathdee, associate dean of global health sciences at UC San Diego, as she gave an overview of the project. “We align research, training and service. And we, the professors, learn as much from the students as they learn from us.”

Before leaving the site, Khosla thanked the graduating medical students for their work. “What you’re doing here is truly amazing,” he said. “I had heard about some of this work, but it is not the same as being here today and seeing the impact.”

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