HIV/AIDS as a Global Health Challenge

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AFYA BORA CONSORTIUM GLOBAL HEALTH LEADERSHIP
FELLOWSHIP PROGRAM
HIV/AIDS as a Global
Health Challenge
Distance Learning
AFYA BORA CONSORTIUM
HIV/AIDs as a Global Health Challenge
Module Instructors
Dr. Carey Farquhar
cfarq@u.washington.edu
Guide for Fellows and Instructors
1
Table of Contents
Course Instructions: For Fellows, Working Group Members, and Facilitators.............................. 3
Learning Objectives..................................................................................................................... 3
Evaluation metrics ...................................................................................................................... 3
Course Guidelines ....................................................................................................................... 4
Course Format............................................................................................................................. 4
Table 1. ......................................................................................... Error! Bookmark not defined.
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Course Instructions: For Fellows, Working Group Members, and Facilitators
This module is one of the Afya Bora Consortium Fellowship’s distance learning modules. The
purpose of this module is to provide Fellows with an update on several critical HIV/AIDS topics
in care, prevention, and policy. It is intended to be a thought-provoking update rather than a
comprehensive overview of the global HIV/AIDS epidemic.
The module takes place over a month’s period of time and although Fellows will view the
lectures separately, they will be expected to engage in face-to-face discussions in order to
expand their understanding of these issues.
Learning Objectives
The purpose of this module is not only to provide you with updates on HIV/AIDS but also to
create the opportunity for you to engage with your Afya Bora colleagues to synthesize, present,
and discuss these issues. Fellows should be prepared to lead at least one discussion.
Presenters should come to the meetings with a short overview (5 – 10 min) as well as key
discussion questions. It should be assumed that the materials have been viewed prior to the
meeting.



Fellows will be able to highlight key points from each of the talks
Fellows will present and facilitate at least one discussion based on one of the talks
Fellows will prepare and submit a written summary of the group discussion.
Evaluation metrics
Fellows will be expected to submit two items for evaluation.
1. Fellows will be expected to present the questions they used to facilitate the group
discussion.
2. Fellows will submit a ½ page (no more than 1 page) synthesis of the key points of the
group discussion. This synthesis can highlight the main points of the presentation and
discuss how the group engaged with the topic. The synthesis may also include the
relevancy of the talk to the Fellows’ context. Did the group view the information as
essential and why? How might this information change inform their practice? This
synthesis is not meant to be a restatement of the lecture.
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Course Guidelines
We have selected 12 of the most relevant lectures recorded at the University of Washington
Principles of HIV and STIs and at international conferences. These have been compiled on the
attached CD and are also available on the UW TREE website, to which each of you should have
access.
Course Format
The recommended format for conducting this course is as follows:

Each fellow will be distributed a CD and this coversheet.

Fellows will be responsible for viewing talks during the weeks indicated on the table below.

Schedules will be established by in-country working group members for Fellows to discuss
the talks as a group. The schedule can vary depending on the needs of a particular group.
However, this is a blended learning course and is designed to have asynchronous learning
activities (ie. listening to the lectures) and synchronous (face to face) elements. Suggested
timelines are as follows.
o Once weekly to discuss the three talks for that week
o Twice over the length of the course and highlight key talks

Once the schedule has been agreed upon, it should be sent to Dr. Farquhar.

Group discussions will be led by 2 or more Fellows who will be assigned specific dates and
talks.

To lead a group discussion, Fellows should be prepared to summarize key points and
present questions to the other Fellows and faculty in order to stimulate conversation.
Fellows should not re-present the lecture. Rather, Fellows should assume all participants
have listened to the lecture and spend only 5 minutes reviewing key points.

Fellows will be expected to submit two items for evaluation: A list of discussion questions
and a synthesis of the full group discussion. These items should be submitted to Angela
Shelton or Dr. Farquhar at the end of your session.

Inviting an outside facilitator who has expertise in the area of one of the talks is strongly
encouraged. This person should be given the opportunity to watch the talk and then
incorporated into the discussion.
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Any problems encountered with the CDs, group meetings or discussions should be reported
immediately to Angela Shelton and Dr. Farquhar at angshelt@uw.edu and cfarq@uw.edu,
respectively.
Table 1. HIV/AIDS talks, presenters, viewing dates and Fellows assigned to talks (TBD)
Viewing
Dates
HIV/AIDS Lectures and Presenters
Group
Fellows
Discussion Assigned to
Session
Lead Session
1. Francois Dabis "Reality Check: Is the End of AIDS in
Sight?"
Week 1
2. Joanne Stekler "HIV Testing Strategies"
TBD
TBD
TBD
TBD
TBD
TBD
TBD
TBD
3. Jared Baeten "Pre-Exposure Prophylaxis (PrEP) for
HIV Prevention"
4. Elizabeth Bukusi "Implementation of Large Scale
Research Projects in Africa"
Week 2
5. Grace John-Stewart "Vertical Transmission of HIV"
6. Jane Simoni "HIV and Mental Health"
7. Stefano Bertozzi "Health Economics and STD/HIV
Prevention"
Week 3
8. Chris Beyrer "The Global MSM HIV Epidemic: Time
to Act"
9. Sharon Hillier "Microbicides"
Week 4
10. Lawrence Corey "Biology of Developing and HIV
Vaccine"
11. Corey Casper "Malignancies in HIV"
12. Thomas Hawn "HIV/TB Co-infections"
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Speaker Biographies (in order of presentation)
Francois Dabis
Dr. Dabis is a medical doctor and Professor of Epidemiology at the School of Public Health
(ISPED) of the University Bordeaux Segalen, in Bordeaux, France. Dr. Dabis has 25 years of
experience in research on HIV epidemiology and global health. He has been leading since 2001
the HIV research team within ISPED. His scientific interest is on the public health challenges of
HIV prevention and care: prevention of mother-to-child transmission in Africa, cohort studies
of antiretroviral-treated adults and children in France and West Africa and more generally
operational research on HIV programs in resource-limited settings. François Dabis is the Chair of
the Coordinated Action n°12 of the French Agency for Research on HIV/AIDS and Viral Hepatitis
(ANRS) in charge of the scientific agenda of the Agency in lower-income countries. He is also
the Chair of the Scientific Committee of the Institut national de la Veille Sanitaire (French CDC)
since 2003. His scientific productivity can be described through more than 450 publications in
peer-reviewed journals and book chapters and his contribution to the Editorial Board of two
leading journals in infectious diseases: AIDS and Journal of the Acquired Immunodeficiency
Syndrome.
Joanne Stekler, MD
Dr. Stekler is an Assistant Professor of Medicine and, Epidemiology, at the University of
Washington and is Deputy Director (Community Services) of the HIV/STD Program, Public Health
- Seattle & King County. Dr. Stekler's research is focused in two primary areas: HIV prevention
through earlier diagnosis of HIV infection and the clinical consequences of primary HIV
infection. With the Public Health - Seattle & King County HIV/AIDS Program, Dr. Stekler is
working to expand routine HIV antibody testing and access to pooled HIV nucleic acid
amplification testing to diagnose acute HIV infection. She leads several studies investigating
novel methods to diagnose acute and early HIV infection; comparisons of rapid HIV tests; and
home, self-testing for HIV infection. Dr. Stekler also works at the University of Washington
Primary Infection Clinic within the clinical core of the Seattle Primary Infection Program
(SeaPIP), a collaboration of local and national virologists, immunologists, and clinicians. Since
1992, the Primary Infection Clinic has enrolled and followed over 300 persons with acute and
early HIV infection. Dr. Stekler's interests include interdisciplinary research to understand
factors associated with HIV transmission, consequences of transmitted drug resistance, viral
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dynamics following HIV acquisition, and clinical outcomes of antiretroviral therapy during
primary HIV infection.
Jared Baeten, MD, PhD
Dr. Baeten is an associate professor in the Departments of Global Health and Medicine and an
adjunct associate professor in the Department of Epidemiology at the University of
Washington. His research focuses on epidemiologic and biologic risk factors for HIV and other
sexually transmitted diseases, and clinical trials of novel interventions for prevention of HIV
transmission.
Current projects include a phase III randomized, placebo-controlled trial of antiretroviral preexposure prophylaxis (PrEP), using oral tenofovir and co-formulated emtricitabine/tenofovir,
for the prevention of HIV acquisition within HIV serodiscordant couples in Kenya and Uganda
(study co-chair), and an upcoming phase III trial of dapivirine vaginal ring for HIV prevention in
women (through the NIH Microbicides Trials Network, study chair). He is also PI or Project
Director of four NIH grants studying best HIV prevention strategies for the heterosexual African
HIV epidemic. He has ongoing collaborative projects exploring clinical, virologic, and
immunologic factors influencing HIV transmission.
Elizabeth Bukusi, MBChB, MMed, MPH, PhD
Dr. Bukusi is a Senior Research Officer at Kenya Medical Research Institute. She is a Honorary
Lecturer in Department of Obstetrics and Gynecology at the University of Nairobi, and holds a
professional research position with the University of Washington Department of Obstetrics and
Gynecology. In addition, Dr. Bukusi is currently the Program Co-Director for a PEPFAR – CDC
funded care program, “Family AIDS Care and Education Services (FACES).” She is also a CoDirector of a Fogarty-funded training program “The KEMRI-UCSF Infectious Disease Training
Research Program,” which aims to build capacity of STI researchers in the East African region.
Dr. Bukusi is a co-investigator on several ongoing studies including “HIV/AIDS Widow
Inheritance” based in Bondo in Nyanza, and “HIV Shedding and the Female Genital Tract” based
in Nairobi. She has been serving on the WHO reproductive health country development
program since 2002. She currently serves on the DSMB for the CIPRA program of the Moi
University referral and teaching hospital based in Eldoret, Kenya, and for a UCSF multi-site
MIRA study.
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Grace John-Stewart, MD, PhD
Grace John-Stewart is a Professor, Departments of Medicine, Epidemiology, Global Health, and
Pediatrics at the University of Washington. Dr. John-Stewart was trained as an internist and
pediatrician prior to infectious diseases, and received a PhD in epidemiology. Her research is
focused on international HIV-1 studies, primarily based in Kenya. These include studies of
transmission, prevention, clinical epidemiology, clinical trials, and molecular epidemiology. Her
interests include mother-to-child transmission of HIV-1, pediatric HIV-1 and co-infections (TB,
helminths, CMV), HIV-1 acquisition and pathogenesis, and treatment and delivery of HIV-1
treatment and prevention services. She has published over 140 peer-reviewed manuscripts. Dr.
John-Stewart's funding has included support from the NIH, CDC, Gates Foundation, EDCTP, and
the Elizabeth Glaser Pediatric AIDS Foundation. Dr. John-Stewart received the Elizabeth Glaser
Scientist Award, has mentored over 60 students/fellows, received a K24 Mentorship Award,
was nominated for the UW post-doctoral mentorship award, for the Marsha Landolt Award,
and received a UW School of Medicine mentorship award. She is currently the Director of the
CFAR International Core, the Kenya Research Program, and the UW Global Center for Integrated
Health of Women, Adolescents and Children (Global WACh).
Jane Simoni, PhD
Jane M. Simoni is a clinical psychologist and a professor in the Department of Psychology, with
adjunct appointments in Global Health and Gender, Women, and Sexuality Studies. She is a
faculty member in the CFAR’s Socio-behavioral and Prevention Research Core. Her research has
focused on behavioral aspects of HIV treatment, with several NIMH-funded intervention studies
in NYC, Seattle, the U.S.-Mexico border, and China. She is also interested in health disparities
among sexual and ethnic/racial minority groups. Recently, she received a Mid-Career
Development Award to support her mentoring activities of graduate students and junior
investigators and to expand her expertise in computer technology to enhance intervention
impact and dissemination.
Stefano Bertozzi, MD, PhD
Dr. Stefano Bertozzi oversees investments in HIV vaccine development, research and product
development for biomedical prevention and diagnostics, and strategies for enhancing the
efficiency and effectiveness of delivery of prevention and treatment services. Prior to joining
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the Foundation in 2009, Dr. Bertozzi was with the National Institute of Public Health (INSP) in
Mexico from 1998-2009, as the director of its Center for Evaluation Research & Surveys, where
he led economics and statistics teams that conducted impact evaluations of large health and
social programs in Mexico, Africa, Asia and Latin America. He also led the INSP's AIDS/Sexually
Transmitted Infections research group. Prior to joining the INSP, he led HIV and health
economics programs at UNAIDS, the World Health Organization (WHO) and the World Bank. Dr.
Bertozzi is a member of the Board of Directors of the Global Fund for AIDS, Tuberculosis, and
Malaria and the Institute of Health Metrics and Evaluation, and is a member of the Scientific
Advisory Board of the President’s Emergency Plan for AIDS Relief. Dr. Bertozzi’s research has
covered a diverse range of topics in health economics and policy, focusing on the economic
aspects of HIV/AIDS and on the health impact of large social programs. He received his BS in
Biology and PhD in Health Policy and Management from MIT, his MD from University of
California, San Diego, and residency training in internal medicine at University of California, San
Francisco.
Chris Beyrer, MD, MPH
Chris Beyrer is Professor in the Departments of Epidemiology, International Health, and Health,
Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. He serves as
Director of the Johns Hopkins Fogarty AIDS International Training and Research Program and as
founder and Director of the Center for Public Health and Human Rights at Johns Hopkins. He
also serves as Senior Scientific Liaison and Chair of the Injecting Drug Use Working Group of the
HIV Vaccine Trials Network (HVTN). He currently has research and/or training activities in
Thailand, China, Burma, India, Laos, Malawi, Uganda, Ethiopia, South Africa, Brazil, Russia, and
the US. He is the author of the 1998 book War in the Blood: Sex, Politics and AIDS in Southeast
Asia (Zed Books, London, St. Martins Press, New York). Dr. Beyrer has published extensively on
HIV/AIDS epidemiology and prevention research, HIV vaccine research, and public health and
human rights and is the author of numerous articles and scientific papers. He has served as a
consultant to the World Bank Institute, the World Bank Thailand Office, The Office for AIDS
Research of the U.S. NIH, The Levi Strauss Foundation, The U.S. Military HIV Research Program,
the Henry M. Jackson Foundation for the Advancement of Military Medicine, The Open Society
Institute, The Royal Thai Army, and numerous other organizations.
Sharon Hillier, PhD
Dr. Sharon L. Hillier is professor and vice chair for faculty affairs, and director of reproductive
infectious disease research in the department of obstetrics, gynecology and reproductive
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sciences at the University of Pittsburgh School of Medicine. In addition, she holds secondary
appointments in the School of Medicine’s department of microbiology and molecular genetics
and with the Clinical and Translational Science Institute, and is a senior investigator at the
University of Pittsburgh-affiliated Magee-Womens Research Institute. Dr. Hillier is an
internationally recognized microbiologist whose work has influenced a nascent field of research
in which women’s health and HIV prevention concerns intersect. In 2006, she was named
principal investigator for the Microbicide Trials Network, an HIV/AIDS clinical trials network
established by the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S.
National Institutes of Health (NIH). As principal investigator, Dr. Hillier leads an international
team of investigators and community and industry partners from seven countries and three
continents, directing an ambitious research agenda imposed by the urgency of the HIV/AIDS
epidemic. MTN’s broad range of clinical trials includes studies considered among the most
critically important for advancing the field of HIV prevention.
Lawrence Corey, MD, PhD
Dr. Lawrence Corey is president and director of Fred Hutchinson Cancer Research Center. His
appointment became effective Jan. 1, 2011. An internationally renowned expert in virology,
immunology and vaccine development, Corey’s research focuses on herpes viruses, HIV and
other viral infections, particularly those associated with cancer. He also is principal investigator
of the Hutchinson Center-based HIV Vaccine Trials Network, an international collaboration of
scientists and institutions that combines clinical trials and laboratory-based studies to
accelerate the development of HIV vaccines. Under Corey’s leadership at the Hutchinson
Center, the HVTN has become the model for global collaborative research; the network involves
scientists on four continents and nine countries. Prior to assuming the leadership of the
Hutchinson Center, Corey directed the Hutchinson Center’s Vaccine and Infectious Disease
Division, which is dedicated to developing and implementing prevention strategies for globally
important infectious diseases, including HIV and viruses and bacteria that can result in cancer.
He also headed the Program in Infectious Diseases at the Hutchinson Center and the Virology
Division in the Department of Laboratory Medicine at the University of Washington School of
Medicine.At UW, Corey is a professor of laboratory medicine and medicine, adjunct professor
of pediatrics and microbiology, and holder of the Lawrence Corey Endowed Chair in Medical
Virology.
Corey Casper, MD, MPH
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Dr. Casper is the Director of the Uganda Cancer Institute (UCI) / Hutchinson Center Cancer
Alliance and an Associate Member at the Fred Hutchinson Cancer Research Center in Seattle
Washington. He is also an Associate Professor of Medicine, Epidemiology and Global Health at
the University of Washington, where he serves as the Assistant Director of the Center for AIDS
Research. Dr. Casper divides his time between engaging in research, teaching and clinical care.
His research efforts focus on the transmission, acquisition, natural history, pathophysiology and
treatment of infection-associated cancers with a special focus on human herpesvirus 8 (HHV-8)
and Kaposi Sarcoma. As director of UPCID, Dr. Casper established a clinical research site in
Kampala Uganda. This site currently has more than 20 ongoing studies examining the control of
HHV-8 replication, biomarkers for the prediction of KS development and successful treatment,
the immunogenetics of infection-associated cancers, treatment of KS and lymphoma, the role
of nutrition in the development and treatment of infection-related cancers, and the discovery
of novel pathogens associated with cancer.
Thomas Hawn, MD, PhD
Thomas Hawn obtained his M.D. and Ph.D. degrees at Johns Hopkins University School of
Medicine. He then moved to the University of Washington, where he trained in an Internal
Medicine residency and then specialized further with a fellowship in Infectious Diseases. Dr.
Hawn is currently an Assistant Professor in the Division of Allergy and Infectious Diseases in the
Department of Medicine at the University of Washington School of Medicine. His laboratory
investigates molecular, cellular, and immunologic mechanisms of disease pathogenesis with an
emphasis on genetic studies of the innate immune response. These studies include
investigations of why individuals have variable susceptibility to tuberculosis and the BCG
vaccine to prevent it. The overall goal is to understand why individuals have different
susceptibility to infections and whether these insights can lead to novel treatment and vaccine
strategies.
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