The Resilience of the HIV Research Community

People attending the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Denver in February witnessed multiple reminders of the resilience of the HIV research community.

The program started with special invited lectures that highlighted progress in research on cure, prevention, and treatment. An especially moving talk was given by former amfAR Trustee Peter Staley, who reflected on how people living with HIV and their advocates had persistently fought to secure equitable access to antiretroviral medicines and against stigma and discrimination.

Subsequent sessions offered state-of-the-science talks on topics ranging from whether GLP-1 weight-loss and diabetes medicines were “the cure for everything” to the latest on HIV prevention and treatment strategies. Updates on new scientific breakthroughs and lessons learned on how to implement them have been summarized by AVAC , aidsmap, and others.

Among the studies at CROI that were conducted among people living with HIV in Asia, amfAR’s TREAT Asia network colleagues at HIV-NAT in Bangkok presented work examining the linkage between liver damage (metabolic dysfunction-associated steatohepatitis, or MASH) and cognitive impairment in a group of aging Thai people living with HIV. One-fifth of their study participants had liver damage, which was found to be associated with worse cognitive performance. TREAT Asia has been supporting this team to conduct studies of biomarkers of Alzheimer’s disease in the same group of participants.

Another team from the U.S. Centers for Disease Control and Prevention and Thailand Ministry of Public Health used rapid tests for recent infection to identify new HIV infections among men who have sex with men (MSM) in a nationwide study. Notably, those 15-24 years of age had more than twice the odds of having recently acquired HIV in comparison to older MSM. Although oral, daily pre-exposure prophylaxis (PrEP) medicines are widely available in Thailand, it remains a challenge to increase uptake among young adults at risk for HIV. This emphasizes the need to expand prevention options to include long-acting injectable and oral antiretroviral medicines, which were the focus of multiple presentations at CROI. However, some middle-income Asian countries are less likely to be included or prioritized in special pricing arrangements that could make such medicines affordable for individual patients or national health insurance programs. This is a key reason why TREAT Asia is continuing our work to address access to medicines across the region (long-acting cabotegravir as PrEP; lenacapavir as PrEP), in partnership with civil society organizations.

Behind many of the scientific advancements presented during the conference were early-career investigators— including graduate students, clinical fellows, and post-doctoral trainees. They are essential to drive the engine of science, but have been among the most vulnerable to the recent grant reductions and cuts instituted by the U.S. National Institutes of Health. They are often reliant on training programs to fund their research and too junior to hold the kinds of large grants that can support their salaries without extra help from senior researchers. Their presence at CROI was especially evident while walking through CROI’s “poster hall,” where attendees can read summaries of studies and discuss them with the investigators who conducted the research. Instead of the gloomy atmosphere in the poster hall at last year’s conference when grant cuts had begun leaving many without job security, this year, there was a renewed sense of purpose and a belief in the enduring power of science to guide innovation and understanding.

It is that power of science that we continue to rely on to inspire the work that we do across amfAR’s programs around the world.

Dr. Annette Sohn is an amfAR vice president and director of TREAT Asia.

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