IPHi Launches Model HIV/AIDS Care Program in PG County, Maryland

The Institute for Public Health Innovation Launches Model HIV/AIDS Care Program in Prince George’s County, Maryland

Washington, DC, April 29, 2013 - The Institute for Public Health Innovation (IPHi) today announced Total Health Partners, a new initiative in Prince George’s County, Maryland that will use highly trained community health workers to provide personalized assistance to people living with HIV/AIDS to help them link to and remain in HIV medical care. The effort is a partnership with Prince George’s County Health Department, Greater Baden Medical Services, and Heart to Hand, Inc. and an expansion of similar efforts that IPHi coordinates in the District of Columbia and Virginia. IPHi recently received prestigious national grants from the Kaiser Permanente National Community Benefit Fund at the East Bay Community Foundation, AIDS United, and M·A·C AIDS Fund to launch the program, along with funding from Washington AIDS Partnership. 

Prince George’s County is home to approximately one-fifth of all people living with HIV in Maryland, second only to Baltimore City. According to the Maryland Department of Health and Mental Hygiene, only 65% of HIV diagnosed persons in the county were linked to care in 2010 and just over one-third (37%) of HIV diagnosed persons were retained in care. Fewer still, 27%, were on antiretroviral therapy, and just 19% achieved viral suppression. These rates are below corresponding rates for Maryland and the nation overall. Research demonstrates that viral suppression is critical not only for the health and quality of life of people living with HIV/AIDS, but for preventing further transmission of the disease.

The community health workers will work as members of interdisciplinary care teams at medical and support service sites across the county. As trusted members of the community who can relate to the experiences of those they support, community health workers are in a unique position to help people living with HIV/AIDS overcome barriers to medical care, including stigma, lack of a basic understanding about the disease and available services, and challenges navigating community resources.

Since 2011, IPHi has trained over 100 community health workers, including approximately 40 who have specialized in providing support to people living with HIV/AIDS. IPHi, together with its partner Washington AIDS Partnership and over 15 community-based and medical providers, has created over 25 community health worker positions throughout DC, Maryland, and Virginia. Among those are 13 community health workers involved in Positive Pathways, a nationally recognized HIV care model in DC that enrolled over 500 people living with HIV/AIDS in its first 18 months. Positive Pathways has an intentional focus on the Wards of DC closest to Prince George’s County.

“The area straddling the border between DC and Prince George’s County is one of the most concentrated HIV/AIDS epidemics in the country,” said Michael Rhein, President and CEO of IPHi. “While there are considerable resources available to address the epidemic in DC, community-based systems of care and support for people living with HIV/AIDS are less developed and integrated across the jurisdictional line in Prince George’s County. Total Health Partners will play a critical role in ensuring that county residents have the assistance they need to access life-saving HIV/AIDS medical and support services.”

“This project is a long time coming for our county,” said Dedra Spears-Johnson, Executive Director of a community-based organization called Heart to Hand, Inc. “Too many people living with HIV/AIDS in the county are not effectively linked to medical care. Total Health Partners will make a huge difference."

About the Institute for Public Health Innovation
The Institute for Public Health Innovation (IPHi) provides technical capacity, leverages resources, and facilitates collaboration across sectors to develop, implement, and evaluate effective strategies that improve health and quality of life in the DC, Maryland and Virginia region. IPHi is one of the newest institutes within the National Network of Public Health Institutes (NNPHI), an organization of 38 members throughout the United States and a growing aspect of the national public health infrastructure. To learn more about IPHi, visit www.institutephi.org.

Contact:
Janelle Suggs
The Institute for Public Health Innovation (IPHi)
130, Connecticut Avenue NW, Suite 200
Washington, DC 20036
202-407-7096
jsuggs@institutephi.org
http://www.institutephi.org

Approaches to HIV Eradication

The various approaches to HIV eradication all address a problem, and that problem is the HIV reservoir. HIV reservoirs have been called the last hiding place for HIV within the body. The final step toward finding a cure against HIV lies in dealing with HIV reservoirs.

Toulon, France, August 30, 2011 - What can be done about HIV eradication? The advancements in scientific technology and medical treatments have made significant progress in managing HIV and making it a chronic condition in most patients; however, the next logical step toward a cure has been elusive. Researchers have been working hard for the past few years on closing the gap between manageable disease and functional cure, and several different approaches have been explored or are currently being discussed. While antiretroviral therapy (ART) has been effective against HIV virus out in the open bloodstream, there are pockets of HIV that lie dormant in cells until antiretroviral therapy ceases, which allow them to become active again. These pockets are called HIV reservoirs. The approaches to HIV eradication focus mainly on how to deal with these reservoirs.

Let's talk about some of the discussed approaches; seven of them to be exact. On one approach, ART is started before HIV has a chance to establish reservoirs. This normally takes place when a person is just infected with HIV (acute HIV infection), very early in the process. The hope is to stop viruses before reservoirs can be established. In another approach, ART is intensified greatly in order to stop completely HIV replication. An alternate strategy is to activate dormant T-cells so the remaining HIV reservoirs can be flushed out and eliminated.

There are also strategies that deal with preventing the virus from infecting additional cells directly. If the HIV reservoirs can't be eliminated, one approach involves keeping the reservoirs dormant forever, keeping the HIV from ever replicating again. This means finding ways to disable the virus's ability to replicate. Alternatively, a sixth strategy protects the uninfected cells from ever being infected. The seventh discussed approach attempts to strengthen the body's natural immune system when exposed to HIV, very much like how a vaccine works.

The various approaches to HIV eradication all address a problem, and that problem is the HIV reservoir. HIV reservoirs have been called the last hiding place for HIV within the body. The final step toward finding a functional cure for HIV lies in dealing with HIV reservoirs. The dormant viruses hiding in these places make it very easy for a person's viral load to increase dramatically if ART is stopped even for a short time. Therefore, in conjunction with ART, one of the known possible approaches for HIV eradication—or possibly approaches that haven't been thought of yet—will become increasingly important to develop and implement.

Contact:

Alain Lafeuillade

AVPS

1208 Av. Cl Picot

Toulon, 83000

France

33494616340

lafeuillade@orange.fr

http://www.hiv-eradication.org

Clues to HIV Persistence on ART

Recent research has found that while antiretroviral therapy (ART) is effective at significantly reducing the number of plasma-to-T-cell transmissions of HIV, it's not as effective against T-cell-to-T-cell. The remaining virus hides in infected T-cells, which allows it to easily be passed on to non-infected ones; this, in fact, is one of the reasons why HIV persists through ART.

Toulon, France, August 23, 2011 - HIV has a built-in backup plan when it comes to its survival. While scientific technology has progressed to the point where antiretroviral drugs can effectively kill HIV viruses in the body that are out in the open, HIV persists in places where the drugs can't get to them. These places are called HIV reservoirs, and these reservoirs ensure that small batches of virus remain in the body, ready to replicate when necessary. This is part of what makes HIV a chronic infection—the remaining virus finds ways to remain dormant in the body until activated. Research is now focusing on cracking the case of HIV persistence.

The goal of researchers now is to remove the "chronic" term from the chronic illness that is HIV and come up with a cure for the disease. A better understanding of HIV and how it infects people to begin with might be the key to discovering ways to enter the reservoirs within the body and eliminate the virus. As we already know, HIV infects cells in two ways: through blood plasma contact with T-cells, and from infected T-cells to non-infected T-cells. Antiretroviral drugs, while effective, don't remove the entire virus quantity, and all it takes is for one HIV virus to remain behind for the replication to continue.

Recent research has found that while antiretroviral therapy (ART) is effective at significantly reducing the number of plasma-to-T-cell transmissions of HIV, it's not as effective against T-cell-to-T-cell. The remaining virus hides in infected T-cells, which allows it to easily be passed on to non-infected ones; this, in fact, is one of the reasons why HIV persists through ART. To use a football analogy, ART is able to intercept passes through the air (plasma) from one cell to another, but it can't stop direct handoffs. A strategy is needed to defend against each separately, because the same defense can't be used against both.

Even with antiretroviral drugs present, infected T-cells can still infect other T-cells in close quarters instead of through the bloodstream; this often happens in the lymph nodes. Therefore, in order to find an actual cure for HIV, researchers need to find a way to deal with HIV reservoirs filled with both latent HIV virus and active virus that is transmitted from cell-to-cell. The clues to HIV persistence are clear, but this is one of those situations where the answer seems obvious but the path toward deriving the answer is extremely difficult.

Contact:

Alain Lafeuillade

AVPS

1208 avenue Colonel Picot

Toulon 83100 France

33-4-94616340

lafeuillade@orange.fr

http://www.isheid.com