Day 1 :
Keynote Forum
Marc H V Van Regenmortel
University of Strasbourg, France
Keynote: Immune correlates of protection in individuals immunized with HIV cannot help to solve the inverse problem of inducing a protecting anti-HIV immune response in humans
Time : 10:05-10:45
Biography:
Marc H V Van Regenmortel has been an Emeritus CNRS Research Director at the University of Strasbourg in France since 2001. He previously held professorship appointments at several Universities in South Africa and France and was the Director of the Immunochemistry department of the CNRS Molecular Biology Institute in Strasbourg for 22 years. He is currently the Editor-in-Chief of Archives of Virology, J. Molec. Recognition and J. AIDS & Clin. Res., Associate Editor of Analytical Biochemistry, Frontiers in Immunology, J Immunol Methods and Bionomina .He has published 17 books in Virology and Immunochemistry, 400 research and review papers and co-edited with Brian Mahy for the third edition of the “Encyclopedia of Virology” published by Elsevier.
Abstract:
Most solvable scientific problems are downstream; direct problems which involve determining what are the effects that follow certain causes. In contrast, upstream, inverse problems involve determining what the causes of observed phenomena are and these are more difficult to solve because they may have several solutions or none at all. Medical diagnosis, for instance, is an inverse problem that consists in guessing the disease from some of its symptoms, while developing an HIV vaccine is an inverse problem which requires the identification of the multiple causes that sometimes allow a limited number of human immune systems to produce antibody (Ab) or cellular responses that protect against HIV infection. When the epitopes of antigens present in HIV Env glycoproteins are used for immunization, they are given the label "immunogens" which suggests that they are able to generate immune responses, in spite of the fact that they only trigger in the immunized host a series of reactions with B-cell receptors while it is actually the immune system (IS) that produces Abs. Many properties of the IS control the types of Abs that are produced, for instance the host Ab gene repertoire, the presence of helper and suppressor T cells, self-tolerance and numerous other immunoregulatory mechanisms in the host . Unfortunately, vaccine designers using the structure-based reverse vaccinology approach tended to ignore these factors because they focused their attention only on the recognition process between a single HIV epitope and one neutralizing MAb, expecting that an antigenic epitope would also be a good immunogen. As a result, they never succeeded in developing an effective HIV vaccine. Subsequently, a major research effort was undertaken to determine the innumerable antibody maturation pathways that lead from germline Abs to neutralizing Abs, but this also did not solve the inverse problem. In recent years, it has become widely believed that in vivo empirical immunogenicity experiments could be the only way to try to solve the inverse problem of how to induce protective immunity against HIV infection by vaccinating humans.
Keynote Forum
Kevin M Galalae
Center of Global Consciousness, Canada
Keynote: Increase fear to decrease growth: strategies of population control in an over populated world
Time : 11:00-11:40
Biography:
Kevin M Galalae is the world’s foremost independent authority on the globalization-depopulation axis around which the international system has revolved since the inception of the USA in 1945, and the first to expose and scientifically demonstrate the existence, methods and consequences of the Global Depopulation Policy. He is the Founder and Director of the Center of Global Consciousness (CGC), which is dedicated to the eradication of all covert chemical, biological, psychosocial and economic methods of population control and to their replacement with overt population control legislation through a global replacement level fertility law.
Abstract:
Statement of the Problem: International security prerogatives and the imperative of sustainability drive a policy of population control that uses fear of sex, misuses medicine, and abuses public health to accomplish demographic, economic, geopolitical and environmental objectives under false pretenses, above and beyond the rule of law and in defianceof fundamental rights and liberties. Fear of STDs is stimulated through false science and simulated through barefaced propaganda to alter sexual habits, create opportunities for involuntary sterilization programs, and increase the contraceptive prevalence rate to force the developing world to reach replacement level fertility, keep the developed world at sub-replacement level fertility, and advance the demographic transition on all continents to halt and ultimately reduce the global population to a sustainable level.
Methodology & Theoretical Orientation: Health policy at the national and international level,leaked classified documents and statements, and the latest statistics are collated to discern fact from fiction with respect to STDs.
Findings: Glaring contradictions between false scientific findings, statistical data and the reality on the ground with respect to Zika and Ebola reveal that the UN system and governments around the world create unfounded fear of new and invented STDs to alter sexual habits, subvert fertility, and increase morbidity and mortality to balance births and deaths within any given population.
Conclusion & Significance: Human reproduction is the undeclared battleground of the sustainability agenda and the continuation of an international framework for peace that sacrifices the human reproductive system and in the process damages health for civilizational outcomes with dire and dangerous repercussions on the ability of our species to perpetuate itself and with equally devastating consequences on the viability of society, the credibility of medical authorities, and the legitimacy of the state. Only a change from covert to overt population control methods can save humanity from self-destruction.
- HIV/AIDS, STDs & STIs
Session Introduction
Mohammad Akram Randhawa
Northern Border University, Saudi Arabia
Title: Religions and marriage for the prevention and control of sexually transmitted diseases
Biography:
Mohammad Akram Randhawa graduated from King Edward Medical College, Lahore, in 1973 and completed his Masters from the University of Punjab in 977. He did his Post-graduate training in Clinical Pharmacology at St Bartholomew’s Hospital, London, UK. Later he obtained PhD degree from the Quaid-i-Azam University, Islamabad. Currently, he is working as Professor and Head of the Department of Pharmacology, College of Medicine, Northern Border University. He has around 50 publications in the international scientific journals, which include his original contributions related to the transport of drugs across body membranes, gastroesophageal reflux disease and Nigella sativa (Black seed).
Abstract:
Religion may be defined as a cultural system of behaviors and practices, based on believes about supernatural being/s and sacred texts that help humanity to live peacefully in a community. About 84% of world's population is linked to one of five major religions: Christianity, Islam, Judaism, Hinduism and Buddhism. Besides others, one thing common in these religions is marriage, which is a life-long cultural and spiritual union between man and women, and serves important objectives: propagation of human race and provision of a companion of life for love and enjoyment. Religions give great emphasis to marriage and discourage immorality and adultery. In Holy Bible, it is narrated, "Then the Lord God said, it is not good that the man (Adam) should be alone; I will make him a helper fit for him" (Genesis: 2, 18). Moreover, it is mentioned, "Let marriage be held in honor among all, and let the marriage bed be undefiled, for God will judge the sexually immoral and adulterous" (Hebrews 13:4). Holy Qoran describes marriage as a divine favor from God Almighty, "Among his signs is that he created for you spouses from among yourselves, that you may live in peace with them, and spread love and compassion between you and them; surely, there are signs in that for those who reflect" (30; 21). In Judaism marriage is an important event and avoiding from it is considered as unnatural. In Vedic Hindu traditions and Buddhism also marriage is a sacred ceremony and lifelong commitment between wife and husband. Present article is aimed to project religions and marriage as significant factors in the prevention and control of sexually transmitted diseases, particularly Human Immune-deficiency Virus (HIV) infection, which is becoming epidemic worldwide and there is no effective vaccine or treatment for that so far.
Gabriela Gore-Gorszewska
Jagiellonian University, Poland
Title: Competent sexual education as a potential STI prevention method. Reflections on ideas from across Europe
Time : 12:10-12:40
Biography:
Gabriela Gore-Gorszewska has her interest in human nature from both philosophical and psychological perspective (Master’s degree from Jagiellonian University, Poland, in 2010 and 2016, respectively). In recent years, her interests focus upon human sexuality as seen by the psychologist. She has done her education from Adam Mickiewicz University in Poznań, Poland, to achieve Diploma in Clinical Sexology. Her main area of expertise and research is sexual functioning of older adults. Her aim is to promote accurate and up-to-date knowledge about age-related changes in sexual life. She beliefs there is still not enough understanding and too much prejudice among healthcare professionals, experts and authorities, seniors themselves and general population, especially within the communities with strong sexual taboo and/or religious attitudes present.
Abstract:
Statement of the Problem: Preventing sexually transmitted infections from spreading is a complex process, based on theoretical findings, as well as thorough, interdisciplinary research, both of biological and psychological nature. Practical application is the crucial part of prevention; plying gathered knowledge in real-life scenarios, testing in practice and affecting actual people.
Methodology & Theoretical Orientation: First-person reports from international team of specialists were gathered. Issues regarding the application of existing knowledge in educating the public were analyzed. An internet search was conducted to obtain details regarding chosen implementation methods.
Findings: Certain deficit of STI prevention programs seems evident. Several social campaigns are cursory. Sexual awareness varies in EU from country to country, reflecting either progressiveness or conservativeness on the grounds of sexual education, and sexual education level itself. Examples of both exemplary and poor educational programs can be found. A selection of evidence-based, innovative and unique programs is presented; those included bring up important, yet controversial issues.
Conclusion & Significance: The core idea is to present already developed strategies that proved to be adequate and applicable in variety of contexts, and to draw from their experience while promoting sexual health and STI prevention.
Joan J Rugemalila
Muhimbili National Hospital, Tanzania
Title: Predictors associated with moderate to severe chronic kidney disease among HIV infected adult patients in Dar es Salaam, Tanzania
Time : 12:40-13:10
Biography:
Joan J Rugemalila is a Medical Specialist working at the Infectious Diseases Unit, Department of Internal Medicine at Muhimbili National Hospital. She has 6 years’ experience managing advanced HIV patients, adverse effects and treatment failure of antiretroviral therapy. She is also working with National Institute of Medical research, Tanzania and St George’s University of London to conduct research on major HIV co- infections, Cryptococcal meningitis and tuberculosis. She has a special interest in clinical research aiming at addressing challenges of HIV therapy. She attained her Doctor of Medicine and Master of Medicine degrees from Tumaini University, Tanzania and holds a Post-graduate Diploma of Tropical Medicine and Hygiene from London School of Hygiene and Tropical Medicine and Fellowship Training in Global Health Leadership. She also serves as a member of the technical working group and clinical subcommittee, care and treatment, National AIDS Control Program.
Abstract:
Background: There is limited evidence of kidney disease and risk factors among people with HIV/AIDS in East Africa. The aim of this study was to determine the risk factors associated with moderate to severe chronic kidney disease (CKD) among HIV patients in Dar es Salaam, Tanzania.
Methods: A cross-sectional analysis of the baseline clinical data for 30,822 HIV-infected adult patients presented at HIV/AIDS care and treatment centers (CTC) in Dar es Salam, Tanzania was done. CKD was defined as presence of estimated glomerular filtration rate (eGFR<60 mL/min). Log binomial regression models were used to estimate relative risks and predictors of CKD.
Results: The overall prevalence of CKD was 11%. In multivariate adjusted analysis, CKD at the time of enrollment into care was significantly associated with age <30 years (RR 0.71, 95% CI 0.63-0.80) and age ≥50 years (RR: 1.93, 95% CI 1.76-2.15), compared with age 30≤40 years. Patients with clinical stage IV (RR 1.32, 95% CI 1.21-1.44) and alanine aminotransferase (ALT)>200 U/L (RR 1.80, 95% CI 1.13-2.86) were also at higher risk. Hemoglobin <7 g/dl (RR 1.67, 95% CI 1.52-1.83) and CD4<100 cells/mm3 (RR 1.18, 95% CI 1.04-1.34) were also associated with prevalence of CKD.
Conclusion: CKD was prevalent at the time of enrollment into care. Advancing age, ALT levels and advanced WHO clinical stage were major risk factors for CKD among HIV patients enrolling for care.
Vera Ketty
Hospital Matilde Hidalgo de Procel, Ecuador
Title: The high seroreversion of Human Immunodeficiency Virus in vertically exposed infants who received all the care measures to reduce the mother-to-child transmission in Guayaquil, Ecuador
Time : 13:10-13:40
Biography:
Ketty Vera Acuna Elizabeth, author of the titling work Prevalence of Latent Tuberculosis determined by the Interferon Gamma (IGRA) in patients from the Luis Vernaza hospital in the period between August of 2015 and March of the 2016. Previous to the obtaining of the title of physician at the Catholic University of Santiago de Guayaquil.
Abstract:
Background: The leading global epidemic Human Immunodeficiency Virus (HIV) infection has been well-documented. It is transmitted from an infected person to an uninfected one by two ways: horizontal and vertical transmission (VT), which is mother-to-child transmission (MTCT) and is acquired at one or more of the following stages: transplacentally in the uterus during pregnancy, perinatally during the process of labor and delivery and postnatally during breastfeeding. The reason of this study is to demonstrate that adequate management at each of these three moments reduces the MTCT.
Methods: A observational-retrospective study was carried out at Maternidad Matilde Hidalgo de Procel in Guayaquil, Ecuador to detect the prevalence of serorevertors newborns of VIH who received prophylactic antiretroviral treatment at birth, formula milk and whose mothers got administered antiretroviral therapy (ART) during pregnancy or partum according to the established schemes. These vertically exposed infants were followed up by an accredited pediatrician by the National Program of HIV-AIDS to receive special care during at least the first 18 months.
Results: One hundred pregnant women were enrolled. ART was started between the 14th and 28th pregnancy week in a 41%, after the 28th week in 24% and during labor or delivery in 35%. 100% of pregnant women received ART intra-partum. 100% of the newborns received antirretroviral prophylaxis from 6 to 8 hours old for 4-6 weeks according to the applied scheme. In both, mothers and children, the most frequently administered regimen was the C with 48% based on zidovudine. 100% of the newborns were fed by formula milk and 100% was serorevertor of HIV.
Conclusions: This study shows that MTCT was 0% due to the seroreversion in children at ≥18 months which represents that the treatments and properly applied procedures reduce the MTCT to zero and place Ecuador at the level of developed countries where the VT has been decreased at 1-2%.
- Public Awareness on STDS
Session Introduction
Chloe Chan
New York University, USA
Title: The effects of contextual factors and dating app usage on sexual risk behaviors among young adults
Biography:
Chloe Chan is doing his Major in Psychology with a Minor in Child and Adolescent Mental Health Studies from New York University, USA. She is currently a Program Coordinator at Health Leads and a Research Assistant at Bellevue Hospital Center. Her research interests lie in health disparities and sexual decision making.
Abstract:
With the rise of social media and smartphones, millennials increasingly report meeting their romantic partners through mobile dating apps. Yet there is concern that this may also be the reason behind the increase in sexually transmitted infection (STI) rates among young adults. This study examines whether contextual factors affect young adults’ perceived STI risk and engagement in sexual risk behaviors. In addition, we compare sexual histories among app users and non-users. We recruited our sample from 111 college Facebook groups over a 10-week period. Depending on their sexual orientation, participants were presented with 1 of 32 scenarios varying in levels of perceived risk. They answered questions pertaining to their sexual decision making, relationship status, dating app and sexual experience, condom usage, and STI testing experience. A total of 4,429 eligible participants between the ages of 18-24 completed the survey. Participants were more likely to believe that their partner had a greater number of sexual partners and engaged in casual sex if the scenario involved a male partner, perceived high-risk location, or one-night stand. They were more likely to enforce condom usage if their partner was male. Lastly, they were more likely to ask about their partner’s STI status if the scenario involved a male partner or one-month dating. Among sexually active participants, dating app usage was associated with sexual experience and having casual relationships,more sexual partners, higher perceived STI risk, and STI testing. While over half of the sexually active participants had inconsistent condom usage and had not been tested for STIs, they generally reported low perceived STI risk. Dating app users are more likely to engage in sexual risk behaviors and to have had STI testing. Thus, dating apps can be a useful platform for increasing STI knowledge and reducing the incidence of STIs among their users.
Patricia Garcia de Olalla
Public Health Agency of Barcelona, Spain
Title: Does the high prevalence of late presentation of HIV infection persist?
Biography:
Patricia Garcia de Olalla is a Medical Doctor, Specialist in Preventive Medicine and Public Health. She is an Associate Professor of Public Health, University Pompeu Fabra. Since 1993, she works as an Epidemiologist at the Epidemiology Department of the Public Health Agency of Barcelona. Since 1995, she is Incharge of surveillance, prevention and control of HIV/AIDS and others sexually transmitted infections in Barcelona. She coordinates the Program Saunas-based
testing to detect HIV infection in Barcelona.
Abstract:
Background & Aim: Early diagnosis of HIV infection and its treatment improves health of patients and is essential to prevent HIV transmission. The aim of this study was to determine the prevalence, describe the trend and identify the factors associated with late presentation (LP) of HIV-infection in Barcelona during the period 2013-2015.
Methods: We analyzed the cases included in the register of HIV-infection. LP were defined as persons presenting for care with a CD4 count below 350 cells/μl or with an AIDS-defining event at the time of HIV diagnosis or within 6 months of the positive test, regardless of the CD4 cell count. Multivariate logistic regression was used to identify predictors of LP.
Results: Of the 1,115 cases studied, 479 (43.0%, 95% confidence interval (CI): 40.1%-45.9%) were LP. The prevalence of LP was 42.4% in 2013, 42.5% in 2014, 44.0% in 2015 (p=0.65). 39.6% (341 cases) of men who has sex with men (MSM) were LP, 60.2% (65 cases) of the heterosexual men (HTM) and 61% (22 cases) of the injecting drug users (IDU). After adjusting for place of birth and year of diagnosis, LP was more frequent in those older than 29 years (between 30 and 49 years old Odds ratio (OR): 1.4; CI: 1.1-1.8; older than 49 years old; OR: 2.5; CI: 1.2-5.38), in HTM and IDU when compared to MSM (OR: 2.5; CI: 1.2-5.38, and OR : 1.9, CI: 1.3-2.9, respectively), and in those reported from hospitals (OR: 2.1; CI: 1.3-3.2) when compared with those from units of sexually transmitted infections.
Conclusion: LP in 2015 remains at levels of previous years and continues to be very high in all transmission groups despite initiatives to increase access to HIV testing in our city. It is necessary to improve and develop new interventions that are more efficient for an early diagnosis of HIV.
Biography:
Lamin Ceesay works at the Santa Yalla Support Society since January 1999. He started advocating for universal access to treatment care and support for people
living with HIV since December 2000.
Abstract:
As a person living with HIV (PLHIV) the author speaks frequently in public about the challenges faced by PLHIV. PLHIVs, especially women and girls face serious problems of stigma and discrimination. We need to address stigma and discrimination by developing a stigma reduction strategy, demystify ignorance and the fear of AIDS. The author also believe that we PLHIV are best placed to stop the further spread of the virus by disclosing our status and create more awareness among individuals and communities of the need for behavior change. We need to promote correct and consistent use of condoms to prevent the spread of the virus. Santa Yalla organizes training workshops on HIV for the members to create awareness about positive living for PLHIV. People want to know if the author still having sex and if yes, with whom. They want to know whether his children know his HIV status. We also conduct community HIV sensitizations meetings. We invite five villages in one forum. We meet with the village chiefs and elders and explain our mission and agreed with the chiefs that each village should come with two elderly men, two elderly women, three boys and three girls, and they will all assemble in the bigger village in that surrounding, and if the village chiefs agreed we select and agreed on a date for the meeting, and they should announce it to every-body in their communities. After all these we do a follow up to see if the announcement have reached everyone to attend the meeting, and we invite the Imam and the Pastor to do the opening prayers to bless the occasion. After the opening prayers, the introduction is done by the program manager, followed by presentation by a PLHIV during which we cover: HIV/AIDS and STIs, HIV counseling and testing, importance of PMTCT, HIV stigma and discrimination, care and support for PLHIV. We provide counseling and testing with partners. We do the counseling and our partner provides testing services. Taking this approach, we have made a lot of progress; a high number of people now know their HIV status. Follow up after testing is also conducted to those who tested positive to support them enrolls into care and into the HIV support groups. It can be concluded that, for effective response to the HIV and AIDS epidemic, concerted efforts are required and PLHIVs actively participate in
the planning, implementation and monitoring of the HIV program.
Gesesew Hailay
Flinders University, Australia
Title: HIV care continuum outcomes: does Ethiopia meet the UNAIDS 90-90-90 targets?
Biography:
Gesesew Hailay has his expertise in Epidemiology. His multi-method approach assessing in each cascades of HIV care continuum will establish a significant contribution for the AIDS ending goal. He has been publishing a lot of peer reviewed articles on the area of HIV care in reputable journals. His publications produced from his PhD will improve the HIV care in developing countries especially Ethiopia. He has been serving as a Clinician, Academician and Researcher.
Abstract:
Background: How Ethiopia’s UNAIDS 90-90-90 targets is progressing was not assessed. We assessed HIV care continuum outcomes as surrogate markers for the 90-90-90 targets.
Methodology: Data were collected from a 12 years retrospective cohort from anti-retroviral therapy (ART) clinic in Southwest Ethiopia. For measuring the UNAIDS diagnosis target, prevalence rate of delayed HIV diagnosis was considered as a surrogate marker. For the treatment target, number of people on ART, number of people who discontinued from ART or transferred out, and number of people who had fair or poor adherence were used as surrogate markers. For the viral suppression target, number of CD4 counts and/or WHO clinical stages were used to assess immunological, clinical and treatment successes and further show the viral suppression. Summary statistics, trends and estimated survival time were reported.
Findings: 8172 patients were enrolled for HIV cares in 2003-2015. For the diagnosis target, 34.5% patients knew their status early (43% children and 33% adults). For the treatment target, 65% patients received ART, 1154 (21.9%) patients discontinued from ART, 1015 (19.3%) patients on ART transferred out to other sites, 916 (17%) of patients on ART had fair or good adherence. For the virological suppression target, 80.7, 80.3 and 65.8% of patients had immunological, clinical and treatment success displaying an estimated 66% of patients achieved the target.
Conclusions: The finding reflects that an estimated 35% of patients knew their status timely, 65% of diagnosed patients received treatment and 66% of patients on ART achieved viral suppression. This is very far from the UNAIDS 90-90-90 targets underscoring the need for concreted efforts such as use of unmanned aerial systems (or drones) for transporting laboratory specimens, immediate or same day ART initiation, community distribution of ART, runaway packs during conflict, and use of GenXpert for HIV viral load testing would help to hit the target.