Mentored Scientist Award

Prevention of mother to child transmission of HIV is now possible through evidence-based strategies that reduce the risk of transmission to less than 2%. However, the effectiveness of these strategies depends on the mothers living with HIV adhering to HIV treatment and being retained in care. Difficulties in adhering to prevention strategies has resulted in mother to child transmission (MTCT) rates that remain unacceptably high. In Kenya, MTCT rates are still estimated at around 14% with over 6,000 newly infected children in 2016.

38 million people are currently living with HIV/AIDS. Although the progress in developing antiretroviral therapies (ART) has been enormous, ART is too expensive or inaccessible for a large fraction of infected individuals, and requires lifelong adherence to a treatment regimen. An HIV cure would address many of these problems, but is still missing.

HIV-infected patients undergoing kidney transplantation are a unique patient subset with significantly increased episodes of graft rejection compared to non-infected transplant recipients. Biomarker development for monitoring of transplant rejection is a critically unmet need, particularly in HIV-infected individuals. Epigenetic mechanisms, including changes in DNA 5-methylcytosine (5mC), contribute to AR and can be used for HIV-infected kidney transplant recipients (HIVKT). screening.

Food insecurity (FI) impacts health via biological, psychological, behavioral, and social-structural pathways. As such, the study of FI in the etiology of poor health has helped illuminate synergistic and multidimensional pathways by which to intervene. For older women of color living with HIV, FI presents a multidimensional challenge and highlights a “Gordian knot” of interactions between aging and living with HIV. For example, HIV accelerates aging-related inflammation that impacts the central nervous system, leading to neurocognitive decline.

Latently infected CD4+ T cells, thought to be the main barrier to HIV cure, are indistinguishable from uninfected cells and are exceedingly rare, rendering the study of HIV latency in vivo particularly challenging. The development of more tractable systems such as in vitro primary cell models of latency has greatly advanced our understanding of the establishment, maintenance and reactivation of HIV latency, since these models permit higher infection frequencies and some employ reporter viruses to readily distinguish latent and productively infected populations.

West Virginia has some of the highest risk areas in the country for HIV transmission. Opioid use, particularly through injection, has risen dramatically in the state which also has the nation’s highest drug overdose death rate.

Food insecurity, which refers to having limited or uncertain availability of nutritionally adequate and safe food, and violence are prevalent among women in the United States, and disproportionately affect HIV-positive women. Both food insecurity and violence are associated with negative health behaviors and outcomes including HIV risk behaviors, chronic diseases, poor mental health, and reduced engagement in HIV care and treatment. Evidence suggests that food insecurity is associated with increased risk for intimate partner violence (IPV).

HIV-infected individuals on antiretroviral therapy have higher than expected rates of cardiovascular disease (CVD) than uninfected individuals, and HIV-induced chronic inflammation is believed to be directly and causally associated with the accelerated atherosclerosis development. Prior studies have revealed that chronic inflammatory states, such as atherosclerosis, show significantly increased levels of circulating endothelium-derived extracellular vesicles (EVs), which are preferentially taken up by monocytes and lead to monocyte activation.

Dr. Joshua Vásquez, MD, Assistant Professor in the Division of Experimental Medicine and the Division of Pulmonary and Critical Care Medicine at UCSF who is establishing himself as a clinician-scientist in HIV immunology. This award will provide him with preliminary data and support to apply for future funding for projects aimed at: (1) characterizing the pulmonary reservoir of HIV and (2) to determining whether defects in alveolar macrophages are associated with HIV-related chronic obstructive pulmonary disease and persist, despite antiretroviral therapy.

Populations in sub-Saharan Africa are the most mobile in the world: up to 80% of households have at least one migrant member. Mobility is a risk factor for HIV transmission, but its impact on medication adherence for persons living with HIV (PLHIV) remains poorly understood. We will leverage the ongoing study Understanding Mobility and Risk in SEARCH Communities (RO1MH104132), which has followed over 1100 PLHIV from 12 East African communities since 2016, to study this association.