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Landers S.,John Snow Inc. | Pickett J.,AIDS Foundation of Chicago | Rennie L.,American Psychological Association | Wakefield S.,HIV Vaccine Trials Network
AIDS and Behavior | Year: 2011

Community mobilization around gay rights in the late 1960s and 1970s led to the first efforts to improve the health of gay and bisexual men. In the 1980s the deadly AIDS epidemic was responded to with fierce organizing and community activism primarily led by gay men. Today community involvement is crucial to many advocacy and organizing efforts for the health of gay and bisexual men. This article begins with the roots of this history and then describes how they are reflected in a number of key health initiatives for this community including the National Black Gay Men's Advocacy Coalition the Legacy Project International Rectal Microbicide Advocates and the Gay Men's health Agenda. A path forward is described in terms of next steps for advocacy for gay men's health and the health of gay and bisexual men of color emphasizing cultural viability development of new leaders and strategic alliances. © 2011 Springer Science+Business Media.

Cheng C.,National Institute of Allergy and Infectious Diseases | Wang L.S.,National Institute of Allergy and Infectious Diseases | Gall J.G.D.,Genvec, Inc. | Nason M.,U.S. National Institutes of Health | And 8 more authors.
PLoS ONE | Year: 2012

Background: The Step trial raised the possibility that uncircumcised men with pre-existing Ad5 neutralizing antibodies carried an increased risk of HIV infection after vaccination. Thus, understanding Ad seropositivity in humans is important to the development of an AIDS vaccine. Here, we analyze the impact of different Ad5-specific neutralizing antibodies on immune function and clinical outcome. Methods and Findings: Ad seropositivity in the Step trial volunteers was analyzed using chimeric rAd5/35 vectors to characterize their specificity for Ad5 fiber and non-fiber external (capsid) proteins. Immune responses and HIV seropositivity were correlated with the specificity of Ad5-neutralizing antibodies. Neutralizing antibodies induced by the vaccine in Ad5 seronegative subjects were directed preferentially to Ad5 capsid proteins, although some fiber-neutralizing antibodies could be detected. Pre-vaccination Ad5 serostatus did not affect the capsid-directed response after three vaccinations. In contrast, anti-fiber antibody titers were significantly higher in volunteers who were Ad5 seropositive prior to vaccination. Those Ad5 seropositive subjects who generated anti-capsid responses showed a marked reduction in vaccine-induced CD8 responses. Unexpectedly, anti-vector immunity differed qualitatively in Ad5 seropositive participants who became HIV-1 infected compared to uninfected case controls; Ad5 seropositive participants who later acquired HIV had lower neutralizing antibodies to capsid. Moreover, Ad35 seropositivity was decreased in HIV-infected subjects compared with uninfected case controls, while seroprevalence for other serotypes including Ad14, Ad28 and Ad41 was similar in both groups. Conclusions: Together, these findings suggest that the case subjects were less immunologically responsive prior to infection. Subjects infected during the Step trial had qualitative differences in immunity that increased their risk of HIV-1 infection independent of vaccination.

Alio A.P.,University of Rochester | Lewis C.A.,University of Rochester | Bunce C.A.,University of Rochester | Wakefield S.,HIV Vaccine Trials Network | And 2 more authors.
Progress in Community Health Partnerships: Research, Education, and Action | Year: 2014

Background: In light of the increasing rates of HIV infection in African Americans, it is essential that black faith leaders become more proactive in the fight against the epidemic. The study aim was to engage faith leaders in a sustainable partnership to increase community participation in preventive HIV vaccine clinical research while improving their access to and utilization of HIV/AIDS prevention services.Method: Leadership Development Seminars were adapted for faith leaders in Rochester, NY, with topics ranging from the importance of preventive HIV vaccine research to social issues surrounding HIV/AIDs within a theological framework. Seminars were taught by field-specific experts from the black community and included the development of action plans to institute HIV preventive ministries. To assess the outcome of the Seminars, baseline and post-training surveys were administered and analyzed through paired sample t Tests and informal interviews.Results: 19 faith leaders completed the intervention. In general, the majority of clergy felt that their understanding of HIV vaccine research and its goals had increased postintervention. A critical outcome was the subsequent formation of the Rochester Faith Collaborative by participating clergy seeking to sustain the collaborative and address the implementation of community action plans.Conclusion: Providing scientific HIV/AIDS knowledge within the context of clergy members’ belief structure was an effective method for engaging black Church leaders in Rochester, NY. Collaborative efforts with various local institutions and community-based organizations were essential in building trust with the faith leaders, thereby building bridges for better understanding of HIV/AIDS prevention efforts, including HIV vaccine research. © 2014 The Johns Hopkins University Press.

Fuchs J.D.,University of California at San Francisco | Sobieszczyk M.E.,Columbia University | Madenwald T.,HIV Vaccine Trials Network | Grove D.,Fred Hutchinson Cancer Research Center | And 7 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2013

In November 2010, the iPrEx study reported that preexposure prophylaxis (PrEP) with daily tenofovir disoproxil fumarate/emtricitabine reduced HIV infections by 44% among men who have sex with men and subsequent trials corroborated efficacy among heterosexual men and women. During regularly scheduled follow-up visits from January to March 2011, participants in an ongoing phase 2b vaccine efficacy trial completed an anonymous Web survey about PrEP. Among 376 respondents, 17% reported they were very likely to use PrEP in the next year. Nonwhite participants were more likely to use PrEP. Among those with some level of interest, intent to use PrEP was greatest if the drug were available through the clinical trial or health insurance. Most (91%) believed taking PrEP would not change their willingness to stay in the vaccine trial and few thought it would affect recruitment. As key stakeholders, currently enrolled trial participants can offer vital input about emerging prevention technologies that may affect the design of future HIV vaccine and nonvaccine prevention trials. Copyright © 2013 by Lippincott Williams & Wilkins.

Voronin Y.,Global HIV Vaccine Enterprise | Zinszner H.,Global HIV Vaccine Enterprise | Karg C.,HIV Vaccine Trials Network | Brooks K.,HIV Vaccine Trials Network | And 22 more authors.
Vaccine | Year: 2015

Antibody-inducing vaccines are a major focus in the preventive HIV vaccine field. Because the most common tests for HIV infection rely on detecting antibodies to HIV, they may also detect antibodies induced by a candidate HIV vaccine. The detection of vaccine-induced antibodies to HIV by serological tests is most commonly referred to as vaccine-induced sero-reactivity (VISR). VISR can be misinterpreted as a sign of HIV infection in a healthy study participant. In a participant who has developed vaccine-induced antibodies, accurate diagnosis of HIV infection (or lack thereof) may require specialized tests and algorithms (differential testing) that are usually not available in community settings. Organizations sponsoring clinical testing of preventive HIV vaccine candidates have an ethical obligation not only to inform healthy volunteers about the potential problems associated with participating in a clinical trial but also to help manage any resulting issues. This article explores the scope of VISR-related issues that become increasingly prevalent as the search for an effective HIV vaccine continues and will be paramount once a preventive vaccine is deployed. We also describe ways in which organizations conducting HIV vaccine trials have addressed these issues and outline areas where more work is needed. © 2014 The Authors.

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