ICAP World AIDS Day Event Focuses on Closing Gaps
ICAP at Columbia, a global public health leader active in more than 40 countries, commemorated World AIDS Day with an event at its home base, Columbia Mailman School of Public Health. The event showcased the breadth of ICAP’s ongoing work on HIV/AIDS while taking stock of overall progress against the pandemic under the theme “Leave No One Behind.” (Watch a video of the event below.)
The December 1 event was attended by more than 300 people in-person and online, including many members of the ICAP team, as well as partner organizations.
In opening remarks, Dean Linda P. Fried spoke to the ways ICAP and its partners perform cutting-edge research to improve prevention and treatment methods and their implementation; and the design, scale-up, and support for HIV services for the populations that most need them. “Today, as we celebrate the progress that has been made in addressing HIV, there is no question that we celebrate the work of ICAP, as well,” she said.
Wafaa El-Sadr, ICAP’s founder and director and University Professor of Epidemiology and Medicine, said World AIDS Day is an opportunity to acknowledge the gravity of the pandemic and remember all those who lost their lives to the disease while also acknowledging the progress in transforming HIV from a death sentence to a chronic disease, as well as new tools to prevent infection. “This [progress] would not have happened without partnerships between researchers, officials, policymakers, implementers, and members of the community,” she said.
Over the last decade, the world has achieved tremendous progress against HIV/AIDS. Since 2010, AIDS deaths have declined by half, and new infections by nearly a third, aided by successful prevention strategies like PrEP (pre-exposure prophylaxis), according to Jessica Justman, ICAP senior technical director and associate professor of medicine in epidemiology.
Some countries have made tremendous strides. They include Eswatini, a small nation within the borders of South Africa where ICAP is active. There, among adults with HIV, levels of viral load suppression—the undetectability of the HIV virus in the bloodstream, which is key for a person living with HIV to stay healthy—jumped from only 28 percent in 2011 to 88 percent in 2021. In fact, Eswatini and seven other Sub-Saharan African countries are now approaching epidemic control, as is Vietnam.
At the same time, progress has not been even, and some populations have lagged behind.
Justman said ICAP HIV multi-country surveys through the PEPFAR-funded Population-based HIV Impact Assessment (PHIA) Project have shown that men consistently lag behind women in awareness of their HIV status. Young people ages 15 to 24 lag behind adults 25 and older on HIV awareness, treatment, and viral suppression.
Meanwhile, the United States continues to contend with stark racial disparities in HIV outcomes, especially in the Southern states, said LaRon E. Nelson, Associate Dean for Global Affairs & Planetary Health Independence Foundation at Yale University. Nearly half of new HIV diagnoses in the South are among Black MSM—more infections than any other region,
including all racial and ethnic groups. There are similar gaps in PrEP coverage. Nelson spoke about an ongoing study he and others, including El-Sadr, are leading to remove structural barriers to close these gaps using a variety of strategies, including, stigma prevention, peer support and social media influencers, and community coalitions for health equity.
El-Sadr led a panel discussion with Nelson; Jessica Justman; Nassaro “Sammy” Said, an HIV peer counselor for ICAP in Tanzania; and Rashaunna K. Redd, a site clinician at ICAP’s Bronx Prevention Center. Redd spoke about an ongoing study in New York City that uses a mobile unit to provide medication for opioid use disorder, HIV prevention and treatment, hepatitis referrals, and peer navigation to connect participants with social supports. One important component is overcoming the stigma of drug use. “With stigma comes mistrust,” she said. “With peer navigation… [many participants] were able to trust us from the beginning.”
Watch the video: