TORONTO, November 27, 2007 -- World AIDS Day, on December 1 of each year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. Twenty-five years into the epidemic, the percentage of people worldwide who are living with HIV has leveled off, and the number of new infections has fallen, according to a recent report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). However, the estimated numbers are still disturbing: 2.1 million deaths from AIDS in 2007, 33.2 million people living with HIV, and 2.5 million people who became newly infected.
York University researchers are investigating both the science of the HIV virus and the community and social supports available to people living with HIV/AIDS. Here, in brief, are some of the projects they are working on:
Sarah Flicker, assistant professor, Faculty of Environmental Studies, flicker@yorku.ca, 416 736 2100 x20728
More than 15,000 Canadians under the age of 29 have tested positive for HIV and new infections are on the rise among young women. Professor Flicker is conducting community-based participatory research, focusing on HIV prevention and support for teens, as well as adolescent sexual health in Canada and, most recently, South Africa. She continues to work with partners in the community on a number of projects:
• The Toronto Teen Survey (TTS). The purpose of the TTS is to gather information from Toronto youth on their experiences receiving sexual health services in Toronto. Surveys were recently conducted with 1,200 youth across nearly 100 community-based settings and outreach to service providers is beginning. This project is a collaboration between York, the University of Toronto, Planned Parenthood Toronto, Toronto Public Health and the Ontario HIV Treatment Network: http://www.ppt.on.ca/research_teensurvey.asp . The project was recently awarded the Community Based Research Award of Merit by the Centre for Urban Health Initiatives.
• Widening the Circle of Aboriginal AIDS Prevention: A study of young Aboriginal people in cities and on reserve to determine the relationship between HIV risk and social inequity. Participants spoke about the need for elders and traditional values to be part of the solution, and for solutions that take into account the links between AIDS and social problems such as poverty, violence and drug use. This is a partnership between York University, the University of Toronto and the Canadian Aboriginal AIDS Network.
• The Positive Youth Project: A study of HIV-positive young people across Canada, ages 12 to 24. Flicker and colleagues discovered confusion among the young people about treatment, and also learned that they find traditional AIDS organizations are not relevant to them, yet youth organizations are uncomfortable with the topic of AIDS. They developed a website: www.livepositive.ca // www.viepositive.ca to help youth manage living with HIV and find resources that make sense to them. This is a partnership between York, the Canadian AIDS Treatment Information Exchange (CATIE), the Hospital for Sick Children and many other research institutions and AIDS Service Organizations.
Jane Heffernan, assistant professor, Department of Mathematics & Statistics, Faculty of Science and Engineering, jmheffer@yorku.ca, 416 736 2100 x33943
Understanding how the human immunodeficiency virus (HIV) infects and eventually weakens the immune system is one of the most important medical problems of the 21st century. Mathematical models of HIV infection describing virus and immune system dynamics have contributed significantly to the understanding of HIV pathogenesis within a single individual, "in-host". However, some of the fundamental properties of HIV dynamics have yet to be elucidated. Professor Jane Heffernan’s research is concerned primarily with the development of mathematical models of pathogen and immune system dynamics in-host, so one of her key focuses is studying how HIV infects the immune system. Her goal is to develop in-host models of HIV that incorporate assumptions that are not integrated in conventional models.
Heffernan’s research has produced new insights into HIV pathogenesis. For example, she has shown that a significant fraction of the clinically measured variability in T-cell count and viral load – the two qualitative measurements of drug therapy efficacy – can be attributed solely to chance interactions between the immune system cells and HIV virions (called baseline variability). Her most exciting finding was that baseline variability is sensitive to the time between consecutive measurements of viral load and T-cell count, resulting in damped oscillations with a defined period. As a result, she advised clinicians that viral load measurements should be separated by at least one month to avoid bias induced by baseline fluctuations.
Recently, Heffernan began a new study on drug therapy adherence and the emergence of drug-resistant mutants. Close adherence to a drug regimen is needed to optimize clinical response and adherence levels greater than 95% are required to maintain virologic suppression. However, actual adherence rates are often far lower; 40-60% of patients are less than 90% adherent and adherence also tends to decrease over time. Thus, viral replication may ensue and drug-resistant strains of the virus may emerge, posing a great threat to the HIV patient. Her current study is expected to provide guidelines for drug adherence, based on T-cell counts, viral load measurements and the number of drug doses missed, in order to control HIV replication.
She recently returned from Uganda where she helped to launch an exciting initiative that teams up Canadian and African researchers to fight HIV.
Tamara Daly, assistant professor, School of Health Policy & Management, Faculty of Health
dalyt@yorku.ca, 416 736 2100 x30522.
The people who are most vulnerable to HIV disease and the care options available have changed dramatically over time. Women now represent one-quarter of all new HIV infections. Since the introduction of Highly Active Antiretroviral Therapy (HAART), HIV disease has become a chronic and manageable illness for many people with access to, and tolerant to drug cocktails, so provision of care has shifted from in-patient to ambulatory and community-based care. Professor Daly is collaborating with researchers from the University of Toronto, in partnership with the National Network on Environments and Women’s Health, on a multi-year study to learn about the emotional and social support needs of women with HIV/AIDS and their access to formal and informal care resources across Toronto. They are taking an interdisciplinary approach, drawing from sociology and political economy, medicine and psychiatry, using both qualitative and quantitative methods. In addition to key informant interviews with women, a number of clinical screening tools and scales are being used to provide data on factors such as depression, social support, and drug use. The research is asking and answering questions that are often neglected in AIDS research, for example:
- Do women living with HIV/AIDS receive the care they need? Are sufficient formal resources in place and appropriate for women? Who do women turn to for the informal care that they need?
- How does being a mother or providing care for others affect their experiences living with HIV/AIDS?
- And how can we create better support systems for women living with AIDS?
Professor Daly can speak about preliminary results.
Eric Mykhalovskiy, assistant professor, Department of Sociology, Faculty of Arts, ericm@yorku.ca, 416 736 2100 x66405
In an era of evidence-based decision-making, Professor Eric Mykhalovskiy is focusing his research on the relationship between scientific information and “lay experience” in the context of HIV. He is studying how community-based organizations manage complex scientific information to help meet the health and treatment information needs of people living with HIV/AIDS.
Mykhalovskiy has three projects underway:
- A project with the Canadian AIDS Treatment Information Exchange (CATIE), evaluating a national initiative designed to help small AIDS organizations deliver health information to HIV-positive people in remote areas of Canada.
- Another project with CATIE (and York Professor Sarah Flicker) to explore the potential of “body mapping” as a health literacy tool. Through the Body Map project, people living with HIV draw and paint full-sized representations of their bodies that tell stories about their lives with HIV. Body mapping is a structured and facilitated group process that combines elements of storytelling, art therapy, memory work, treatment literacy and activism. Mykhalovskiy’s contribution is to explore participants’ experiences with the initiative.
- An initiative exploring the implications of changes in how HIV treatments are understood and used; in particular, how treatments that were initially developed to treat HIV infection are now being promoted as tools to prevent the transmission of HIV infection.
Dasantila Golemi-Kotra, assistant professor, Department of Chemistry, Faculty of Science & Engineering, dgkotra@yorku.ca, 416 736 2100 x33827
Professor Dasantila Golemi-Kotra’s research focuses on viral and bacterial infections, which involve interactions between a variety of biomolecules such as DNA, RNA, proteins, metabolites, etc. Scientists hope that tampering with these vital bimolecular interactions efficiently will lead to treatments for many bacterial and viral infections.
Within the field of human immunodeficiency virus, two main strategies have been pursued in an effort to inhibit HIV infection: developing vaccines, and designing small molecules, organic- or peptide-based drugs that inhibit different stages of virus life-cycle. However, development of resistance has compromised the success in these efforts, as the virus evolves to acquire a resistance when exposed to a neutralizing antibody or a drug.
In her research on the human immunodeficiency virus (HIV), Golemi-Kotra is looking closely at the fusion process of HIV virus with the host cell, and proteins involved in this step. She is particularly interested in the envelope glycoprotein complex and is using chemical and biological tools to study the protein-protein interactions involved in the formation of this complex.
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Media contact:
Janice Walls, Media Relations, York University, 416 736 2100 x22101 / wallsj@yorku.ca
