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1st appeared 23 July 1998 Messages from Geneva -- Focus on Prevention and Immune Response UCSF researchers and clinicians brought back two clear messages from the recent World AIDS Conference in Geneva -- the immune responses to HIV therapy need to be better understood and prevention efforts need a greater investment. The UCSF AIDS Research Institute (ARI) sponsored a public forum yesterday on the Geneva conference, with nine speakers discussing what they presented -- and what they learned -- at the meeting. "In Geneva, UCSF scientists had a very large and important presence," said Thomas Coates, director of ARI, who moderated the forum. Jay Levy, professor of medicine, discussed virology and immunology and how the conference's theme of "Bridging the Gap" not only applied to the distance in HIV approaches between developed and developing countries but also to that between immunologists and virologists. Levy said there was a "paradigm shift" at the conference in that more emphasis was now being placed on understanding the immune response than on attacking the virus. Bridging the gap between virologist and immunologist in a creative fashion, Levy said, should "bring us closer" to developing therapies and a vaccine. "It's fair to say that we didn't come back with any earth-shattering revelations in terms of therapies," said Paul Volberding, professor of medicine and director of the Center for AIDS Research. Reiterating Levy's message, Volberding said that "there was no real enthusiasm for eradication" of the virus at the conference but there were some "exciting" new directions in drug therapy. For example, drug regimens are on the road to becoming less complicated and more effective, he said. "More and more we're moving our drug regimens to no more than twice a day," Volberding said. Although the conference produced promising reports on the effect of antiretroviral treatment on quality of life and mortality, some scientists cautioned against relying too heavily on drug treatment at the expense of prevention. Ron Stall, an associate professor of epidemiology and biostatistics, said that a reliance on technology without reducing risk behavior might make a bad situation worse. "I regard this as a very dangerous moment in our history," he said, citing statistics that high-risk sexual behavior is sharply increasing among gay men in San Francisco and the lack of prevention dollars. "Low technology," ground-based prevention efforts are cost-effective in preventing infection, Stall said, yet "we refuse to spend money on them." Prevention efforts are still a priority to many UCSF researchers at the Center for AIDS Prevention Studies, including Craig Waldo, who presented his finding that self-acceptance of gay identity is negatively related to high-risk sexual behavior. Steve Morin, associate professor in the School of Medicine, echoed the prevention message, saying that approximately three million transmissions of HIV could be avoided each year if a particular package of prevention measures -- which would cost $2.6 billion to implement worldwide -- were adopted. Reasons why the prevention cry has not been heard in some parts of the world are, he said, that there is "a denial that AIDS is a problem, a reluctance to help people who practice risky behaviors, a preference for moralistic responses and the pressure to treat at the expense of prevention." Links: HIV Insite (which offers a real audio broadcast of the forum) Center for AIDS Prevention Studies Daybreak articles on Geneva reports:
by Paula Murphy |
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