AIDS conference in Bangkok will draw on Brown researchers' international focus

Ten Brown faculty members will present research and learn new ways to fight the pandemic, and new international guidelines for antiretroviral treatment, written in part by Charles Carpenter, a physician and professor of medicine, will be released.

by Wendy Y. Lawton

On four continents, Brown faculty work to stem the tide of HIV and AIDS. Nowhere are their international efforts more aggressive than Asia, where professors care for the sick, track the spread of the virus, run clinical trials and train health care workers.

Soon the epidemic in Asia will grab the global spotlight.

From July 11-16, the XV International AIDS Conference convenes in Bangkok, where an estimated 15,000 scientists, advocates, physicians and government officials will discuss the latest science initiatives and policy issues surrounding HIV and AIDS.

Ten Brown faculty members will travel to Bangkok to present research and learn new ways to fight the pandemic. Professors will make more than two dozen written and oral presentations on topics ranging from the effectiveness of microbicides to the prevalence of HIV in prisons.

New international guidelines for antiretroviral treatment, written in part by Charles Carpenter, a physician and professor of medicine, will also be released.

Kenneth Mayer, a physician who directs the Brown University AIDS Program, said Brown's Asian involvement stems from several factors - the University's international focus, the leadership of physicians such as Carpenter, and the spread of HIV itself.

One of every four new HIV infections occurs in Asia. According to the Joint United Nations Programme on HIV/AIDS, 7.4 million people in Asia now live with the disease. Last year, 500,000 Asians died from it.

"The jury is still out on how bad the epidemic will be in Asia," Mayer said. "But when you've got poverty and populous countries like India and China, there is fear that HIV could explode."

To keep the virus in check, Brown faculty are busy.

Through the Brown-Tufts Fogarty AIDS International Training and Research Program, professors have trained about 100 health care workers from India, Cambodia, Indonesia, Bangladesh and the Philippines on how to conduct research in their home countries.

Brown professors Susan Cu-Uvin and Joseph Harwell are establishing a women's clinic in Cambodia. Faculty are also studying the spread of HIV and its impact, as well as treatment and prevention strategies, in Indonesia, India, Cambodia and the Philippines.

A booming collaboration exists with the YR Gaitonde Center for AIDS Research and Education, in Chennai, India. The center serves 5,500 people with HIV/AIDS and is the largest prescriber of antiretrovirals in southern India. Working with center staff, Brown professors are testing new antiretrovirals, studying mother-child transmission, tracking the spread of the virus through truckers and other migrants, and developing cheaper tests and tools needed to treat HIV patients.

Brown Professor Tim Flanigan said the epidemic in Asia poses different challenges than it does in the United States. Most Asians with HIV are heterosexual, Flanigan said. The sex trade and injection drug use is rampant in some regions. Several countries are poor and don't have enough doctors, clinics and basic equipment to prevent and treat the disease.

Flanigan said the stigma surrounding HIV is also extreme.

"HIV is like leprosy in Asia," Flanigan said. "You could lose your job, your home, your family. The stigma also exists because you get the disease through sex. And people think that once you get it, it's hopeless."

Mayer notes that India and Thailand produce and distribute inexpensive generic versions of antiretrovirals - some as cheap as 55 cents a day.

A majority still can't afford them. Carpenter, who spent eight weeks this spring helping to oversee the rollout of antiretrovirals in South Africa, said more money is needed to make lifesaving drugs available in developing countries. But education, Carpenter said, is just as vital.

"Family members have to accept and support the treatment and people need to understand the importance of taking their drugs every day," he said. "So you need money and training simultaneously. And we can't wait. People are dying all the time."