Title

Harnessing information for HIV prevention

Code

TUSY02

Session Type

Symposia Session

Venue

Hall 10

Date Time

Tuesday 24 July, 11:00 - 12:30

Co-Chairs:

Lorraine Sherr, University College London, United Kingdom
Roger Kouyos, University of Zurich, Switzerland

Several state-of-the-art methodologies and technologies have been introduced over the past decade, including:

the theory of syndemics (for example, mental health, substance abuse, and sexual risk taking) within key and vulnerable populations and how they may interact with adverse social conditions (for example, migration, political unrest, and financial instability) in different geographical regions to drive the ongoing HIV epidemic
real-time molecular epidemiology that can be used to rapidly identify clusters of new infections within geographically or demographically defined groups
geographical information systems that can be used to understand the social and geographical structure of communities and to identify locations with high HIV prevalence and/or incidence

This session will describe ways in which information from these methodologies and technologies can be incorporated into prevention programmes that are tailored to local populations. The session will also discuss some of the ethical and legal issues that may arise when incorporating these methodologies into prevention programmes.

11:00 TUSY0201	Introduction

11:05 TUSY0202	An introduction to syndemic theory, the role of syndemics in driving the HIV epidemic in different key and vulnerable groups, and how this information can be used to support tailored prevention programmes Tonia Poteat, Johns Hopkins Bloomberg School of Public Health, United States	Slides

11:20 TUSY0203	Understanding infection clusters – can this help us to target prevention? Christophe Fraser, University of Oxford, United Kingdom	Slides

11:35 TUSY0204	Use of spatial analytical approaches to identify of ongoing HIV micro-epidemics in rural South Africa Frank Tanser, University of KwaZulu-Natal, South Africa	Slides

11:50 TUSY0205	The ethical and legal issues that may arise when using syndemic theory, real-time molecular epidemiological methods and GIS to identify sexual and social networks at risk of HIV Gail Henderson, University of North Carolina, United States	Slides

12:05 TUSY0206	Panel discussion

12:25 TUSY0207	Closing remarks

AUTHOR

Tonia Poteat

SUMMARY

New methodologies present opportunities and challenges for HIV prevention programs. This session provided a broad overview of syndemic theory, real-time molecular epidemiology, and geographical information systems used to inform interventions as well as a rich discussion of the practical, ethical, and legal implications that arise when incorporating these methodologies.

HIGHLIGHTS

The session opened with a description of syndemic theory as the concentration and harmful interaction of two or more health conditions as a consequence of structural and social inequities. Syndemic frameworks for interventions offer opportunities for interdisciplinary collaboration to include attention to multi-level social drivers and disease interactions in future HIV research. New phylogentics technologies can identify the direction of HIV transmission between individuals with an overall 83% accuracy. However, potential missing intermediaries cannot be identified. Thus, such techniques are best used for “epidemiology not forensics.” Geospatial analysis can identify emerging local areas of high HIV prevalence; and population viral load can predict HIV incidence in these “hot spots.” The session closed the session with a reminder to apply ethical principles we already know to addressing concerns about risks and benefits of these new methodologies.

CRITICAL ASSESSMENT

This valuable session highlighted the importance of multi-level approaches to addressing HIV prevention in ways most likely to generate impact. Incorporating syndemic approaches to applications of molecular epidemiology and geospatial analysis is feasible and would benefit from funding that specifically calls for a multi-disciplinary, ethics-informed approach. Social and biological methodologies form complementary aspects of HIV prevention.