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Enlist in the war against HIV

Mark Mulligan

Mark Mulligan

HIV Vaccine Awareness Day occurs every May 18 to raise awareness of, and encourage participation in, HIV vaccine clinical trials in humans.

We need an HIV vaccine. Every year for 15 years, about 56,000 Americans have become newly HIV-infected. This number has not fallen despite behavioral education efforts.

Over the same period, HIV treatment has improved tremendously, and AIDS deaths are down dramatically, from 55,000 to 16,000 annually.

In a disturbing calculus, treatment success paired with prevention failure means the United States is adding 40,000 more people living with HIV each year. The global trend is similar: 900,000 more people are living with HIV each year. So a vaccine for HIV is a key missing prevention tool.

Earlier, candidate vaccines in four large clinical trials failed to prevent HIV infection or lower virus levels after infection. Then, in 2009, an HIV vaccine study of 16,000 heterosexual men and women in Thailand demonstrated — for the first time ever — a modest reduction (31 percent) in HIV infections in vaccinated people over a three-year follow-up period.

When the analysis was limited to the first year after vaccination, a 60 percent protection rate was observed, suggesting that a booster was needed.

However encouraging these findings are, the hard truth is that we are still several years away from a widely available vaccine. Sadly, that means millions more women and men will become HIV-infected before we have the vaccine we need.

Last week, a panel of experts recommended that the FDA approve preventive use of the HIV medication Truvada, a combination of tenofovir and emtricitabine, in people who are HIV-negative but at high risk of infection. Emory scientists were the inventors of emtricitabine, which has helped transform treatment for infected individuals over the past decade. The FDA, which usually accepts such expert panel recommendations, will decide by mid-June on Truvada for prevention.

The prevention pill could be a supplement to — but not a replacement for — condoms, counseling, and safer sex. If it is not taken daily, its effectiveness goes down. One barrier to broad uptake is the cost, $14,000 per year, and there’s more we need to learn about its long-term side effects and the development of resistance.

Still, it is good to know that we may soon have a new FDA-approved HIV prevention tool for some truly high-risk people who can afford the drug and take it faithfully. Ultimately, however, we still need a vaccine!

The Emory Vaccine Center at Emory University, along with the Yerkes National Primate Research Center, is a global leader in laboratory-based HIV/AIDS vaccine research. The Hope Clinic at Emory conducts cutting-edge AIDS vaccine clinical trials in volunteers who are not HIV-infected.

On Friday, HIV Vaccine Awareness Day, consider becoming a local participant in these trials at the Hope Clinic. If you are not infected with HIV, this is a powerful way to — literally — roll up your sleeves, take a shot, and help fight HIV.

To learn more, visit or call 877-424-HOPE.

Or, you can support HIV vaccine research through advocacy. One community organization that for 10 years has been a model of support and tireless fundraising for HIV vaccine research is Action Cycling Atlanta, which puts on the AIDS Vaccine 200 Bike Ride this weekend. Learn more at

It’s inspiring that more than 200 people are choosing to bike 200 miles this weekend to fight AIDS.

Dr. Mark J. Mulligan is a professor of medicine within the Division of Infectious Diseases at Emory University. Dr. Mulligan serves as co-director of the Clinical Core for the Emory Center for AIDS Research. He is also executive director of the Hope Clinic of the Emory Vaccine Center, a human research clinic focused on clinical trials of vaccines and other prevention technologies, translational immunology studies, education and training the next generation of vaccine researchers.

Put the health of Georgia first

Dr Harry Heiman“So what’s new?” the reporter asked. “Haven’t we heard this all before?” His inquiry was striking in its simplicity, yet it was a harsh wake-up call to reality. 

His question came at the end of a recent press conference at the state Capitol where physicians, public health professionals and advocates from a spectrum of consumer health groups had just finished describing the compelling human and financial burden of tobacco-associated disease on our country and Georgia. That journalist, in spite of the plethora of facts and the credentials and credibility of the presenters, remained unmoved.

His skepticism is, unfortunately, very prescient because in spite of the fact that over 70 percent of the citizens of Georgia and a large portion of the Legislature now support a dollar increase in the per-pack tax on cigarettes, the legislative and state leadership apparently remain unmoved – more bound by political pledges of “no new taxes” than their duty of office which requires them to act in the best health interests of Georgia’s citizens.

Tobacco is the leading cause of preventable illness and death in the United States. More than obesity, poor diet, lack of physical activity. Cigarette smoking is responsible for one out of every five deaths. More than 440,000 people die each year from diseases due to smoking, including more than 10,000 Georgians. That’s more than 1,200 people each day nationally and more than one person each hour in Georgia.

Yet almost one in five people still smoke, including one in five high school students, most of whom will continue smoking into adulthood. Seventy percent of adult smokers began before the age of 18.

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