The Newsletter of amfAR, fThe Foundation for AIDS Research Fall 2008

amfAR Report Exposes Global Failure to Address HIV Among MSM HIV Among MSM 19 Times Higher Than General Population

mfAR has released the first comprehensive report detailing the failure of governments and global health institutions to a address the disproportionate spread of HIV/AIDS among men who have sex with men (MSM). Released on August 4 during the XVII International AIDS Conference, the report paints a picture of collective denial and inac - tion fueling a worldwide public health crisis. According to the report, the HIV/AIDS epidemic appears to be expanding significantly among MSM, but in many countries surveillance data remain scarce and funding for MSM-specific programs is inadequate or nonexist - ent. In addition, HIV services are rarely extended to MSM, and the human rights of these men are regularly threatened. The First International March Against Homophobia was held in (continued on page 6) Mexico City during the XVII International AIDS Conference.

Co-Discoverers of HIV Win Nobel Prize

rofessor Françoise Barré-Sinoussi and Professor Luc “Our progress against AIDS to date is the result of brilliant P Montagnier received the 2008 Nobel Prize in Medicine work by scientists like Drs. Barré-Sinoussi and Montagnier,” for their 1983 discovery of HIV, the virus that causes Frost said. “And we believe that, through the work of dedicated AIDS. Both Professor Barré-Sinoussi and Professor scientists, the mysteries of HIV will continue to unravel and we Montagnier were recipients of amfAR research grants in will ultimately find a cure for AIDS.” the mid-1980s. In its citation, the Nobel Assembly said Barré-Sinoussi’s “The impact of the work of both Françoise Barré-Sinoussi and Montagnier’s 1983 discovery paved the way toward under - and Luc Montagnier cannot be overstated,” said amfAR CEO standing how HIV interacts with host cells and evades the Kevin Robert Frost. “In identifying the mysterious killer that immune system. This led to the development of methods for we now know as HIV, these scientists opened the door to enor - testing patients and screening blood, which have proved invalu - mous scientific breakthroughs, and helped save countless lives.” able in containing the spread of the HIV/AIDS epidemic. In amfAR funded some of the earliest HIV research conduct - addition, their work has aided scientists in developing several ed by both Nobelists in the 1980s, work that was published in classes of lifesaving antiretroviral drugs, and provided knowl - prestigious journals such as Science, Nature, The Lancet, and the edge that may lead to the discovery of new treatments, vaccines,

New England Journal of Medicine . and ultimately, a cure. I From the CEO amfAR, The Foundation for AIDS Research he approach of the was complex, expensive, and impractical. Still, it www.amfar.org 1-800-39-amfAR New Year brings suggests that it might actually be possible to elimi - T nate HIV from a person’s body. amfAR has already 120 Wall Street, 13th Floor both renewed hope New York, NY 10005-3908 and significant challenges. convened some of the world’s best scientists to tel: (212) 806-1600 fax: (212) 806-1601 Our concern, of course, determine what can be ascertained from this case and how best to apply this new knowledge. Visit our 1150 17th Street, NW, Suite 406 is rooted in the uncertain Washington, DC 20036-4622 economic outlook that new website—www.amfar.org—for updates on this tel: (202) 331-8600 fax: (202) 331-8606 confronts individuals and other important research stories. On a somber note, we mourn the recent loss TREAT Asia and organizations across Exchange Tower America, and its possible of Dr. Allan Rosenfield, a true champion of public 21st Floor, Suite 2104 health and hero in the fight against AIDS, who 388 Sukhumvit Road effects on funding for Klongtoey, Bangkok 10110 passed away in October after a heroic battle with Thailand HIV/AIDS programs both here and abroad. tel: (+66) 2 663-7561 Fortunately, amfAR is in a strong position to with - Lou Gehrig’s Disease. Dean of Columbia fax: (+66) 2 663-7562 stand the economic downturn. And with your help, University’s Mailman School of Public Health and we will continue to move forward vigorously with a long-time amfAR board member, Allan’s expert Management Group Kevin Robert Frost a range of important AIDS research initiatives. guidance and warm humanity will be sorely missed. Chief Executive Officer All of us at amfAR extend our best wishes Anthony Ancona Our hopefulness stems from the vitality of Director, Human Resources science and the potential of political change. The for 2009. We look forward to working as partners Susan J. Blumenthal, M.D., M.P.A. Senior Medical and Policy Advisor newly elected Obama administration has already with you in pursuit of our shared goal of a world Brad Jensen without AIDS. Chief Financial Officer staked out some thoughtful positions on AIDS. Rowena Johnston, Ph.D. Through our advocacy efforts, we will work with Vice President and Director of Research Joshua Lamont the new administration on improving and expand - Vice President, Public Information Jeffrey Laurence, M.D. ing our nation’s response to HIV/AIDS. Our first Senior Scientific Consultant priority will be to urge the President-elect to quick - John F. Logan, Esq. Vice President and General Counsel ly develop a comprehensive national AIDS strategy. Annette Sohn Vice President and Director Recent research developments give us another of TREAT Asia good reason to be optimistic. An intriguing medical case, widely reported in the press, centers on a Newsletter Staff Andrew McInnes patient who appears to have been functionally cured Kevin Robert Frost Director, Public Information Constance Herndon of HIV/AIDS. The medical procedure involved Chief Executive Officer Senior Staff Writer Carolyn Hanson Winnie McCroy Contributors Raoul Norman-Tenazas Creative Director Yolande Hunter Production Artist New Faces at amfAR Joshua Lamont, who previously served as vice president and director of corporate giving at Lehman Brothers and as communications director for GLSEN, the Gay, Lesbian and Straight Education Network, is amfAR’s new vice president for public information. In September, Annette Sohn, M.D., a highly regarded pediatrician and researcher with amfAR meets the BBB Wise extensive experience treating HIV/AIDS Giving Alliance’s Standards for Charity Accountability among women and children in Southeast Asia, was appointed vice president and director of TREAT Asia. Also in September, Bradley Jensen, formerly director of finance

and administration at the Global Alliance amfAR recognizes American Airlines for TB Drug Development, became amfAR’s for its generous support of new chief financial officer. amfAR’s mission.

2 amfAR News • Fall 2008 public policy U.S. Approves Massive Funding Hike for Global AIDS Programs amfAR Senior Policy and Medical Advisor Dr. Susan Blumenthal PEPFAR Budget Swells to $48 Billion with U.S. Department of Health and Human Services Secretary Michael Leavitt at the White idely acknowledged as one of ever funded House for the PEPFAR signing. the most effective foreign aid by one nation W programs in U.S. history, the to fight a sin - President’s Emergency Plan for AIDS gle disease. By Relief (PEPFAR) was signed into law on March 31, 2008, the program had July 30 with a budget of $48 billion, $20 supported antiretroviral treatment for U.S. Borders Opening billion more than President George W. approximately 1.73 million people across Bush requested and triple what the pro - the globe, and funded prevention of moth - to HIV-Positive gram received during its first five years. er-to-child HIV transmission services for Visitors? The PEPFAR legislation—passed nearly 12.7 million pregnant women. by an overwhelming majority in both the Over the next five years, PEPFAR is he reauthorization of the House and the Senate despite being held expected to provide treatment for at least President’s Emergency Plan up for three months by a small but vocal 3 million people and care for 12 million, T for AIDS Relief (PEPFAR) has contingent in the Senate—will fund including 5 million orphans and vulnera - paved the way to ending the ban on HIV/AIDS prevention, care, and treat - ble children. Its prevention services are travel and immigration to the U.S. ment in the world’s poorest countries, expected to avert up to 12 million new by HIV-positive foreigners. particularly in Africa. In its new incarna - infections. Under the new PEPFAR legisla - tion, PEPFAR loses a highly controversial PEPFAR prioritizes resource- tion, HIV-positive foreign visitors and clause requiring that at least one-third limited countries with high HIV/AIDS immigrants will no longer be barred of prevention funds be used to promote prevalence rates. The 15 current focus from entering the U.S. Previously, U.S. abstinence until marriage, replaced with countries are Botswana, Côte d’Ivoire, immigration law prohibited foreigners the requirement that Congress receive Ethiopia, Guyana, Haiti, Kenya, with “any communicable disease of pub - reports if less than half of HIV prevention Mozambique, Namibia, Nigeria, Rwanda, lic health significance” from entering funding is spent on abstinence and fidelity South Africa, Tanzania, Uganda, Vietnam, the country, but only HIV was named programs. and Zambia. explicitly in the statute. Now, all that First implemented in 2003, PEPFAR amfAR will continue its advocacy stands in the way of ending the travel initially provided $15 billion over the work to ensure that PEPFAR policies are restriction completely is for the course of five years for HIV/AIDS pro - science-based and in support of removing Department of Health and Human grams in developing countries, making it certain provisions in the program, includ - Services (HHS) to remove HIV from the largest international health initiative ing the anti-prostitution pledge. I a list of diseases that render people ineligible to enter the U.S. But this change may not occur until 2009; as an HHS spokesperson noted, revising the rule is a “time-consuming Facing Down process.” Meanwhile, in September, the Department of Homeland Security AIDS in Asia issued a new rule intended to streamline the visa process for HIV-positive foreign Highlighting the devastation of Asia’s HIV/ visitors, giving consular offices overseas AIDS epidemic, amfAR’s policy office held a film screening and panel discussion on July 16 in the authority to grant temporary, non- Washington, D.C. Tom Lennon’s Academy Award- immigrant visas. I winning Blood of the Yingzhou District , at left, was one of two documentaries shown at the event. The panel discussion is available via webcast at www.kaisernetwork.org (search AIDS in Asia ). amfAR News • Fall 2008 3 research amfAR Think Tanks: A Blueprint for Action Against HIV/AIDS By Rowena Johnston, Ph.D., and Jeffrey Laurence, M.D.

mfAR gathered HIV experts at the restored? These issues were addressed dur - social and behavioral factors are inextricably a end of September for three think ing another think tank. A test tube of woven into the responses of individuals, tanks that tackled the complexities immune cells infected with HIV can be groups, and governments to the challenges of circumcision, the possibility of a cure “cured” through gene therapy approaches. posed by HIV, this meeting explored the for AIDS, and the need for a cohesive effort How might test-tube successes be replicated need for a social/behavioral research collab - to address international research issues. to reach all HIV-infected cells in an infected oration. Every region of the world, and the The first think tank addressed the role person? According to a report from a single various groups within those regions, experi - of adult male circumcision in HIV preven - patient in Berlin, this feat may already have ences its own mix of stigma, mistrust, lack tion. In recent years, three trials conducted been accomplished by using a bone marrow of awareness, and cultural, economic, and in Africa found that men who underwent transplant involving stem cells obtained sociopolitical forces that influence the effi - circumcision experienced a reduction of up from a donor’s blood. cacy of prevention or treatment. to 60 percent in their risk of acquiring HIV A 40-year-old HIV-positive man This think tank addressed key via penile-vaginal intercourse. But surgical with leukemia received a transplant questions such as, to what extent are complications, costs, and a dearth of local from a donor who had a genetic condition experiences in these different contexts expertise in this surgery constitute critical known as delta32-CCR5, a mutation that similar or different? Will solutions that potential impediments to the widespread renders the person’s immune cells resistant work in one region of the world, or in one roll-out of adult male circumcision. to infection by most types of HIV. The population, be applicable across diverse Is there an alternative? Could a chemi - transplant was a success, with the patient’s regions or populations? cal applied to the foreskin mimic the pro - leukemia in complete remission. The What will amfAR’s next steps be? tective effect of its removal? This think tank patient has also remained off all his anti- How do we seize the moment to convert addressed alternatives to surgical circumci - HIV drugs for more than a year, yet there is challenges into opportunities? Think tanks sion. no detectable HIV in his body. Has he been like these begin to shape answers and a

What if infection has already occurred? cured? Can this success be replicated in blueprint for action. I It is unlikely that we will ever be able to another patient? This think tank considered treat our way out of this pandemic, but will these and other related questions. Dr. Laurence is amfAR’s senior scientific AIDS ever be cured—the virus eliminated Social and behavioral research was also consultant. Dr. Johnston is amfAR’s vice from the body and the immune system the focus of a think tank. Recognizing that president of research.

Optimizing HIV Treatment, Searching for a Cure amfAR Awards $1.4 Million in New Research Grants

mfAR awarded more than $1.4 million in July for 12 Eight of the newly funded research projects involve biomed - a research projects focused on attempts to eradicate HIV ical studies of HIV persistence and potential strategies for eradi - and on understanding some of the barriers to effective cation. Several researchers are studying the viral reservoirs where prevention and treatment. HIV persists beyond the reach of highly active antiretroviral ther - “Advances made in HIV treatment have arguably been the apy (HAART) with the aim of developing strategies to prevent or great success story of AIDS research, and yet two limitations eliminate these reservoirs. Others are testing treatment strategies continue to dog our efforts,” said Dr. Rowena Johnston, amfAR’s that may lead to the eradication of HIV. Dr. David Margolis of vice president of research. “One is that not all people, even in the the University of North Carolina-Chapel Hill, for example, is U.S., benefit equally from these treatment advances. And second, studying a class of compounds that, in the presence of HAART, there is still no cure for HIV.” can deplete the amount of latent virus in an infected person. 4 amfAR News • Fall 2008 global amfAR at International AIDS Conference

mfAR had an active presence at the amfAR for supporting his own early research on hetero - a XVII International AIDS Conference sexual transmission of HIV. in Mexico City, August 3–8, garner - Dr. Adeeba Kamarulzaman, chair of the TREAT Asia ing widespread attention for its special steering committee, delivered a plenary address on harm report on HIV among men who have sex reduction, and TREAT Asia’s director of research, with men (MSM) ( see page 1 ) and drawing Jeffery Smith, reported on the progress of a collaborative attention to the HIV/AIDS epidemic in program to build capacity for the monitoring and surveil - Asia and the Pacific with updates from its lance of HIV drug resistance in developing countries in TREAT Asia initiative. Asia and Africa. amfAR was a co-sponsor of a pre- Dr. Adeeba Kamarulzaman, TREAT Asia also presented research data from the conference event titled “The Invisible chair of the TREAT Asia steering TREAT Asia HIV Observational Database in two poster Men: Gay Men and Other MSM in the committee, spoke out strongly sessions. A third poster described the activities and in support of harm reduction pro - Global HIV/AIDS Epidemic.” The event grams in a plenary address at the progress of a program to standardize HIV genotypic directed attention to the growing need to International AIDS Conference. resistance testing. In addition, representatives of the fund global HIV research on MSM and TREAT Asia-affiliated Purple Sky Network presented improve prevention, treatment, care, and support for this popula - two posters detailing aspects of their work with MSM and with tion. Speakers included MSM Initiative Director Jeffrey Stanton peer outreach. I and Jack Arayawongchai, TREAT Asia’s MSM program coordi - nator. In addition, Stanton was one of 30 speakers who addressed MSM Grantee Wins Prestigious more than 10,000 people at the First International March Against Homophobia on August 2. The event was organized by Red Ribbon Award the Global Forum on MSM & HIV and co-sponsored by UNAIDS, the International AIDS Society, and others. he Center for Popular Speaking at the pre-conference event on MSM, Dr. Peter Education and Human Piot, executive director of UNAIDS, paid tribute to amfAR’s T Rights, Ghana, an amfAR MSM Initiative, praising the Foundation for “pioneering this MSM Initiative grantee, was supporting community action on men who have sex with men, among only five organizations and against homophobia.” He also expressed his gratitude to awarded the United Nations Development Programme’s prestigious Red Ribbon Award for outstanding leadership in Anita Confidence Cobbinah (left), responding to HIV/AIDS. assistant women’s director, and Mac- The four social and behavioral studies funded by amfAR Secretary-General Ban Ki- Darling Cobbinah (right), executive focus on factors that affect a person’s decision to follow the national director of the Centre for moon presented the group Popular Education and Human Rights, advice of healthcare professionals. Dr. Scott Rhodes of Wake with the award and $20,000 at Ghana, recieving the Red Ribbon Forest University Health Sciences will examine beliefs, atti - an August 7 ceremony during Award. (Photo CEPEHRG) tudes, and other factors that influence Latinos’ decisions to the XVII International AIDS Conference in Mexico City. The access or avoid science-based HIV treatment and prevention Center was selected from more than 550 organizations nominated services. The study aims to shape new strategies to reduce the for this award, which is presented every other year. They were rapidly rising HIV infection rate among Latinos. honored for their pioneering work among men who have sex with Other social and behavioral projects include two studies men (MSM), which includes innovative HIV treatment and men - in South Africa: an examination of the beliefs and attitudes tal health services, and a drop-in clinic. amfAR’s MSM Initiative surrounding male circumcision, recently shown to reduce the grant allows the group to train HIV prevention peer educators, risk of acquiring HIV by around 50 percent, and an investiga - and to create informational materials to promote safe sex among tion of false HIV beliefs and misinformation among South MSM in greater Accra. I African men who have sex with men. I amfAR News • Fall 2008 5 Syringe Exchange Transforms

Lives in Harlem Volunteer Ron Thomson (far left) conducts outreach activities in East Harlem. A syringe exchange staffer wo trailers sit in the shadow of the (left) administers a rapid T commuter train tracks, which rise oral HIV test to a client. above street level in New York City’s East Harlem. On a sunny Tuesday morning, most of the people who stop at this mobile syringe exchange site stay only minutes, to Syringe Exchange: The Facts exchange used syringes for clean ones or to pick up safe injecting supplies, condoms, • HIV prevalence among IDUs in New York City and literature. These brief interactions are dropped from 50 percent in 1990–1992 to 15 part of a much larger trend: the dramatic percent in 1999–2002. reduction of HIV infections among injection drug users (IDUs) in New • During the same period, the number of syringes York, as well as lasting, visible change within communities like East Harlem. exchanged per year in the city increased from amfAR has played an integral role in syringe exchange in New York 250,000 to 3 million. since before it was legal, funding early studies showing the benefits of harm • The projected lifetime cost of treating just one reduction, and providing seed funding for the first legal syringe exchange person with HIV in the U.S. is $400,000– programs in New York City. Since 1992, amfAR has been distributing sup - $600,000. plies to all the state’s programs, with funding from the state department of The highest-funded syringe exchange program health. In many states, the debate about syringe exchange rages on, but in • in New York State, which receives less than New York, the practice has been shown to be an unqualified success. I $300,000 per year, pays for itself by preventing To read the full story, visit www.amfar.org. just one new infection a year.

among MSM is indefensible. These organizations have policies MSM (continued from page 1) on women, drug users, migration–but not one of them has a comprehensive policy on MSM.” Titled MSM, HIV, and the Road to Universal Access–How Far Criminalization of male-male sexual activity is a major Have We Come? , the amfAR report documents an HIV infection driver of the epidemic among MSM in many countries, according rate among MSM in low- and middle-income countries that is to the amfAR report. Seven out of the 10 countries with the high - 19 times higher than the general population. In the U.S., a new est reported prevalence among MSM criminalize homosexuality. report by the Centers for Disease Control and Prevention shows Globally, 86 countries criminalize male-male sexual activity, and in that HIV infections among MSM have risen 75 percent over seven countries, male-male sexual activity is punishable by death. the last 15 years. “amfAR’s MSM report paints a tragic picture of denial, The amfAR report, generated by the Foundation’s MSM indifference, and inaction that has taken a tremendous toll on Initiative, studied 128 country reports submitted to the UN the lives of men who have sex with men,” said Jeffrey Stanton, this year and found that nearly half of the countries (44 percent) director of the MSM Initiative. failed to offer any data whatsoever on MSM. Despite a unanimous The MSM report was well received by conference partici - commitment made in 2001 by all UN member countries to scale pants and the press. “I would rank the special report among up HIV/AIDS programs towards universal access by 2010, 71 the best documents on AIDS country intelligence I have seen,” percent of countries said they did not have any information on said Luiz Loures of the UNAIDS secretariat. Many prominent the percentage of MSM reached by HIV prevention programs. international news outlets from around the world covered the “World leaders are finally saying the right things, but report, including the Washington Post, Financial Times, Prensa they need to follow their words with actions,” said amfAR Latina, Montreal Gazette, Toronto Globe & Mail, Sydney CEO Kevin Frost. “The failure of the the world’s global health Morning Herald, La Jornada (Mexico), El Mundo (Spain), bodies to devote significant resources toward reducing HIV rates Times of India, AP, Reuters, and BBC World Radio. I 6 amfAR News • Fall 2008 Honoring With Pride

Held on June 9 in New York, Honoring With Pride raised $250,000 for amfAR's programs. Multi-platinum recording artist Special thanks: Morgans Hotel Group and the Taylor Dayne Hudson Hotel, SKYY Vodka, Anheuser-Busch, performed songs T. Edward Wines, and Morrell Wine. from her new album, Satisfied , and hits such as “Tell It to My Heart.”

The “Broadway Walk On” lot auctioned off by Tony Award- Jerry Mitchell, Julie Davids, and Chris winning actress Marissa Salgardo, president of Kiehl’s Since amfAR Chairman of the Board Kenneth Cole, Jaret Winokur (left) 1851, received Awards of Courage. Taylor Dayne, host Mario Cantone and amfAR brought the highest Founding Chairman Dr. Mathilde Krim. bid of the evening.

amfAR supporters raised a glass at Manhattan’s High Bar on September 17 for amfAR Around Town: Socializing With a Conscience, a new series for young philanthropists. amfAR Around Town

Special thanks: The High Bar, Cape North David Earls, Vodka, and Pipeline Brands. In collaboration Nancy Schafer with the Tribeca Film Festival. of the Tribeca Film Festival, and Monica Valenti of Product(RED).

Guests included Erika Chasin, Jeff Barrera, and Actress Jill Powell amfAR Director of Development Eric Muscatell. with Karen Harnesk.

Broadway Comes to Bucks County

The fourth annual Bucks County Cabaret, held at Cradle Valley Farm in Solebury, Pennsylvania, on September 21, raised more than $80,000 for amfAR.

Special thanks: Candace Jones and Stephen Phillips of Cradle Valley Farm, Cheyenne Jackson, Seth Rudetsky, and Peter Cassell of T. Edward Wines. Jackson, who sang selections from his past shows including Altar Boys and Xanadu , appeared Hosts Stephen with event co-chairs (left to right) Dave Topel, Phillips and David McShane, Scott Bass, and Ken Schaefer. Candace Jones with Broadway star Cheyenne Cocktails were served poolside. Jackson. amfAR News • Fall 2008 7 VeISITv THEe NEnW atsmfar.org eamfAvR, TheeFoundnation fotr AIDs S Research 120 Wall Street, 13th Floor, New York, NY 10005-3908

INSIDE Fall 2008 • Nations Fail to Tackle HIV Among Gay Men • Nobel Prize Goes to Co-Discoverers of HIV

• amfAR Think Tanks: A Cure for AIDS?

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