From the very beginning of the 40-year HIV pandemic until today, HIV disparities have remained an intractable issue. This plenary will explore these disparities in multiple contexts and populations, as well as their drivers and solutions. It will also touch on HIV disparities in the context of various efforts to end HIV transmission across the globe.

Gregorio (Greg) Millett is a Vice President at the Foundation for AIDS Research (amfAR) and the Director of amfAR’s Washington DC-based Public Policy Office. He is an experienced HIV researcher and policy analyst. From 2000 to 2009, Mr Millett served as a Centers for Disease Control and Prevention Senior Scientist in the Division of HIV/AIDS Prevention (DHAP), where he published about HIV infection disparities in the United States and served as a recognized national expert on the issue. From 2009 to 2013, Mr Millett served as Senior Policy Advisor in the White House Office of National AIDS Policy, where he was a key author of President Barack Obama’s original National HIV/AIDS Strategy and worked to support the strategy’s implementation across the federal government. At the White House, Mr Millett played a lead role in organizing the federal government’s engagement with the 2012 International AIDS Conference in Washington DC.

Mr Millett has published first-author manuscripts in top-tier medical, policy and public health journals, including The Lancet, JAMA, American Journal of Public Health, JAIDS, Health Affairs and other peer-reviewed publications. His work on HIV disparities, as well as HIV prevention research, have been featured in The New York Times, Time magazine, The Washington Post, Associated Press, CNN, The Wall Street Journal, Reuters and other news outlets. He is an alumnus of Dartmouth College and the University of North Carolina, Chapel Hill. 

An effective vaccine or functional cure will be needed to end the AIDS epidemic. Immune responses induced through natural infection are unable to durably control and eradicate HIV due to the tremendous genetic diversity of the virus, its ability to integrate irreversibly in long-lived target cells and the generalized immune dysfunction induced by the virus. This lecture will discuss the logistical and scientific challenges in HIV and vaccine and cure research and highlight some of the most promising approaches to achieving an effective vaccine, immune based-prevention or functional cure, particularly in communities where these interventions are urgently needed.

Thumbi Ndung’u is the Deputy Director (Science) and a Max Planck Research Group Leader at the Africa Health Research Institute (AHRI) in Durban, South Africa. He is Professor and Victor Daitz Chair in HIV/TB Research at the Nelson R Mandela School of Medicine, University of KwaZulu-Natal. He holds the South African Research Chair in Systems Biology of HIV/AIDS and is Professor of Infectious Diseases at University College London. Dr Ndung’u is the Programme Director of the Sub-Saharan African Network for TB/HIV Research Excellence (SANTHE), a research and capacity-building initiative funded by the African Academy of Sciences and the Wellcome Trust. He graduated with a Bachelor of Veterinary Medicine from the University of Nairobi, Kenya, and obtained a PhD in Biological Sciences in Public Health from Harvard University, United States. Dr Ndung’u was a Postdoctoral Fellow in Virology at Harvard Medical School. He is a member of the Academy of Science of South Africa and a fellow of the African Academy of Sciences. His research interests are host-pathogen interactions, particularly immune mechanisms of HIV and TB control, and he has co-authored more than 200 manuscripts in peer-reviewed journals. He has received grant funding from the South African National Research Foundation, the US National Institutes of Health, the Howard Hughes Medical Institute and the Wellcome Trust, among others. Dr Ndung’u leads a multidisciplinary team of researchers working in the fields of HIV and TB immunopathogenesis, vaccine development and immune-based HIV functional cure strategies. He has a special interest in capacity building for biomedical research in Africa.

This plenary will address the unique issues confronting long-term survivors of HIV, which includes those who acquired HIV perinatally or as adults and have lived for decades with the virus. The talk will review the biologic basis of HIV-related health decline, including recent interventions, and highlight some of the social implications of growing up and growing old with HIV. It will be a call to refocus HIV care on improving life-long well-being and ensuring healthy aging.

Reena Rajasuriar is an Associate Professor at the Department of Medicine, University of Malaya, and an adjunct Research Fellow at the Peter Doherty Institute for Infection and Immunity, Melbourne University, Australia. She graduated with a Bachelor of Pharmacy (Hons) and a Master’s in Clinical Pharmacy from University of Science Malaysia. She worked as a pharmacist and junior faculty at the Department of Pharmacy, University of Malaya, prior to obtaining her PhD in immunology at Monash University, Australia. Her doctoral research was focused on immunogenetics and immune activation in HIV. She returned to Malaysia to establish the core immunology research facility at the Faculty of Medicine, University of Malaya, which she currently heads. 

Dr Rajasuriar coordinates the translational research programme in HIV immunology and ageing at the Centre of Excellence for Research in AIDS (CERiA) at the University of Malaya. Her research focuses on understanding the immunopathogenesis of aging in people living with HIV and other disease models of accelerated aging, namely childhood cancer survivors. In collaboration with her colleagues, she established the Malaysian HIV and Aging (MHIVA) cohort to study the phenotype of aging and associated risk factors among people living with HIV in low- and middle-income settings. Dr Rajasuriar’s work is guided by the hypothesis that the process of aging is more accurately captured by functional versus chronological age and that studying both social factors and mechanistic/biologic drivers is important in informing our understanding of this process.

Needs: treatment for all and optimal ART during pregnancy, advanced disease, TB and comorbidities Wants: rapid ART, simple ART, drug reducing ART, long acting ART

José R Arribas is the head of the Infectious Diseases Unit and Research Director of HIV and Infectious Diseases at La Paz Hospital and Associate Professor of Medicine at the Autonoma University School of Medicine, all in Madrid, Spain. Dr Arribas received his medical degree from the Complutense University School of Medicine, Madrid. Following this, he completed his residency in internal medicine at La Paz Hospital before going on to pursue a fellowship in infectious diseases at Washington University, St. Louis, Missouri, US. During his fellowship, he performed clinical research at the Washington University AIDS Clinical Trials Unit. 

His research interests include antiretroviral therapy, development of new antiretrovirals and emerging infectious diseases. This has driven the publication of more than 340 scientific papers, many of them about clinical trials or antiretroviral therapy. Dr Arribas is a member of the GESIDA  (Spanish Group for the study of AIDS) and Chair of the antiretroviral panel of the European AIDS Clinical Society (EACS) guidelines. He is a member of the editorial committees of Antiviral Therapy, HIV Medicine, Open Forum in Infectious Diseases and Lancet HIV. 

What are the major social factors that drive the HIV and AIDS pandemic? How can social scientific approaches that draw on quantitative and qualitative methodologies, an intersectional lens and historical analysis be instrumental in helping us address current issues in the epidemic? In this talk, sociologist Celeste Watkins-Hayes will review the state of literature about the social drivers of, and responses to, the epidemic at the structural, institutional and individual levels.

Celeste Watkins-Hayes is Professor of Sociology and African American studies at Northwestern University and a faculty fellow at the Institute for Policy Research. She is a nationally recognized scholar in the US and an expert on urban poverty, social policy and inequality. Her most recent book, Remaking a Life: How Women Living with HIV/AIDS Confront Inequality, analyses the transformation of the AIDS epidemic and is based on interviews with more than 200 female AIDS activists, policy officials, advocates and women living with HIV/AIDS who have been on the frontlines of the response. The book’s release has been covered by Ms. magazine, EBONY, Chicago Public Radio, New York Public Radio, POZ magazine and Chicago Tonight.  

Dr Watkins-Hayes marries data-driven analyses with rich storytelling to illuminate the real-world issues that limit human potential. Her scholarship directly addresses current policy debates in the areas of health, safety nets, inequality and the HIV/AIDS epidemic, as well as discussions about transformative leadership among women. In addition to her academic articles and essays, she has published pieces in The Atlantic, Chicago magazine and other media outlets. She recently penned a New York Times op-ed that went viral about the significance of “Queer Eye” star Jonathan Van Ness’s disclosure of his HIV status and history of childhood sexual trauma.  

Dr Watkins-Hayes holds a PhD and MA in sociology from Harvard University and a BA from Spelman College, where she graduated summa cum laude. 

 The climate crisis threatens our very future. CO2 levels in the atmosphere continue to climb, increasing even during the COVID-19 hiatus. This talk outlines the ways in which the biological, social and political dimensions of HIV and climate change intersect. We explore the potential for environmental destruction to exacerbate the HIV pandemic, but equally, how HIV scientists and advocates can play a role in tackling the climate “pandemic”.

This presentation will highlight the importance of expanded investments in initiatives that support women living with HIV. By linking life stories, policy analysis and advocacy it will demonstrate how the resilience, power and collective vision of women living with HIV has shaped the trajectory of their lives and informed better policy and programming.

Lucy Wanjiku Njenga is the Founding Coordinator of Sauti Skika, the first network of adolescents living with HIV in Kenya and the founder and team leader of Positive Young Women Voices, a grassroots community-based organization that works to empower adolescent girls and young women living with or affected by HIV. She is the African Delegate on the NGO Delegation to the UNAIDS Programme Coordinating Board.

She serves as the Alternate Board Member of the Kenya Country Coordinating Mechanism of the Global Fund to fight AIDS, Tuberculosis and Malaria, representing people living with HIV, is a former member of the Board of Directors for the End AIDS Coalition, and is an advisory group member for the Global Coalition on Women and AIDS. In addition, she plays an active role in the Athena’s Network #WhatWomenWant Campaign and its Young Women’s Leadership Initiative, where she supports young women and adolescent girls in expanding their leadership, visibility and engagement on accountability.

Launched in mid-2016 by activists and researchers in New York City, the community-led U=U movement has engaged more than 1,000 organizations from 100 countries, reaching key affected populations on every continent. This plenary will share how people worldwide are sharing the message to improve the lives of people with HIV, dismantle HIV stigma, change policies to increase access and remove barriers to treatment and care. U=U is forever changing what it means to love and to live with HIV, but it is not without its challenges and detractors.

Dayana Hernandez is a trans-consultant and trans-activist on issues of access to healthcare, STIs and HIV and human rights. She is the founder of Transvida, an organization dedicated to ending exclusion and improving the living conditions of transgender women in Costa Rica.

Transvida has worked for equity, against exclusion and with the conviction that improving citizens’ quality of life is the only way to achieve progress and development.

Ms Hernandez is trained in public health with an emphasis on HIV, STIs, alcoholism and substance use, abuse and dependence. She is the co-manager of the “De las calles a las aulas” programme that won the Costa Rican “Quality of Life Improvements Award”.  She also leads the project, “Empresas Diversas” for legal recognition of gender identity in documents, titles and Costa Rica’s political constitution.

Much progress has been made in the prevention of HIV in children, yet many of them continue to acquire HIV and die as a result of delayed diagnosis and suboptimal treatment. Urgent action is required in countries to address persistent gaps. New technologies to diagnose HIV at the point of care, very early treatment, novel therapeutics and more comprehensive packages of care hold the promise of securing an AIDS-free future for children. However, only by enhancing and tailoring paediatric HIV services through robust operational research, political will and by placing children and families at the center of our response, can we end AIDS in this vulnerable population.

Martina Penazzato is the paediatric HIV lead for the HIV, Hepatitis and STI Programme at the World Health Organization (WHO) Headquarters in Geneva, Switzerland. She is an infectious disease specialist and has spent more than 15 years contributing to clinical research and developing global policies on paediatric HIV. She obtained her MD and PhD at the University of Padua and a Master’s in Public Health in Developing Countries at the London School of Hygiene & Tropical Medicine.  

Prior to joining WHO, she worked in Uganda and collaborated with the Penta Foundation, where she further developed her research interest focused on the optimization of diagnosis and treatment of infants and children living with HIV. In her work for WHO, in addition to major contributions to guidelines development processes in the areas of HIV, tuberculosis and child health, she has provided technical assistance to several countries, particularly in the African region. For the past six years, she has led the work of WHO on paediatric treatment and care and contributed to a number of global initiatives to improve access to HIV services for children living with HIV. She is a co-founder of the Global Accelerator for Paediatric Formulations and a key contributor to the work that WHO is undertaking to accelerate access to better medicines for children. 

Where are we, why are we there and what is needed to reach the Sustainable Development Goal (SDG) for HIV. A detailed analysis of where we are globally, regionally, at the country and community level and what needs to change to achieve this goal with less than 10 years remaining.

Ambassador-at-Large Deborah L Birx, MD, is the Coordinator of the U.S. Government Activities to Combat HIV/AIDS and U.S. Special Representative for Global Health Diplomacy. Her three-decade-long career has focused on HIV/AIDS immunology, vaccine research and global health. As the U.S. Global AIDS Coordinator, she oversees implementation of PEPFAR and all U.S. Government engagement with the Global Fund. As the U.S. Special Representative for Global Health Diplomacy, she aligns the U.S. Government’s diplomacy with foreign assistance programmes that address global health challenges. Ambassador Birx began her career with the U.S. Department of Defense as a clinician in immunology, focusing on HIV/AIDS vaccine research. She reached the rank of Colonel and was awarded two U.S. Meritorious Service Medals and the Legion of Merit Award for her research, leadership and management skills.

No population has been more neglected and excluded than people who inject drugs. Consequently, the epidemics of HIV, HCV and TB infection continue to rise among this key population. Despite this reality, there are also examples of successes such as innovative harm reduction, drug treatment, decriminalization and better approaches to HIV prevention and treatment, such as addressing ChemSex and other practices that increase vulnerability. This talk will also present what it means when policy makers are sensitized to the topic and what is the impact of the transition from using donor to domestic resources for sustainable programmes for people who inject drugs.

Andriy Klepikov is the Executive Director of the Alliance for Public Health, one of the largest HIV- and TB-focused NGOs in Ukraine and the Eastern and Central Europe (EECA) region. As its Founding Director, he manages the organization by implementing a complex and comprehensive HIV prevention, treatment and care programme, Mr  Klepikov manages one of the largest harm reduction programmes globally in partnership with field-level NGOs, reaching more than 200,000 people who inject drugs. He leads the transition to state funding of the largest opioid-substitution therapy programme in the EECA region.  

He also manages the TB/MDR TB programme in Ukraine and leads advocacy efforts for access to hepatitis C treatment, including managing a direct-acting antiviral (DAA) treatment programme for key populations.  

He completed a PhD in philosophy and holds a degree in sociology, as a visiting scholar, from New School for Social Research in New York.  

This talk will cover why, despite its high efficacy, daily oral PrEP alone is not sufficient to reach all populations who need highly effective prevention strategies. Strategies including scale up of treatment (U=U); alternate PrEP dosing schedules, drugs, and modes of delivery; post-exposure prophylaxis; and HIV vaccines will be discussed.

Susan Buchbinder is the Director of Bridge HIV at the San Francisco Department of Public Health and Clinical Professor of Medicine, Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). Dr Buchbinder has been conducting HIV epidemiologic and prevention research since the late 1980s. Her primary interest is in developing, evaluating and implementing strategies likely to have the greatest impact in preventing new HIV infections. She is currently conducting trials on HIV vaccines, pre-exposure prophylaxis, topical microbicides, vaginal rings, HIV home self-testing and strategies to improve uptake and adherence to PrEP. She holds leadership positions in both the HIV Vaccine Trials Network and the HIV Prevention Trials Network, two NIH-funded global HIV prevention networks.  

Dr Buchbinder is a founding member and serves on the steering committee of Getting to Zero San Francisco, an initiative that aims to eliminate new HIV infections, HIV-associated deaths and HIV stigma. She is an attending physician at San Francisco General Hospital’s Richard Fine People’s Clinic. She also mentors students, residents and fellows in UCSF’s Advanced Training in Clinical Research Program and through the mentorship programme at UCSF’s Center for AIDS Research. Dr Buchbinder is a graduate of Brown University, UCSF Medical School and the Primary Care Internal Medicine Residency at San Francisco General Hospital.