35 Years of Advances in HIV/AIDS: What has Changed for Women?

The Institute will focus on current knowledge regarding HIV and women over the life course in a global context: epidemiology, pathogenesis, transmission and prevention, women-centered HIV treatment, and gender inequalities.  Emphasis will be given to the social aspects of women and HIV/AIDS, including gender-based vulnerabilities and empowerment, as well as most at risk populations such as adolescents.  State of the art approaches to women’s HIV prevention will be presented: PrEP/microbicides; ARV-based prevention; male circumcision and potential benefits for women; mother-to-child transmission; reproductive decision-making - including pre-conception counseling, contraception and HIV/reproductive health service integration; and economic and behavioral interventions.  Discussions will emphasize a holistic approach that includes men/partners, families and communities as key influences on HIV infected and at risk women. The institute will use a multidisciplinary team approach to understanding these complex issues in both resource-rich and poor settings.

Convening Faculty

Susan Cu-Uvin
Professor of Obstetrics and Gynecology and Medicine; Director of Immunology, Miriam Hospital
Director of the Women and AIDS Core for the Center for AIDS Research (CFAR) at Brown University

Dr. Cu-Uvin is the Director of the Immunology Center at the Miriam Hospital, Brown University, a clinic that serves almost 1,200 HIV infected patients. She is also the director of the Women and AIDS Core, for the Center for AIDS Research (CFAR) at Brown University. In addition, she is the director of the Research program of the Brown/Women and Infants Hospital Center of Excellence in Women's Health. She devotes 100% of her time to HIV related care and clinical research. Dr. Cu-Uvin's research focuses on Human Immunodeficiency Virus (HIV) in women primarily in understanding the effect of antiretroviral therapy on HIV shedding in the female genital tract. She is also involved in research on Sexually Transmitted Diseases (STDs): human papilloma virus (HPV, genital warts) in the cervix and anal canal of HIV infected women, cervical/anal dysplasia or cancer, HPV vaccines, herpes and bacterial vaginosis. She collaborates on studies of microbicides to prevent HIV transmission.

Abigail Harrison
Assistant Professor (Research), Department of Behavioral and Social Sciences, Program in Public Health and Population Studies & Training Center

Dr. Harrison’s current research focuses on adolescents and the transition to adulthood in the context of HIV/AIDS in southern Africa. In collaboration with South African colleagues, she serves as co-investigator on a study of education, schooling patterns and HIV prevention in secondary schools, as well as a research project "Structurally Linking HIV/AIDS and Family Planning Services," in collaboration with the Reproductive Health Research Unit with funding from the Hewlett Foundation. Harrison’s research also focuses on analysis of ethnographic data from her long-term project on “Adolescents through the Lifecourse in Rural South Africa,” and on the interrelationships between non-marital unions, fertility and HIV risks among young adult women in South Africa.

Visiting Faculty

Kathryn Anastos
Professor of Medicine, Epidemiology, and Population Health, Albert Einstein College of Medicine, Yeshiva University

Dr. Anastos is a physician executive, clinician and medical researcher who for more than 20 years has provided both clinical care and operational and clinical leadership in the South Bronx.  She has extensive experience in innovative development of large programs designed to increase access to high quality, culturally sensitive care by poor communities of color, while meeting both a clinical and financial bottom line. She has served as executive director of several large systems of ambulatory care in the Bronx, and has provided leadership during design, construction and opening of new primary care clinics.  Clinically Dr. Anastos trained and actively practices as a primary care internist with expertise in the comprehensive care of HIV infected individuals and HIV infection in women. 

Curt Beckwith
Associate Professor of Medicine, Brown University

Dr. Beckwith conducts research on developing innovative HIV testing, linkage, and retention programs for vulnerable populations, particularly for persons involved with the criminal justice system. Dr. Beckwith is currently funded by NIDA to investigate the expansion of HIV testing among incarcerated populations. He is also working with colleagues to develop technology-based counseling tools to promote ART adherence and linkage to community HIV care for HIV-infected jail detainees through NIDA's criminal justice Seek, Test, and Treat initiative. Dr. Beckwith is co-leader of the Prisoner Health and Human Rights Scientific Program of the Lifespan/Tufts/Brown Center for AIDS Research, is the Associate Director of the Brown University Infectious Diseases Fellowship, and is an active HIV provider in Providence, RI.

Larry Brown
Professor of Psychiatry and Human Behavior, Brown University

Dr. Brown is a board-certified child and adolescent psychiatrist with a particular interest in HIV and risk behaviors among adolescents.  His current research interests focus on HIV risk and the efficacy of HIV prevention treatments among subgroups of adolescents such as those with psychiatric disorders. He is the Principal Investigator of several major projects, funded by National Institute of Memtal Health (NIMH), that focus on the relationship between psychopathology and HIV risk behaviors.

Carla Chibwesha
Assistant Professor of Obstetrics and Gynecology, Centre for Infectious Disease Research in Zambia, University of North Carolina at Chapel Hill

Dr. Chibwesha’s research interests include cervical cancer screening, family planning, and HIV prevention and treatment, as avenues to improve women’s health and protect their human and reproductive health rights. She has been living in Lusaka full-time and working at the UNC-affiliated Centre for Infectious Disease Research in Zambia (CIDRZ) since 2009.  While in Zambia, Dr. Chibwesha has served as lead investigator on several women’s health research and service projects. Through this work, she has developed expertise in global women’s health, conducting research that informs clinical care and health policy, and strengthening local health systems through targeted training and enhanced accountability.

Timothy Flanagan
Professor of Medical Sciences & Health Policy and Practice, Brown University

Timothy P. Flanigan has spearheaded both clinical care and clinical research programs for improved HIV treatment among marginalized communities. He has been funded through the CDC, NIH, Substance Abuse and Mental Health Services Administration (SAMSA) and Ryan White to provide improved HIV treatment and prevention among individuals in jail and prison and among active substance abusers. He is also currently engaged in HIV treatment programs in Ghana and Ukraine. Furthermore, Dr. Flanigan developed the HIV Core Program at the Rhode Island State Prison to provide care for HIV infected individuals and link them to community based resources upon release. Over 70% of individuals in Rhode Island who are HIV infected link with primary medical care at The Immunology Center.
Dr. Flanigan has been the PI on two special projects of national significance funded by HRSA to develop combined therapy for opiate addiction and HIV, as well as a model program of linkage to care for HIV positive person's leaving jail. 

Jennifer Friedman
Associate Professor of Pediatrics, Brown University

Dr. Friedman is a pediatrician who conducts international health research out of Lifespan’s Center for International Health Research at Rhode Island Hospital.  Her research addresses quantification of and mechanisms of morbidity of parasitic diseases among pregnant women and children. 

Sally Hodder
HIV/AIDS Program in the Division of Infectious Diseases, New Jersey Medical School

Dr. Hodder received her BA from the Mount Holyoke College and her MD from Case Western Reserve University. She was a fellow in the Infectious Disease Division at CASE Western/University Hospitals in Cleveland, where she also worked as an attending physician, consultant and Associate Professor until 1999. She then joined Bristol-Myers Squibb Company as a sub team leader in the medical affairs organization during the acquisition of DuPont Pharma. She was later appointed Senior Director of U.S. Virology Scientific Operations and a few months later was promoted to be the Vice-President of the U.S. Virology Medical Affairs. In February 2005 she joined the Infectious Disease Division at New Jersey Medical School. Dr. Hodder has received numerous awards including the President's award from Bristol-Myers Squibb Co , she has been a member in different committees such as the National Board of Medical Examiners and the National coalition to eliminate tuberculosis. 

Milu Kojic
Associate Professor of Medicine, Brown University

Dr. Kojic's current research is on HPV/HIV co-infection in women. She is currently studying anogenital HPV infections and related diseases of HIV in women and is chairing an AIDS Clinical Trial Group (ACTG) study on the safety of the Quadrivalent HPV vaccine in HIV infected women. This research study seeks to assess the safety and immunogenicity of the HPV vaccine among HIV infected women with different CD4 counts and viral loads.

Michael Koster
Assistant Professor of Pediatrics, Brown University

Dr. Michael Koster is a pediatric hospitalist and infectious diseases specialist. His areas of interest are in physician decision-making regarding diagnosis and testing of pneumonia and meningitis. He is very committed to education and enjoys mentoring fellows, residents, and students on research and global health projects. Dr. Koster has ongoing collaborations in Haiti, Rwanda, and Ukraine. His global health interests extend to pneumonia, meningitis, HIV, malnutrition, and medical education.

Michelle Lally
Associate Professor of Medicine and Health Services, Policy and Practice, Brown University 

Dr. Lally serves as the Director of the HIV Vaccine Clinical Trials Unit for Brown University/The Miriam Hospital; her primary research interests include HIV prevention, testing, and vaccine development. Her attention also focuses on health care disparity, access to HIV and other STD education, testing, and treatment, and the representation of women and minorities in clinical trials. Dr. Lally has also worked extensively in the area of rapid HIV testing and its potential community applications.

Scott McClelland
Associate Professor of Medicine, Epidemiology, and Global Health, University of Washington

Dr. McClelland is co-Director of the University of Washington's Center for AIDS Research (CFAR) International Core, and a member of the International AIDS Research and Training Program and the Kenya Research Program faculty. Dr. McClelland is Site Leader for the University of Washington (UW)/University of Nairobi (UON) Mombasa HIV/STD Research Site.  Dr. McClelland's research focuses on human immunodeficiency virus (HIV) and sexually transmitted infection (STI) epidemiology and prevention in most at-risk populations including female sex workers and men who have sex with men. This includes both primary prevention strategies for reducing the risk of HIV/STI acquisition and secondary prevention aimed at reducing infectiousness and risk behavior in people living with these conditions. A new NIH/NICHD funded R01 grant titled, "Women's Lifecourse Events & HIV Transmission Potential: A Multidisciplinary Study," was funded in early 2012. This study will explore transmission potential in HIV-positive women on antiretroviral therapy in relation to key life course events including marriage, decisions about contraception, conception, pregnancy, the post-partum period, and menopause.

Kate Morrow
Associate Professor of Psychiatry and Human Behavior, Brown University

Dr. Morrow’s research focuses on behavioral HIV/STI prevention interventions, and the development of biomedical products and devices for HIV/STI prevention, including characterizing user sensory perceptions and experiences of product use (perceptibility), acceptability of and adherence to vaginal and rectal microbicides.  Dr. Morrow’s work incorporates quantitative, qualitative, and mixed methodologies.  

Rebecca Papas
Assistant Professor (Research), Brown University

Dr. Papas is core faculty in the International Health Institute, on the advisory board of the Brown Kenya program, and an affiliate member of the Brown Alcohol Research Center on HIV and the Tufts/Lifespan/Brown Center for AIDS Research. Her clinical research interests include the cultural adaptation of empirically validated behavioral interventions, randomized clinical trials of behavioral interventions to reduce alcohol use and other HIV risk behaviors and to improve mental health functioning, and gender health disparities in resource-limited settings.

Audrey Pettifor
Associate Professor of Epidemiology, University of North Carolina at Chapel Hill

Dr. Pettifor's research focuses on determinants of HIV/STI infection in sub-Saharan Africa with the goal of identifying modifiable risk factors and developing novel interventions to prevent new HIV infections particularly in young women. Dr Pettifor is currently PI of an NIH R01/HPTN 068 which explores the effect of providing cash transfers to young South African women and their families conditional on school attendance with the goal of reducing HIV incidence combined with a community level intervention focused on mobilizing young men to change negative risk behavior and gender norms. Dr. Pettifor is also co-Chair of HPTN 062 which is a study to determine the feasibility and acceptability of a behavioral intervention developed for individuals with Acute HIV Infection (AHI) in Malawi and is co-PI of an MP3/R01 exploring the potential of a combined behavioral and therapeutic intervention for individuals diagnosed with AHI to reduce the onward transmission of HIV.

Bharat Ramratnam
Associate Professor of Medicine, Brown University

Dr. Ramratnam is the head of the Laboratory of Retrovirology, Division of Infectious Diseases, Department of Medicine, Brown Medical School. He also directs the COBRE Center for Cancer Research Development at Rhode Island Hospital and is an Attending Physician at Miriam and Rhode Island Hospitals. Dr. Ramratnam’s focus is on defining the key cellular components that impact the replication of viruses such as HIV-1, herpes simplex virus (HSV) one and two, influenza, and hepatitis B/C. He uses a variety of genetic and proteonomic techniques to identify host factors that impact viral replication, some of which may constitute novel targets for pharmacotherapy.

Jeffrey Stringer
Global Women's Health Division, University of North Carolina at Chapel Hill

Dr. Stinger graduated from Columbia University College of Physicians and Surgeons, New York, NY in 1995. Between 2001 and 2012, Dr. Stringer lived in Lusaka, Zambia, where he and his wife, Dr. Elizabeth Stringer, established and led the Centre for Infectious Disease Research in Zambia (CIDRZ); a Lusaka-based non-profit company with approximately 600 employees and an important partner to the Zambian government in its effort to improve the public health. CIDRZ began supporting services to prevent mother-to-child HIV transmission in 2001 and has served over 1,400,000 women to protect their infants from HIV infection. In 2003, CIDRZ launched a family-centered AIDS treatment program that has now treated more than 250,000 adults and children with antiretroviral drugs. The organization also works in cervical cancer screening (more than 100,000 women served) and in safe obstetrics. Stringer’s research focuses on prevention of mother-to-child HIV transmission and obstetrical outcomes research. He is Principal Investigator of grants from the NIH, US Agency for International Development, Bill and Melinda Gates Foundation, Absolute Return for Kids, and the Doris Duke Charitable Foundation. He is the author of over 120 scientific articles.

Marina Tolou-Shams
Assistant Professor of Psychiatry and Human Behavior, Brown University

Dr. Tolou-Shams is an Assistant Professor (Research) at The Warren Alpert Medical School of Brown University, Staff Psychologist at Rhode Island Hospital and the Director of the Rhode Island Family Court, Mental Health Clinic. She is trained as a pediatric psychologist and has many years of clinical experience with assessing and treating high-risk adolescents and their families. Dr. Tolou-Shams is also an active clinical researcher who focuses on developing evidence-based mental health, substance abuse and HIV risk reduction interventions for juvenile drug court offenders. She is currently developing a family-based program for substance abusing offenders. This program emphasizes teaching young offenders and their parents how to regulate their emotions and improve parenting skills to reduce adolescent substance abuse and the co-occurrence of other high-risk behaviors, such as unprotected sexual activity.

Morenike Ukpong
Associate Professor, Obafemi Awolowo University, BIARI Alumna and Resident Fellow, 2012

Dr. Morenike Ukpong, is a trained pediatric dentist and holds a Fellowship of the West African College of Surgeons and a Bachelor’s degree in Dentistry, as well as a Masters in Business Administration. For the last 12 years she has worked in the HIV/AIDS field in Nigeria, regionally, and internationally, particularly in building capacity to enable communities engage effectively in HIV prevention research.  Dr. Ukpong has extensive experience in program and project management, including design, planning, training, implementation, monitoring and evaluation. Her particular expertise is in the development of curricula and implementation of capacity-building training and workshops including those on research literacy. She has worked with the National Agency for the Control of AIDS (NACA) to develop national training manuals for persons most at risk for HIV infection, such as men who have sex with men, drug users, and sex workers; with NELA to develop and implement home base care for PLWHIV training curriculum; with NHVMAS to develop and implement training curricula for laypersons on research protocol review and research monitoring; and with Population Council, Nigeria to develop and implement the sexual diversity training curriculum.

David Wilson
Director, Global HIV/AIDS Program, World Bank 

David Wilson, a Zimbabwe