5^th International Conference on HIV/AIDS, STDs and STIs November 13-14, 2017 Las Vegas, Nevada, USA (Venue: Renaissance Las Vegas Hotel)

Mark Schweizer has completed his Doctor of Dental Surgery from the University of Maryland, College of Dental Medicine and a Master’s in Public Health from Nova Southeastern University College of Osteopathic Medicine. He is the Director of development and special projects at Nova Southeastern University College of Dental Medicine and Dental Director, Southeast AIDS Education and Training Center. He has lectured nationally on oral health and HIV and has developed, implemented and evaluated multiple oral health HIV programs across the State of Florida. He has been providing oral health care to HIV/AIDS patients for over 25 years. \r\n\r\n

Oral health problems can generate considerable negative effects on the quality of life of patients living with HIV/AIDS (PLWHA). Almost 90% of PLWHA experience at least one oral manifestation and 32-46% will have at least one major HIV-related oral health problem. Oral manifestations are often the first indicator of symptoms and disease progression. In addition, a large number of PLWHA do not have access to regular dental care. Lack of providers, finances, stigma, and awareness of the importance of oral health are all factors that affect access. Poor oral health can impact food intake and nutrition, leading to poor absorptions of medications, leaving PLWHA susceptible to progression of the disease. The relationship between oral health diseases and other systemic disease has also been well established. As part of the goal to decrease the transmission of HIV through viral suppression, antiretroviral therapy (ART) remains one of the major tools used by health professionals. The number and severity of oral manifestations have decreased with antiretroviral therapy, but there has been a shift in the type of oral manifestations which may be attributed to the improvement in immunity gained by therapy and the increased longevity of patients on ART. This presentation will serve to update health professionals on the shift in oral condition in the era of ART and the presence and early treatment of oral lesions. In addition, there will be focus on the role the dental professional plays in the overall health and viral suppression of PLWHA.

Bhaswati Sengupta is Director Professor at All India Institute of Hygiene and Public Health, Kolkata, India. The Institute is a premier one, in teaching and training Public Health since 1932 under Ministry of Health and Family Welfare, Government of India. She has been engaged in teaching and training Public Health for more than 25 years. She is mainly a Teacher, training Post-graduate medical and paramedical students, and administrative work of the department and the institute. She has more than 100 publications in national and international journals. Her subject of interest is HIV/AIDS and she had undergone training on HIV/AIDS epidemiology as a Fogarty Scholar in the Department of Epidemiology UCLA, USA under Professor Roger Detels.

Transgender are those who have a gender identity or gender expression that differs from their assigned sex. Transgender also include people, whose gender identity is the opposite of their assigned sex (trans men and trans women).They may identify as heterosexual, homosexual, bisexual, asexual, etc., or may consider conventional sexual orientation labels inadequate or inapplicable. In India, commonly identified as hijras and are officially recognized as third gender by the government, being neither completely male nor female and have been given the status of third gender and are protected as per the law despite the social ostracism. They are subject to poverty, feel rejected, or flee their family of origin. Many work as street beggars and sex workers for survival. Their mobile nature, unsafe sexual practice makes them vulnerable to STDs and HIV/AIDS. The purpose of the study was to determine among the transgender, their sexuality and knowledge, attitude and practice towards sexually transmitted diseases including HIV/AIDS. This is essential for policy making at the national level for the control of HIV/AIDS. 52 transgender persons were purposively selected from a NGO at Kolkata, working with this group and catering to their needs. A questionnaire with relevant questions pertaining to their sexual habits and knowledge about HIV/AIDS and STDs was used. A majority of the group (59.6%) belonged to 20-30years. Males comprised 84.6%, while others identified themselves as third gender. 86.5% were married and the rest (13.5%) were single! 3.5% were sex workers and the rest had other occupation. 13.9% were illiterate and 16.7% studied till high school. 100% had heard about HIV/AIDS and knew about transmission by sexual route but only 75% knew about transmission by sharing of needles and syringes, 50% from mothers during pregnancy and 94.2% by blood transmission. About 40% had past history of STDs.

Abdoulaye Sylla, UNFPA of Guinea, Guinea\r\n

Context: As part of the national response to HIV infection, the Government of Guinea has launched a five-year national strategic planning process since 2002, namely the 2003-2007 plan, the 2008-2012 plan and the 2013-2017 plan the basis of a 1.5% national HIV prevalence (Demographic Health Survey, DHS 2005), at 1.7% in 2012 (Demographic Health Survey, DHS 2012), with a feminization of the epidemic. HIV seroprevalence among women increased from 0.9% in 2005 to 2.1% in 2012; It is within this framework that the strategic HIV plans have placed particular emphasis on the fight against the stigmatization of PLHIV through axis three in the form of Protection and support to PLHIV and people affected by HIV and other groups. This axis supports the technical and institutional capacity of the network of people living with HIV set up in 2005 by the SE-CNLS in partnership with the TFPs.\r\n \r\nIt is within this framework that the NGO Guinean Association of HIV-affected Widows and their Orphans received technical and financial support from UNFPA, PNPCSP, CNLS, UNDP, UNAIDS and others TFPs for the empowerment of women to reduce stigma and provide psychosocial support to PLHIV and orphans and vulnerable children. The aim of this intervention is to give a human face to the HIV infection for the acceptance of the knowledge of the status serology.\r\n\r\n\r\nObjectives To contribute to reducing the stigma and discrimination of PLHIV\r\n\r\nMethodology: It focused on the medical care and psychosocial support of people living with HIV, the constitution of associations of people living with HIV, capacity building associations, sharing of South-South experiences associations of people living with HIV, support for people living with HIV for open-ended testimony, support for the development of the network of people living with HIV, and capacity building for project management, networking, results-based management and the participation of network members in the design, implementation, monitoring and evaluation of the national strategic framework for the fight against AIDS\r\n.\r\n\r\nResults: After strengthening the capacities of the REGAP PLUS Network, UNFPA, in partnership with UNAIDS, has supported the Guinean association of HIV-infected widows and their orphans by strengthening the technical capacity in saponification of a group of 37 PLHIV women, psycho-social support from 121 OVC.\r\n\r\nMobilization of other partners for scaling up of IGAs\r\n• Reintegration of 9 people living with HIV including 2 men, 4 widows and 3 girls at the community level and the celebration of several marriages between infected persons\r\n• Improving the decision-making power of women in the network through the post of President of REGAP PLUS, second vice-president of the national coordinating body for the three diseases (Tuberculosis Malaria and HIV) financing of the Global Fund and member of the HIV Theme Group\r\n• Development of partnership with the Ministry of Health through the health district for reference and counter referral of PHAs and pregnant women\r\n• Reducing the stigma of people living with HIV through the recognition of community-based association, open-ended stories and sensitization in radio\r\n\r\n\r\nLessons learned\r\nThe synergy of capacity building of members of the PLHIV network by the CNLS SE in collaboration with the technical and financial partners has made it possible to improve the visibility of REGAP plus and to decentralize the activities of the network at national level. REGAP PLUS is now recognized as the defensive structure of the rights of people living with HIV. The member associations of the network work and the results are capitalized at the Network level. This transparency reinforced the good governance of the network and the strengthening of the partnership with the TFPs.\r\n Thus, REGAP plus has been identified as sub-recipients of the HIV component under funding from the Global Fund.\r\n \r\nThe synergy of the partners\' interventions allowed the sustainability of the activities of the IGAs to support the psychosocial care of PLHIV and OVC. The empowerment of PLHIV through IGAs allows for better integration of PLHIV at the community level and reduces their discrimination.\r\n\r\n \r\nChallenges: The weak monitoring of the saponification intervention by a specialized structure to document the financial benefits and the improvement of the economic level of the beneficiary women.\r\n\r\n \r\n\r\nConclusions and recommendations: Networking of associations of people living with HIV has strengthened the technical and institutional capacities of associations. Women\'s empowerment through the development of IGAs for women\'s organizations has contributed to improving the well-being of HIV-positive women and girls, reducing stigma and improving psychosocial care for OVC and promoting certain women to community and national decision-making positions.\r\n\r\n\r\n\r\nRecommendations and Advocacy: Associations of people living with HIV are operational structures on which to build a partnership for the prevention of STI / HIV and the promotion of family planning. School girls, abandon excision and early marriage of the girl who continues to ravage girls and women the birth of childbirth Continue to take care of orphaned children and other vulnerable children to allow them to study or insert them in craft learning centers so that they can take over from their adoptive parents as they have lost their biological parents through hiv, tuberculosis and malaria.\r\n

Mulatu Biru is a Doctoral student at Child and Family Health Lund University, Sweden.

Introduction: Attrition from antiretroviral therapy (ART) programmes is a critical challenge among children receiving care in resource-limited settings. Our objective was to determine the rates and predictors of attrition among children on ART in Ethiopia.\r\n\r\nMethods: Between December 2014 and September 2016, we conducted a prospective cohort study in eight health facilities in Ethiopia. Eligibility criteria included age 3 months–14 years; being on ART for not more than a month. Outcome was attrition due to death and/or loss to follow-up. Predictor variables were child clinical and socio-demographic characteristics, and caregiver socio-demographic characteristics. We used Cox Regression analyses to examine the association between predictors and outcome. \r\n\r\nResults: Of 309 children, 304 were included, 52% were male. Their median age was 9 years (Inter-quartile range, IQR, 6–12). At ART initiation, their median CD4 was 362 cells/mm3 (IQR 231–499); and 74.3% had WHO stage 1 or 2 disease. During 287.7 person-years of observation (PYO), 24 attritions were recorded, yielding an attrition rate of 8.3 per 100 PYO (95% CI 5.4–12.1). Of these, six children were reported dead, leading to a mortality rate of 2.1 per 100 PYO (95% CI 0.8–4.3). Eighteen were lost to follow-up (LTFU) leading to LTFU rate of 6.26 per 100 PYO (95% CI: 3.83–9.70). The majority, 14 (58%) of attrition occurred during the first six months of treatment. Age below three years [aHR]=5.14 (95% CI: 2.07–12.96), rural residence (aHR=3.97, 95% CI: 1.34–11.78) and baseline Hgb in g/dl<10 g/dl [aHR]=5.68 (95% CI: 2.03–6.23) predicted higher risk of attrition. Baseline Hgb<10 g/dl (aHR=16.63, 95% CI: 1.64–168.4) and WHO stage III or IV (aHR=12.25, 95% CI: 1.26–119.05) predicted the death of the child. Higher attrition was documented among children of both biological parents alive and biologically related close family caregivers.\r\n\r\nConclusion: Younger children, those from rural areas, and children with anaemia were at higher risk of attrition, especially during the early months of treatment, and therefore should be prioritized during treatment follow-up. Further studies should examine underlying reasons for higher attrition. \r\n

Foroughi M has completed her graduation from Medical School at the Iran University of Medical Sciences in 2011 and obtained a special Doctorate of Research at TUMS in 2014. She worked at the Iranian Research Center for HIV/AIDS (IRCHA) as a Medical Researcher and Physician from 2009 and has 15 publications. She is now working as a Research Fellow at Aventura Hospital in Florida.

Introduction: Globally, the HIV infection rate in women has been trending down around the world but that is not the case in Iran where the number of newly HIV infected women has been increasing. Changes in HIV transmission routs from needle sharing to sexual transmission in Iran increases the need for better education of women on the prevention of HIV.\r\n\r\n \r\n\r\nMethods: We recruited 250 women who have attended behavioral clinics or shelters in Tehran. We used a standardized questionnaire, which asked about demographics, sexual partner and knowledge about HIV/STDs.\r\n\r\nResults: The median age of our group surveyed was 40. 82% were married and among them 16% were married but lived alone. Among the total 250 surveyed, 56% (140) were sexually active in the last 30 days, 19.2% (48) had a history of a one-night stand and 2.4% had more than one sexual partner. 212 people answered questions about condom use, 60% (127) of them did not use condoms at all.\r\nTable 1: Reasons for not using condoms\r\n \r\nRegarding knowledge about signs and symptoms related to STDs, we retrieved answers from 229 cases. 63% believe abdominal pain have no relationship to STDs. Also 44%, 43%, 37%, 40% believed that dyspareunia, dysuria, malodorous vaginal discharge and change in color of vaginal discharge, respectively, are not linked to STDs. This means that the knowledge is only about 50%. 13% who presented with these symptoms in the past 30 days have not sought medical evaluation.\r\n\r\nTable 2 is about HIV knowledge:\r\n \r\nWe need to emphasize the use of condoms among the male population but we faced with a challenge to do so because it goes against the government’s campaign of pronatalism. Improving the knowledge of protected sex should start from the teenage years and at school to reach maximum STD prevention planning. Most women in our study did not know about healthy sexual lifestyles and this shows the need for sexual health education before marriage or even in schools.

Dr. Sylvia Lee-Huang is a Professor of Biochemistry and Molecular Pharmacology at New York University School of Medicine, in New York, New York, USA. Dr. Lee-Huang received her Ph.D. in Biophysics from the University of Pittsburgh with Professor Gary Felsenfeld. She did her post-doctoral research with Dr. Liebe Cavalieri at the Sloan-Kettering Institute for Cancer research. She started her academic research with Nobel Laurate Professor Severo Ochoa at NYU School of Medicine, Department of Biochemistry, in Molecular Biology and Biochemistry. Professor Lee-Huang has a broad background in biochemistry, biophysics, cell biology, molecular biology, molecular genetics and virology. As a graduate student, she studied the interactions of DNA, RNA and protein with Dr. Gary Felsenfeld, laying the groundwork for nucleic acid interactions. As a postdoctoral fellow, she studied the mechanism of DNA replication with Dr. Liebe Cavalieri. She proposed the first concept and provided the first experimental evidence for the reversed flow of genetic information from RNA to DNA. Her work challenged and revolutionized the “central dogma” in gene expression. As a research associate with Nobel laureate Professor Severo Ochoa, she studied the regulation of gene expression and discovered small RNAs act as inhibitors and activators in gene expression. This work laid the concept for small regulatory RNAs including today’s RNAi, miRNA, and lncRNA. As a PI on NIH-grants, her lab was the first to clone and express human erythropoietin. Recently, her lab studied the mechanism of anti-HIV compounds. Her team isolated, purified, characterized and elucidated the mechanism of anti-HIV proteins, oligopeptides, and small molecules. Her work has been published in major journals, including Cell, Nature, Science, PNAS, Biochemistry (JACS), BBRC and others.\r\n\r\n

HIV-1 can infect host target cells by both cell-free viral infection and cell-to-cell transmission of the virus. In cell-free viral infection, free virus is exposed to cellular, immunological, and drug barriers, so infection efficiency is low and drug sensitivity is high. In cell-to-cell transmission, virus is transmitted directly from cell to cell, shielded from most of the barriers. Thus, the infection efficiency is much higher, and drug sensitivity is lower. Importantly, HIV spreads in vivo mainly by cell-to-cell transmission. In contrast to cell-free viral infection, the mechanism of cell-to-cell transmission of HIV-1 is much less understood. At present, there is no drug to cure AIDS and no vaccine to prevent HIV infection. Viral mutation, viral latency, epitope specificity/accessibility, and mechanism of cell-to-cell viral transmission all contribute to difficulties in prevention and cure. Mitochondria have long been known to be essential organelles. In addition to providing metabolic energy, they are involved in many cellular signaling pathways, including host innate immunity, apoptosis, autophagy, and aging. We used live-cell, real-time fluorescence imaging of co-cultures of HIV-1-infected T cells and uninfected target cells to investigate the role of mitochondria in cell-to-cell HIV transmission. We discovered that mitochondria of HIV-infected cells carrying the virus enter uninfected target cells, mediate cell-to-cell HIV-1 transmission and viral spread. Our results show that human mitochondria serve as HIV-1 reservoirs and carriers and move from infected cells to target cells. Furthermore, we discovered for the first time that cell-free mitochondria purified from HIV-1-infected cells are infectious. These results offer new insights into the mechanisms of cell-to-cell transmission of HIV-1 as well as identify mitochondria as new host targets for viral infection and therapeutic development.

I am a community psychologist with a specialty in statistics and methodology and a background in adolescent and young adult risk behaviors. I received my training at Wichita State University and completed a NIH dual-appointment post-doctoral position at The Pennsylvania State University. I am currently an assistant professor at the University of Houston, where I contribute to the field of prevention science through teaching, community involvement, and personally meaningful research. Specifically, my focus is on 1) psychosocial and socio-environmental factors that promote or deter condom use and other STI risk-taking behaviors, and 2) family resilience as a health protector among underserved populations. My goal is to create, tailor, and evaluate health promotion programs that reflect the unique cultural needs of underserved populations

With an increase in technology and social media applications, college students have a way of connecting with others more efficiently than ever. The present study identified whether amount of time spent on Facebook, currently the most popular social media application, was related to sexual risk behaviors (i.e. sex without a condom, multiple concurrent sex partners, and pursuing “hookups”). The hypotheses tested whether Facebook usage would be associated with having sex without a condom, having concurrent sex partners, and pursuing “hookups” on Facebook. Gender was tested as a moderator in these relationships as well, given the differences in STI risk behaviors and online dating behavior. Data were gathered from 236 African American college-aged students. Facebook usage of 3 or more daily hours was associated with having sex without a condom and using Facebook to pursue hookups. In addition, females who spent 3 or more hours on Facebook were less likely to have sex without a condom, but more likely to have concurrent sex partners than men whose usage was 3 or more hours daily; and men who spent 3 or more hours on Facebook were more likely to pursue hookups via Facebook than women whose usage was 3 or more hours daily. This study provides a starting point to further explore how social media consumption can be used to perpetuate or ameliorate risky sexual behavior among a vulnerable population