Currently, there is no vaccine to prevent or treat HIV/AIDS. Some vaccines are in development, but these vaccine candidates are mainly directed against HIV strains that circulate in the developed world. Additionally, these vaccine candidates use technologies that will be prohibitively expensive for use in developing nations. Furthermore, the vaccines that are being developed are mainly being developed by for-profit companies, who will need to recoup research and development costs by charging large sums of money for the vaccine. Many people will not be able to afford such a vaccine – these people are the fathers, mothers and children living in developing nations where the HIV/AIDS epidemic is hitting the hardest.
GAIA VF supports the development of a globally relevant, globally accessible HIV vaccine by building infrastructure and fostering collaborations at the site of future vaccine trials: Providence, Rhode Island and Bamako, Mali. GAIA VF collaborates with the University of Bamako, University of Pennsylvania, Miriam Hospital, University of Massachusetts Medical Center, University of Rhode Island and EpiVax, Inc on the development a globally relevant HIV vaccine that will be distributed on a not-for-profit basis throughout the developing world.
How Are We Developing the GAIA HIV Vaccine? HIV mutates rapidly. Currently, there are over 100,000 HIV sequences existing in databases, reflecting the more than 20 different HIV strains, or clades, that have been identified thus far. Focusing on any one strain of HIV excludes the rest if the HIV-infected population from protection.
Why? Response to any vaccine – even polio or flu – is dependent upon recognition of epitopes contained within those vaccines by the hosts’ immune system. Epitopes are much like words of a language with many dialects. The words which are conserved and understood across the dialects are universally recognized as part of that language. Hence, discovering the epitopes, or HIV “words” which are common to all the “dialects”, of HIV in the world is the key to a globally relevant, globally accessible HIV Vaccine.
GAIA VF’s Approach. We have applied computer tools – called “informatics” or "immunoinformatics" tools to select highly conserved regions (epitopes) of HIV. These epitopes are confirmed in vitro and a vaccine is then constructed from these epitopes by cloning their coding sequences into a vector. The final GAIA vaccine will likely be a combination of two inexpensive technologies: a DNA vaccine and a live vector (such as a bacteria or virus that does not cause disease). Every day brings us closer to making this vaccine a reality.
What does GAIA know about HIV prevention in Mali? GAIA VF has performed surveys about HIV knowledge at the FMPOS medical school (2004) and the markets (2005). To summarize, knowledge about the existence of HIV/AIDS is widespread (87% of 279 persons interviewed in the Bamako market places knew about HIV/AIDS) but the rate of condom use remains extremely low (14 % for females and 15% for males) and only a few respondents had been tested (less than 2.5%). Very few individuals were aware of ARVs and their life-saving effects. Many knew about condoms but few had access to them. Even fewer had been HIV tested, despite having participated in high-risk behaviors. Misconceptions about HIV infection and people living with HIV/AIDS (PLWH/A) were very common. Much remains to be done to improve the average Malian’s ability to reduce HIV risk.
In 2005, GAIA VF performed three KAP studies (Knowledge, Attitudes, and Practices) in collaboration with local health officials in Mali (DRS), to evaluate baseline levels of HIV knowledge and willingness to participate (WTP) in an HIV vaccination trial. Of 399 persons surveyed in Sikoro-Mekin, a peri-urban neighborhood of Bamako, 78% were WTP in an HIV vaccine trial, 65% were WTP in a malaria vaccine trial and 61% were WTP in a TB vaccine trial. Women were more WTP (81%) than men (76%). The abstracts for this study were presented at the World AIDS Conference in 2006.