International organizations and countries around the world are working to eliminate HIV/AIDS by 2030. To reach this goal, new approaches are needed–particularly among difficult-to-reach groups such as people who inject drugs (PWID), who are 30 times more likely to contract HIV/AIDS compared with the general population.
Matthew Akiyama, M.D., assistant professor of medicine at Albert Einstein College of Medicine and an internist at Montefiore Health System, is one of only two recipients of a one-year, $2.5 million HIV/AIDS Research Avenir Award from the National Institute on Drug Abuse (NIDA), which will fund his efforts to use advanced genetic epidemiological tools to curb infection among PWID. The NIDA award is part of the National Institute of Health’s Director’s Pioneer Awards program.
“We expect this study to provide essential information for policy makers and researchers who need to focus their limited resources on the most effective strategies for preventing the spread of HIV among PWID,” said Dr. Akiyama.
Targeting difficult-to-reach groups
Ending the HIV epidemic requires engaging PWID. While new HIV infections among adults declined by 14% worldwide between 2011 and 2017, no decrease has occurred among PWID. They also bear a disproportionately high burden of other blood-borne, virus-caused diseases, including hepatitis C. Harm reduction services, such as needle and syringe exchange programs and medication-assisted treatment for opioid use disorder, help reduce the spread of infection in this group, but implementing such services in low- and middle-income countries is difficult.
Dr. Akiyama’s project aims to identify PWID who are central to hepatitis C transmission networks in Kenya, East Africa, using computerized models. Since many people with hepatitis C are co-infected with HIV, this approach can be applied to both viral infections.
Tracking the viral evolution
Researchers will assess the evolving genetic makeup of hepatitis C as the virus spreads through groups of people. By sequencing many samples of the virus, researchers can identify those people who are “hubs” of infection in their network.
The investigators will also develop models to show how the wider population benefits if these central players receive treatment, disrupting the transmission of hepatitis C and HIV.