At Yale's First HIV/AIDS Symposium, Memories of a Mysterious Epidemic

During the summer of 1981, an unknown illness emerged in California and New York hospitals. At the time, Gerald Friedland, Professor Emeritus of and Senior Research Scientist in Medicine (Infectious Diseases), worked at a hospital in the Bronx.

“At Montefiore [Hospital], where I was, Jerome Avenue was the nearby commercial street, and was wonderfully crowded, colorful, noisy, and vibrant,” Friedland told the audience of Yale’s first HIV symposium. One night, Friedland had a dream that Jerome Avenue was deserted by people who had succumbed to the disease; it was a bland, black and white stretch of road. The only sound was the mechanic rattling of a train. “In the early days of the AIDS epidemic,” he said, “it felt like that.”

It’s nearly four decades later, and clinicians, basic science researchers and public health workers are still fighting the HIV/AIDS pandemic. They’ve made remarkable strides toward stopping the virus’s spread. At Yale’s first HIV Symposium, researchers from these fields came together to track their progress.

With symposium organizers Merceditas Villanueva, MD, Associate Professor of Medicine (AIDS); Serena Spudich MD, MA Professor of Neurology; and Richard Sutton, Associate Professor of Medicine (Infectious Diseases) and of Microbial Pathogenesis, preparing to submit a grant proposal to the NIH to establish a Developmental Center for AIDS Research (D-CFAR) at Yale, it was the perfect time to unite university HIV/AIDS researchers and clinicians.

“We’re hoping that through the symposium and the D-CFAR application that we can promote improved collaboration between the many types of research going on at Yale,” said Villanueva. According to her, it was also an appropriate way to honor Friedland, who directed the AIDS program at Yale from 1991-2010, to celebrate his recent retirement. 

With the emergence of treatments like highly active antiretroviral therapies, or HAART, contracting the HIV virus (that causes AIDS) is no longer a death sentence.  Still, other medical problems may arise because of HIV infection reported Amy Justice, MD, PhD, Professor of Medicine (General Medicine) and of Public Health (Health Policy).

Justice presented data from her Veterans Aging Cohort Study (VACS) at the symposium, a study that has been collecting data on HIV positive veterans and age/race/site matched controls for the past twenty years. Justice showed that people aging with HIV are at higher risk for cardiovascular disease, liver disease, and cancer, even if they’re on HAART and virally suppressed. “Living with HIV is not the same as living without it,” she said.

Discoveries of health complications arising from HIV infection motivate the search for a cure and vaccine. Walther Mothes, PhD, Professor of Microbial Pathogenesis, is researching the HIV envelope protein with hopes of developing vaccine candidates. But, as he told the audience, it “has been a notoriously difficult target.”

While the world waits for a vaccine, many at Yale are implementing strategies to decrease the rate of HIV transmission. Implementation-focused research is about “taking public health principles and studying how you can make them work,” said Villanueva. “Implementing that type of practical public health within the field of HIV has really taken off at Yale.” Several researchers at the symposium, including Sheela Shanoi, MD, MPH, Assistant Professor of Medicine (AIDS), and Sten H. Vermund, MD, PhD, Dean and Anna M.R. Lauder Professor of Public Health, presented their work implementing HIV prevention and treatment programs in Asia and Africa.

For his part, Friedland saw the symposium as stimulation for people considering careers researching or treating HIV.

When Friedland began working with HIV/AIDS patients in 1981, clinicians and researchers knew very little, if anything, about the disease. Since then, the field has developed life-saving treatments and preventive measures. More people are living with HIV than are dying from it. “We’ve now successfully reached the first base camp,” Friedland said, comparing the end of the AIDS epidemic to a hike up Mount Everest, “but the summit of the end of the AIDS epidemic is still aspirational.”

This article was submitted by Adrian Bonenberger on July 6, 2018.