Number of people living with HIV globally

The HIV/AIDS epidemic continues to be one of the most formidable public health issues of our era, with an estimated 33.4 million people living with the disease worldwide.  AIDS claimed approximately two million lives in 2008, of which 280,000 were children. The epidemic is most severe in low and middle income countries, where 97% of people with HIV/AIDS reside and particularly in sub-Saharan Africa. Antiretroviral treatment reduces both the morbidity and the mortality of HIV infection, but routine access to these drugs is still not universally available, and the majority of people with HIV are unaware that they are infected. New data projects that expanded access to prevention could avert approximately 30 million of the 60 million HIV infections expected to occur by 2015. Yet prevention efforts are faltering and inaccessible to many people. An estimated half a million infections occurred in the United States alone in the last decade. 

The Challenge
The HIV/AIDS epidemic is a winnable battle.  Recent studies show that early identification of HIV infection and sustained antiretroviral treatment not only improves health outcomes for persons with the disease but also lowers their risk of transmitting the virus to others.  Multi-level and combined  approaches are needed to increase our impact including safe, effective, and affordable HIV prevention, both in countries with emerging epidemics and in those with high HIV infection rates, as well as available and affordable access to detection, care, and treatment for persons with HIV/AIDS.  Because of the global nature of the epidemic, much of this work  has to be undertaken with international partners.

Our Response
The School of Public Health’s Center for Interdisciplinary Research on AIDS (CIRA) supports the conduct of interdisciplinary research focused on the prevention of HIV infection and the reduction of negative consequences of HIV disease in vulnerable and underserved populations nationally and internationally.  The Center also supports research focused on specific population groups, such as women, children, youth, drug users (especially injection drug users), and racial/ethnic minorities.  Specifically, CIRA aims to:

  • Strengthen and expand basic and clinical research and practice that contribute to reduction in the global burden of HIV/AIDS and the resulting morbidity and mortality.
  • Build global capacity to effectively implement and monitor the application of evidence-based interventions.
  • Establish and expand new collaborative relationships and strengthen established ones locally and internationally.
  • Train the next generation of global-health HIV/AIDS scientists and practitioners.

What We Hope to Achieve
CIRA is committed to develop and support innovative and interdisciplinary research that has a demonstrable impact on the global effort to eradicate HIV/AIDS.  This work involves an ongoing commitment to community-based HIV prevention and research, as well as heightened efforts to conduct collaborative research focusing on HIV prevention, care, and treatment in national and international settings. Legal, policy, and ethical issues are considered in the design of every CIRA research project, and investigators are supported in developing policy-related and policy-relevant research. To fulfill its potential, CIRA plans to:

  • Expand interdisciplinary research, engaging clinical social and behavioral scientists within and beyond the School of Public Health in the discovery, development, and delivery of interventions globally that will have a greater impact on the epidemic.
  • Strengthen international partnerships in resource-poor settings around the globe, to understand and address the epidemic, particularly in Russia, India, China, and several African countries where CIRA has established research projects. A growing share of this international research will include intervention and policy studies as well as translational research in order to prevent and treat the disease.
  • Develop domestic research to scientifically evaluate components of the new national HIV/AIDS strategy which seeks to reduce new infections, link and retain persons with HIV in treatment and care, and reduce HIV-related health disparities.
  • Develop, evaluate, and disseminate interventions with proven effectiveness and study combined approaches of these individual social, behavioral and biomedical interventions for greater effect
  • Conduct training programs for the next generation of HIV research scientists , clinicians, and public health practitioners in the United States and globally with an emphasis on increasing the ranks of HIV scientists from underrepresented racial/ethnic groups.

Partnership for Change
We will use Yale’s intellectual resources to meet the challenges of mounting effective responses to HIV/AIDS.  For this purpose, we will work closely with scientists in diverse disciplines such as medical specialists, epidemiologists, virologists, immunologists, statisticians, sociologists, health services researchers, ethicists, behavioral scientists, and lawyers. In addition to employing the resources within this University, a critical element of our strategy is to partner with other institutions in the U.S. and throughout the world in order to prevent, detect, and treat HIV/AIDS.

Programmatic Needs
To make a measurable, meaningful, and sustainable difference we need:

  • Programmatic funds to support innovative pilot projects, interdisciplinary cross-campus collaborations, seminars, and research retreats
  • Financial support for pre- and post-doctoral students
  • Funds for new faculty who will become the next generation of leading researchers
  • Major support for professorial chairs in these areas of research so that the School and Yale can attract and retain the world’s brightest scholars
  • Support to strengthen the curriculum at Yale for undergraduate, graduate, and professional students with an interest in HIV/AIDS including funds to support HIV/AIDS focused internships.

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