The goal of our work is to identify innovative and effective HIV prevention strategies, including behavioral and biomedical approaches. We work with many populations in New York City, including men who have sex with men, transgender persons, and heterosexual women and men.
Established in 1993, Project ACHIEVE, is part of the New York Blood Center’s Laboratory of Infectious Disease Prevention.
- We are part of the largest clinical trials program devoted to the development and testing of preventive HIV vaccines worldwide (www.hvtn.org)
- We use epidemiology to stay up to date on who is at risk and why
- We design and test innovative prevention strategies to increase HIV testing and reduce risk.
We have conducted studies to better understand the health and well-being of New Yorkers and others around the U.S.
Black men who have sex with men (MSM)
- In the largest group of Black MSM in the US followed over time, the rate of new HIV infections was high, particularly among young men.(1)
- Black MSM who were newly diagnosed with HIV were more likely to be unemployed, have sexually transmitted diseases (STDs) and engage in unprotected receptive anal intercourse than other Black MSM.(2)
- Targeted, tailored and culturally appropriate HIV prevention strategies addressing economic disenfranchisement, engagement in care, screening for STDs, with safer sex prevention interventions, and biomedical interventions are urgently needed to lower these rates.
Neighborhoods and gay men’s health in New York City
- In the largest study of urban neighborhoods among MSM, we developed novel approaches used to collect data on the effect of neighborhoods on MSM’s health.(3)
- Using data from qualitative interviews with MSM, we found that neighborhoods can both physically and socially reinforce social class and oppression, which in turn produce disparities in sexual health.(4)
- We found that having multiple partners in overlapping time periods (concurrency) was common among MSM. Concurrency was associated with unprotected anal intercourse, substance use during sex, having an anonymous partner, and having many sex partners. This could further increase HIV risk among MSM. (5)
- The DNA/rAd5 vaccine regimen did not reduce either the rate of new HIV infection or the HIV viral-load set point among men and transgender women who have sex with men.(6)
- The development of a safe and effective HIV vaccine remains a challenge. The experience from the past 5 years highlights the importance of conducting efficacy studies that continue to move us closer toward the goal of a safe, effective, durable, and universal HIV preventive vaccine.(7)
Women at Risk
- A three-city study of women found a high percent of women had male partners at risk. The HIV incidence was 0.3%. New strategies are needed to identify US women at high risk (8)
Black heterosexual men in New York City
- Our theory-based HIV prevention intervention showed significant declines in the number of total and new female partners, unprotected sex partners, and partner concurrency in both primary and nonprimary sex partnerships between baseline and 3 months post-intervention.(9)
Other HIV Prevention Research
- In the EXPLORE Study, 9.6% of men only had receptive anal intercourse, 16.7% only had insertive anal intercourse, and 63.0% had both receptive and insertive anal intercourse. Having both receptive and insertive anal intercourse was more likely with primary and HIV-negative/unknown status partners and among younger men and substance users but less likely among Blacks and with higher number of partners. Exclusively receptive role was more likely with HIV-negative/unknown status partners and among younger men and substance users but less likely with higher number of partners.(10)
- In a behavioral intervention study of substance-using men who have sex with men, the proportion of substance-using MSM who also have sex with women is low. However, these men engage in unprotected sex with women, particularly with primary female partners.(11)
Behavioral and Social Science in HIV prevention
- Results of recent trials indicate that the division of biomedical and behavioral prevention approaches works against the goal of ending the HIV epidemic. The prevention ‘‘bar’’ needs to move to a place of interdisciplinary, comprehensive, and tailored prevention approaches that are cost efficient and scalable. (12)
- Integration of social and behavioral sciences early in idea generation and study design is imperative for the successful conduct of biomedical trials and for ensuring optimal data collection approaches necessary for the interpretation of findings, particularly in cases of unexpected results.(13)
Want more information about our study results?
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Research papers cited:
1) Koblin BA, Mayer KH, Eshleman SH, Wang L, Mannheimer S, del Rio C, Shoptaw S, Magnus M, Buchbinder S, Wilton L, Liu TY, Cummings V, Piwowar-Manning E, Fields SD, Griffith S, Elharrar V, Wheeler D; HPTN 061 Protocol Team. Correlates of HIV acquisition in a cohort of Black men who have sex with men in the United States: HIV prevention trials network (HPTN) 061. PLoS One 2013; 8(7):e70413. doi: 10.1371/journal.pone.0070413.
2) Mayer KH, Wang L, Koblin B, Mannheimer S, Magnus M, Del Rio C, Buchbinder S, Wilton L, Cummings V, Watson CC, Piwowar-Manning E,Gaydos C, Eshleman SH, Clarke W, Liu TY, Mao C, Griffith S, Wheeler D; HPTN061 Protocol Team. Concomitant Socioeconomic, Behavioral, and Biological Factors Associated with the Disproportionate HIV Infection Burden among Black Men Who Have Sex with Men in 6 U.S. Cities. PLoS One 2014; 9(1):e87298. doi: 10.1371/journal.pone.0087298
3) Koblin BA, Egan JE, Rundle A, Quinn J, Tieu HV, Cerdá M, Ompad DC, Greene E, Hoover DR, Frye V. Methods to measure the impact of home, social, and sexual neighborhoods of urban gay, bisexual, and other men who have sex with men. PLoS One 2013; 8(10): e75878. doi:10.1371/journal.pone.0075878.
4) Frye V, Egan JE, Tieu HV, Cerdá M, Ompad D, Koblin BA. "I didn't think I could get out of the fucking park." Gay men's retrospective accounts of neighborhood space, emerging sexuality and migrations. Soc Sci Med 104:6-14, 2014.
5) Tieu HV, Nandi V, Frye V, Stewart K, Oquendo H, Bush B, Cerda M, Hoover DR, Ompad D, Koblin BA; NYC M2M Study Team. Concurrent partnerships and HIV risk among men who have sex with men in New York City. Sex Transm Dis 2014 Mar;41(3):200-8.
6) Hammer SM, Sobieszczyk ME, Janes H, Karuna ST, Mulligan MJ, Grove D, Koblin BA, Buchbinder SP, Keefer MC, Tomaras GD, Frahm N, Hural J, Anude C,Graham BS, Enama ME, Adams E, DeJesus E, Novak RM, Frank I, Bentley C, Ramirez S, Fu R, Koup RA, Mascola JR, Nabel GJ, Montefiori DC, Kublin J,McElrath MJ, Corey L, Gilbert PB; HVTN 505 Study Team. Efficacy trial of a DNA/rAd5 HIV-1 preventive vaccine. N Engl J Med 2013; 369:2083-92.
7) Tieu HV, Rolland M, Hammer SM, Sobieszczyk ME. Translational research insights from completed HIV vaccine efficacy trials. J Acquir Immun Defic Syndr 2013; 63 Suppl 2: S150-4.
8) Koblin BA, Metch B, Novak RM, Morgan C, Lucy D, Dunbar D, Graham P, Swann E, Madenwald T, Escamilia G, Frank I; HVTN 906 Study Team.Feasibility of identifying a cohort of US women at high risk for HIV infection for HIV vaccine efficacy trials: longitudinal results of HVTN 906. J Acquir Immune Defic Syndr 2013; 63:239-44.
9) Frye V, Henny K, Bonner S, Williams K, Bond KT, Hoover DR, Lucy D, Greene E, Koblin BA; Straight Talk Study Team Straight Talk" for African-American heterosexual men: results of a single-arm behavioral intervention trial. AIDS Care 2013; 25:627-31.
10) Tieu HV, Li X, Donnell D, Vittinghoff E, Buchbinder S, Parente ZG, Koblin B. Anal sex role segregation and versatility among men who have sex with men: EXPLORE Study. J Acquir Immune Defic Syndr 2013; 64:121-125.
11) Greene E, Frye V, Mansergh G, Colfax GN, Hudson SM, Flores SA, Hoover DR, Bonner S, Koblin BA. Correlates of unprotected vaginal or anal intercourse with women among substance-using men who have sex with men. AIDS and Behav 2013; 17:889-99.
12) Koblin BA, Mansergh G, Chesney M, Coates T. Moving the Bar to the Right Place: Positioning Interventions in HIV Prevention. AIDS Behav 2014; 18: 634-637.
13) Koblin BA, Andrasik M, Austin J. Preparing for the unexpected: the pivotal role of social and behavioral sciences in trials of biomedical HIV prevention interventions. J Acquir Immune Defic Syndr 2013; 63 Suppl 2:S183-6.
A safe and effective HIV vaccine offers our best hope for ending the HIV epidemic.
What is a vaccine?
- A vaccine is a product that causes the immune system to protect against a disease. The immune system is your body’s disease fighting mechanism.
- After getting a vaccine, your body is prepared to fight against a disease.
- Vaccines have been used for decades around the world, most commonly in children. They are safe when manufactured and used properly.
- Vaccines are the most effective tool we have to prevent many infectious diseases.
How might HIV vaccines work?
- HIV vaccines are designed to stimulate the immune system to produce antibodies (proteins that kill virus found free-floating in the blood) and/or cytotoxic lymphocytes (CTLs or "killer T cells" that destroy HIV infected cells).
- HIV vaccines are being studied to see if they can prevent infection or slow down disease progression in people who become infected with HIV.
- HIV vaccines under study DO NOT contain real HIV and therefore cannot cause HIV infection.
How are HIV vaccines tested?
- Potential vaccine products are first tested in the laboratory and in animal models.
- Studies with humans are done in three phases:
- Phase 1 – Small number of participants. Documenting safety is main objective
- Phase 2 – Larger number of participants. Measure safety and immune response
- Phase 3 -- Hundreds to thousands of participants to see if the vaccine is safe and effective in preventing HIV infection
Are there risks in HIV vaccine studies?
- Any vaccine can cause side effects. For the most part these are minor (for example, a sore arm or low-grade fever) and go away within a few days. We don’t know all of the risks of HIV vaccines.
- There are other risks to being in an HIV vaccine study. Volunteers can test HIV antibody positive due to the immune system’s response to vaccination. Volunteers may experience social harms from immigration, incarceration, military, health/life insurance services and social stigmatization.
- Before enrolling in a HIV vaccine study, our staff will review this information with you.
Would HIV vaccines eliminate the need for other ways to prevent HIV infection?
No. It is unlikely that HIV vaccines will be 100% effective. Therefore, condoms are needed to provide protection against HIV and STDs. HIV vaccines could also be used in combination with other ways to prevent HIV infection such as pre-exposure prophylaxis (PrEP).
Want to find out more about HIV vaccine trials?
Email us at email@example.com.
View the "Why Not You" photo exhibit to hear about people who have taken part in an HIV vaccine trial.