BD Live, 27 October 2014

LEADING HIV/AIDS researcher Quarraisha Abdool Karim gives only the briefest of answers when questioned on her personal life, but speaks easily and passionately when probed on women and AIDS, the field to which she has dedicated her career. "We can celebrate the fact that we have the largest treatment programme in the world, but we are reaching less than 50% of those who need it. People are unable to overcome stigma and discrimination, whether real or perceived, and are still choosing death over life," says Prof Abdool Karim, who is one of the world's leading HIV/AIDS epidemiologists.

She is associate scientific director of the Centre for the Aids Programme of Research in Africa at the University of KwaZulu-Natal, and professor of epidemiology at Mailman School of Public Health at Columbia University in the US.

On Sunday she was awarded the 2014 Lenovo Science Award by The World Academy of Sciences, the latest in a string of accolades recognising her 25 years of HIV/AIDS research. Earlier this month, she was elected as a foreign associate of the US Institutes of Medicine and was awarded the science for society gold medal by the Academy of Science of SA. She is due to receive another medal from the Medical Research Council later this week for her scientific achievements.

SA has one of the world's worst HIV/AIDS epidemics, with more than 6-million people infected. The latest figures from the Treasury show that treatment is reaching about 2.7-million patients.

Prof Abdool Karim is perhaps best known for her work on the landmark Caprisa 004 study, which provided the first clinical evidence that a vaginal gel containing an antiretroviral (ARV) called tenofovir could protect women from sexual transmission of HIV. The study, which she conducted with her husband and fellow scientist Salim Abdool Karim, was met with a standing ovation at the 18th International AIDS conference.

It was described as one of the top 10 scientific advances of 2010 by the prestigious journal Science and has been cited by more than 1,000 other scientists. Work is under way to confirm the findings of the Caprisa 004 study.

But Prof Abdool Karim has also published influential work on HIV infection in teenage girls, and investigated strategies for introducing treatment in communities with limited resources.

She has been studying HIV in SA since 1990, when she conducted SA's first population survey. "The striking thing for me in that data was the fourfold higher burden of infection in women than men," she says, noting that nearly 15 years later many of those differences remain. "We have addressed gender difference in infancy and childhood, but in adolescence we start to see them come through again."

Her research has had a notable effect beyond SA's borders, and has provided the basis for the World Health Organisation's international policies and guidelines on treating patients infected with both HIV and tuberculosis. She is a member of the expert science panel of the United Nations' joint agency on HIV/AIDS, UNAids and chairs the prevention task team of the South African National Aids Council.

The widescale provision of ARVs has blunted the urgency that fuelled debate, funding and research when treatment was not available, she says.

"I think there are some people who think 'we've got this all in hand, so let's move on', but it is far from over. Men are not forthcoming about testing, the issues of young women and adolescents are not being addressed and clinics are not easily accessible to people who work," Prof Abdool Karim says.

"...There is a stabilising of HIV prevalence. But we should be seeing an increase, given the number of people on treatment, as more people live longer. The intriguing question is why we are not seeing this increase," she says.

by Tamar Kahn

Source: BC Live