The Centers for Disease Control and Prevention Division of STD Prevention (DSTDP) and The American Sexually Transmitted Diseases Association (ASTDA) have partnered to bring you the latest research and best practices for STD prevention with the STD Prevention Science Series.
This quarterly series brings lectures on cutting edge issues by scientists and program experts of world renown to all persons interested in the prevention of STI including HIV.
Presentations in the Series
A Journey through Syphilis: How does Treponema pallidum cause such a complex disease?
Sheila Lukehart, PhD
Syphilis is a disease that comes and goes, with manifestations affecting many different organ systems. The clinical course is the result of interactions between the host’s immune response and the bacterium’s ability to overcome or evade that response, a duel that can last a lifetime. This presentation will focus on our evolving understanding of these host and bacterial mechanisms, and their implications for syphilis control.
STDs, the Genital Microbiome and HIV Transmission: What is Happening Down There?
Dr. Rupert Kaul
Antiretroviral therapy (ART) dramatically reduces HIV transmission when used as treatment or as PrEP, but the global rate of new HIV infections currently outstrips our ability to provide ART. Most of these new HIV infections are acquired through sex, when the mucosal lining of the vagina, penis or rectum is exposed to HIV-infected genital fluids. Sexual HIV transmission is surprisingly inefficient, with a per-contact risk under 1% for most exposures. Today’s presentation will focus on how this risk is dependent on the dynamic interaction between our immune system and microbes – both HIV, other STIs and the larger microbiome – at the mucosal surfaces of the genital tract and gut, and will highlight some challenges of translating these research findings into new HIV prevention strategies.
Comprehensive Sexual Health Care for Sexual and Gender Minority Patients in the HAART and PrEP Era
by Kenneth Mayer, MD
Sexual and gender minority patients have experienced sexual health disparities that are partially related to behaviors (e.g. frequent partner change among some subgroups), biology (e.g. increased susceptibility of the rectal mucosa to HIV and several other STIs), and structural factors (e.g. lack of culturally competent care, unsupportive socio-political environments). The advent of highly active antiretroviral therapy (HAART) and pre-exposure prophylaxis (PrEP) means that individuals can engage in condomless sex without HIV transmission. The implications of the new findings in HIV prevention for STI management and control will be explored in the talk, with suggestions for the development of new paradigms to enhance the sexual health of these populations.
Risks and Resiliencies: HIV and STIs among Gay Men, other Men who have Sex with Men and Transgender Women Globally
by Stefan Baral, MD, MPH, FRCPC
This talk will present the results of recent systematic reviews of the burdens of HIV and STI among gay men, other men who have sex with men, and transgender women in both high and low and middle income settings as well as a discussion of the vulnerabilities that potentiate risks for adverse health outcomes among these populations.
Adaora Adimora, MD, MPH
It’s now well understood that social factors are a major determinant of HIV and other STDs. But how can we develop relevant interventions? And what are the methodological challenges of social determinants research? This talk will explore how these issues can impact STD epidemiologic research among African Americans.
Myron S. Cohen, M.D.
Since the time HIV was discovered as the cause of AIDS, we have known that a wide variety of STDs amplify transmission of the virus. The biological forces that create such risk are increasingly well understood. The greatest challenge has been to design strategies that link detection and treatment of STDs to reduced transmission of HIV.
Matthew Golden, MD
From Partner Services to Field Services: The Evolving Role of Public Health Outreach to Control HIV/STDs
Recently, Dr. Golden spoke about the evolving role of public health outreach in the area of HIV/STD. Partner services have been a component of public health STD control since the 1940s, but were not initially widely employed to combat the HIV epidemic and were never adequately funded to meaningfully affect rates of chlamydial infection. The advent of expedited partner therapy for gonorrhea and chlamydial infection, a new national emphasis on the HIV care continuum, and HIV/STD program integration are now fundamentally altering the role of disease investigation and outreach in the control of HIV/STD, both in the U.S. and in low income nations. Dr. Golden presented evidence supporting an expanded role for field outreach in the control of HIV/STD and discuss outstanding operational research questions that confront this area of public health practice.
Dr. Golden is the Director of the Public Health – Seattle & King County HIV/STD Program, and a professor of medicine at the University of Washington School of Medicine. He received his BA in history from Grinnell College, his MD and MPH from Johns Hopkins University, and completed a residency in internal medicine and a fellowship in infectious diseases at the University of Washington. Dr. Golden’s research seeks to integrate public health practice with operational research in the area of HIV/STD prevention. Much of his work has related to the implementation of expedited partner services for gonorrhea and chlamydial infection, HIV partner services, and the use of field outreach to improve the HIV care continuum.
HIV Transmission Dynamics: From Viral Particles to Sexual
Networks. Implications for HIV Prevention
by Thomas Quinn, MD, MS
Director of Global Health, Johns Hopkins University
Associate Director for International Research, NIAID
Dr. Quinn reviews the current epidemiological trends in the global AIDS pandemic and review recent findings in the dynamics of viral transmission from both a viral and population level perspective. He will discuss how this biomedical information can be incorporated in the implementation of combination preventions strategies in efforts to control this pandemic.
Program Science in STI and HIV Prevention – Global Challenges and Emerging Experience
James Blanchard, MD, MPH, PhD
Centre for Global Public Health, University of Manitoba
“Program Science” is a relatively new construct that has emerged to help address the gap between the domains of public health programs and scientific research. In this presentation Dr. Blanchard discusses the challenges and issues for developing, synthesizing and translating scientific knowledge into the design and implementation of public health programs focusing on STI and HIV prevention. Examples from several different countries in diverse epidemiological and socio-cultural contexts are used to illustrate emerging approaches to improve assessment and program strategies, definition of programs and prevention services, and measuring the progress and achievement of programs.
The Microbiome of the Penis in Adolescent Men
J. Dennis Fortenberry, MD, MS
Indiana University School of Medicine, Indianapolis, IN
In this seminar, Dr. Fortenberry summarizes methodologic issues in conducting a prospective study of the penis microbiome among 14-17 year old adolescents. The microbiota of the coronal sulcus and urethra will be described, along with potential interactions of the penis microbiota with urethritis, Chlamydia infections and other STI. The overall objective is to develop a new paradigm for understanding the developmental sexual health of young men.
The Road From Observation to Intervention to Implementation: Perspectives of a Pragmatic HIV Prevention Researcher
Connie Celum, MD, MPH
University of Washington, Seattle
In this webinar, Dr. Celum describes lessons learned in moving from observational epidemiology of STIs and HIV interaction with a focus on HSV-2 to testing interventions to reduce HIV acquisition and transmission. She describes work on combination HIV prevention to achieve high coverage of HIV testing and linkages to effective interventions (HIV treatment and male circumcision) in subSaharan Africa.
Contraception and STI/HIV: Balancing the Tradeoffs in Different Contexts
by Ward Cates, MD, MPH
Dr. Cates introduces health care professionals and program staff who serve people at risk for STDs to the five reproductive life stages (RLS) of women. The webinar also highlights how contraceptive choice affects a woman’s STI/HIV risk as well as how STD/HIV context could affect contraceptive options.
The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) to provide continuing medical education for physicians.
For complete information on Continuing Education and this program, please visit the CDC website.
It’s Not Just the Pathogen Anymore: The Genital Microbiome and Implications for Sexually Transmitted Infections
Jeanne Marrazzo, MD, MPH, FACP, FIDSA
University of Washington, Seattle
BV is a common cause of vaginitis and increases women’s risk of pelvic inflammatory disease, adverse pregnancy outcomes, and risk of STD/HIV acquisition. This session provides background on BV, and discuss recent developments in our understanding of the epidemiologic and microbiologic data that inform understanding of this complex dysbiosis.