‘Test and treat’ won’t stop HIV/AIDS epidemic, study finds

first_imgImplementing a program of universal HIV testing and immediate antiretroviral treatment (ART) for infected individuals could have a major impact on the HIV/AIDS epidemic in Washington, DC, but a new study by led by Harvard researchers finds that it would not halt the epidemic, something that a previous report had projected.In a paper that will appear in the August 15 issue of Clinical Infectious Diseases and has been released online, researchers find that the so-called “test-and-treat” strategy could reduce new HIV infections by 15 percent over the next five years while conferring large survival benefits to HIV-infected patients.“Test-and-treat will save lives, but it won’t stop the HIV epidemic in its tracks all by itself,” says Rochelle P. Walensky, MD, MPH, an associate professor of medicine at Harvard Medical School (HMS), of the Massachusetts General Hospital (MGH) Division of Infectious Disease, who led the study. “It is only a single new and important page in the HIV-prevention playbook.”Test-and-treat has been the subject of widespread interest and controversy in the scientific community. In January 2009, WHO scientists published a report in The Lancet suggesting that a voluntary system of annual HIV testing of all adults, followed by immediate provision of ART for those testing positive, “could nearly stop transmission and drive HIV into an elimination phase.”Inspired by the Lancet report, researchers and public health officials have rushed to design and implement test-and-treat studies and interventions. The National Institute for Allergy and Infectious Diseases (NIAID) recently announced a two-year, $26.4 million partnership with the Washington, DC, Department of Health that includes a pilot study of the test-and-treat strategy. However, some experts have expressed concern that the assumptions underlying the WHO findings painted too optimistic a picture of the likely outcomes.The current study used epidemiologic data and results from HIV screening programs conducted in the U.S. capital to give a realistic picture of the likely impact of a test-and-treat effort in that city, which has one of the nation’slargest rates of HIV infection. This contrasts with the WHO study which employed data from sub-Saharan Africa and assumed truly universal screening and treatment with optimal clinical outcomes. “The reality of HIV screening programs, even the best ones, is that many people are never reached for screening, some refuse screening or do not link to care, and many of those who are treated do not maintain viral suppression,” notes Kenneth A. Freedberg, MD, MSc, an HMS associate professor of medicine in the MGH Department of Medicine, the report’s senior author.The study finds that a test-and-treat program in Washington, DC, could extend life expectancy of HIV-infected patients – currently projected at about 24 years after diagnosis – another one to two years and could reduce the rate of new infections 15 percent over a five-year period. Survival and prevention impacts would be even greater with improvements in screening, linkage to treatment and retention in care – improvements not yet reflected in the “best cases” reported by any U.S. program. Such optimistic but possibly achievable scenarios could extend survival to 29 years after HIV diagnosis and decrease new infections by as much as 50 percent over five years.“The benefits of expanded testing to persons with undiagnosed HIV infection are unquestioned,” Walensky says. “Earlier detection and linkage to care saves lives; this alone is a reason for test-and-treat. But pinning all our hopes on the latest ‘magic bullet,’ underestimating the logistical obstacles, and forgetting that prevention requires an integrated package of strategies puts us at risk of falling into a trap we’ve seen before. Our analysis suggests that test-and treat will likely be a very important addition to the treatment and prevention armamentarium, but the expectations for its impact should be realistic.”Additional co-authors of the Clinical Infectious Diseases report are Bethany Morris, Callie Scott, MSc, and Erin Rhode, MS, MGH Department of Medicine; A. David Paltiel, PhD, Yale School of Medicine; Elena Losina, PhD, Brigham and Women’s Hospital; and George Seage, ScD, Harvard School of Public Health.The study was supported by grants from the NIAID, the National Institute of Mental Health and the Doris Duke Charitable Foundation.last_img read more

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Center for the Environment welcomes 2010-12 fellows

first_imgThe Center for the Environment welcomes an incoming group of environmental fellows for the 2010-12 academic years. These four new fellows will join a group of five scholars who will be beginning the second year of their fellowships.The new environmental fellows are Daniel A. Barber, Elizabeth Landis, Alexander (Zan) Stine, and Rich Wildman.Together, the fellows form a community of researchers with diverse backgrounds united by intellectual curiosity, top-quality scholarship, and a drive to understand some of the most important environmental challenges facing society.For more on the fellows and their research, visit the center’s website.last_img read more

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Technology speeds audio preservation

first_imgStudents, faculty, and researchers can now access audio materials faster than ever before, and audio engineers working in Loeb Music Library’s Audio Preservation Studio (APS) are enjoying streamlined workflows – both are the products of a nearly two-year-long collaboration between APS staff and Harvard College Library’s Information Technology Services (HCL ITS) unit. The end result of the cooperative effort was the installation earlier this year of a computer system designed to allow engineers to seamlessly work with digitized audio on both PCs and Macintosh computers, simplifying what had once been a frustratingly complex preservation process.“Life is definitely easier now with the new system,” APS Lead Audio Engineer David Ackerman said. “The system we had was something we made work because we had to make it work. The new system is much more efficient, and easier to use.”Known as a SAN (short for Storage Area Network), the system is essentially a large shared storage device which serves as the digital workspace for sound engineers. Hardware, however, is only half of the equation. For the storage system to work, software is also needed to ensure engineers can read, write, copy and otherwise manipulate the stored files.Ultimately, it is the patrons who will see the benefits of the new system, Ackerman said.“With our previous system some tasks became impractical once the work progressed past a certain point,” he said. “In the current environment, there is no such impediment. Aside from a few quirks, the new system behaves the way any hard drive on any computer behaves – all the technology is invisible. The cross-platform capability of this new system will benefit library users by allows us to further refine and improve the audio materials we provide to patrons. It’s definitely resulting in better output.”last_img read more

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HSPH alum freed from Iranian prison, thanks supporters

first_img Read Full Story Kamiar Alaei, who received a master of science degree from HSPH in 2007, thanked David Bloom, chair, Department of Global Health and Population at HSPH, and the Physicians for Human Rights organization for working for his freedom from an Iranian prison, a Boston Globe June 17, 2011, article reports. Alaei’s first public remarks since gaining his freedom last October were made at a Washington, D.C., ceremony where he received the prestigious Global Health Council Prize.Alaei and his brother, Arash Alaei, who remains imprisoned, were arrested in 2008 by the Iranian government for their AIDS prevention work.“No prison walls can break the spirit of a human being with a cause,” Kamiar Alaei said at the award ceremony.last_img read more

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The return of ROTC

first_imgAmong the top Harvard stories of 2011 was the return of the Reserve Officers’ Training Corps (ROTC) to campus after an absence of 40 years. In March, the University signed an agreement with the Navy. By September, offices had opened in Hilles Hall for the Naval ROTC’s Old Ironsides Battalion.ROTC was banned from campus in 1971 during the Vietnam War protest — though starting in 1976 Harvard ROTC students could train at the Massachusetts Institute of Technology. By the mid-1980s, antiwar fervor at Harvard had been replaced by disappointment that gays and lesbians could not openly join the Armed Forces, a circumstance that kept ROTC from campus for decades more. That changed on Sept. 20. When the U.S. policy known as “Don’t Ask, Don’t Tell” expired, the doors of the military were opened to sexual diversity. Harvard captured the moment, thanks to initiatives begun years before by President Drew Faust, a Civil War historian and the daughter of a World War II veteran.ROTC students at Harvard, present and past, are grateful that the military is back. “Every one at Harvard is serving their country in some way,” said Catherine Philbin ’14, midshipman third class with the Naval ROTC. “This is just the way we’re serving.”Harvard’s “long crimson line” of military service stretches back to the 17th century, and includes 17 recipients of the Congressional Medal of Honor, the most of any university outside the service academies. Harvard’s relationship with ROTC dates to 1916, the year Army ROTC was established. The University’s “Harvard Regiment,” mobilized that year with 1,000 students, was among the first ROTC units in the country.last_img read more

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Alumna hopes video will help stem the cholera tide

first_imgA new animated video about cholera—how people get infected, how it spreads, and how to treat it—is drawing attention from health workers around the globe.The video’s producer, Deborah Van Dyke, is a nurse practitioner in Vermont, a longtime aid worker for Doctors Without Borders, and a 1993 graduate of Harvard School of Public Health.Van Dyke hopes the video, as well as others she is producing on newborn care, will benefit health care workers in low-resource settings all over the world. “People learn and remember through visual media,” she said. “It’s a great tool.”Van Dyke’s videos—some animated, some live—are being produced through her fledgling nonprofit, the Global Health Media Project, and will be available for free via Internet download, viewable on smartphones or other mobile devices, and available on DVD or flash drive. Read Full Storylast_img read more

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A.R.T. reaps Tony Awards notice

first_imgWhen Diane Paulus heard that her production “The Gershwins’ Porgy and Bess” garnered 10 Tony Award nominations, she burst into tears. Then she got back to business.The American Repertory Theater’s (A.R.T.) indefatigable artistic director was on the early morning train to Manhattan to attend auditions for the theater’s upcoming production of Tennessee Williams’ “The Glass Menagerie” when the text messages started pouring in and the nominations started piling up, including one to Paulus as best director, and one to “Porgy” as best revival of a musical.“I was texting back, ‘Are you sure?,’ ” said the director, who started to cry, but then promptly began trying to sell season tickets to her seatmate, a resident of a Boston suburb who was lamenting his lack of engagement with the theater.“It was a classic moment,” she said. “There I was, selling him a subscription to the A.R.T.”Even before “Porgy” premiered, Paulus had drawn criticism from veteran composer Stephen Sondheim for tinkering with the classic. But she persevered with her vision, with approval from the Gershwin estate and the help of Pulitzer Prize-winning writer Suzan-Lori Parks and two-time Obie Award winner Diedre Murray. She also had support from stars Audra McDonald and Norm Lewis, who both eventually earned Tony nominations for their performances. The show premiered at the A.R.T. last fall before moving on to Broadway.“We never thought we would encounter the ride that we ultimately went on. This moment is just a very happy part of that ride, and is a tribute to the team’s work,” said Paulus in praise of her collaborators. “For me, as a director, there is nothing more gratifying than having your team recognized.”And the accolades keep coming. Monday night, her musical received two Elliot Norton Awards, which recognizes excellence in Boston-area theater. “Porgy” won for Outstanding Musical (Large Theater), and McDonald won for Outstanding Musical Performance (Actress, Large Theater).Paulus was also thrilled that another production with ties to the A.R.T. garnered a slew of Tony nominations. British theater director John Tiffany, who was a fellow at Harvard’s Radcliffe Institute for Advanced Study last year, workshopped his musical “Once,” based on the low-budget hit film about a pair of aspiring musicians, at the A.R.T. last year. The show received 11 nominations.Tiffany is the associate director of the National Theatre of Scotland, a nomadic production company that likes to stage shows in unlikely locations such as a museum, a ferry, and a forest, in keeping with its motto: “Theatre without walls.”He connected with Paulus while at Radcliffe, and the two directors, who both love breaking theater’s boundaries, became fast friends. “I have admired his work for years,” said Paulus. “He shares a very passionate feeling about theater as an event, and audience.”While at Harvard, Tiffany had directed a show with students from the American Repertory Theater / Moscow Art Theater School Institute for Advanced Theater Training at Harvard University, and Paulus encouraged him to bring his work-in-progress “Once” to Cambridge for fine-tuning. Tiffany polished the production at Oberon with a mix of performers from the institute and professional actors.As a result, institute student Erikka Walsh went on to Broadway as a member of the cast, and the A.R.T.’s sound designer and engineer Clive Goodwin received a Tony nomination for the best sound design of a musical for his work.“Nothing made us happier than seeing that show so deeply recognized as well,” said Paulus. “It was this amazing day for the A.R.T.”The dynamic director, who will direct “The Glass Menagerie” next February, is quick to draw a connection between the Tony nominations and Harvard President Drew Faust’s commitment to the arts. “I feel so strongly the recognition A.R.T. received is truly a tribute to the level of artistic work being done at Harvard University,” Paulus said, “and the support and the commitment that this University shows to excellence in the arts.”After her first brush with the Tonys — Paulus’ hit revival of “Hair” won the 2009 Tony for best revival of a musical — she knows what to expect of the awards ceremony.“It’s kind of surreal,” she said of the show, which lasts for several hours and employs seat fillers, people who rush to sit in an empty seat when its occupant gets up so the viewers at home see a theater that is perpetually full. She also knows to arrive prepared, thanks to the famed British director Phyllida Lloyd, who sat behind Paulus in 2009 with plenty of treats to ward off hunger.“She told me,” said Paulus, “you have to bring snacks.”last_img read more

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Souter, back on the bench

first_imgDavid Souter hung up his judge’s robes more than three years ago, after nearly two decades on the nation’s highest court. But on Thursday night, the retired Supreme Court justice seemed as sharp as ever as he directed his easygoing, often droll, always astute wit at the Harvard Law School (HLS) students arguing before his bench.Souter — joined by Reena Raggi of the U.S. Court of Appeals for the 2nd Circuit and Mark Wolf of the U.S. District Court for Massachusetts — presided over the final round of the 102nd Ames Moot Court Competition. The evening’s oral arguments, held in a packed Ames Courtroom in Austin Hall, marked the culmination of more than a year of research, brief writing, endless practice sessions, and two qualifying rounds that winnowed 38 teams to two.At the completion of the Ames Moot Court Competition, Emma Freeman was named best oralist.Even among the mock courtrooms of other top law schools, Ames stands out for its rigor, its emphasis on brief writing, and its glamorous final showdown, often judged by an active or retired Supreme Court justice (Justice Sonia Sotomayor last year; Chief Justice John Roberts the year before). Adding to the pressure, each team of six faced the possibility of joining the fortuitous ranks of previous winners: a list that includes former Justice (and Roe v. Wade author) Harry Blackmun, HLS Professor Cass Sunstein, and Gov. Deval Patrick of Massachusetts.“There’s nothing as electric as the Ames,” Raggi told the crowd.The case in question concerned constitutional questions of state and federal powers. The fictional state of Ames had passed a “Buy American” law requiring state and local agencies to restrict purchase of green technologies to those manufactured and sourced in the United States.The petitioners, led by oralists Vivek Suri and Cormac Early, argued on behalf of a Chinese-sourced company that the law intruded on the federal government’s supremacy in foreign affairs. The respondents’ oralists, Emma Freeman and Michael Lieberman, countered that the law was perfectly constitutional, and wouldn’t stop companies that used foreign materials from selling to other clients in Ames, or in any other state.After rapid-fire questioning and 15 minutes of deliberation, the justices returned to offer their final opinion.“Counsel in all their performances, written and oral, were so extraordinarily good that we had to draw some very, very fine lines,” Souter ’61, LL.B. ’66, Hon. ’10, said, adding — perhaps extraneously, given the blunt nature of the arguments — “We’re not being polite.”The team honored for best brief included Michael Lieberman (from left), William Milliken, Yaira Dubin, Benjamin Jackson, Emma Freeman, and Michael Springer Jr.His advice to the students? “If an issue is before the Supreme Court of the United States, there is one thing you can be reasonably sure: that it was not taken up merely to fine-tune little doctrinal statements,” he said. Rather than looking for technicalities to bolster a case, “find a big thing to argue if you can,” he added.In this instance, he said, the federal government’s absence from the case in question was, by itself, a demonstration of how the Buy American law had already overstepped federal bounds. No such case would be decided by the Supreme Court, he said, without the participation or opinion — even in the form of a friend-of-the-court brief — of the federal government.In the end, the judges favored the respondents, who had argued the constitutionality of the state’s Buy American Act. Their meticulous briefs “respected the rule that, as they say, God is in the details,” Souter said, and the team’s oral performance barely edged out that of the petitioner’s team. Freeman was named best oralist.Just as with a real Supreme Court case, however, there was some dissension in the ranks. Raggi favored the petitioner’s briefs and oral performance, but acknowledged her bias for the underdog. “When I was an Ames participant, I was a losing Ames participant,” she said. (She had also watched her own child compete in the Ames Courtroom, she said, a true test: “How long can a parent really hold his or her breath?”)Though her own loss in the Ames finals had left her “convinced my life was over,” Raggi, J.D. ’76, reassured both teams that “there’s life after Ames, sometimes even on the federal bench.”Wolf and Souter, who had also competed in the Ames competition as HLS students, were more blasé about their losses.“I don’t think I made it out of the first round,” said Wolf, J.D. ’71. “I’m sure glad I got my Harvard Law School degree and my judgeship decades ago. I don’t think I’d fare well in competition with any of you.”Souter — known in his Law School days as a bit of a wild card, who once engaged in a casual swordfight that landed him in health services — took a different lesson from his team’s loss. Unlike Raggi, “I did not think my life’s prospects were coming to an end at all,” he told the audience. “I simply said, ‘I’ve got to find better judges.’ ”last_img read more

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Childhood abuse linked to sleep disturbances in pregnancy

first_img Read Full Story A history of childhood abuse is associated with increased odds of stress-related sleep disturbances for women during pregnancy, according to researchers from Harvard T.H. Chan School of Public Health and colleagues. The study is believed to be the first to associate abuse during childhood to poor sleep quality in pregnant women.The study is published in the October 2015 issue of the Sleep Medicine.“Our study shows pregnant women who have experienced abuse as children may be at increased risk of developing poor sleep quality and stress-related sleep disturbances in pregnancy. This is irrespective of adulthood experiences of trauma, demonstrating the long-lasting detrimental effects of childhood abuse,”said lead author Bizu Gelaye, research scientist in epidemiology at Harvard Chan School. “There is ample evidence that sleep disturbances are associated with adverse pregnancy outcomes. Our study now adds new evidence to the intergenerational effects of early trauma.”“We hope our findings, if replicated, might be used to help develop antenatal [prenatal and pregnancy] care programs that recognize and respond to the effects of childhood trauma,” said senior author Michelle Williams, Steven B. Kay Family Professor of Public Health, chair of the Department of Epidemiology, and director of the Harvard Catalyst Health Disparities and Population Health Research Programs.last_img read more

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Harvard’s Federico Capasso co-recipient of Rumford Prize

first_imgThe American Academy of Arts and Sciences named Harvard John A. Paulson School of Engineering and Applied Sciences Professor Federico Capasso and electrical engineer Alfred Cho as the recipients of the 2015 Rumford Prize on Tuesday, in recognition of their contributions to the field of laser technology.The award will be presented to Capasso and Cho, both of whom are members of the academy, on April 14 at the American Academy’s headquarters in Cambridge, Mass. Capasso is the Robert L. Wallace Professor of Applied Physics and Vinton Hayes Senior Research Fellow in Electrical Engineering at the Harvard John A. Paulson School.At Bell Laboratories in 1994, Capasso and Cho invented the quantum cascade (QC) laser, a concept first proposed by Rudolf Kazarinov and Robert Suris in 1971. A revolutionary new light source, the QC laser is widely used as a source of radiation for chemical sensing and spectroscopy. Common commercial applications of QC lasers include trace gas analysis, medical diagnostics, and pollution monitoring.First awarded in 1839, the Rumford Prize is one of the oldest scientific prizes in the United States. The prize recognizes contributions to the fields of heat and light, broadly defined. Previous Rumford Prize recipients include Thomas Edison, in 1895, for his work in electric lighting; Edwin Land, in 1945, for his applications in polarized light and photography; Enrico Fermi, in 1953, for his studies of radiation theory and nuclear energy; and Sidney Drell, Sam Nunn, William Perry, and George Shultz, in 2008, for their collective efforts to reduce the global threat of nuclear weapons.“On behalf of the American Academy, I am pleased to present the Rumford Prize to Dr. Capasso and Dr. Cho for their achievements,” said Jonathan F. Fanton, president of the American Academy of Arts and Sciences. “Along with Louis Agassiz, Alexander Graham Bell, Albert Einstein, Niels Bohr, and others, they are part of a distinguished lineage of scientists who have been academy members. We are proud to have highly accomplished scientists like Dr. Capasso and Dr. Cho as part of our membership.”Capasso joined Harvard Paulson School in 2003 after 27 years at Bell Labs, where he was member of the technical staff, department head, and vice president for physical research. In addition to the American Academy of Arts and Sciences, he is a member of the National Academy of Sciences, the National Academy of Engineering, the Academia Europaea, and a foreign member of the Accademia dei Lincei (Lincean Academy). He has received numerous awards recognizing his achievements in nanoscale science and technology, which include the IEEE David Sarnoff Award in Electronics (1991), the Materials Research Society Medal (1995), the Wetherill Medal of the Franklin Institute (1997), the Rank Prize in Optoelectronics (1998), the Robert Wood Prize of the Optical Society of America (2001), the American Physical Society’s Arthur Schawlow Prize in Laser Science (2004), the IEEE Edison Medal (2004), the King Faisal International Prize for Science (2005), the Berthold Leibinger Zukunftspreis (2010), the Jan Czochralski Award for lifetime achievements in materials science (2011), the European Physical Society’s Prize for Applied Aspects of Quantum Electronics and Optics (2013), and the SPIE Gold Medal (2013).Cho is the adjunct vice president of semiconductor research at Alcatel-Lucent’s Bell Labs. He is a member of several other honorary societies, including the National Academy of Sciences, the National Academy of Engineering, the Academia Sinica, the Third World Academy of Sciences, and a foreign member of the Chinese Academy of Sciences. He has received numerous awards recognizing his contributions to science and technology.For more information, visit the American Academy website.last_img read more

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