Reena Rajasuriar
Co-President of APACC 2023, Chief Researcher at the Center of Excellence for HIV/AIDS Research (CERiA) at the University of Malaya, Associate Professor at the Faculty of Medicine, University of Malaya, Research Fellow at the Peter Doherty Institute for Infection and Immunity, University of Melbourne. She is primarily responsible for the University of Malaya’s HIV Immunology Translational Research Program, with her current research focus on the immunopathogenic mechanisms of aging in HIV/AIDS patients and their impact on patient health.
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Highlights and Significance of APACC 2023
Dr. Rajasuriar: This is the first Asia-Pacific regional conference three years after the COVID-19 pandemic, and we have adopted a combination of online and in-person formats. I believe this is a great start, bringing everyone together for face-to-face interactions and fostering connections between healthcare professionals and community service workers, which is crucial in the field of HIV/AIDS prevention and treatment.
At the forefront of this year’s APACC conference is the World Health Organization’s goal to “End the Global HIV Epidemic by 2030,” specifically the “three 95s”: 95% of people living with HIV knowing their HIV status, 95% of diagnosed people with HIV receiving antiretroviral therapy, and 95% of people on antiretroviral therapy having suppressed viral loads. We are also addressing the challenges we currently face in achieving this goal and the strategies to overcome them. For instance, in HIV/AIDS prevention, we are discussing various new implementation models, especially the use of long-acting injectable drugs in pre-exposure prophylaxis (PrEP). In terms of treatment, topics include how to manage treatment-experienced and drug-resistant HIV/AIDS patients, and the selection of second-line treatment drugs. In addition to clinical research advancements in HIV/AIDS prevention and treatment, we have established special discussions on improving the quality of life for HIV/AIDS patients and addressing the aging issues among them.
Furthermore, to achieve the goal of ending the HIV epidemic by 2030, we recognize the importance of community work. Therefore, this conference has also invited outstanding community workers and public health management experts from the Asia-Pacific region to share their achievements and research results, as well as their advice on how to collaborate with scientists to drive progress in the field of HIV/AIDS.
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Eliminating Regional Disparities to Achieve the 2030 Goal
Dr. Rajasuriar: Whether we can achieve the goal of ending the HIV epidemic by 2030 is a recurring theme throughout this conference. In this year’s APACC conference, we awarded the “Lifetime Achievement Award” to Professor Praphan Phanupak from the Faculty of Medicine at Mahidol University in Bangkok, who has been dedicated to eliminating regional disparities and ending the HIV epidemic for decades. In February 1985, Professor Phanupak diagnosed the first three cases of HIV/AIDS in Thailand and has since been involved in HIV/AIDS prevention and treatment research. He co-founded HIV-NAT in Bangkok in 1996 with the late Professor Joep Lange and Professor David Cooper, which was Asia’s first HIV clinical trials center.
Professor Phanupak has dedicated decades to HIV/AIDS prevention and treatment. He has actively advocated for combination antiretroviral therapy to prevent mother-to-child transmission, and he believes that proactive prevention of HIV should start with early antiretroviral therapy, advocating for the principle of “test and treat” upon diagnosis. He pioneered Key Population-Led Health Services (KPLHS) in Thailand, leading peers to provide high-quality HIV/AIDS prevention and treatment training to community service workers. Professor Phanupak’s lifelong achievements have had an immeasurable impact on advancing HIV/AIDS prevention and treatment efforts in the Asia-Pacific region.
Currently, there are significant disparities among regions worldwide in HIV/AIDS prevention, diagnosis, and treatment. However, we face nearly universal challenges. For instance, all countries are striving to reach individuals or groups that the current HIV/AIDS management systems cannot adequately serve. Addressing HIV/AIDS-related stigma and discrimination remains a crucial issue that spans treatment and prevention efforts in all countries. While we may have made some progress over the years, this is still a vulnerable area that requires more work. Furthermore, we increasingly recognize that communities are a vital component of a comprehensive plan to eliminate HIV transmission. They need better services and support, integration into healthcare systems, funding, and opportunities for leadership and platforms. In this regard, I believe that we can learn from European and American countries.
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Community-Based Screening Model for Elderly HIV-Infected Individuals
Dr. Rajasuriar: In this conference, I introduced a comprehensive care screening model aimed at addressing the issue of aging in HIV-infected individuals. Traditionally, our focus has been on monitoring the HIV/AIDS disease itself. In this research, we applied the World Health Organization’s Intrinsic Capacity Assessment for the first time to the HIV population, incorporating common conditions in the elderly such as diabetes, hypertension, and frailty into the screening. The goal is to comprehensively assess the physical, mental, and social functioning of HIV-infected individuals and provide them with more holistic care and support.
The results of this study indicate that HIV-infected individuals have higher levels of intrinsic capacity deficits. These deficits manifest in various areas, including cognition, hearing, vision, mobility, emotions, and vitality. Compared to the control group, more HIV-infected individuals reported deficits in two or more areas. The study’s findings suggest that HIV-infected individuals require comprehensive care and support to address difficulties they may encounter in multiple aspects of their lives.
Our work was conducted through a website and yielded very positive results, which is highly encouraging. Because the assessment items in this model do not require specialized training, biochemical analysis, or even simple blood glucose tests, all assessment items can be conducted at community service stations after training. It is highly efficient and convenient. These research results provide an opportunity for us to reconsider how we assess aging in HIV/AIDS patients and aging-related issues, potentially offering a more person-centered comprehensive care model in the future.
