February 2005

HIV Vaccines Questions and Answers for
HIV Treatment Advocates

1. Why do I need to know about HIV vaccine research?

   As a treatment advocate, you are in contact with different segments of the community and many people will turn to you for all types of HIV research information. Therefore, in addition to answering questions about HIV treatment research, it is important for you to be able to provide general information about HIV vaccines and explain the difference between therapeutic and preventive vaccines. Also, some of the individuals you come in contact with may be enrolled in an HIV vaccine trial and it would be helpful for you to know how it can affect them and their seropositive status.

   HIV vaccine advocates work to address many of the same issues that you struggle with as a treatment advocate-ethical issues, community involvement, access to care, sustainability, among others. Additionally, treatment and prevention (e.g., vaccine, behavioral and microbicide) research are often conducted in the same institutions, clinics, and geographical areas. Much could be gained from shared advocacy and resources.

2. Why is HIV treatment important to HIV prevention research and vice versa?

A combination of preventive approaches will likely be required to protect individuals and the public against HIV and to control the global AIDS epidemic. Such approaches include:

• Prevention strategies directed at individuals or communities for reducing risk of HIV transmission associated with sexual activity and/or with injection drug use
• Antiretroviral therapy to care for those already infected and to reduce the infectiousness of HIV-infected persons
• Microbicides for vaginal or rectal use
• Treatment of sexually transmitted infections (STIs) that are cofactors for HIV transmission
• Prophylaxis to prevent mother-to-child transmission
• A safe and effective HIV vaccine

In this context, treatment can be viewed as a valuable component of a comprehensive approach to HIV prevention. Several HIV vaccines are being evaluated to determine if they have therapeutic as well as preventive effects. Even if a vaccine given prior to exposure cannot prevent HIV infection, it may prove to delay or prevent the onset of AIDS or have therapeutic value in individuals infected prior to immunization. A combination of preventive approaches will likely be required to protect individuals and the public against HIV and to control the global AIDS epidemic. Such approaches include:
3. How does an HIV vaccine affect someone's seropositive status?

   Some HIV vaccines stimulate the production of antibodies against multiple HIV proteins. Since standard HIV tests (e.g., ELISA) detect antibodies in blood directed against certain HIV proteins, a person who is receiving an HIV vaccine could test positive for HIV. The HIV vaccines being tested do not contain HIV and, therefore, cannot cause HIV infection. Other tests are available to determine if an HIV vaccine trial volunteer is actually infected with HIV as a result of his or her own behavior-related to exposure to HIV.

4. Does research for a preventive HIV vaccine detract from research for a therapeutic vaccine?

   No. Researchers continue to evaluate therapeutic vaccines to treat people with HIV infection or AIDS. Many of the same vaccines are being tested to determine their preventive and therapeutic effects. What works to prevent HIV infection may not necessarily work to treat people who are already infected with HIV. Nonetheless, findings from preventive HIV vaccine research may provide critical information that can further HIV treatment research and vice versa.

5. What are the basic facts about preventive HIV vaccines?

• HIV vaccines being tested in humans do not contain HIV and cannot cause HIV.

• If HIV vaccine trial participants engage in behaviors that expose them to HIV, they may become infected with HIV. It is always important for you to continue to stress the importance of safe behaviors that will reduce the risk of HIV infection.

• At present, there is not an HIV vaccine to prevent infection or disease. Contrary to what some people in the community may think, an HIV vaccine is not currently available. Research is underway to find a safe and effective vaccine that will protect people from being infected with HIV, but it will continue to take more time until a promising vaccine is discovered.

6. Is there a general message about HIV vaccines that I can help deliver to the community?

   Yes. You can encourage people to learn more about HIV preventive vaccine research and help educate others about the need for an HIV vaccine within the context of your work. Just as more research is needed to find a cure for AIDS, more research is needed to find a way we can prevent others from becoming infected. Therefore, in addition to helping those who are already infected with HIV learn more about and gain access to therapeutic research, we need to continue aggressive prevention efforts, including comprehensive risk-reduction strategies, and stress the importance of an HIV vaccine in helping to control the spread of HIV.

   As you encourage those already infected with HIV to get involved in clinical research studies, you can encourage those individuals who are not already infected to consider volunteering for an HIV vaccine trial or other prevention study, such as a microbicide or behavioral research study.

7. Where can I go for more information?

   For more detailed information about HIV vaccine and current research, you can visit the National Institute of Allergy and Infectious Diseases (NIAID) website at http://www.niaid.nih.gov/daids/vaccine/default.htm, the HIV Vaccine Trials Network at http://www.hvtn.org, or the Vaccine Research Center at www.niaid.nih.gov/vrc.

   For general information about HIV vaccines as well as a comprehensive database that can be searched for HIV vaccine trials by location or product, you can visit the AIDSinfo website at http://aidsinfo.nih.gov/.

Department of Health and Human Services

National Institutes of Health (NIH) Bethesda, Maryland 20892

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