By Musa Otieno Ngayo, Winner of the IAS/ANRS Young Investigator Award for Track B: Clinical Sciences during the IAS 2011 for abstract entitled
Association of abnormal vaginal flora with male-to-female HIV-1 transmission among HIV-1 discordant couples in sub-Saharan Africa
I have been enthusiastic in sharing my research findings at the IAS Conference, as well as contributing to the Scientific Programme Committee, by providing critical abstract reviews since 2006. However the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011) in Rome was my first to attend and I was delighted to share an aspect of helpful and exciting research activities I am engaged in Kenya.
The nomination of our abstract for the 2011 IAS/ANRS Young Investigator Award was not only a tremendous honor for my team's work but also an indicator that the very basic research activities done in resource-limited nations using basic conventional techniques such as Gram stain still has impact in the current equipment heavy scientific world.
This award was for work that I feel passionately about, yet this condition is rarely tested for nor given attention it deserves given its implication on the epidemiology of HIV/AIDS. In Africa, the region most affected by the HIV-1 pandemic, the majority of new HIV-1 infections occur in women. Apart from the biological behavioral and socioeconomic factors, the disturbances of the normal vaginal flora contribute substantially to the population-level risk of HIV-1 acquisition.
Bacterial vaginosis (BV) (Nugent's score 7-10), the extreme end of abnormal vaginal flora is a common disorder characterized by changes in vaginal flora in which normally predominant Lactobacillus species are replaced by potential pathogens, including Gardnerella vaginalis, genital Mycoplasma and fastidious anaerobic bacteria. BV is more common among women from developing countries and it has been associated with a 60% increased risk of HIV-1 acquisition in women.
In this study we measured the effect of abnormal vaginal flora (Nugent's score 4-10) compared to normal vaginal flora (Nugent's score 0-3) on male-to-female HIV-1 transmission risk in a prospective study of African HIV-1 serodiscordant heterosexual couples recruited from seven east and southern African countries (Kenya, Uganda, Botswana, Rwanda, Tanzania, Zimbabwe and South Africa). Participants were followed for up to 24 months; vaginal Gram stains obtained every three months were evaluated using Nugent's criteria. Our study demonstrated that women who had abnormal vaginal flora had an increased incidence of HIV-1 even after adjustment for the confounding factors.
It was momentous occasion for me to stand on stage at the IAS 2011 plenary session with Elly Katabira, at the time President of the International AIDS Society and Jean-Francoise Delfraissy, Director of the French National Agency for Research on AIDS and viral hepatitis (ANRS). The applause from the international community of researchers and policy makers was a great honor for me and I promise to live up to their high expectations.
Since the award I have developed various studies to understand epidemiology, etiology, pathogenesis of abnormal vaginal flora including other STDs and HIV/AIDS. I have received various grants and scholarships for these studies including from Kenya Medical Research Institute Internal Grant (KEMRI/IG-20), HIV research Trust (HIVRT13-091), Fondation Recherche sur le SIDA in Luxembourg among others.
The IAS 2013 "IAS/ANRS Young Investigator Award" and the IAS/ANRS Young Investigator Award-Special HIV Cure Prize will be presented on Wednesday, 3 July at 8.50 before the Wednesday Plenary Session.