The Emory Center for AIDS Research works to end the HIV/AIDS pandemic through innovation, coordination, and mentorship

By Kelly Jordan

Collaboration and innovation are intertwined with the mission of public health, and are integral to the research conducted at the Emory Rollins School of Public Health and across Emory University.

These attributes have proven critical in guiding pandemic responses, as the most recent COVID-19 pandemic and the long battle against HIV/AIDS can attest. Open dialogue, mentorship, and sustained dedication fosters thought, discovery, and hope, which is exactly the dynamic exemplified by the Center for AIDS Research at Emory University (Emory CFAR).

Established in 1998 and funded by the National Institutes of Health (NIH), the Emory CFAR is one of 18 CFARs across the United States working to end the HIV/AIDS epidemic by accelerating the highest caliber translational research. Public health calendars mark December 1 as World AIDS Day—a time to reflect and remember—though investigators within the Emory CFAR tirelessly work year-round to address the HIV/AIDS epidemic by advancing science to prevent new cases and improve the well-being of people living with HIV across the globe.

It has now been 40 years since the Centers for Disease Control and Prevention published its Morbidity and Mortality Weekly Report in June 1981, documenting five mysterious cases of rare pneumonia in previously healthy young gay men in Los Angeles. This report is acknowledged as the first scientific account of what would become known as HIV/AIDS.

James W. Curran, MD, MPH, dean of the Rollins School of Public Health and co-emeritus director of the Emory CFAR, was an epidemiologist in CDC’s Sexually Transmitted Control Division at the time. He was asked to head up CDC’s task force developed to investigate this strange new virus, and held that role for 15 years before transitioning to his position as dean at Rollins.

“Over the past 40 years of the HIV/AIDS pandemic, much has been accomplished but many challenges remain,” says Curran. “Our colleagues—including those affiliated with the Emory CFAR—have worked with many in communities throughout the U.S. and the world to advance research, clinical care, and prevention. World AIDS Day is an inspirational reminder to renew our commitment and energy to combat the HIV/AIDS pandemic.” 

The Emory CFAR directly contributes to NIH’s mission through operationalizing several cores that provide services, training, and expertise to bolster HIV research at Emory University. CFAR services and resources are available to support HIV research with priority access given to Emory and Morehouse School of Medicine faculty and early stage investigators. On the Emory CFAR website, researchers can request the services of the following cores and select from a menu of options to assist with their specific needs.

“The Emory CFAR cores are a vital part of the infrastructure that the Emory CFAR provides since they make available a variety of critical services at-cost to CFAR investigators across the HIV research spectrum,” says Eric Hunter, PhD, professor of pathology and laboratory medicine and co-emeritus director of the Emory CFAR. “They are particularly helpful to young investigators, as they initiate their research programs, through provision of both expertise and key pieces of equipment that would be otherwise unavailable.” 

Emory CFAR's Cores

• The Administrative Core provides leadership, allocates resources, influences HIV/AIDS research priorities at Emory, and supports the growth and development of junior investigators. Specific services offered by this core include social media support, letters of support for grant submissions, and career development programs for early stage investigators.
• The Developmental Core provides needed support to promising early career faculty as they navigate the journey from unfunded mentee to NIH-funded independent AIDS investigator, to HIV research mentor. This core offers training (like grant-writing workshops and NIH reviewer training), writing support, proposal and manuscript development, and CFAR pilot and small grant funding, among other functions.
• The Clinical Research Core supports clinical studies in HIV immunology, pathogenesis, treatment, and prevention. The Core supports research through four clinical sites that collectively see approximately 11,000 patients living with HIV and approximately 2,000 HIV- volunteers, comprising one of the largest CFAR-based HIV clinical research populations in the United States. Core services include training; community engagement and education; consulting; and access to research space, shared equipment, data, materials, and support services. 
• The Prevention and Implementation Sciences Core advances research and interventions designed to prevent new HIV infections and improve health equity in populations living with and at risk for HIV. Those utilizing the services of this core can tap into consultation offerings (on such topics as app development, project management for HIV studies, and more), training, and access to shared equipment and tools.
• The Virology and Molecular Biomarkers Core supports virology studies at all points along the spectrum of HIV/AIDS and SIV research for human and non-human primates. Services offered include consulting, training, and laboratory services.
• The Systems Immunology Core performs assessments of immunological function for studies of the pathogenesis, treatment, and prevention of immunodeficiency virus infections in humans and non-human primates. Specific services include consultations, training, cell sorting, and analytic flow cytometry.
• The Biostatistics & Bioinformatics Core provides high-quality statistical and data management training and support for the design, implementation, analysis, and publication of HIV research. Investigators requesting assistance from this core can do so for consulting, assistance developing algorithms, training, statistical analyses and more.

The Impact

Since 2011, the Emory CFAR Developmental Core-funded pilot grants have led to 16 subsequent NIH awards, including eight R01s. During the Emory CFAR’s last five-year project period, there were 776 peer-reviewed, CFAR-supported publications that have been cited a total of 7,731 times. Likewise, total HIV/AIDS NIH funding to Emory University has grown significantly from $61 million in 2015 to $74 million in 2019 (latest data), representing 95 unique principal investigators in total.

Recent high-impact CFAR-supported pilot projects include the work of Jessica Sales, PhD, associate professor at Rollins, and Anandi Sheth, MD, associate professor at Emory School of Medicine, who were awarded an NIH CFAR Ending the HIV Epidemic Supplement grant in August 2019 for their project focused on ending HIV among women in Atlanta. Their project, funded through a competitive, national NIH funding initiative focused on implementation science and community engagement, aims to, “address both supply and demand barriers for reducing HIV among women by strengthening the use of evidence-based practices for HIV testing and adoption of PrEP/PEP services among the 30 Title X-funded clinics in Cobb, DeKalb, Fulton and Gwinnett counties; and raise awareness, interest in, and connection to HIV testing and PrEP/PEP among women using an evidenced-based community organizing approach.” 

This community engagement approach to HIV prevention and care is also reflected in the partnership between the Emory and DC CFARs to administer the CFAR Adelante Mentored Research Program, which aims to, “advance HIV research in Hispanic and/or Latinx communities by providing mentored development to early-career investigators whose research focuses on decreasing HIV-related health disparities among these communities.” 

The program is now on its fourth cohort of funded pilot projects, all of which feature a three-person Adelante team led by an early-stage investigator and featuring a community-based collaborator and CFAR scientific mentor. Cohort III scholar, Valeria Cantos, MD, assistant professor at Emory School of Medicine, is wrapping up her CFAR Adelante project entitled, Development of a Comprehensive HIV Prevention App for Latino Men who have Sex with Men. Cantos has partnered with Atlanta-area community based organization, Latino LinQ, and her CFAR mentor, Aaron Siegler, PhD, associate professor at Rollins, to develop a culturally-responsive app for Latino gay and bisexual men called SaludFindr to help these men locate and access HIV testing and prevention services from the comfort of their home. The NIH has recently used the CFAR Adelante Program as a model for new, national academic-community partnership research initiatives.

Relationship-Driven

Community outreach and partnerships are major aspects of the Emory CFAR’s work. The Emory CFAR Community Liaison Council helps to drive these collaborations through the shared expertise and support of community advocates, local HIV service organization leaders, public health experts, and people living with or at risk for HIV from diverse communities that reflect the metro-Atlanta epidemic. This group works to build a bridge between HIV researchers and local community members by supporting community-focused research events and other informal opportunities for open communication between the researchers and the community. This in turn ensures the Emory CFAR investigators’ research ideas are relevant and responsive to community needs, and enables CFAR-supported research findings to be easily shared within the community.

The relational aspect of the Emory CFAR’s work is also evident internally, with its strong emphasis on mentorship and on championing the research of early career investigators. Patrick Sullivan, PhD, DVM, Charles Howard Candler Professor of Epidemiology, an Emory CFAR investigator whose HIV research has gained international acclaim, received an Emory CFAR grant as his first grant at Emory. Both of the center’s recently appointed co-directors—Ann Chahroudi, MD, PhD, associate professor of pediatrics and co-director for basic science, and Colleen Kelley, MD, MPH, associate professor of medicine, and co-director for prevention science— attribute much of their research success and career growth to the support and opportunities they received through the Emory CFAR. Both received pilot funding through the center’s developmental funding program as early stage investigators.

“I owe my success in academic HIV research directly to the mentorship and early career funding opportunities available through the Emory CFAR,” says Kelley. “As a junior investigator, I was the first CFAR03-K awardee, successfully competed for two national supplements, and I have utilized the CFAR microgrant mechanism to aid in my research. I can attest first-hand to the critical role that the Emory CFAR plays in the fostering of junior investigators, the building of successful collaborations and teams, and the synergizing of the Emory HIV research community around a common goal: to expand the Emory CFAR footprint nationally and globally and to contribute to ending the HIV epidemic locally.”

Chahroudi notes that an important mission of the Emory CFAR is to facilitate the development of junior scientists. “This mission aligns well with my own passion for meaningful mentoring,” she says. “Being a part of [my mentees’] accomplishments has been one of the most rewarding aspects of my career, and it is an honor to be able to support HIV scientists on a larger scale as a member of the CFAR leadership.”

The theme of World AIDS Day 2021 is, “End inequalities. End AIDS. End Pandemics.”  Carlos del Rio, MD, co-director for clinical science at the Emory CFAR notes, “As clinicians and as researchers we know that inequalities drive this pandemic as well as many other pandemics such as COVID-19. The Emory CFAR’s mission is to, ‘contribute to ending the HIV epidemic by accelerating the highest caliber translational research – fostering team science, equity, and multidirectional stakeholder engagement.’ Our goals are to discover, translate, disseminate, and implement cutting-edge HIV research with the goal of ending the HIV epidemic. We are committed to working toward equity and have established in collaboration with Morehouse School of Medicine a Health Equity Scientific Working Group. We hope that on World AIDS Day we all acknowledge the painful inequalities that drive the HIV epidemic and other pandemics and that we all commit to work toward ending them. Without addressing inequalities, HIV will never end.”