Larry Scott-Walker was six years old when he first heard about HIV. He remembers being fearful of the disease.
While attending Morehouse College in the late 90s, Scott-Walker learned that several of his friends were living with HIV. In 2007, he would find out that he also had the disease. Now, Scott-Walker, 43, is the executive director of THRIVE SS, an organization founded in 2015 to support Black gay and bisexual men living with HIV in the Atlanta metro area. Having lived through the evolution of how HIV is treated, prevented and viewed, he says that a medically effective HIV vaccine would be “amazing.”
“It would signal the beginning of the end of such a high prevalence of incidents of HIV,” Scott-Walker said.
Emory’s Hope Clinic Vaccine Center is one of four sites selected to participate in the International AIDS Vaccine Initiative’s clinical trials, taking part in the first human evaluation of mRNA technology in HIV vaccines.
According to Emory researchers, mRNA — short for “messenger RNA” — vaccines can be prepared, manufactured and brought to trials in months, as opposed to the years needed to develop a new vaccine using other methods, such as protein- and DNA-based vaccines. The upcoming trial makes use of new mRNA vaccine technology first successfully used in coronavirus vaccines. In the search for an HIV vaccine, a variety of older vaccine technologies have been tried, but none of them have been successful at preventing infection with the virus.
In 2019, the South accounted for more than half of new HIV infections and half of those cases were seen in Black people. The Atlanta metro area ranked second in the country for the rate of new HIV diagnoses in 2019, according to the Centers for Disease Control and Prevention’s 2019 HIV Surveillance Report. Georgia had a rate of 27.6 new diagnoses per 100,000 people in 2019, coming in second in the country behind D.C.
Credit: HYOSUB SHIN / AJC
Credit: HYOSUB SHIN / AJC
Some say that because of these and other factors, Atlanta is an ideal site for HIV vaccine research.
“Being able to include people who are living in and around Atlanta in the research, so that we can be a part of the solution not only for the world but for ourselves, is really powerful. That’s why I think it’s important for the research to be conducted in Atlanta…,” Dázon Dixon Diallo, founder and president of SisterLove, Inc, explained. “I believe that you should go look for the solutions where the problems are the worst. That’s what we’re doing in Atlanta.”
In 2002, Emory University opened The Hope Clinic of Emory Vaccine Center as a research facility to work on HIV vaccine development. Since then, the clinic has worked with the National Institutes of Health and other entities to evaluate vaccines and other products in clinical trials.
“We have the track record for having the capacity and the skills and expertise to be able to recruit the population of the trials,” Dr. Sri Edupuganti, a professor of medicine specializing in infectious disease at the Emory University School of Medicine and lead investigator of the trials, said.
The Ponce De Leon Center is also serving as a vaccine development site, and a partnership with Morehouse School of Medicine is in the works, Edupuganti noted.
Emory will initially take part in Phase 1 trials, which involve testing the vaccine in healthy human volunteers to ensure its safety. If Phase 1 goes well, a Phase 2 trial would study the immune response produced by the vaccine. That could be followed by efficacy trials using those most at risk for acquiring HIV as participants.
The trials are a partnership between IAVI — a research organization that develops vaccines — and Moderna, the manufacturer of the vaccine candidate.
“Based upon the success of the COVID vaccine development, (an mRNA vaccine) could lead to really specific and strong immune responses,” Edupuganti said.
While the HIV mRNA vaccine has much optimism behind it, there are challenges too. The HIV virus is error-prone when making copies of itself, giving rise to a high level of genetic variance that can make it hard for the body’s immune system to recognize. And, unlike the coronavirus, the body’s natural immune response is not strong enough to fight HIV.
“While the pursuit of an HIV vaccine has not yet been successful, it actually has driven the level of scientific discovery in vaccine research to a new level of productivity and sophistication. The COVID vaccine effort benefited significantly from that,” said Mark Feinberg, CEO and president of the International AIDS Vaccine Initiative.
“A number of the tools that were validated in the course of the pandemic are now being applied to the pursuit of an HIV vaccine. It’s kind of mutually enabling.”
To trigger an immune response, many vaccines put a weakened or inactivated virus into our bodies. Instead, mRNA vaccines use mRNA created in a laboratory to teach our cells how to make a protein that triggers an immune response.
When mRNA vaccines for COVID-19 were developed, scientists zeroed in on the spike proteins found on the surface of the virus, which is used to infect healthy cells. The vaccine uses mRNA inside the body to train the body’s own immune system to recognize and attack those spikes. For the HIV vaccine, a similar process will be followed, mimicking part of the HIV virus.
“What we are trying to do is to develop an HIV vaccine that is able to induce broadly neutralizing antibodies. What that means is an antibody response that is able to recognize and block infection with genetically diverse strains of HIV,” Feinberg told The Atlanta Journal-Constitution.
“The genetic diversity of HIV is one of the major obstacles to vaccine development.”
Information for interested volunteers:
The Hope Clinic is still recruiting for these trials. Eligible participants are healthy individuals ages 18-50, who do not have any major chronic health conditions. Members of the LGBTQ+ community are encouraged to sign up.
Phone: 877-288-0048
Email: hope.community@emory.edu.
Find a link to interest form here.
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