Premise: AIDS is arguably the scariest of sexually transmitted diseases. It is both personally terrifying and the number of cases has grown to have a global impact. Mathematics has been crucial in advances made in fighting it. Mathematical models have made it possible to understand the nature of AIDS in individuals and in populations, and through the effectiveness of the resulting strategies are responsible for saving many lives. An emerging tactic in fighting HIV is through vaginal microbicides. They are designed to prevent infection in women. They are currently considered the most promising biomedical intervention. However there is considerable concern that, if used by HIV-positive women, HIV will develop resistance. We show mathematically that planned trial designs could mask resistance risks and therefore enable high-risk microbicides to pass clinical testing. The effects on a heterosexual population prove to be paradoxical. In reducing an individual's risk of resistance during a trial, unexpectedly high rates of resistance may arise afterwards when microbicides are used in public health interventions. Another curious consequence of the analysis is that the microbicides could be of greater benefit to men, even though they will be used by women to protect themselves against infection.
Bio: Sally Blower is an international expert in modeling the evolutionary dynamics of drug resistance, particularly drug-resistant HIV and tuberculosis. She has published almost 100 research articles in peer reviewed journals including landmark studies in Science, Nature Medicine, the Lancet and Proceedings of the National Academy of Sciences. She is the Director of the Biomedical Modeling Centre in the David Geffen School of Medicine at the University of California Los Angeles. She obtained her B.Sc. in Ecology from the University of Edinburgh, her Ph.D. in Biology from Stanford University, and received post-doctoral fellowships at Princeton University and Imperial College of Science Technology and Medicine. Her research focuses on modeling the transmission dynamics of infectious diseases and developing the study of infectious diseases into a predictive science. She is a biomathematician who develops and uses models as health policy tools: (i) to predict the emergence of antibiotic and antiviral resistance, (ii) to design epidemic control strategies based upon epidemiological and ethical considerations, and (iii) to develop vaccination strategies. Her research focuses particularly on HIV, but also on syphilis, genital herpes, smallpox, MRSA, tuberculosis, leprosy, trachoma, and influenza. She is currently collaborating with infectious disease experts, statisticians, mathematicians and ethicists in Australia, Europe, North America, and Africa.
Tuesday, March 25, 2008 at 7:30 PM in Conron Hall (University College 224)
Director, Biomedical Modeling Center
David Geffen School of Medicine
Professor, Semel Institute of Neuroscience and Human Behavior
University of California at Los Angeles