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The news spread around the globe, but U.S. Ambassador to Thailand Eric John capped the enthusiasm with a less-than-glowing observation, “This trial will be recognized. The conclusion has brought us one step closer to AIDS vaccine development.”
While researchers and subjects in the study were probably expecting a bit more excitement they will have to settle for only diplomacy for the time being.
Expectations in the field of AIDS research are understandably high around the world. But because of one research failure after another, and the constant emergence of resistant strains, effective cures or treatments to actually prevent infection have been elusive.
This is why the Thai study is having such public impact; for the first time, it apparently shows that infection can be prevented among groups routinely at risk from HIV infection. Half of the volunteers received the vaccine and the other half received a placebo; among the vaccinated group, 51 became infected with HIV, compared with 74 among the placebo group.
The spread of HIV/AIDS has brought to the fore one aspect of human behavior – sexual behavior. Abstinence used to be an option, but it has routinely been sidestepped and even denounced by scientists, academics and “victims” of AIDS, who face uncertain if not dismal futures because of infections often brought about by engaging in risky personal relationships.
Recruitment for the study began in October 2003 and results were announced in September 2009, but in between, little if any progress has been made in addressing the behavioral aspects of HIV/AIDS infection. Naturally those who are infected, or stand a more-than-slight risk of being infected, want AIDS prevention first and then effective treatment if prevention doesn’t work.
Human behavior, and acceptance of what has traditionally been deemed deviant human behavior, has changed significantly over the decades and centuries, with variations depending on the times and the society in which the behavior arose.
In the 21st century many now accept homosexuality – except in Muslim nations like Iran, whose president has stated that there are no homosexuals in his country. Even the word “gender” has taken on new shades with a so-called “third gender” or “she-males.”
As human sexual behavior has become comparatively riskier, with more widespread consequences, the published results of studies like the one announced in Bangkok can have a significant impact on people’s expectations. If an effective HIV/AIDS vaccine becomes available it will encourage those who advocate “free will” in personal behavior.
It is important that details of this latest Thai HIV study are made public. That two previously unsuccessful vaccines were combined in this latest study and were 30 percent successful in preventing infection – according to the study – is by logic an anomaly.
As Colonel Jerome Kim, deputy director of the U.S. Military Research Program, a partner in the project, stated, "Although the results were modest, this is a very important scientific advance and gives us hope that a globally effective vaccine may be possible in the future." He also observed that researchers would have to determine why the vaccine worked.
Of course researchers will have to determine whether it was the vaccine itself or other factors, such as behavior, that may have influenced the observed result. Statistics are only as good as the data they are derived from, and have to be held suspect unless rigid scientific parameters have been verified over and over again.
For example, with the current public discourse on HIV/AIDs prevention – which includes such measures as creams, withdrawal and other combined prophylactics – participants in the study may have already been behaving more reservedly than in the past. Without the study data being published in full this is another unknown.
The knowns in the study may also serve as food for thought. The U.S. Military Research Program was co-partnered in the study by vaccine manufacturer Sanofi Pasteur and Global Solutions for Infectious Disease. The detailed procedures and results will be presented at the AIDS Vaccine 2009 meeting in Paris on Oct. 20.
Faith in the efficacy of medical breakthroughs can sometimes be observed in company stock performance, as in the past when investors benefitted greatly from a one-day surge in the stock of a biotech company that announced a SARS vaccine in advance.
In this latest Thai HIV study case, the stock price high for Sanofi-Aventis actually fell by US$0.23 on Sept. 24, when the results were announced.
For Global Solutions for Infectious Disease, the story is different. It is a global nonprofit organization “engaged in the development of diagnostic and preventive tools for infectious diseases, including HIV.”
Time will tell, but the cause is best served by extreme caution. Readers may wish to refer to http://www.hivresearch.org/index.html for details on the U.S. military’s involvement in HIV/AIDS research and treatment.
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(Frank G. Anderson is the Thailand representative of American Citizens Abroad. He was a U.S. Peace Corps volunteer to Thailand from 1965-67, working in community development. A freelance writer and founder of northeast Thailand's first local English language newspaper, the Korat Post – www.thekoratpost.com – he has spent over eight years in Thailand "embedded" with the local media. He has an MBA in information management and an associate degree in construction technology. ©Copyright Frank G. Anderson.)
