In recognition of NLAAD, ACTG is highlighting research that continues to advance HIV prevention, treatment, and care in Hispanic and Latino communities and throughout the diaspora. One investigator contributing to that effort is Dr. Jessica Castilho, Associate Professor of Medicine at Vanderbilt University Medical Center and a cross-appointed ACTG investigator. In addition to recently leading one of ACTG’s HIV aging studies at the Vanderbilt Therapeutics Clinical Research Site, Jessica serves as a co-leader of the Caribbean, Central and South America Network for HIV Epidemiology (CCASAnet), a multinational research consortium that marked its 20th anniversary this year.
CCASAnet includes 11 sites across seven countries and maintains an observational database representing more than 60,000 people affected by HIV throughout the region. Since its founding in 2006, the consortium has helped researchers better understand HIV prevention, treatment outcomes, and long-term health among people living with HIV across Latin America and the Caribbean.
Jessica explained that the region’s HIV epidemic contains both unique challenges and important lessons. While several countries in Latin America were early adopters of antiretroviral therapy (ART) through universal healthcare systems, important public health challenges remain, including increasing rates of new HIV acquisitions in parts of Latin America, the need for expanded access to HIV prevention services, earlier diagnosis, and sustained engagement in care. These challenges make continued research and international collaboration especially important.
When discussing the value of global HIV research, Jessica shared a guiding principle common among many infectious disease researchers: “We’ve embraced the fact that viruses really know no borders and neither should we.”
That philosophy has shaped HIV research for decades and is reflected in both ACTG’s multi-site partnerships and CCASAnet’s collaborative approach. Through collaborative research networks, investigators can identify successful prevention and treatment strategies, learn from different healthcare systems, and apply those lessons to improve care across diverse populations.
One example comes from Jessica’s work studying HIV and aging in Brazil. Researchers are evaluating a screening tool for frailty and geriatric syndromes that was developed by a Brazilian geriatrician. The goal is to determine whether the same tool can help identify individuals at risk for adverse aging outcomes in other settings, including elsewhere in Latin America and even the United States.
For Jessica, international collaboration is about more than sharing scientific findings. It is also about learning how different healthcare systems approach common challenges. “A lot of the things that we have learned about what works and what doesn’t in care models and in understanding how we can best make our clinics efficient and scalable is really going to require us to look at this picture more broadly and to learn from our colleagues in the Southern Hemisphere and across the world,” she said.
Those lessons are increasingly important as HIV treatment continues to improve and researchers turn their attention toward new questions. Decades ago, HIV research focused heavily on survival and access to effective treatment. Today, thanks to advances in HIV care, many people living with HIV can anticipate long and fulfilling lives. As a result, researchers are increasingly focused on understanding how to support healthy aging, prevent frailty, and maintain quality of life across a person’s lifespan.
This question lies at the center of much of Jessica’s current research. “How can I help people who are living with HIV now, whatever age they are, maintain the well-being and function that they desire as they reach older ages?” she asked.
Her work examines how healthcare providers can help people living with HIV manage and sustain their health throughout the aging process. From addressing chronic conditions and maintaining physical function to supporting independence and overall well-being, researchers are working to ensure that longer life expectancy is accompanied by a higher quality of life.
As ACTG recognizes NLAAD, Jessica’s work highlights both the progress that has been made and the work that remains. For Hispanic and Latino communities in the United States, as well as people living with HIV throughout Latin America and the Caribbean, continued advances in prevention, treatment, and healthy aging depend on sustained research and collaboration.
Through partnerships such as ACTG and CCASAnet, researchers are not only improving care across the United States, Latin America, and the Caribbean but also generating knowledge that benefits people living with HIV around the world. As Jessica notes: “We need to think about ways that we can help individuals living with HIV age with dignity, with support, with function, and with high well-being.”
Written by Whitney Wingate, Ph.D., Vanderbilt Therapeutics CRS