‘We are on the frontlines of the war on HIV’

Mario Stevenson, Ph.D., has always been fascinated by science. As a boy, he would gaze at the stars and dream of becoming an astronomer, although he came to realize that he would rather pursue science through a microscope than a telescope.

Today, as professor of medicine, Chief of the Division of Infectious Diseases in the Department of Medicine and Co-Director of the Center for AIDS Research, Stevenson is considered one of the country’s foremost scientists in HIV and infectious disease.

South Florida’s HIV epidemic attracted him to the University of Miami Miller School of Medicine in 2010. His high-tech lab at the Life Sciences and Technology Park bustles with young researchers in full protective gear conducting hundreds of tests with the live virus each week. “We are on the frontlines of the war on HIV. This is where we have to have the best weapons,” said Stevenson, a Scotland native who comes from a family of restaurateurs and considers himself a “black sheep” for choosing a different path.

Stevenson recently established the UM HIV/AIDS Institute with a $1 million research grant from the State of Florida. Here, he chats with the Medical Communications team and discusses his work to find an HIV vaccine and cure and how he’s built a team of world-class UM scientists to help him in the fight.

What attracted you to the University of Miami?

Prior to coming to UM, I was at the University of Massachusetts for 15 years and the University of Nebraska for 10 years prior to that. My research focused more on a cure and what more we can do to get rid of the virus and helping the people who are affected. At the University of Massachusetts we had fabulous researchers. My laboratory was right next to a Nobel laureate and two National Academy of Science members. It was just an extraordinary research environment, but we didn’t have the patient population, and my research needed access to the patient population. I came to Miami and thought it was an incredible opportunity. It’s also a wonderful place to live. I hope to stay here forever, because I love working here.

Miami and the South Florida region lead the nation in the number of HIV infections and new cases. Why has the region been hit so hard by the epidemic?

Miami is unique. We have the whole spectrum of high-risk populations and types of cases. This includes substance abuse and homelessness, which make it difficult to treat individuals and keep them healthy. We have a high percentage of people who are unaware of their status, which increases the spread of the virus. The region also has an influx of high-risk people from Latin America and the Caribbean. Then we have ethnic barriers. HIV disproportionately affects Blacks and Hispanics, and to some extent the prevention messages that were created to educate people on the risks and how to protect themselves don’t appeal to those ethnic groups and haven’t had the same impact. After learning the hard way, we’ve had to create specific messages for those groups.

UM is working hard to find a vaccine and cure. Tell us more about that.

The University of Miami is steadily putting together the infrastructure and the people to really mount a campaign against this virus. The physicians and researchers at UM are some of the best in the world. Two of our most recent senior recruits to the medical school, David Watkins and Ronald Desrosiers, are scientists whose life’s work has been dedicated to developing a vaccine. I and other researchers such as Dr. Savita Pahwa are working on developing a cure, because even if we have a vaccine, we still need to address the 45 million people who are already infected.

It’s important to remember that long-term use of HIV drugs can have a toxic effect on the body, and the disease also ages the immune system, which can lead to cardiovascular problems and reduces people’s lifespans by about seven years. We can’t live with the status quo of keeping people healthy. We have to work toward finding a cure. One main focus of our research on a cure is zeroing in on where the virus is hiding. If it becomes undetectable in the blood, then we need to know where it is hiding in the body and find a way to flush it out of the system.

You’ve been instrumental in the National Institutes of Health study that uses HIV antiretroviral medication to prevent HIV transmission among high-risk men in Miami. Is this approach effective and does it serve as a vaccine?

Yes. We’re used to thinking of antiretroviral drugs to treat people who are already infected but the drugs also are highly effective in preventing HIV transmission. Essentially, they can act as a vaccine. So if you are not infected and taking the drugs prophylactically, you’re highly protected. However, the biggest problem with a vaccine based on long-term medication is remembering to take the pills every day. Most vaccines are given in one shot. Now some companies are developing formulations of the antiretroviral drugs that will give people the option of getting a shot that will last about three months. I think that is going to take us closer to having the concept of a vaccine. Since adherence is one of the greatest obstacles for people on HIV drugs, this could be the thing that stems HIV transmission and revolutionizes management of the disease.

Where have UM’s HIV treatment and outreach efforts been most effective in the local community?

We’ve had a tremendous impact on managing HIV infections, which is extremely difficult in South Florida. It’s hard to get people who are drug-addicted to come to the clinic for check-ups so we have some really superb clinicians, such as Allan Rodriguez and Michael Kolber, who have mounted aggressive community outreach campaigns, which includes partnerships with local supermarkets, the church community, clinics and community based organizations. Our clinicians go to these various locations and treat people. These outreach efforts have really had a significant impact because we’ve reached people who were thought to be unreachable.

What are some of your hobbies and avocations?

I love to travel and meet people, especially people who are engaged in research. I love getting their perspective on things. And this job gives me the opportunity to travel to other countries, meet people and strike up collaborations and share my expertise. I also love to teach, although it’s also part of my occupation. David Watkins and I started a course in Brazil about 10 years ago and we’ve been going there to teach every year. Otherwise, I used to speed skate and do a lot of biking but now I’m sort of a couch potato, although I’ve come to really enjoy carpentry, odd jobs and building things around the house, because I’m using parts of my brain that I don’t normally use and it’s still problem solving.

Also, everyone has a few bucket list items. I checked off one item while in Brazil in 2007. I was in Carnival in Rio de Janeiro. I put on a costume and was with about 40,000 marchers and in front of a million spectators. It was an incredible event. The color, the energy, celebrating life, that’s what it’s all about. But, that’s something that you only do once so I’m looking for the next bucket list item. Actually, finding a cure for HIV would be a nice bucket list item to check off.

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