Kimberly Powers

Last updated
Kimberly A. Powers
Alma mater
Scientific career
Institutions
Thesis HIV transmission dynamics: Infectivity, sexual partnership patterns, and the role of early infection  (2010)
Doctoral advisor Myron S. Cohen

Kimberly A. Powers is an American epidemiologist who is an associate professor of epidemiology at the UNC Gillings School of Global Public Health. She combines epidemiology, statistics and mathematical modelling to understand the transmission of infectious diseases. In 2011 her work on antiretroviral therapy for the management of human immunodeficiency virus was selected by Science as the breakthrough of the year. During the COVID-19 pandemic, Powers looked to understand the spread of SARS-CoV-2.

Contents

Early life and education

As a child Powers considered becoming as physician. [1] She eventually studied mathematics at Hamilton College and graduated in 1998. After graduating she joined a healthcare consultancy, where she was first introduced to epidemiology. [1] She spent a year at The University of New Mexico where she studied tobacco use in the community. [1] In 2002 she moved to Los Alamos National Laboratory, where she worked as a graduate assistant in the biophysics group. [1] There she developed mathematical models that could describe viral transmission. [1] She was eventually accepted as a graduate student at the University of North Carolina at Chapel Hill, where she eared a Master's in Public Health. During her second year at UNC she saw a talk from Myron S. Cohen, and became interest in the use of antiretroviral drugs to treat HIV. [1] She remained at the University of North Carolina at Chapel Hill for her doctoral studies, where she studied the transmission dynamics of HIV in the laboratory of Cohen. [2] During her doctoral research, Cohen realised that Powers would need formal training in epidemiology. [1] She spent one year in the United Kingdom, studying at the London School of Hygiene & Tropical Medicine and Imperial College London. [1] In particular, her research considered acute- and early-stage HIV infection in Lilongwe. [1] She spent weeks at a time visiting a STD clinic in Lilongwe, where she looked to improve patient care as well as track trends in HIV transmission. [1]

Research and career

In 2010 Powers started a postdoctoral research position at the UNC Gillings School of Global Public Health. [1] She identified that almost 40% of HIV transmission occurred before patients or physicians knew about it, meaning that treatment often started after infection had occurred. [3] People who are unaware about their own HIV infection contribute significantly to the ongoing transmission of virus. [4] She was awarded the University of North Carolina at Chapel Hill award for research excellence in 2011. [5]

Powers recognised that population-level prevention of HIV would require regular testing, to detect the virus in its early stages, as well as the provision of antiretroviral drugs. [6] Powers was part of the HPTN 052 clinical trial, and demonstrated that there was a 96% reduction in transmission in couples who had been treated with antiretroviral therapy. [1] She looked to apply this understanding to other populations, including in the US prison community. The proportion of HIV positive Americans in the United States prison system is significant; between 5 and 7 times that of the general population. [7]

During the COVID-19 pandemic, Powers looked to understand the spread of SARS-CoV-2 in North Carolina. [8] [9] She predicted that by early April cases in North Carolina would reach 4,000. [8] Her prediction was proved correct, even without people in North Carolina having access widespread testing. [8] [10] Her mathematical model included estimates of the rate at which people interact, and was adapted to take into account quarantine restrictions and social distancing. [11]

Selected publications

Related Research Articles

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV, maintains function of the immune system, and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same sex and opposite sex partners so long as the HIV-positive partner maintains an undetectable viral load.

HIV/AIDS Spectrum of conditions caused by HIV infection

Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual may not notice any symptoms, or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged incubation period with no symptoms. If the infection progresses, it interferes more with the immune system, increasing the risk of developing common infections such as tuberculosis, as well as other opportunistic infections, and tumors which are otherwise rare in people who have normal immune function. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS). This stage is often also associated with unintended weight loss.

Economic epidemiology is a field at the intersection of epidemiology and economics. Its premise is to incorporate incentives for healthy behavior and their attendant behavioral responses into an epidemiological context to better understand how diseases are transmitted. This framework should help improve policy responses to epidemic diseases by giving policymakers and health-care providers clear tools for thinking about how certain actions can influence the spread of disease transmission.

HIV/AIDS in Zimbabwe HIV/AIDS in Zimbabwe

HIV and AIDS is a major public health issue in Zimbabwe. The country is reported to hold one of the largest recorded numbers of cases in Sub-Saharan Africa. According to reports, the virus has been present in the country since roughly 40 years ago. However, evidence suggests that the spread of the virus may have occurred earlier. In recent years, the government has agreed to take action and implement treatment target strategies in order to address the prevalence of cases in the epidemic. Notable progress has been made as increasingly more individuals are being made aware of their HIV/AIDS status, receiving treatment, and reporting high rates of viral suppression. As a result of this, country progress reports show that the epidemic is on the decline and is beginning to reach a plateau. International organizations and the national government have connected this impact to the result of increased condom usage in the population, a reduced number of sexual partners, as well as an increased knowledge and support system through successful implementation of treatment strategies by the government. Vulnerable populations disproportionately impacted by HIV/AIDS in Zimbabwe include women and children, sex workers, and the LGBTQ+ population.

The United States Military HIV Research Program was initiated by the United States Congress in 1986, in reaction to the threat of lost effectiveness of U.S./Allied troops due to HIV infection. The mission of MHRP is to develop an HIV-1 vaccine, provide prevention, care, and treatment, and conduct meaningful HIV/AIDS research for the global community through the President's Emergency Plan for AIDS Relief (PEPFAR). It is centered at the Walter Reed Army Institute of Research (WRAIR), and has established five international research sites in Africa and Asia. MHRP also partners with the Armed Forces Research Institute of Medical Sciences (AFRIMS) in Thailand. MHRP works closely with The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), most notably in the development of the RV144 HIV vaccine in Thailand. MHRP is the largest research program supported by the HJF.

Alimuddin Zumla British-Zambian physician

Sir Alimuddin Zumla,, FRCP, FRCPath, FRSB is a British-Zambian professor of infectious diseases and international health at University College London Medical School. He specialises in infectious and tropical diseases, clinical immunology, and internal medicine, with a special interest in HIV/AIDS, respiratory infections, and diseases of poverty. He is known for his leadership of infectious/tropical diseases research and capacity development activities. He was awarded a Knighthood in the 2017 Queens Birthday Honours list for services to public health and protection from infectious disease. In 2012, he was awarded Zambia's highest civilian honour, the Order of the Grand Commander of Distinguished services - First Division. In 2021, for the fourth consecutive year, Zumla was recognised by Clarivate Analytics, Web of Science as one of the world's top 1% most cited researchers. In 2021 Sir Zumla was elected as Fellow of The World Academy of Sciences.

Didier Pittet is an infectious diseases expert and the director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University Hospital of Geneva, Geneva, Switzerland. Since 2005, Pittet is also the External Lead of the World Health Organization (WHO) Global Patient Safety Challenge "Clean Care is Safer Care" and African Partnerships for Patient Safety.

Myron Scott Cohen is an American physician-scientist who has made substantial contributions to our understanding of the transmission prevention of transmission of HIV. He is best known as chief architect of HIV Prevention Trials Network 052, a large-scale randomized clinical trial which demonstrated proof-of-concept for “treatment as prevention”: treating an HIV-infected person with antiviral drugs makes them less contagious and prevents transmission to their sexual partners. Cohen is J. Herbert Bate Distinguished Professor of Medicine, Microbiology and Immunology, and Epidemiology at the University of North Carolina at Chapel Hill. He is also co-chair of the National Institutes of Health's HIV Prevention Trials Network.

Julio S. G. Montaner, is an Argentine-Canadian physician, professor and researcher. He is the director of the British Columbia Centre for Excellence in HIV/AIDS, the chair in AIDS Research and head of the Division of AIDS in the Faculty of Medicine at the University of British Columbia and the past-president of the International AIDS Society. He is also the director of the John Ruedy Immunodeficiency Clinic, and the Physician Program Director for HIV/AIDS PHC. He is known for his work on HAART, a role in the discovery of triple therapy as an effective treatment for HIV in the late 1990s, and a role in advocating the "Treatment as Prevention" Strategy in the mid-2000s, led by Myron Cohen of the HPTN 052 trial.

Treatment as prevention (TasP) is a concept in public health that promotes treatment as a way to prevent and reduce the likelihood of HIV illness, death and transmission from an infected individual to others. Expanding access to earlier HIV diagnosis and treatment as a means to address the global epidemic by preventing illness, death and transmission was first proposed in 2000 by Garnett et al. The term is often used to talk about treating people that are currently living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) to prevent illness, death and transmission. Although some experts narrow this to only include preventing infections, treatment prevents illnesses such as tuberculosis and has been shown to prevent death. The dual impact on well being and its 100% effectiveness in reducing transmission makes TasP the most important element in the HIV prevention toolkit. In relation to HIV, antiretroviral therapy (ART) is a three or more drug combination therapy that is used to decrease the viral load, or the measured amount of virus, in an infected individual. Such medications are used as a preventative for infected individuals to not only spread the HIV virus to their negative partners but also improve their current health to increase their lifespans. Other names for ART include highly active antiretroviral therapy (HAART), combination antiretroviral therapy (cART), triple therapy and triple drug cocktail. When taken correctly, ART is able to diminish the presence of the HIV virus in the bodily fluids of an infected person to a level of undetectability. Undetectability ensures that infection does not necessarily have an effect on a person's general health, and that there is no longer a risk of passing along HIV to others. Consistent adherence to an ARV regimen, monitoring, and testing are essential for continued confirmed viral suppression. Treatment as prevention rose to great prominence in 2011, as part of the HPTN 052 study, which shed light on the benefits of early treatment for HIV positive individuals.

Francis Allan Plummer was a Canadian scientist, academic and HIV/AIDS researcher. He was "a recognized specialist in infectious diseases whose work influenced public health policy in Canada and abroad". He was Distinguished Professor Emeritus of Medicine and Medical Microbiology at the University of Manitoba and Scientific Director General, National Microbiology Laboratory.

David Albert Cooper was an Australian HIV/AIDS researcher, immunologist, professor at the University of New South Wales, and the director of the Kirby Institute. He and Professor Ron Penny diagnosed the first case of HIV in Australia.

Pontiano Kaleebu is a Ugandan physician, clinical immunologist, HIV/AIDS researcher, academic and medical administrator, who is the executive director of the Uganda Virus Research Institute.

Helen Y. Chu is an American immunologist who is an Assistant Professor of Medicine at the University of Washington. Her research considers maternal immunization, with a focus on influenza and respiratory syncytial virus. During the COVID-19 pandemic, Chu was the first physician to recognise community transmission of the coronavirus disease within the United States.

Sylvie Champaloux Briand is a French physician who is Director of the Pandemic and Epidemic Diseases Department at the World Health Organization. Briand led the Global Influenza Programme during the 2009 swine flu pandemic. During the COVID-19 pandemic, Briand launched the WHO Information Network for Epidemics which looked to counter the spread of COVID-19 misinformation.

Sarah Fidler is an immunologist, researcher and professor in HIV Medicine at Imperial College London and consultant physician in HIV for St Mary's Hospital, London.

Catherine Wilfert was an American pediatrician specializing in infectious diseases. She became a professor at Duke University School of Medicine and known internationally for her work in pediatric HIV prevention. After 1993, using zidovudine during pregnancy led to an estimated reduction of mother-to-infant transmission of HIV in the United States by 75 percent and a 47 percent decrease in new HIV infections globally.

Michel Alary Canadian academic, doctor

Michel Alary is a Canadian academic, doctor of preventive medicine and a health researcher. He is a Professor of Social and Preventive Medicine at Université Laval and the director of population health research at the Research Centre of the CHU de Quebec – Université Laval. He also serves as a Medical Consultant at the Institut national de santé publique du Québec. Alary has published over 260 research papers and has produced major reports for the World Bank and UNAIDS about HIV in sub-Saharan Africa. He also evaluated the Bill & Melinda Gates Foundation's India AIDS Initiative for which his project received the Avahan Recognition Award. He has conducted epidemiological and preventive research on blood-borne infections, HIV and other Sexually Transmitted Diseases (STD) among the most vulnerable populations in developed and developing countries.

Debby Bogaert is a Dutch physician who is Professor of Paediatric Infectious Diseases at the University of Edinburgh. Her research considers the physiology and pathophysiology of respiratory infections.

Cheryl Cohen is a South African public health researcher who is a professor at the University of the Witwatersrand. She looks to develop evidence-based policy to reduce the burdens of respiratory diseases. During the COVID-19 pandemic. Cohen investigated the rates of COVID-19 in South Africa.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 Price, Michael (2011-12-23). "Science's 2011 breakthrough: Behind the Scenes". Science | AAAS. Retrieved 2020-04-30.
  2. ↑ HIV transmission dynamics: Infectivity, sexual partnership patterns, and the role of early infection. 2010. OCLC   1105796778.
  3. 1 2 Powers, Kimberly A; Ghani, Azra C; Miller, William C; Hoffman, Irving F; Pettifor, Audrey E; Kamanga, Gift; Martinson, Francis EA; Cohen, Myron S (2011-07-16). "The role of acute and early HIV infection in the spread of HIV and implications for transmission prevention strategies in Lilongwe, Malawi: a modelling study". The Lancet. 378 (9787): 256–268. doi:10.1016/S0140-6736(11)60842-8. ISSN   0140-6736. PMC   3274419 . PMID   21684591.
  4. ↑ Powers, Kimberly; Miller, William. "Reaching Unaware Sexual and Social Contacts to Interrupt Ongoing HIV Transmission". Grantome.
  5. ↑ "Postdoc Awards for Research Excellence". UNC Research. Retrieved 2020-05-01.
  6. ↑ Powers, Kimberly A.; Kretzschmar, Mirjam E.; Miller, William C.; Cohen, Myron S. (2014-11-03). "Impact of early-stage HIV transmission on treatment as prevention". Proceedings of the National Academy of Sciences. 111 (45): 15867–15868. Bibcode:2014PNAS..11115867P. doi: 10.1073/pnas.1418496111 . ISSN   0027-8424. PMC   4234559 . PMID   25368195.
  7. ↑ "Prisons and Jails | The Center for HIV Law and Policy". www.hivlawandpolicy.org. Retrieved 2020-05-01.
  8. 1 2 3 Bonner, Lynn. "Coronavirus cases in North Carolina could swell into the thousands by early April". 2020-03-17.
  9. ↑ Wan, William; Johnson, Carolyn Y. (2020-04-06). "America's most influential coronavirus model just revised its estimates downward. But not every model agrees". Washington Post. Retrieved 2020-04-30.
  10. ↑ "NCDHHS: COVID-19 North Carolina Dashboard". www.ncdhhs.gov. Retrieved 2020-04-30.
  11. ↑ "KIMBERLY POWERS: How do we predict the future of COVID-19?". WRAL.com. 2020-04-13. Retrieved 2020-04-30.
  12. ↑ Powers, Kimberly A; Poole, Charles; Pettifor, Audrey E; Cohen, Myron S (2008-09-01). "Rethinking the heterosexual infectivity of HIV-1: a systematic review and meta-analysis". The Lancet Infectious Diseases. 8 (9): 553–563. doi:10.1016/S1473-3099(08)70156-7. ISSN   1473-3099. PMC   2744983 . PMID   18684670.
  13. ↑ Pilcher, Christopher D.; Joaki, George; Hoffman, Irving F.; Martinson, Francis E.A.; Mapanje, Clement; Stewart, Paul W.; Powers, Kimberly A.; Galvin, Shannon; Chilongozi, David; Gama, Syze; Price, Matthew A. (2007-08-20). "Amplified transmission of HIV-1: comparison of HIV-1 concentrations in semen and blood during acute and chronic infection". AIDS (London, England). 21 (13): 1723–1730. doi:10.1097/QAD.0b013e3281532c82. ISSN   0269-9370. PMC   2673564 . PMID   17690570.
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