By Tony Kirby
"The last person that I train, I want that training to be in something other than HIV", says Jared Baeten. Speaking to The Lancet Infectious Diseases from the HIV Research for Prevention Conference (HIVR4P) in Chicago, IL, where he brought a 12-strong team of his researchers, Baeten explains: “When that time comes, I want HIV to have been eliminated as public health threat, so we can focus on other diseases”.
This is not to say Baeten has not enjoyed his career battling the HIV epidemic. Like many in this field, he has seen many tragedies and also celebrated many victories over his 20 year career. Today, he is vice chair in global health and a professor in global health, allergy and infectious diseases, and epidemiology at the University of Washington.
Raised in Green Bay, Wisconsin, Baeten completed medical school at UW, now an epicentre of research in HIV and global health. He studied public health and infectious diseases at graduate school, which back then was a rare choice. Later, he ran a clinic and HIV research centre for women in Mombasa, Kenya, and was among the first doctors there offering voluntary HIV testing for women. “While the early antiretroviral treatments were not available in Kenya, knowing your status enabled families to plan for their future”, he explains.
Having finished additional medical training in Boston, Baeten returned to Seattle in 2006 where he has been based ever since. His career has been all about HIV prevention. “It’s a tremendously powerful motivation to work on projects that will stop people becoming infected”, he says. He prescribed early treatment (to patients with CD4 cell counts above the threshold for treatment) before treatment as prevention was standard, and has been involved in some of the most high profile trials in prevention. In the Partners Pre-exposure Prophylaxis Study (the Partners PrEP Study), HIV PrEP drugs were given to the HIV-negative partner in more than 4000 HIV discordant couples in Uganda and Kenya, with the results showing a staggering reduction of 90% in transmission among those who were regimen adherent. “There were so many questions to be answered - would this work? Would it be safe? Was it ok to give people a drug for something they may never get?” recalls Baeten. But he also remembers vividly the call from the trial’s Data Safety and Monitoring Board, telling his team the trial must be stopped as there had been a huge drop in the rate in new infections in the PrEP group and it was no longer ethical to continue without giving all couples PrEP. “PrEP is a huge revolution for HIV. It changes what HIV prevention and care are all about and tells us where we can make investments to stop the epidemic. It is empowering and anxiety lifting for those most at risk, including couples, women in Africa and men who have sex with men worldwide”, he says. Recently, Baeten co-led the ASPIRE trial, which found a vaginal ring containing PrEP (dapivirine) could prevent HIV in women in Malawi, South Africa, Uganda, and Zimbabwe—some of the countries hardest hit by the epidemic. “There are no magic bullets in HIV prevention”, he says, “but we now have incredibly powerful tools and I am hopeful for a future where multiple prevention options are available and individuals can choose the best method for them to avoid infection—much as women worldwide currently chose their most suitable contraceptive method”.
He adds: "One thing that is vitally important to me, and I think to all who work in HIV research, is deep, longstanding and mutually beneficial collaboration", says Baeten. "Big questions can be answered, and big impact made, only through a team effort - bringing together institutions, disciplines, sectors, and cultures. That's what successful global health is all about."
"Jared has infused not only his research but the entire field with an infectious enthusiasm to translate great science into people's lives", says Mitchell Warren, executive director of the HIV prevention advocacy organization AVAC in New York City, NY. "His landmark scientific achievements, especially in recent PrEP trials, have been matched by his incredible patience with - and great delight in - talking with trial participants, advocates, and community members about what it all means."
Outside work, Baeten and his husband Mark Ruffo have their hands full raising a young daughter, while trying to make the most of the travelling opportunities connected with their multiple global commitments. "I have had the pleasure - and fun - of working with Jared Baeten for about 15 years, during which his work has focused on HIV prevention among young women and their partners, and the interface between sexual and reproductive health and HIV", says Helen Rees, executive director of the University of Witwatersrand, Johannesburg, South Africa. "Having a new generation of committed leaders such as Jared is critically important if we are going to reduce new infections and successfully tackle the HIV epidemic."
This profile originally appeared in The Lancet Infectious Diseases Journal, Volume 17, No. 1.