"Demographers have noted that the South is one of the regions that have seen the most rapid influx of Latino workers," Marisa Trevio, who writes the blog "Latina Lista," writes in a USA Today opinion piece. She adds, "So with a steady influx of Latinos, and a growing number of them contracting HIV/AIDS, why aren't states making inroads via aggressive public awareness campaigns in attacking this preventable and treatable disease?"
According to Trevio, a recent study from the Latino Commission on AIDS "found that HIV/AIDS cases are rising at alarming rates among the two million Latinos in Alabama, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee." She adds, "Prevention education isn't keeping pace." Trevio writes that public awareness efforts likely are not having much effect among Hispanics because the "targets of these messages -- which include legal and undocumented workers -- don't trust the messenger." A report from Progressive States Network found that "every state identified by the study, with the exception of Alabama, has passed policies criminalizing undocumented immigration," according to Trevio. "These laws intimidate people from seeking any assistance," she writes, adding, "For example, South Carolina passed a series of laws that include establishing a hotline to report suspected nonresidents and making it a crime to transport or harbor undocumented immigrants." The report found that as a "result of this anti-immigrant climate and the high rate of people without health insurance," many HIV-positive Hispanics do not "seek medical attention until they are in its late stages," Trevio writes.
However, some "states are trying to confront this crisis," according to Trevio, who adds that North Carolina in October "conducted a bilingual campaign to encourage people to get tested. Even so, the report found that these states didn't have enough bilingual professionals to address the crisis." Trevio writes that the study "made several recommendations, all rooted in communication. Whether it's utilizing more Spanish-language media to market prevention programs, training more people to speak Spanish, partnering with Latino organizations to replicate their successful programs or connecting with Hispanic religious and community leaders, it all comes down to opening lines of communication to a population that has been forced to stay in the shadows of society." She concludes, "For their health and for the health of the country, these Latinos must come forward -- and the sooner the better" (Trevio, USA Today, 12/19).
Visit www.aids-drugs-online.com for treatment options
Saturday, December 27, 2008
South Carolina Medicaid Cuts $61 Million in Services, Ends Enrollment in HIV/AIDS
South Carolina's Medicaid agency will stop enrolling people living with HIV as part of a $61 million round of budget cuts, officials announced on Wednesday, the AP/Charlotte Observer reports. According to the AP/Observer, no longer enrolling HIV-positive people will save the agency $40,000. Some health care advocates argue the budget cuts mean that many people will become even sicker when left without care, leading to more costly emergency department visits "or worse," the AP/Observer reports. Carmen Julious, executive director of Palmetto AIDS Life Support Services in Columbia, said the Medicaid HIV/AIDS program provides "lifesaving medications," adding, "Compared to people's lives, that ($40,000) doesn't seem like a good balance to me." Sue Berkowitz, executive director of the low-income advocacy group South Carolina Appleseed Legal Justice Center, said that people "are going to die" because of the budget cuts.
The AP/Observer reports that other budget cuts include ending hospice care for Medicaid-only patients; decreasing the amount of assistance for prescription drug costs for low-income, elderly populations; reducing home health nurse visits from 75 to 50 per year; and reducing assistance to hospitals and nursing homes. The Medicaid program has lost $137 million since July while state spending has been reduced by $1 billion because of the economic situation and faltering tax collections (Davenport, AP/Charlotte Observer, 12/17). The Columbia State reports that the $61 million in state budget cuts will result in the loss of $398 million in federal matching funds. Jeff Stensland, a spokesperson with the state health department, said the budget cuts will affect patients but not essential care, adding that a proposed federal aid package for states could help fund some of the programs that will be eliminated or reduced (O'Connor, Columbia State, 12/18). Stensland also said that the department is "not happy about having to do any of these" cuts and that an increase in the demand for the state's Medicaid program is "just around the corner" because of the economic situation (AP/Charlotte Observer, 12/17).
The AP/Observer reports that other budget cuts include ending hospice care for Medicaid-only patients; decreasing the amount of assistance for prescription drug costs for low-income, elderly populations; reducing home health nurse visits from 75 to 50 per year; and reducing assistance to hospitals and nursing homes. The Medicaid program has lost $137 million since July while state spending has been reduced by $1 billion because of the economic situation and faltering tax collections (Davenport, AP/Charlotte Observer, 12/17). The Columbia State reports that the $61 million in state budget cuts will result in the loss of $398 million in federal matching funds. Jeff Stensland, a spokesperson with the state health department, said the budget cuts will affect patients but not essential care, adding that a proposed federal aid package for states could help fund some of the programs that will be eliminated or reduced (O'Connor, Columbia State, 12/18). Stensland also said that the department is "not happy about having to do any of these" cuts and that an increase in the demand for the state's Medicaid program is "just around the corner" because of the economic situation (AP/Charlotte Observer, 12/17).
Medicare Part D and Ryan White
"Ryan White Care Act: First-Year Experiences Under the Part D Administrative Expense Cap" (.pdf), Government Accountability Office: The report was conducted to examine the effect of the Ryan White HIV/AIDS Treatment and Modernization Act of 2006, which took effect in fiscal year 2007 and capped the amount of money that Part D grantees could spend on administrative services at 10%. In response to the GAO survey, 83 grantees reported that they provide a variety of medical and support services to clients, with the majority saying that they have not made changes in response to the cap. The majority of the respondents said that the cap has not affected services they provide. Four respondents reported increasing services and three reported reducing services because of the cap. The majority of grantees also said that the cap has had a negative impact on their Part D programs even if it has not affected services. For example, the cap has made it necessary for clinical staff to conduct administrative duties. About half of the grantees said that not all of their Part D administrative expenses were covered by the 10% allowance ("Ryan White Care Act: First-Year Experiences Under the Part D Administrative Expense Cap," Government Accountability Office, December 2008).
New Orleans Officials Should Ensure That 'Glitch' in Ryan White Process Will Not Create 'Problem' With 2009 Grants
"The grant process for agencies working with" HIV-positive people is "maddening," a New Orleans Times-Picayune editorial says. According to the editorial, it "took six months" for Mayor Ray Nagin's administration to "distribute $7 million in federal grant money this year," and the city's Office of Health Policy "received the money" from the Ryan White Program in March but did not "send out grant award notices to agencies until June." It adds that contracts were not "finalized until last month."
Following criticism from the City Council on the "slow-moving process," Health Policy Director Fran Lawless "promised that her office would do better with the next round of grants," the editorial says, adding, "Unfortunately, that hasn't been the case so far." According to the editorial, a "public notice published last week to launch the 2009 process included errors that forced the city to cancel the effort and push back its start." It adds, "Even the best operations can make the type of clerical errors in the failed notice. And there are points in the public notice process where things can occasionally go wrong." However, "these problems are worrisome considering the office's history of delays," the editorial says, adding that Nagin "needs to make sure the office's director and employees can efficiently accomplish this task or find some who can." Concerns from officials involved with the grant process "surely pal[e] in comparison with the anguish of more than 4,000 people with HIV/AIDS who get treatment and case management services from the entities that the grants fund," according to the editorial. It adds, "At least one of those agencies had to close during the summer because of the city's delays. That left hundreds of people without the help they need." The editorial concludes that city "officials promise that the glitch in the process won't cause a problem with the 2009 grants. They need to ensure that it doesn't" (New Orleans Times-Picayune, 12/22).
In the event that service disruptions affect your health care management plan, be sure to visit http://www.aids-drugs-online.com
Following criticism from the City Council on the "slow-moving process," Health Policy Director Fran Lawless "promised that her office would do better with the next round of grants," the editorial says, adding, "Unfortunately, that hasn't been the case so far." According to the editorial, a "public notice published last week to launch the 2009 process included errors that forced the city to cancel the effort and push back its start." It adds, "Even the best operations can make the type of clerical errors in the failed notice. And there are points in the public notice process where things can occasionally go wrong." However, "these problems are worrisome considering the office's history of delays," the editorial says, adding that Nagin "needs to make sure the office's director and employees can efficiently accomplish this task or find some who can." Concerns from officials involved with the grant process "surely pal[e] in comparison with the anguish of more than 4,000 people with HIV/AIDS who get treatment and case management services from the entities that the grants fund," according to the editorial. It adds, "At least one of those agencies had to close during the summer because of the city's delays. That left hundreds of people without the help they need." The editorial concludes that city "officials promise that the glitch in the process won't cause a problem with the 2009 grants. They need to ensure that it doesn't" (New Orleans Times-Picayune, 12/22).
In the event that service disruptions affect your health care management plan, be sure to visit http://www.aids-drugs-online.com
Thursday, December 18, 2008
Women More Susceptible to HIV/AIDS than Originally Thought
A new study has found that HIV appears to attack normal, healthy genital tissue in women and does not require breaks in the skin to infiltrate cells, offering new perspectives on how the virus is spread, researchers said on Tuesday, Reuters reports. Thomas Hope, a study author from Northwestern University's Feinberg School of Medicine, said that scientists have had little detailed understanding of how HIV is transmitted sexually in women and that it was "previously thought there had to be a break in [genital tissue] somehow" for women to contract the virus. He added that the study's findings show that "[n]ormal skin is vulnerable."
For the study, researchers in a partnership between Northwestern and Tulane University introduced HIV -- which carried fluorescent, light-activated tracers, a new method developed to better see how the virus worked -- to newly removed vaginal tissue taken from hysterectomy surgeries. A microscope was used to observe the virus as it penetrated the outer lining of the female genital tract -- also called the squamous epithelium -- and found that HIV was able to move quickly past the skin barrier to reach immune cells. The process also was observed in nonhuman primates, according to Reuters. In addition, the results of the study suggest that HIV focuses on areas of the genital tissue where skin cells recently had been shed, Hope said (Steenhuysen, Reuters, 12/16). Hope said the results are "an important and unexpected result -- we have a new understanding of how HIV can invade the female vaginal tract." He added, "We urgently need new prevention strategies or therapeutics to block the entry of HIV through a woman's genital skin" (BBC News, 12/17).
According to Reuters, researchers in the past have assumed that HIV sought out breaks in the skin -- like a herpes sore -- to gain access to immune system cells deeper in tissue, and some thought the normal lining of the vaginal tract could work as a barrier to transmission during sexual intercourse. Reuters reports that the study "casts doubt" on the theory that HIV transmission requires a break in the skin or that the virus gains access through the cervical canal's single layer of skin cells. The findings also "might explain why some prevention efforts" -- such as diaphragms or herpes treatment -- have "failed," Reuters reports (Reuters, 12/16).
Lisa Power from the Terrence Higgins Trust in the United Kingdom said the results are an "important finding" but "sadly, not surprising" because it has been "long known that it is easier for a man to transmit HIV sexually to a woman than for a woman to transmit it to a man." She added that the study "helps us understand why" and "will help in developing better prevention mechanisms -- but until then, it's more clear than ever that a condom is a vital part of safer sex." The British not-for-profit organization AVERT said that the study "serves to strengthen" the argument for condom use during heterosexual intercourse and "will hopefully give weight to the need for safer heterosexual sex to be advocated further by governments and practitioners worldwide" (BBC News, 12/17). According to Hope, the findings emphasize the importance of methods to prevent transmission, such as a vaccine and condom use. He said, "People need to remember that they are vulnerable. The sad part is if people just used a condom, we wouldn't have this problem" (Reuters, 12/16).
For the study, researchers in a partnership between Northwestern and Tulane University introduced HIV -- which carried fluorescent, light-activated tracers, a new method developed to better see how the virus worked -- to newly removed vaginal tissue taken from hysterectomy surgeries. A microscope was used to observe the virus as it penetrated the outer lining of the female genital tract -- also called the squamous epithelium -- and found that HIV was able to move quickly past the skin barrier to reach immune cells. The process also was observed in nonhuman primates, according to Reuters. In addition, the results of the study suggest that HIV focuses on areas of the genital tissue where skin cells recently had been shed, Hope said (Steenhuysen, Reuters, 12/16). Hope said the results are "an important and unexpected result -- we have a new understanding of how HIV can invade the female vaginal tract." He added, "We urgently need new prevention strategies or therapeutics to block the entry of HIV through a woman's genital skin" (BBC News, 12/17).
According to Reuters, researchers in the past have assumed that HIV sought out breaks in the skin -- like a herpes sore -- to gain access to immune system cells deeper in tissue, and some thought the normal lining of the vaginal tract could work as a barrier to transmission during sexual intercourse. Reuters reports that the study "casts doubt" on the theory that HIV transmission requires a break in the skin or that the virus gains access through the cervical canal's single layer of skin cells. The findings also "might explain why some prevention efforts" -- such as diaphragms or herpes treatment -- have "failed," Reuters reports (Reuters, 12/16).
Lisa Power from the Terrence Higgins Trust in the United Kingdom said the results are an "important finding" but "sadly, not surprising" because it has been "long known that it is easier for a man to transmit HIV sexually to a woman than for a woman to transmit it to a man." She added that the study "helps us understand why" and "will help in developing better prevention mechanisms -- but until then, it's more clear than ever that a condom is a vital part of safer sex." The British not-for-profit organization AVERT said that the study "serves to strengthen" the argument for condom use during heterosexual intercourse and "will hopefully give weight to the need for safer heterosexual sex to be advocated further by governments and practitioners worldwide" (BBC News, 12/17). According to Hope, the findings emphasize the importance of methods to prevent transmission, such as a vaccine and condom use. He said, "People need to remember that they are vulnerable. The sad part is if people just used a condom, we wouldn't have this problem" (Reuters, 12/16).
Two-Thirds of HIV-Positive Kenyan Children Do Not Have Access to Antiretroviral Treatment, Report Says
Although the Kenyan government runs a program to provide no-cost antiretroviral medication, about two-thirds of HIV-positive children in Kenya lack access to the drugs, according to a report released Tuesday by Human Rights Watch, Kenya's Daily Nation reports. According to the report, titled "A Question of Life or Death: Treatment Access for Children Living With HIV in Kenya," about 25,000 HIV-positive children in Kenya have access to antiretroviral medication but about 50,000 children under the country's HIV/AIDS care program lack treatment access. The report also states that 40,000 children likely will die in the next two years if they do not receive antiretroviral treatment. About half of all HIV-positive infants who do not receive treatment will die before reaching age two, the report said.
According to the report, many local health facilities do not test children for HIV or offer tham antiretroviral treatment. In addition, some medical staff "are often not trained to deal with HIV in children and there are too few community health workers to help children gain access to testing and treatment," the report said. Juliane Kippenberg, a senior researcher on Africa in HRW's Children's Rights Division, said that the Kenyan government has focused on providing treatment to adults living with HIV. Dorothy Ngacha, associate professor in the pediatric department of University of Nairobi's School of Medicine, added that another "barrier" to antiretroviral treatment access for children is a "lack of knowledge" about HIV status. Ngacha said there are "no concrete statistics" on the number of HIV-positive children in Kenya, only "mere estimates." According to Ngacha, the Kenya National AIDS/STD Control Program estimates that at least 60,000 children in Kenya need antiretroviral treatment. However, this number could be "considerably higher" when accounting for government guidelines that require all HIV-positive infants to receive treatment, the Daily Nation reports.
Kippenberg said that Kenya has taken a "step in the right direction" by expanding infant testing, "but the government needs to do much more to help children overcome treatment access barriers." According to Ngacha, Kenya's Ministry of Health Care and Medical Services plans to decentralize HIV/AIDS services to dispensary levels to allow more children to access treatment (Kumba/Mathenge, Daily Nation, 12/17). Ben Rawlence, HRW spokesperson, said cost should not be a factor in improving treatment access because antiretrovirals are "not that expensive." According to Rawlence, HIV/AIDS treatments "already exist" in Kenya, but the government must distribute the drugs, increase availability for children, train health workers and ensure that children attend clinics and follow-up appointments to guarantee treatment adherence. He added that partners such as the World Health Organization and the Clinton Foundation already provide support for HIV testing and treatment for Kenyan children (Lesser, VOA News, 12/17).
Online The report is available online.
According to the report, many local health facilities do not test children for HIV or offer tham antiretroviral treatment. In addition, some medical staff "are often not trained to deal with HIV in children and there are too few community health workers to help children gain access to testing and treatment," the report said. Juliane Kippenberg, a senior researcher on Africa in HRW's Children's Rights Division, said that the Kenyan government has focused on providing treatment to adults living with HIV. Dorothy Ngacha, associate professor in the pediatric department of University of Nairobi's School of Medicine, added that another "barrier" to antiretroviral treatment access for children is a "lack of knowledge" about HIV status. Ngacha said there are "no concrete statistics" on the number of HIV-positive children in Kenya, only "mere estimates." According to Ngacha, the Kenya National AIDS/STD Control Program estimates that at least 60,000 children in Kenya need antiretroviral treatment. However, this number could be "considerably higher" when accounting for government guidelines that require all HIV-positive infants to receive treatment, the Daily Nation reports.
Kippenberg said that Kenya has taken a "step in the right direction" by expanding infant testing, "but the government needs to do much more to help children overcome treatment access barriers." According to Ngacha, Kenya's Ministry of Health Care and Medical Services plans to decentralize HIV/AIDS services to dispensary levels to allow more children to access treatment (Kumba/Mathenge, Daily Nation, 12/17). Ben Rawlence, HRW spokesperson, said cost should not be a factor in improving treatment access because antiretrovirals are "not that expensive." According to Rawlence, HIV/AIDS treatments "already exist" in Kenya, but the government must distribute the drugs, increase availability for children, train health workers and ensure that children attend clinics and follow-up appointments to guarantee treatment adherence. He added that partners such as the World Health Organization and the Clinton Foundation already provide support for HIV testing and treatment for Kenyan children (Lesser, VOA News, 12/17).
Online The report is available online.
Ryan White Funding Delays
Errors in a public notice last week in New Orleans have forced city officials to delay the start of the 2009 process for distributing an expected $5 million in Ryan White Program funding for local HIV/AIDS agencies, the New Orleans Times-Picayune reports. The announcement of the delay comes after Fran Lawless -- who serves as director of Mayor Ray Nagin's Office of Health Care Policy -- in October testified before the city council's Housing and Human Needs Committee that 2008 funding distribution was delayed by six months and that service providers went without funding from March to October.
According to the Times-Picayune, City Council member Arnie Fielkow called on officials to begin the application process for 2009 earlier in the year. In an effort to meet this request, officials listed a public request for proposals in the Times-Picayune on Dec. 8, 9 and 10, which set the deadline for picking up applications as Dec. 5 -- a date that had already past. The deadline for submission also was listed incorrectly in the electronic notice sent directly to the service providers, which left many of them confused, according to the Times-Picayune. Carlos Butler -- Health Policy office manager and the contact who was listed in the public notice -- said that the request for proposals was canceled and referred questions to Lawless and a Nagin spokesperson, who did not respond to requests for comment, the Times-Picayune reports.
Several agencies that receive funding to provide assistance to more than 4,000 people living with HIV/AIDS in the city complained in October that they would be unable to operate if their funding continued to face delays as it had in 2008, according to the Times-Picayune. Doug Morgan, who administers Ryan White Program funding for the federal Health Resources and Service Administration, said, "Our hope is that some of the issues they faced in [2008] will not be repeated in [2009]." He added, "I'm unhappy to learn the initial draft of the (requests for proposal) had glitches in it. It sounds like they're close to repeating some of the timelines they had last year, and that makes me a little nervous."
A new notice appeared Tuesday in the Times-Picayune and the deadline for submitting requests was listed as Jan. 9. The notice also will appear Wednesday and Thursday in the newspaper. Dave Munroe of In This Together -- a not-for-profit agency serving 225 patients that was forced to shut down over the summer because of the delay in funding and reopened in October -- said that the agency will not apply for 2009 funding because of "continuing issues of truthfulness, transparency and professionalism" at the city level (Hammer, New Orleans Times-Picayune, 12/17).
In the event that funding runs out, and you require alternatives, please visit www.aids-drugs-online.com
According to the Times-Picayune, City Council member Arnie Fielkow called on officials to begin the application process for 2009 earlier in the year. In an effort to meet this request, officials listed a public request for proposals in the Times-Picayune on Dec. 8, 9 and 10, which set the deadline for picking up applications as Dec. 5 -- a date that had already past. The deadline for submission also was listed incorrectly in the electronic notice sent directly to the service providers, which left many of them confused, according to the Times-Picayune. Carlos Butler -- Health Policy office manager and the contact who was listed in the public notice -- said that the request for proposals was canceled and referred questions to Lawless and a Nagin spokesperson, who did not respond to requests for comment, the Times-Picayune reports.
Several agencies that receive funding to provide assistance to more than 4,000 people living with HIV/AIDS in the city complained in October that they would be unable to operate if their funding continued to face delays as it had in 2008, according to the Times-Picayune. Doug Morgan, who administers Ryan White Program funding for the federal Health Resources and Service Administration, said, "Our hope is that some of the issues they faced in [2008] will not be repeated in [2009]." He added, "I'm unhappy to learn the initial draft of the (requests for proposal) had glitches in it. It sounds like they're close to repeating some of the timelines they had last year, and that makes me a little nervous."
A new notice appeared Tuesday in the Times-Picayune and the deadline for submitting requests was listed as Jan. 9. The notice also will appear Wednesday and Thursday in the newspaper. Dave Munroe of In This Together -- a not-for-profit agency serving 225 patients that was forced to shut down over the summer because of the delay in funding and reopened in October -- said that the agency will not apply for 2009 funding because of "continuing issues of truthfulness, transparency and professionalism" at the city level (Hammer, New Orleans Times-Picayune, 12/17).
In the event that funding runs out, and you require alternatives, please visit www.aids-drugs-online.com
Government of Indonesian Province Rejects Plan To Implant Microchips in Some HIV-Positive People
The parliament in the Indonesian province of Papua has rejected plans to implant microchips in some HIV-positive people following opposition from government officials, health care workers and advocates, the AP/Google.com reports. According to lawmaker Weinard Watori, the parliament on Tuesday agreed to drop a section of the health bill currently under consideration that would have called for the tagging of some HIV-positive people with computer chips inserted under the skin (Karmini, AP/Google.com, 12/16).
The HIV/AIDS Handling bylaw would have allowed the implantation of microchips in "sexually aggressive" people living with HIV/AIDS, the Jakarta Post reports. According to Komarudin Watubun, deputy legislative council speaker, Papua's provincial legislative council earlier this week did not endorse the bylaw because the "legislative and executive branches had different perceptions on the use of microchips" for HIV-positive people. Komarudin added that the executive branch viewed the bylaw as violating human rights, while the legislative councilors saw it as "an effort to build awareness within society" (Somba, Jakarta Post, 12/16).
The AP/Yahoo! News reports that there had been strong opposition to the bylaw -- including from Papua's Vice Governor Alex Hasegem, who called the plan a "violation of human rights" -- as well as from health workers and advocates, some of whom called the bylaw "abhorrent." They added that sex education and increased condom use are the best ways to curb the spread of HIV in Papua (Karmini, AP/Yahoo! News, 12/16). Hasegem said that the plan to implant microchips into people living with HIV/AIDS was not "in accordance" with the "principles" that should be applied to addressing HIV-positive populations, adding that implanting microchips is a "form of stigmatizing" (Jakarta Post, 12/16). Papua's parliament is scheduled to conclude discussion of other issues in the health bill, including efforts to curb the spread of HIV, by the end of the week, according to Watori (AP/Google.com, 12/16).
The HIV/AIDS Handling bylaw would have allowed the implantation of microchips in "sexually aggressive" people living with HIV/AIDS, the Jakarta Post reports. According to Komarudin Watubun, deputy legislative council speaker, Papua's provincial legislative council earlier this week did not endorse the bylaw because the "legislative and executive branches had different perceptions on the use of microchips" for HIV-positive people. Komarudin added that the executive branch viewed the bylaw as violating human rights, while the legislative councilors saw it as "an effort to build awareness within society" (Somba, Jakarta Post, 12/16).
The AP/Yahoo! News reports that there had been strong opposition to the bylaw -- including from Papua's Vice Governor Alex Hasegem, who called the plan a "violation of human rights" -- as well as from health workers and advocates, some of whom called the bylaw "abhorrent." They added that sex education and increased condom use are the best ways to curb the spread of HIV in Papua (Karmini, AP/Yahoo! News, 12/16). Hasegem said that the plan to implant microchips into people living with HIV/AIDS was not "in accordance" with the "principles" that should be applied to addressing HIV-positive populations, adding that implanting microchips is a "form of stigmatizing" (Jakarta Post, 12/16). Papua's parliament is scheduled to conclude discussion of other issues in the health bill, including efforts to curb the spread of HIV, by the end of the week, according to Watori (AP/Google.com, 12/16).
Violence Against Women Contributes to Spread of HIV in Ghana
Violence against women in northern Ghana increases their vulnerability to HIV/AIDS, according to a study recently released by ActionAID Ghana, Public Agenda reports. For the study -- titled "Violence and HIV/AIDS: The Interface, Voices of Women in Northern Ghana" -- researchers led by Yaa Peprah Agyemang Amekudzi examined the association between violence against women and HIV/AIDS in six districts of northern Ghana. According to the report, HIV transmission sometimes can occur as a result of sexual violence. In addition, "Fear of violence prevents women from negotiating safe sex," Amekudzi said, adding that HIV-positive women often face additional stigma and violence, sometimes leading them to pursue commercial sex work. According to Amekudzi, violence against women and HIV can negatively impact social, economic and political development because it affects women as caregivers and financial supporters of their families. According to Public Agenda, of the approximately 33 million HIV-positive people worldwide in 2007, 15.4 million were women.
According to the report, violence against women can occur as a result of misinformation and misinterpretation of religious and cultural practices. In addition, "Poverty and lack of formal education were also identified as being used to perpetuate violence against women," Amekudzi said. The study determined that current HIV efforts are insufficient to stem the high HIV prevalence among girls and women in Northern Ghana, adding that female condom use is minimal in three northern regions because women do not make decisions about their use. The study recommends that the government provide housing and services for survivors of violence and people living with HIV/AIDS, and that religious groups support these populations. The report adds that indicators should be used to track awareness levels about HIV and domestic violence. Adwoa Kwateng-Kluvitse, country director of ActionAID, said that power dynamics must be addressed before Ghana can reduce domestic violence and HIV prevalence. She added that the organization is "working on building and strengthening the voice" of HIV-positive people with an aim "to increase their access to information and skills, especially the vulnerable ones" (Amankwah, Public Agenda, 12/15).
According to the report, violence against women can occur as a result of misinformation and misinterpretation of religious and cultural practices. In addition, "Poverty and lack of formal education were also identified as being used to perpetuate violence against women," Amekudzi said. The study determined that current HIV efforts are insufficient to stem the high HIV prevalence among girls and women in Northern Ghana, adding that female condom use is minimal in three northern regions because women do not make decisions about their use. The study recommends that the government provide housing and services for survivors of violence and people living with HIV/AIDS, and that religious groups support these populations. The report adds that indicators should be used to track awareness levels about HIV and domestic violence. Adwoa Kwateng-Kluvitse, country director of ActionAID, said that power dynamics must be addressed before Ghana can reduce domestic violence and HIV prevalence. She added that the organization is "working on building and strengthening the voice" of HIV-positive people with an aim "to increase their access to information and skills, especially the vulnerable ones" (Amankwah, Public Agenda, 12/15).
Needle-Exchange Programs 'Save' Lives, Money
The "simple truth about needle-exchange programs is that they save lives and save money," a San Antonio Express-News editorial says. It continues, "Numerous research studies and practical experience with such programs around the nation demonstrate the savings," adding, "The same studies and practical experience also refute the primary rationale for opposing needle-exchange programs -- the notion that they increase" injection drug use.
This notion was the "buzz saw advocates of safe, cost-effective needle-exchange ran into during the last legislative session" in Texas, according to the editorial. However, the "same bipartisan group of lawmakers who pushed the legislation" allowing for the establishment of needle-exchange programs in the state "plans to reintroduce similar measures in the upcoming session," it says, adding that there "can be little doubt that given the opportunity for floor votes in the Senate and House, Texas will join the 49 other states in making needle-exchange programs legal."
"Along with protecting law enforcement and health care workers who frequently come into physical contact with the [IDU] community, the case for needle change is overwhelming," the editorial says, concluding, "This time, a measure that saves lives and taxpayer dollars deserves a simple up or down vote in the Legislature" (San Antonio Express-News, 12/14).
This notion was the "buzz saw advocates of safe, cost-effective needle-exchange ran into during the last legislative session" in Texas, according to the editorial. However, the "same bipartisan group of lawmakers who pushed the legislation" allowing for the establishment of needle-exchange programs in the state "plans to reintroduce similar measures in the upcoming session," it says, adding that there "can be little doubt that given the opportunity for floor votes in the Senate and House, Texas will join the 49 other states in making needle-exchange programs legal."
"Along with protecting law enforcement and health care workers who frequently come into physical contact with the [IDU] community, the case for needle change is overwhelming," the editorial says, concluding, "This time, a measure that saves lives and taxpayer dollars deserves a simple up or down vote in the Legislature" (San Antonio Express-News, 12/14).
HIV/AIDS Envoy Calls on Caribbean Governments To Decriminalize Homosexuality
George Alleyne, the United Nations special envoy for HIV/AIDS in the Caribbean, on Thursday said that Caribbean countries should repeal laws that criminalize same-sex contact, EFE/Latin American Herald Tribune reports. "I believe that the existence of these laws contribute to infected and potentially infected men not coming forward to be tested, and I believe and I will propose that such laws be revised," Alleyne said at a multifaith meeting in Georgetown, Guyana. He also called for a "civil discourse" between the religious community and policymakers on the public health and moral aspects of criminalizing same-sex contact. According to Alleyne, "rampant homophobia" is one of the "most egregious manifestations of stigma and discrimination." In addition, he said that few officials in the Caribbean have the courage to call for the repeal of such laws.
Rudolph Cummings, program manager for Health Sector Development at the Caribbean Community, said at a later news conference that most people in the region continue to reject homosexuality. "It's a political mine-field fraught with a lot of difficulties for the regional governments at this particular juncture and time," he said, adding, "While we have made certain types of social advances in the region, this is an area where many governments have indicated that their citizens are not quite at a position where they can endorse some of the kinds of broad-based legislation which has been endorsed in Europe and other places." According to Cummings, "painstaking work" is needed to guarantee that vulnerable groups -- such as commercial sex workers and men who have sex with men -- are reached through Caricom's HIV/AIDS programs (EFE/Latin American Herald Tribune, 12/11).
Rudolph Cummings, program manager for Health Sector Development at the Caribbean Community, said at a later news conference that most people in the region continue to reject homosexuality. "It's a political mine-field fraught with a lot of difficulties for the regional governments at this particular juncture and time," he said, adding, "While we have made certain types of social advances in the region, this is an area where many governments have indicated that their citizens are not quite at a position where they can endorse some of the kinds of broad-based legislation which has been endorsed in Europe and other places." According to Cummings, "painstaking work" is needed to guarantee that vulnerable groups -- such as commercial sex workers and men who have sex with men -- are reached through Caricom's HIV/AIDS programs (EFE/Latin American Herald Tribune, 12/11).
Experimental Treatment Lengthens Lifespan of Monkeys With Simian Version of HIV
Macaque monkeys with simian immunodeficiency virus -- the simian equivalent of HIV -- that received a single dose of an experimental treatment survived nearly twice as long as monkeys who did not receive the drug, according to a study published Wednesday in the journal Nature, BBC News reports. Immunodeficiency viruses typically function by signaling the body to suppress immune responses; however, the new treatment blocks this signaling system and thus boosts immune cell function, according to BBC News.
For the study, researchers injected a blocking antibody into nine monkeys who had developed AIDS from SIV. The study found that monkeys who received the experimental treatment survived an average of two times longer than monkeys who did not receive the drug. In addition, the treated monkeys showed evidence of more active immune systems and reduced viral loads, both indicators that the experimental treatment helped control SIV more efficiently. Although the treatment did not fully suppress SIV for any of the monkeys, the researchers said the treatment might prove more successful when administered in multiple doses or in conjunction with antiretroviral treatment.
Rama Amara of the Emory University Vaccine Center, who led the study, said that it is "important to note" that the experimental treatment "was effective without antiretroviral drugs and in monkeys with severe AIDS." She added that stimulating protective immune responses is "critical" to the development of a "successful immune therapy to control" HIV/AIDS. Thomas Lehner, an immunologist from King's College London, called the study's findings "very interesting," adding that although the "safety of the drug is a concern," the treatment potentially could be modified for treating HIV-positive humans. Lehner added that multiple doses of the treatment could suppress the virus, "although the present experiment has not shown that." Ade Fakoya of the International HIV/AIDS Alliance said that although the study is "an important avenue" to pursue, there could be a "long process of many years" before SIV research could be applied to humans "on a large enough scale for it to be another useful tool in HIV treatments" (BBC News, 12/10).
Online An abstract of the study is available online.
For the study, researchers injected a blocking antibody into nine monkeys who had developed AIDS from SIV. The study found that monkeys who received the experimental treatment survived an average of two times longer than monkeys who did not receive the drug. In addition, the treated monkeys showed evidence of more active immune systems and reduced viral loads, both indicators that the experimental treatment helped control SIV more efficiently. Although the treatment did not fully suppress SIV for any of the monkeys, the researchers said the treatment might prove more successful when administered in multiple doses or in conjunction with antiretroviral treatment.
Rama Amara of the Emory University Vaccine Center, who led the study, said that it is "important to note" that the experimental treatment "was effective without antiretroviral drugs and in monkeys with severe AIDS." She added that stimulating protective immune responses is "critical" to the development of a "successful immune therapy to control" HIV/AIDS. Thomas Lehner, an immunologist from King's College London, called the study's findings "very interesting," adding that although the "safety of the drug is a concern," the treatment potentially could be modified for treating HIV-positive humans. Lehner added that multiple doses of the treatment could suppress the virus, "although the present experiment has not shown that." Ade Fakoya of the International HIV/AIDS Alliance said that although the study is "an important avenue" to pursue, there could be a "long process of many years" before SIV research could be applied to humans "on a large enough scale for it to be another useful tool in HIV treatments" (BBC News, 12/10).
Online An abstract of the study is available online.
Saturday, December 06, 2008
Microchips for Poz People?
Indonesia's National AIDS Commission last week said a provision that would require some people living with HIV/AIDS to be implanted with microchips in the province of Papua is unworkable and a violation of human rights, Reuters India reports. "We reject this bylaw because it is against human rights and technically cannot be done," Nafsiah Mboi, secretary of the commission, said, adding, "How can someone know if a person is having sex or jumping and dancing?" (Reuters India, 11/27).
The provision would require "sexually aggressive" people living with HIV/AIDS to be implanted with microchips. According to John Manangsang, a lawmaker who supports the bill, authorities would be able to identify, track and punish people living with HIV/AIDS in the country's province of Papua who intentionally spread the virus with a $5,000 fine or up to six months in jail. Manangsang said, "Aggressive means actively seeking sexual intercourse." Under the provision, a committee would be created to establish which HIV-positive people should be implanted with microchips and to monitor their behavior. The technical and practical details of the bill are still being decided by lawmakers. The provincial parliament of Papua has given its full support to the measure, which will be enacted next month if it receives the expected majority vote (Kaiser Daily HIV/AIDS Report, 11/25). Manangsang on Thursday said that the bylaw initially would only establish a Papua HIV/AIDS center to determine whether the microchip idea is feasible. Mboi said that the central government cannot stop the bylaw but that it is attempting to negotiate with lawmakers to drop articles that violate human rights. She added that said Papua's governor could refuse to sign the bylaw (Reuters India, 11/27).
In related news, the Indonesian Network of People Living with HIV/AIDS in Papua recently said that it will consider accepting the provision if lawmakers supporting it agree to undergo HIV tests and be similarly implanted with microchips if they are found to be HIV-positive. "If it is the best solution for Papua, we will accept it on one condition," Enita Rouw, a representative for the network, said, adding, "We will agree to be implanted with the chips once all of the council members agree to undergo HIV/AIDS tests as demanded by the bylaw." Rouw added that all authorities in Papua should be tested for HIV and that the results should be published to ensure that any human rights violations associated with the provision are dealt out equally (Flassy/Suherdjoko, Jakarta Post, 11/28).
Online AFP/Google.com on Saturday examined the spread of HIV/AIDS in Papua.
The provision would require "sexually aggressive" people living with HIV/AIDS to be implanted with microchips. According to John Manangsang, a lawmaker who supports the bill, authorities would be able to identify, track and punish people living with HIV/AIDS in the country's province of Papua who intentionally spread the virus with a $5,000 fine or up to six months in jail. Manangsang said, "Aggressive means actively seeking sexual intercourse." Under the provision, a committee would be created to establish which HIV-positive people should be implanted with microchips and to monitor their behavior. The technical and practical details of the bill are still being decided by lawmakers. The provincial parliament of Papua has given its full support to the measure, which will be enacted next month if it receives the expected majority vote (Kaiser Daily HIV/AIDS Report, 11/25). Manangsang on Thursday said that the bylaw initially would only establish a Papua HIV/AIDS center to determine whether the microchip idea is feasible. Mboi said that the central government cannot stop the bylaw but that it is attempting to negotiate with lawmakers to drop articles that violate human rights. She added that said Papua's governor could refuse to sign the bylaw (Reuters India, 11/27).
In related news, the Indonesian Network of People Living with HIV/AIDS in Papua recently said that it will consider accepting the provision if lawmakers supporting it agree to undergo HIV tests and be similarly implanted with microchips if they are found to be HIV-positive. "If it is the best solution for Papua, we will accept it on one condition," Enita Rouw, a representative for the network, said, adding, "We will agree to be implanted with the chips once all of the council members agree to undergo HIV/AIDS tests as demanded by the bylaw." Rouw added that all authorities in Papua should be tested for HIV and that the results should be published to ensure that any human rights violations associated with the provision are dealt out equally (Flassy/Suherdjoko, Jakarta Post, 11/28).
Online AFP/Google.com on Saturday examined the spread of HIV/AIDS in Papua.
Poor Grades for Developed Nations
Although wealthy countries might be better equipped to provide antiretroviral treatment to HIV-positive people than some developing nations, wealthy nations often are less effective at collecting the data necessary to understand and curb HIV/AIDS, according to a study released last week by AIDS Accountability International, the Financial Times reports. In this first attempt to assess countries' compliance with commitments they made at the United Nations in 2001 and 2006 to ramp up their response to HIV/AIDS, the score card highlights that many high-income nations -- including most European countries and the U.S. -- are "worse at monitoring and/or reporting on the fundamentals of their epidemics and their responses" than their low-income counterparts. In addition, AAI found that although developed countries insisted on monitoring and reporting when they provided funding for antiretroviral treatment in the developing world, they failed to meet the same standards at home (Jack, Financial Times, 11/25).
The U.S., along with countries such as North Korea and Saudi Arabia, received an "E" on the score card, which is one step above the lowest grade possible, Bloomberg reports. AAI said the main reason for the score was the lack of information provided to UNAIDS. According to Bloomberg, the absence of data from the U.S. and other developed countries -- including Denmark, Ireland and Italy -- makes it difficult to determine which governments are having success against the disease and why others are not. Per Strand, AAI's scientific director, said, "Reporting may be poor for a number of reasons, and there may be, if I may say, a certain amount of arrogance from rich countries." Strand added, "It is clear that in some cases the reporting does not reflect the response." Officials from HHS did not immediately return calls for comment, Bloomberg reports.
According to Bloomberg, countries including Mexico and Tajikistan received "A" grades from AAI, indicating they reported on measures such as financial resources allocated to HIV prevention and treatment; engagement of nongovernmental organizations; human rights protections for people affected by HIV/AIDS; and coordination of efforts (Lauerman, Bloomberg, 11/25).
According to the Times, AAI said that the current data made available are inadequate to assess international progress, and it called for auditing to ensure that data provided by national governments on their HIV/AIDS policies are independently validated. AAI also said that the existing 25 indicators recommended by the United Nations are "necessary but insufficient" because they fail to monitor issues such as the quality of implementation of policy. This creates "major obstacles to holding governments accountable," according to the report (Financial Times, 11/25).
The U.S., along with countries such as North Korea and Saudi Arabia, received an "E" on the score card, which is one step above the lowest grade possible, Bloomberg reports. AAI said the main reason for the score was the lack of information provided to UNAIDS. According to Bloomberg, the absence of data from the U.S. and other developed countries -- including Denmark, Ireland and Italy -- makes it difficult to determine which governments are having success against the disease and why others are not. Per Strand, AAI's scientific director, said, "Reporting may be poor for a number of reasons, and there may be, if I may say, a certain amount of arrogance from rich countries." Strand added, "It is clear that in some cases the reporting does not reflect the response." Officials from HHS did not immediately return calls for comment, Bloomberg reports.
According to Bloomberg, countries including Mexico and Tajikistan received "A" grades from AAI, indicating they reported on measures such as financial resources allocated to HIV prevention and treatment; engagement of nongovernmental organizations; human rights protections for people affected by HIV/AIDS; and coordination of efforts (Lauerman, Bloomberg, 11/25).
According to the Times, AAI said that the current data made available are inadequate to assess international progress, and it called for auditing to ensure that data provided by national governments on their HIV/AIDS policies are independently validated. AAI also said that the existing 25 indicators recommended by the United Nations are "necessary but insufficient" because they fail to monitor issues such as the quality of implementation of policy. This creates "major obstacles to holding governments accountable," according to the report (Financial Times, 11/25).
AIDS Cases in Asia Could Reach 10 Million by 2010
The number of HIV/AIDS cases in Asia could reach 10 million by 2010 -- more than double current estimates -- unless countries take increased action to curb the spread of the disease, health officials said on Friday at the launch of an online database on HIV/AIDS in the Asia-Pacific region, AFP/Google.com reports. The database -- available at aidsdatahub.org -- includes information on HIV/AIDS prevalence, risky behaviors and government responses in various Asian countries and regions within certain countries (AFP/Google.com, 11/28). It was launched by officials from UNICEF, UNAIDS, the World Health Organization and the Asian Development Bank in Manila, the Philippines (Xinhuanet, 11/28).
According to the officials, there could be 500,000 new HIV/AIDS cases annually unless countries take increased action against the disease. In addition, Amala Reddy of UNAIDS said that about 50 million women in the region are at risk of the disease because of the behaviors of their husbands and partners. Reddy added that HIV/AIDS prevalence in Asia likely would reach 3% to 5% at most and is still concentrated among groups such as commercial sex workers, injection drug users and men who have sex with men. In addition, an estimated 75 million men in the region frequent sex workers, who number about 10 million, Reddy said, adding that there are 20 million IDUs and MSM in Asia. ABD Special Advisor Ian Anderson said that HIV/AIDS could have a serious effect on the region because many people living with the disease are in their economically productive years. "Because it is relatively small, this is the time to keep it small," he said, adding, "So we won't have to put the genie back in the bottle later."
In some Asian countries, such men may continue to have sex with their wives and other women, Reddy added (AFP/Google.com, 11/28). WHO Regional Advisor on HIV/AIDS Massimo Ghidinelli said WHO cannot determine a "fully accurate picture" on how MSM are contributing to the spread of HIV/AIDS because of the sensitivity of the issue and government neglect. "It is a new phenomenon, and we have insufficient understandings and studies," Ghidinelli said, adding, "The problem may be much greater than what we have believed." Reddy said that there should be "aggressive promotion of condom usage" to address the issue. She added, "We know the ways. It is only that political leaders have to have the political will to do the right things" (Xinhuanet, 11/28).
According to the officials, there could be 500,000 new HIV/AIDS cases annually unless countries take increased action against the disease. In addition, Amala Reddy of UNAIDS said that about 50 million women in the region are at risk of the disease because of the behaviors of their husbands and partners. Reddy added that HIV/AIDS prevalence in Asia likely would reach 3% to 5% at most and is still concentrated among groups such as commercial sex workers, injection drug users and men who have sex with men. In addition, an estimated 75 million men in the region frequent sex workers, who number about 10 million, Reddy said, adding that there are 20 million IDUs and MSM in Asia. ABD Special Advisor Ian Anderson said that HIV/AIDS could have a serious effect on the region because many people living with the disease are in their economically productive years. "Because it is relatively small, this is the time to keep it small," he said, adding, "So we won't have to put the genie back in the bottle later."
In some Asian countries, such men may continue to have sex with their wives and other women, Reddy added (AFP/Google.com, 11/28). WHO Regional Advisor on HIV/AIDS Massimo Ghidinelli said WHO cannot determine a "fully accurate picture" on how MSM are contributing to the spread of HIV/AIDS because of the sensitivity of the issue and government neglect. "It is a new phenomenon, and we have insufficient understandings and studies," Ghidinelli said, adding, "The problem may be much greater than what we have believed." Reddy said that there should be "aggressive promotion of condom usage" to address the issue. She added, "We know the ways. It is only that political leaders have to have the political will to do the right things" (Xinhuanet, 11/28).
MSM and Infection Rates in Massachusets
Men who have sex with men are the most affected by HIV/AIDS in Massachusetts, according to a report released by the state Department of Public Health ahead of World AIDS Day, the AP/Worcester Telegram reports. According to the report, although Massachusetts has seen success in curbing the spread of HIV/AIDS among injection drug users and heterosexual men and women, it has had less success among MSM. "The message of prevention is missing too many men in Massachusetts," Kevin Cranston, director of the health department's HIV/AIDS Bureau, said.
The report found that more than half of HIV cases between 2004 and 2006 occurred among MSM. Four to nine percent of men in Massachusetts report having sex with other men in annual surveys, according to the AP/Telegram. It also found that 56% of MSM who participated in a 2005-2006 health survey reported regular condom use -- an increase compared with 36% in 2000.
In addition, the report said that 17,295 people in Massachusetts were living with HIV/AIDS as of May 2008, and male-to-male sexual contact is the primary mode of HIV transmission in the state. The proportion of MSM living with HIV/AIDS was 25 times greater than men who reported sex with only female partners, according to the report. Sixty-eight percent of white men reported exposure to HIV through same-sex contact, compared with 25% of black men and 25% of Hispanic men.
To improve the fight against HIV/AIDS in the state, the health department plans to merge its HIV/AIDS Bureau with its Communicable Disease Control Bureau. In addition, the report recommends that Massachusetts increase its efforts to promote condom use, including "widespread free condom availability" to MSM, including high-school students. "Condoms save lives, so it is a good sign that we are seeing an increase in condom use," health department Commissioner John Auerbach said, adding, "However, it is clear given the data in this report that more needs to be done with respect to reaching men who have sex with men with important HIV prevention messages."
The report also calls for increased access to rapid HIV tests and routine screening in hospital emergency departments, community health centers and private practices. It also recommends increasing HIV/AIDS prevention resources directed at MSM; expanding HIV testing efforts that target MSM; making prevention messages available at public, private and commercial venues, including the Internet; and preserving the availability of treatment (LeBlanc, AP/Worcester Telegram, 11/30).
The report found that more than half of HIV cases between 2004 and 2006 occurred among MSM. Four to nine percent of men in Massachusetts report having sex with other men in annual surveys, according to the AP/Telegram. It also found that 56% of MSM who participated in a 2005-2006 health survey reported regular condom use -- an increase compared with 36% in 2000.
In addition, the report said that 17,295 people in Massachusetts were living with HIV/AIDS as of May 2008, and male-to-male sexual contact is the primary mode of HIV transmission in the state. The proportion of MSM living with HIV/AIDS was 25 times greater than men who reported sex with only female partners, according to the report. Sixty-eight percent of white men reported exposure to HIV through same-sex contact, compared with 25% of black men and 25% of Hispanic men.
To improve the fight against HIV/AIDS in the state, the health department plans to merge its HIV/AIDS Bureau with its Communicable Disease Control Bureau. In addition, the report recommends that Massachusetts increase its efforts to promote condom use, including "widespread free condom availability" to MSM, including high-school students. "Condoms save lives, so it is a good sign that we are seeing an increase in condom use," health department Commissioner John Auerbach said, adding, "However, it is clear given the data in this report that more needs to be done with respect to reaching men who have sex with men with important HIV prevention messages."
The report also calls for increased access to rapid HIV tests and routine screening in hospital emergency departments, community health centers and private practices. It also recommends increasing HIV/AIDS prevention resources directed at MSM; expanding HIV testing efforts that target MSM; making prevention messages available at public, private and commercial venues, including the Internet; and preserving the availability of treatment (LeBlanc, AP/Worcester Telegram, 11/30).
AIDS Advocate Evicted from Home
An HIV-positive Chinese advocate on Tuesday was forced back to her home in central Henan province after participating in ceremonies in Beijing marking World AIDS Day, Reuters India reports. Li Xige, who had previously been under house arrest for more than two years because of her search for compensation and judicial action, contracted HIV from a blood transfusion in 1995 and transmitted it to her daughters, one of whom died from AIDS-related illnesses. Henan province was the center of numerous HIV/AIDS cases in the 1990s, when unhygienic blood-buying schemes and a lack of testing allowed the virus to spread to recipients of blood transfusions. The Henan government often has sought to block media coverage of the issue to avoid embarrassment from discontentment of people there living with HIV/AIDS, Reuters India reports (Hornby, Reuters India, 12/3).
In addition, "[a]fter years of denying that AIDS was a problem, Chinese leaders have shifted gears in recent years, confronting the disease more openly and promising anonymous testing, free treatment for the poor and a ban on discrimination against people with the virus," the AP/Google.com reports. However, advocates "walk a thin line in their work and are often detained, threatened or even attacked" (Sanderson, AP/Google.com, 12/3).
According to Reuters India, Li was escorted to her home Tuesday and warned to stop speaking out or she would be imprisoned. Li said she was being prevented from leaving her home by five officials (Reuters India, 12/3). She had escaped her home about 10 days ago and went to Beijing to also give a statement to the Supreme Court after a local court refused to hear her case demanding compensation from a local hospital where she contracted HIV; the Supreme Court turned her away, the AP/Google.com reports (AP/Google.com, 12/3). Li said she wants the Chinese government "to take responsibility for not having told me so many years that I had [HIV] ... I've been from government offices to court to government offices again, bounced about like a ball" (Reuters India, 12/3). Wan Yanhai, founder of a not-for-profit organization working on HIV/AIDS education and awareness, said that Li's case exposes how attitudes toward the disease in China need to change. "Every year on the AIDS Day we see leaders visiting AIDS patients. But we also see people who contracted AIDS and asked for compensation taken away by police" (AP/Google.com, 12/3).
In addition, "[a]fter years of denying that AIDS was a problem, Chinese leaders have shifted gears in recent years, confronting the disease more openly and promising anonymous testing, free treatment for the poor and a ban on discrimination against people with the virus," the AP/Google.com reports. However, advocates "walk a thin line in their work and are often detained, threatened or even attacked" (Sanderson, AP/Google.com, 12/3).
According to Reuters India, Li was escorted to her home Tuesday and warned to stop speaking out or she would be imprisoned. Li said she was being prevented from leaving her home by five officials (Reuters India, 12/3). She had escaped her home about 10 days ago and went to Beijing to also give a statement to the Supreme Court after a local court refused to hear her case demanding compensation from a local hospital where she contracted HIV; the Supreme Court turned her away, the AP/Google.com reports (AP/Google.com, 12/3). Li said she wants the Chinese government "to take responsibility for not having told me so many years that I had [HIV] ... I've been from government offices to court to government offices again, bounced about like a ball" (Reuters India, 12/3). Wan Yanhai, founder of a not-for-profit organization working on HIV/AIDS education and awareness, said that Li's case exposes how attitudes toward the disease in China need to change. "Every year on the AIDS Day we see leaders visiting AIDS patients. But we also see people who contracted AIDS and asked for compensation taken away by police" (AP/Google.com, 12/3).
Tuesday, December 02, 2008
Generics Really Do Measure up to Brand Name Drugs
Brand-name drugs for treating cardiovascular disease don't appear to be clinically superior to generic versions, say U.S. researchers who reviewed studies comparing the drugs.
Some doctors and patients have expressed concerns that the drugs may not be equivalent in their effects, although generic drugs are chemically equivalent in terms of active ingredients, the study's authors said.
In Wednesday's issue of the Journal of the American Medical Association, Dr. Aaron Kesselheim of Brigham and Women's Hospital and Harvard Medical School in Boston and his colleagues combined the results of 30 studies done since 1984 that compared nine subclasses of cardiovascular medications, 81 per cent of which were randomized controlled trials.
"The studies in our sample concluded that generic and brand-name cardiovascular drugs are similar in nearly all clinical outcomes," the researchers concluded.
Brand-name prescription drugs are sold at high prices after approval by the U.S. Food and Drug Administration and while under patent protection, the study's authors said. Brand-name cardiovascular drugs may cost as much as a few dollars per pill while generics may be as little as a few cents a pill, Kesselheim added.
"If a patient is prescribed a generic drug because that's what's appropriate for their condition, then they should feel confident taking that drug. And physicians themselves should also feel confident prescribing generic drugs where appropriate," Kesselheim said in a telephone interview.
The review of randomized clinical trials found clinical equivalence in:
* 7 of 7 trials for beta-blockers.
* 10 of 11 trials of diuretics.
* 5 of 7 trials for calcium-channel blockers.
* 3 of 3 trials for antiplatelet agents.
* 2 of 2 trials of statins.
* A single trial for angiotensin-converting enzyme or ACE inhibitors.
* A single trial for alpha-blockers.
Cost questions
Of 43 editorials and commentaries reviewed, 23 or 53 per cent expressed a negative view of the interchangeability of generic drugs compared with 12 (28 per cent) that encouraged substitution of generic drugs, with the remaining eight not reaching a conclusion, Kesselheim and his colleagues said.
As for why, commentaries may be more likely to highlight doctors' concerns based on anecdotal experience, and the conclusion of the editorial writers could be skewed by financial relationships, the team said in noting that nearly half of the editorials and commentaries did not identify sources of funding.
Generic medications account for 65 per cent of all prescriptions dispensed in the U.S. and less than 21 per cent of money spent on prescriptions, according to IMS Health, a company that tracks prescription drug sales.
"The contention that brand-name medicines drive up the cost of health care is fatally flawed," Ken Johnson, senior vice-president of the Pharmaceutical Research and Manufacturers of America, or PhRMA, which represents brand-name drug makers, said in a statement released in response to the study.
"Without today's innovative brand-name drugs to legally copy, there would be no generic drug industry," he said.
The study's authors reported no financial disclosures.
With files from Reuters
Some doctors and patients have expressed concerns that the drugs may not be equivalent in their effects, although generic drugs are chemically equivalent in terms of active ingredients, the study's authors said.
In Wednesday's issue of the Journal of the American Medical Association, Dr. Aaron Kesselheim of Brigham and Women's Hospital and Harvard Medical School in Boston and his colleagues combined the results of 30 studies done since 1984 that compared nine subclasses of cardiovascular medications, 81 per cent of which were randomized controlled trials.
"The studies in our sample concluded that generic and brand-name cardiovascular drugs are similar in nearly all clinical outcomes," the researchers concluded.
Brand-name prescription drugs are sold at high prices after approval by the U.S. Food and Drug Administration and while under patent protection, the study's authors said. Brand-name cardiovascular drugs may cost as much as a few dollars per pill while generics may be as little as a few cents a pill, Kesselheim added.
"If a patient is prescribed a generic drug because that's what's appropriate for their condition, then they should feel confident taking that drug. And physicians themselves should also feel confident prescribing generic drugs where appropriate," Kesselheim said in a telephone interview.
The review of randomized clinical trials found clinical equivalence in:
* 7 of 7 trials for beta-blockers.
* 10 of 11 trials of diuretics.
* 5 of 7 trials for calcium-channel blockers.
* 3 of 3 trials for antiplatelet agents.
* 2 of 2 trials of statins.
* A single trial for angiotensin-converting enzyme or ACE inhibitors.
* A single trial for alpha-blockers.
Cost questions
Of 43 editorials and commentaries reviewed, 23 or 53 per cent expressed a negative view of the interchangeability of generic drugs compared with 12 (28 per cent) that encouraged substitution of generic drugs, with the remaining eight not reaching a conclusion, Kesselheim and his colleagues said.
As for why, commentaries may be more likely to highlight doctors' concerns based on anecdotal experience, and the conclusion of the editorial writers could be skewed by financial relationships, the team said in noting that nearly half of the editorials and commentaries did not identify sources of funding.
Generic medications account for 65 per cent of all prescriptions dispensed in the U.S. and less than 21 per cent of money spent on prescriptions, according to IMS Health, a company that tracks prescription drug sales.
"The contention that brand-name medicines drive up the cost of health care is fatally flawed," Ken Johnson, senior vice-president of the Pharmaceutical Research and Manufacturers of America, or PhRMA, which represents brand-name drug makers, said in a statement released in response to the study.
"Without today's innovative brand-name drugs to legally copy, there would be no generic drug industry," he said.
The study's authors reported no financial disclosures.
With files from Reuters
Friday, November 28, 2008
President Elect Obama Urged to take Leadership on HIV and AIDS
HIV/AIDS advocates on Tuesday called on President-elect Barack Obama to adopt a comprehensive approach to domestic HIV/AIDS policy when he takes office, CQ HealthBeat reports. The groups encouraged the incoming administration to develop a national strategy to address HIV/AIDS in the U.S. and recommended implementing a domestic HIV/AIDS program modeled after the President's Emergency Plan for AIDS Relief. HIV/AIDS researcher Robert Gallo recently proposed a similar approach. "It is astonishing that [the U.S.] has never really set an overall plan and agenda for the country, with measurable outcomes, accountability established and specific timetables for getting to those results," Rebecca Haag, executive director of AIDS Action Council, said. The advocates also called for increased federal funding for HIV/AIDS prevention, treatment and research programs and called for a departure from some policies enacted under the Bush administration.
Carl Schmid, director of federal affairs at the AIDS Institute, said he is "optimistic" about Obama's election and hopes the new administration will bring "renewed leadership on the domestic HIV/AIDS front" because the disease is "still a major, significant health crisis" in the U.S. Advocates in a letter sent to Obama's transition team -- which included policy recommendations aimed at guiding him during his first 100 days in office -- encouraged the administration to support the higher amounts proposed for federal funding for HIV/AIDS prevention, treatment and research programs in competing fiscal year 2009 appropriations measures. According to Schmid, the priority given to HIV/AIDS programs in the President-elect's first budget "will be a good signal to the Obama administration's commitment to the domestic [HIV/AIDS] epidemic."
The advocates also called for an increase in federal funding for NIH, including an increase of $450 million for HIV/AIDS research. They also support additional funding for CDC, including an increase of $200 million for HIV prevention and surveillance. In addition, the group called for a $100 million increase in FY 2009 funding for the Ryan White Program and a $614.49 million increase for the program in FY 2010. Christine Lubinski, vice president of global health at the Infectious Diseases Society of America, said the Ryan White Program "has not been funded at adequate levels," adding, "We'll be looking for a budgeting increase and leadership in extending the Ryan White Care Act, which will sunset on Sept. 30."
Haag called on Obama to end some existing policies, including the ban on federal funding for needle-exchange programs, which she called "one of the most effective" tools to reduce HIV transmission. Haag also criticized abstinence-only sex education programs. According to Haag, strong leadership will be necessary to unite and coordinate the efforts of 17 federal agencies that currently work on HIV/AIDS issues. "We have asked that the national AIDS strategy be driven out of the White House," Haag said, adding that "the force of the president's leadership" will be necessary to address HIV/AIDS in the U.S. (Weyl, CQ HealthBeat, 11/25).
Carl Schmid, director of federal affairs at the AIDS Institute, said he is "optimistic" about Obama's election and hopes the new administration will bring "renewed leadership on the domestic HIV/AIDS front" because the disease is "still a major, significant health crisis" in the U.S. Advocates in a letter sent to Obama's transition team -- which included policy recommendations aimed at guiding him during his first 100 days in office -- encouraged the administration to support the higher amounts proposed for federal funding for HIV/AIDS prevention, treatment and research programs in competing fiscal year 2009 appropriations measures. According to Schmid, the priority given to HIV/AIDS programs in the President-elect's first budget "will be a good signal to the Obama administration's commitment to the domestic [HIV/AIDS] epidemic."
The advocates also called for an increase in federal funding for NIH, including an increase of $450 million for HIV/AIDS research. They also support additional funding for CDC, including an increase of $200 million for HIV prevention and surveillance. In addition, the group called for a $100 million increase in FY 2009 funding for the Ryan White Program and a $614.49 million increase for the program in FY 2010. Christine Lubinski, vice president of global health at the Infectious Diseases Society of America, said the Ryan White Program "has not been funded at adequate levels," adding, "We'll be looking for a budgeting increase and leadership in extending the Ryan White Care Act, which will sunset on Sept. 30."
Haag called on Obama to end some existing policies, including the ban on federal funding for needle-exchange programs, which she called "one of the most effective" tools to reduce HIV transmission. Haag also criticized abstinence-only sex education programs. According to Haag, strong leadership will be necessary to unite and coordinate the efforts of 17 federal agencies that currently work on HIV/AIDS issues. "We have asked that the national AIDS strategy be driven out of the White House," Haag said, adding that "the force of the president's leadership" will be necessary to address HIV/AIDS in the U.S. (Weyl, CQ HealthBeat, 11/25).
Ventura County, Calif., Effort Seeks To Encourage Hispanics To Talk Openly About HIV/AIDS
A task force of Hispanic community leaders in Ventura County, Calif., this week launched a campaign that aims to encourage the Hispanic community to talk openly about HIV/AIDS, the Ventura County Star reports. One-third of the Ventura County population in 2005 was Hispanic, and the group made up 60% of new AIDS cases that year, according to the Ventura County AIDS Partnership, which is launching the campaign. The subject of HIV/AIDS is sometimes considered taboo in the Hispanic community, the Star reports.
Cultural norms, taboos and myths about HIV/AIDS contribute to the spread of the disease in the Hispanic communities across the nation, according to Jesus Torres, social marketing chair of the partnership. Madhu Bajaj, executive director of the group, said he was prompted by results of local surveys, focus groups and other research to begin the initiative, called Cuidate, which means "take care" in Spanish. As part of the effort, the group is running newspaper advertisements beginning this week and lasting through February. The task force also will start training groups that teach others how to talk openly about HIV/AIDS and will first target mothers and teenage daughters.
"Our campaign tag is 'Let's start the conversation,'" Bajaj said, adding "There's a stigma. There's a silence" about HIV/AIDS in the Hispanic community. Torres said, "With this campaign, we will give the tools, resources and know-how to our Latino community so that they may protect their health" (Ventura County Star, 11/21).
Cultural norms, taboos and myths about HIV/AIDS contribute to the spread of the disease in the Hispanic communities across the nation, according to Jesus Torres, social marketing chair of the partnership. Madhu Bajaj, executive director of the group, said he was prompted by results of local surveys, focus groups and other research to begin the initiative, called Cuidate, which means "take care" in Spanish. As part of the effort, the group is running newspaper advertisements beginning this week and lasting through February. The task force also will start training groups that teach others how to talk openly about HIV/AIDS and will first target mothers and teenage daughters.
"Our campaign tag is 'Let's start the conversation,'" Bajaj said, adding "There's a stigma. There's a silence" about HIV/AIDS in the Hispanic community. Torres said, "With this campaign, we will give the tools, resources and know-how to our Latino community so that they may protect their health" (Ventura County Star, 11/21).
Monday, November 24, 2008
Young Travellers in Australia at Higher HIV Exposure Risk
HIV-positive people receiving treatment for the virus might be at an increased risk of developing heart disease and type 2 diabetes because some antiretroviral drugs can cause fat on the arms, legs, face and buttocks to move to the stomach, researchers at Australia's Garvan Institute said Monday, the Sydney Morning Herald reports. According to the Herald, excess weight around the waist can increase a person's chances of developing cardiovascular and metabolic disorders, but physicians say newer classes of drugs, which do not cause fat redistribution, are too expensive for most people.
Katherine Samaras -- lead author of the study, which was published in the journal Obesity -- said the findings indicate that older antiretrovirals, still commonly used in Australia, can give many HIV-positive patients the same level of heart disease risk seen in obese people with sedentary lifestyles. The Herald also reports the study found that antiretrovirals can cause fat cells to create inflammatory molecules promoting certain diseases. Samaras said, "When fat cells are healthy, they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce" numerous chemicals linked to heart disease. She added, "We also have the problem that the older drugs are off-patent now and very cheap, so they are the frontline treatment" in developing countries. According to Samaras, "There are drugs on the market which do not have these side effects, but they are not yet on" Australia's pharmaceutical benefits programs and are "too expensive for most people. The primary concern is to optimize viral suppression, that is reduce the virus load in the body, to minimize its effects." She added that physicians should ensure that their HIV-positive patients are regularly screened for diabetes (Benson, Sydney Morning Herald, 11/18).
Katherine Samaras -- lead author of the study, which was published in the journal Obesity -- said the findings indicate that older antiretrovirals, still commonly used in Australia, can give many HIV-positive patients the same level of heart disease risk seen in obese people with sedentary lifestyles. The Herald also reports the study found that antiretrovirals can cause fat cells to create inflammatory molecules promoting certain diseases. Samaras said, "When fat cells are healthy, they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce" numerous chemicals linked to heart disease. She added, "We also have the problem that the older drugs are off-patent now and very cheap, so they are the frontline treatment" in developing countries. According to Samaras, "There are drugs on the market which do not have these side effects, but they are not yet on" Australia's pharmaceutical benefits programs and are "too expensive for most people. The primary concern is to optimize viral suppression, that is reduce the virus load in the body, to minimize its effects." She added that physicians should ensure that their HIV-positive patients are regularly screened for diabetes (Benson, Sydney Morning Herald, 11/18).
Increased Diabetes Risk with Antiretrovirals
HIV-positive people receiving treatment for the virus might be at an increased risk of developing heart disease and type 2 diabetes because some antiretroviral drugs can cause fat on the arms, legs, face and buttocks to move to the stomach, researchers at Australia's Garvan Institute said Monday, the Sydney Morning Herald reports. According to the Herald, excess weight around the waist can increase a person's chances of developing cardiovascular and metabolic disorders, but physicians say newer classes of drugs, which do not cause fat redistribution, are too expensive for most people.
Katherine Samaras -- lead author of the study, which was published in the journal Obesity -- said the findings indicate that older antiretrovirals, still commonly used in Australia, can give many HIV-positive patients the same level of heart disease risk seen in obese people with sedentary lifestyles. The Herald also reports the study found that antiretrovirals can cause fat cells to create inflammatory molecules promoting certain diseases. Samaras said, "When fat cells are healthy, they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce" numerous chemicals linked to heart disease. She added, "We also have the problem that the older drugs are off-patent now and very cheap, so they are the frontline treatment" in developing countries. According to Samaras, "There are drugs on the market which do not have these side effects, but they are not yet on" Australia's pharmaceutical benefits programs and are "too expensive for most people. The primary concern is to optimize viral suppression, that is reduce the virus load in the body, to minimize its effects." She added that physicians should ensure that their HIV-positive patients are regularly screened for diabetes (Benson, Sydney Morning Herald, 11/18).
Katherine Samaras -- lead author of the study, which was published in the journal Obesity -- said the findings indicate that older antiretrovirals, still commonly used in Australia, can give many HIV-positive patients the same level of heart disease risk seen in obese people with sedentary lifestyles. The Herald also reports the study found that antiretrovirals can cause fat cells to create inflammatory molecules promoting certain diseases. Samaras said, "When fat cells are healthy, they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce" numerous chemicals linked to heart disease. She added, "We also have the problem that the older drugs are off-patent now and very cheap, so they are the frontline treatment" in developing countries. According to Samaras, "There are drugs on the market which do not have these side effects, but they are not yet on" Australia's pharmaceutical benefits programs and are "too expensive for most people. The primary concern is to optimize viral suppression, that is reduce the virus load in the body, to minimize its effects." She added that physicians should ensure that their HIV-positive patients are regularly screened for diabetes (Benson, Sydney Morning Herald, 11/18).
Friday, November 14, 2008
Bone Marrow Transplant Eradicates AIDS in Patient
An American man who suffered from AIDS appears to have been cured of the disease 20 months after receiving a targeted bone marrow transplant normally used to fight leukemia, his doctors said.
While researchers, and the doctors themselves, caution that the case might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims two million lives each year. The virus has infected 33 million people worldwide.
Dr. Gero Huetter said his 42-year-old patient, an American living in Berlin who was not identified, had been infected with the AIDS virus for more than a decade. But 20 months after undergoing a transplant of genetically selected bone marrow, he no longer shows signs of carrying the virus.
"We waited every day for a bad reading," Huetter said.
It has not come. Researchers at Berlin's Charite hospital and medical school say tests on his bone marrow, blood and other organ tissues have all been clean.
However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests have probably not been extensive enough.
"A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said.
Eradicating AIDS?
This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported.
Huetter's patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.
As Huetter — who is a hematologist, not an HIV specialist — prepared to treat the patient's leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection. If the mutation, called Delta 32, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway.
"I read it in 1996, coincidentally," Huetter told reporters at the medical school. "I remembered it and thought it might work."
Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient's marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation.
Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system — a treatment fatal to between 20 and 30 per cent of recipients.
He was also taken off the potent drugs used to treat his AIDS. Huetter's team feared that the drugs might interfere with the new marrow cells' survival. They risked lowering his defences in the hopes that the new mutated cells would reject the virus on their own.
Promise of gene therapy
Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a first-line cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.
"It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate," Fauci said.
David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development.
"That's a long way down the line, because there may be other negative things that go with that mutation that we don't know about."
For the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain.
"The virus is wily," Huetter said. "There could always be a resurgence."
While researchers, and the doctors themselves, caution that the case might be no more than a fluke, others say it may inspire a greater interest in gene therapy to fight the disease that claims two million lives each year. The virus has infected 33 million people worldwide.
Dr. Gero Huetter said his 42-year-old patient, an American living in Berlin who was not identified, had been infected with the AIDS virus for more than a decade. But 20 months after undergoing a transplant of genetically selected bone marrow, he no longer shows signs of carrying the virus.
"We waited every day for a bad reading," Huetter said.
It has not come. Researchers at Berlin's Charite hospital and medical school say tests on his bone marrow, blood and other organ tissues have all been clean.
However, Dr. Andrew Badley, director of the HIV and immunology research lab at the Mayo Clinic in Rochester, Minn., said those tests have probably not been extensive enough.
"A lot more scrutiny from a lot of different biological samples would be required to say it's not present," Badley said.
Eradicating AIDS?
This isn't the first time marrow transplants have been attempted for treating AIDS or HIV infection. In 1999, an article in the journal Medical Hypotheses reviewed the results of 32 attempts reported between 1982 and 1996. In two cases, HIV was apparently eradicated, the review reported.
Huetter's patient was under treatment at Charite for both AIDS and leukemia, which developed unrelated to HIV.
As Huetter — who is a hematologist, not an HIV specialist — prepared to treat the patient's leukemia with a bone marrow transplant, he recalled that some people carry a genetic mutation that seems to make them resistant to HIV infection. If the mutation, called Delta 32, is inherited from both parents, it prevents HIV from attaching itself to cells by blocking CCR5, a receptor that acts as a kind of gateway.
"I read it in 1996, coincidentally," Huetter told reporters at the medical school. "I remembered it and thought it might work."
Roughly one in 1,000 Europeans and Americans have inherited the mutation from both parents, and Huetter set out to find one such person among donors that matched the patient's marrow type. Out of a pool of 80 suitable donors, the 61st person tested carried the proper mutation.
Before the transplant, the patient endured powerful drugs and radiation to kill off his own infected bone marrow cells and disable his immune system — a treatment fatal to between 20 and 30 per cent of recipients.
He was also taken off the potent drugs used to treat his AIDS. Huetter's team feared that the drugs might interfere with the new marrow cells' survival. They risked lowering his defences in the hopes that the new mutated cells would reject the virus on their own.
Promise of gene therapy
Anthony Fauci, director of the National Institute of Allergy and Infections Diseases in the U.S., said the procedure was too costly and too dangerous to employ as a first-line cure. But he said it could inspire researchers to pursue gene therapy as a means to block or suppress HIV.
"It helps prove the concept that if somehow you can block the expression of CCR5, maybe by gene therapy, you might be able to inhibit the ability of the virus to replicate," Fauci said.
David Roth, a professor of epidemiology and international public health at the London School of Hygiene and Tropical Medicine, said gene therapy as cheap and effective as current drug treatments is in very early stages of development.
"That's a long way down the line, because there may be other negative things that go with that mutation that we don't know about."
For the patient in Berlin, the lack of a clear understanding of exactly why his AIDS has disappeared means his future is far from certain.
"The virus is wily," Huetter said. "There could always be a resurgence."
Monday, November 10, 2008
Global Financial Crisis Could Adversely Effect AIDS Funding
The current global financial crisis could harm HIV/AIDS funding and increase the factors that make people vulnerable to the disease, UNAIDS Executive Director Peter Piot said on Tuesday during an event at the Center for Strategic and International Studies, CQ HealthBeat reports. According to Piot, as rising food and energy costs drive more people into poverty worldwide, the factors that drive the spread of HIV also could increase. "That must have an impact on the spread of HIV, although it's not so clear," he said, adding that it is certain that low-income countries will be more affected by and vulnerable to the financial crisis when it comes to providing HIV/AIDS treatment. For example, 100% of the cost to provide 50,000 HIV-positive people in Rwanda with antiretroviral drugs at the end of last year was paid by donors -- such as the Global Fund To Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief -- according to Piot. He added that Brazil receives no donor funding to provide similar treatment services to its HIV-positive citizens.
Countries likely will not feel the effects of the financial crisis on HIV/AIDS "in the next six or 12 months because of commitments that have been made in better times," Piot said, adding that he wonders if it will be possible to continue enrolling 700,000 to one million people in drug treatment programs over the next few years. "If not, deaths will go up again, deaths from AIDS, no doubt about it," he said, adding, "We estimate that even if (funding) continues at the same level, deaths will go up to about three million per year by 2011."
Piot also praised the Bush administration and Congress for continuing PEPFAR, which he said is an "unprecedented program that has saved millions of lives." Piot added, "It is quite rare in international development that you can count so easily, you can measure, the impact of actions, and yet this has been the case when it comes to what PEPFAR has done, and it's unprecedented in international development." In addition, Piot commended President Bush and Secretary of State Condoleezza Rice for their comments at the recent White House summit on international development about how the U.S. should not reduce aid. "I hope that the next president will follow along the same lines," Piot said.
Jennifer Kates -- vice president and director of HIV policy at the Kaiser Family Foundation -- said it is difficult to assess how the financial crisis will affect future funding levels. "How the financial crisis plays into that, we still don't know," she said.
Piot will leave his position at UNAIDS at the end of the year to head the new Institute for Global Health at Imperial College London (Vadala, CQ HealthBeat, 10/28).
Recession proof your medicine cabinet today by switching to generic AIDS drugs. Visit www.aids-drugs-online.com
Countries likely will not feel the effects of the financial crisis on HIV/AIDS "in the next six or 12 months because of commitments that have been made in better times," Piot said, adding that he wonders if it will be possible to continue enrolling 700,000 to one million people in drug treatment programs over the next few years. "If not, deaths will go up again, deaths from AIDS, no doubt about it," he said, adding, "We estimate that even if (funding) continues at the same level, deaths will go up to about three million per year by 2011."
Piot also praised the Bush administration and Congress for continuing PEPFAR, which he said is an "unprecedented program that has saved millions of lives." Piot added, "It is quite rare in international development that you can count so easily, you can measure, the impact of actions, and yet this has been the case when it comes to what PEPFAR has done, and it's unprecedented in international development." In addition, Piot commended President Bush and Secretary of State Condoleezza Rice for their comments at the recent White House summit on international development about how the U.S. should not reduce aid. "I hope that the next president will follow along the same lines," Piot said.
Jennifer Kates -- vice president and director of HIV policy at the Kaiser Family Foundation -- said it is difficult to assess how the financial crisis will affect future funding levels. "How the financial crisis plays into that, we still don't know," she said.
Piot will leave his position at UNAIDS at the end of the year to head the new Institute for Global Health at Imperial College London (Vadala, CQ HealthBeat, 10/28).
Recession proof your medicine cabinet today by switching to generic AIDS drugs. Visit www.aids-drugs-online.com
ARV Therapy Should Start Earlier
People living with HIV should begin antiretroviral treatments earlier than what current guidelines recommend, according to a large new study presented on Sunday, the AP/Yahoo! News reports. According to the AP/Yahoo! News, current guidelines by the International AIDS Society-USA and the government recommend that patients who are not showing symptoms of the virus delay treatment until their CD4 T-cell counts drop below 350 per milliliter of blood.
Physicians traditionally have delayed antiretroviral treatment for HIV patients to avoid the treatment's side effects, which can include heart and cholesterol problems, diarrhea, nausea and other conditions. Robert Schooley, infectious disease chief at the University of California-San Diego, said, "There was this thinking, maybe the drugs were worse than the disease. If you could wait as long as you possibly could wait, you would have fewer side effects."
The new study, however, shows that a treatment delay can nearly double the risk of death in the next few years. The study's findings were reported at a conference held by the American Society of Microbiology and the Infectious Diseases Society of America. The National Institute of Allergy and Infectious Diseases helped provide funding for the study (Marchione, AP/Yahoo! News, 10/26).
For the study, researchers led by Mari Kitahata of the University of Washington examined information in the International Epidemiology Databases to Evaluate AIDS, a global network of HIV clinics from 1996 to 2005. Researchers looked at records for 8,374 healthy HIV patients with CD4 counts of 351 to 500 who had never taken highly active antiretroviral treatments. Thirty percent of the patients began antiretroviral treatment, and the remainder delayed treatment until their CD4 counts dropped below 350. The study shows that the patients who delayed treatments were 71% more likely to die during the course of the study period than those who began treatments early (Reuters, 10/26).
Schooley, who helped write the current guidelines for AIDS treatments and acts as a consultant for several companies that make antiretroviral drugs, said the new study and others like it "have all shown the same thing -- that we were starting too late" and need to continue treatments when they have been started. "The data are rather compelling that the risk of death appears to be higher if you wait than if you treat," Anthony Fauci, director of NIAID, said (AP/Yahoo! News, 10/26). He added that treatment guidelines committees are "certainly going to look hard at these data next time they meet" (Sternberg, USA Today, 10/27).
Physicians traditionally have delayed antiretroviral treatment for HIV patients to avoid the treatment's side effects, which can include heart and cholesterol problems, diarrhea, nausea and other conditions. Robert Schooley, infectious disease chief at the University of California-San Diego, said, "There was this thinking, maybe the drugs were worse than the disease. If you could wait as long as you possibly could wait, you would have fewer side effects."
The new study, however, shows that a treatment delay can nearly double the risk of death in the next few years. The study's findings were reported at a conference held by the American Society of Microbiology and the Infectious Diseases Society of America. The National Institute of Allergy and Infectious Diseases helped provide funding for the study (Marchione, AP/Yahoo! News, 10/26).
For the study, researchers led by Mari Kitahata of the University of Washington examined information in the International Epidemiology Databases to Evaluate AIDS, a global network of HIV clinics from 1996 to 2005. Researchers looked at records for 8,374 healthy HIV patients with CD4 counts of 351 to 500 who had never taken highly active antiretroviral treatments. Thirty percent of the patients began antiretroviral treatment, and the remainder delayed treatment until their CD4 counts dropped below 350. The study shows that the patients who delayed treatments were 71% more likely to die during the course of the study period than those who began treatments early (Reuters, 10/26).
Schooley, who helped write the current guidelines for AIDS treatments and acts as a consultant for several companies that make antiretroviral drugs, said the new study and others like it "have all shown the same thing -- that we were starting too late" and need to continue treatments when they have been started. "The data are rather compelling that the risk of death appears to be higher if you wait than if you treat," Anthony Fauci, director of NIAID, said (AP/Yahoo! News, 10/26). He added that treatment guidelines committees are "certainly going to look hard at these data next time they meet" (Sternberg, USA Today, 10/27).
Isentress More Effective in Un-Treated Patients
Merck's antiretroviral drug Isentress suppresses levels of HIV in previously untreated patients better than the company's antiretroviral efavirenz, according to research presented Sunday at a meeting of the American Society of Microbiology and the Infectious Diseases Society of America, Reuters reports. According to Phase III clinical trial results, Isentress -- known generically as raltegravir -- reduced HIV viral loads to undetectable levels in 86% of patients compared with 82% of patients treated with efavirenz (Fox, Reuters, 10/26).
FDA in October 2007 approved raltegravir for use by HIV-positive people who have not responded to other treatments. Raltegravir works by blocking an HIV enzyme called integrase. Integrase is one of the three enzymes necessary for HIV to replicate in the body, and integrase inhibitors stop HIV from inserting its genes into uninfected DNA (Kaiser Daily HIV/AIDS Report, 10/15/07). The agency also granted Isentress accelerated approval for use among patients who showed initial signs of resistance to existing antiretrovirals. According to Merck, up to 40% of the approximately 500,000 HIV-positive people in the U.S. receiving antiretrovirals have developed resistance to the drugs. In addition, researchers at the conference said that drug-related adverse effects were significantly fewer in patients treated with Isentress (44%) than with efavirenz (77%) (AFP/Yahoo! News, 10/26).
Robin Isaacs, executive director for infectious disease clinical research at Merck, said, "There was a desperate unmet medical need for those patients who had failed other therapies" until recent years. He added that Isentress and Pfizer's Selzentry -- also approved last year -- helped address that need, along with three other new drugs: Boehringer Ingelheim's Aptivus, and Johnson & Johnson's Prezista and Intelence. According to Isaacs, patients "have all these different options now, which they didn't before, to build new successful regimens."
According to AP/Yahoo! Finance, Pfizer at the conference also presented research from a 48-week study comparing its antiretroviral Selzentry with Bristol-Myer Squibb's antiretroviral Sustiva in a total of 417 patients also receiving GlaxoSmithKline's antiretroviral combination drug Combivir. In both groups, 68% of patients had the HIV virus reduced to undetectable levels; however, 4.2% of those who got Selzentry and 14.2% taking Sustiva stopped because of side effects (Johnson, AP/Yahoo! Finance, 10/26).
FDA in October 2007 approved raltegravir for use by HIV-positive people who have not responded to other treatments. Raltegravir works by blocking an HIV enzyme called integrase. Integrase is one of the three enzymes necessary for HIV to replicate in the body, and integrase inhibitors stop HIV from inserting its genes into uninfected DNA (Kaiser Daily HIV/AIDS Report, 10/15/07). The agency also granted Isentress accelerated approval for use among patients who showed initial signs of resistance to existing antiretrovirals. According to Merck, up to 40% of the approximately 500,000 HIV-positive people in the U.S. receiving antiretrovirals have developed resistance to the drugs. In addition, researchers at the conference said that drug-related adverse effects were significantly fewer in patients treated with Isentress (44%) than with efavirenz (77%) (AFP/Yahoo! News, 10/26).
Robin Isaacs, executive director for infectious disease clinical research at Merck, said, "There was a desperate unmet medical need for those patients who had failed other therapies" until recent years. He added that Isentress and Pfizer's Selzentry -- also approved last year -- helped address that need, along with three other new drugs: Boehringer Ingelheim's Aptivus, and Johnson & Johnson's Prezista and Intelence. According to Isaacs, patients "have all these different options now, which they didn't before, to build new successful regimens."
According to AP/Yahoo! Finance, Pfizer at the conference also presented research from a 48-week study comparing its antiretroviral Selzentry with Bristol-Myer Squibb's antiretroviral Sustiva in a total of 417 patients also receiving GlaxoSmithKline's antiretroviral combination drug Combivir. In both groups, 68% of patients had the HIV virus reduced to undetectable levels; however, 4.2% of those who got Selzentry and 14.2% taking Sustiva stopped because of side effects (Johnson, AP/Yahoo! Finance, 10/26).
Tuesday, October 28, 2008
FDA Approves Prezista for Use in Treatment Naive Individuals
FDA on Tuesday approved Johnson & Johnson's protease inhibitor Prezista for use by people who have never taken antiretroviral drugs in the past, the Wall Street Journal reports. FDA in 2006 approved Prezista for HIV-positive people who had developed resistance to other drugs. The agency also granted tentative approval for the drug as part of FDA's accelerated approval mechanism, which allows drugs to be sold while further studies are conducted. J&J obtained full approval for Prezista after submitting studies to FDA through this mechanism (Corbett Dooren, Wall Street Journal, 10/23).
According to J&J, patients beginning HIV treatment should take Prezista -- generically known as darunavir -- in combination with ritonavir. Ritonavir -- sold by Abbott Laboratories under the brand name Norvir -- works in combination with Prezista by slowing down the body's processing of the drug, Reuters reports (Reuters, 10/22). As a protease inhibitor, Prezista works by blocking a protein that HIV requires for replication. Treatment-naive HIV-positive people are recommended to take two 400 mg tablets of Prezista with 100 mg of ritonavir twice daily, and patients who have previously taken other HIV medications are recommended to take 600 mg of Prezista twice daily. J&J will discontinue the production of a 300 mg tablet following a decline in demand. According to the company, the wholesale price of the drug is about $740 monthly.
Glenn Mattes, president of J&J's Tibotec Therapeutics, said FDA approval of Prezista for newly diagnosed HIV-positive people "is a significant expansion of our ability to reach the entire population of patients who should be treated with a protease inhibitor." According to the AP/Boston Globe, during a study that compared Prezista with Kaletra -- a similar drug produced by Abbott -- 84% of patients treated with Prezista had HIV viral loads drop to an undetectable level, compared with 78% of patients taking Kaletra. However, this difference was not considered statistically significant (AP/Boston Globe, 10/22). Side effects of Prezista include diarrhea, headache, nausea, skin rash and, in some cases, hepatitis and liver failure (Reuters, 10/22).
According to J&J, patients beginning HIV treatment should take Prezista -- generically known as darunavir -- in combination with ritonavir. Ritonavir -- sold by Abbott Laboratories under the brand name Norvir -- works in combination with Prezista by slowing down the body's processing of the drug, Reuters reports (Reuters, 10/22). As a protease inhibitor, Prezista works by blocking a protein that HIV requires for replication. Treatment-naive HIV-positive people are recommended to take two 400 mg tablets of Prezista with 100 mg of ritonavir twice daily, and patients who have previously taken other HIV medications are recommended to take 600 mg of Prezista twice daily. J&J will discontinue the production of a 300 mg tablet following a decline in demand. According to the company, the wholesale price of the drug is about $740 monthly.
Glenn Mattes, president of J&J's Tibotec Therapeutics, said FDA approval of Prezista for newly diagnosed HIV-positive people "is a significant expansion of our ability to reach the entire population of patients who should be treated with a protease inhibitor." According to the AP/Boston Globe, during a study that compared Prezista with Kaletra -- a similar drug produced by Abbott -- 84% of patients treated with Prezista had HIV viral loads drop to an undetectable level, compared with 78% of patients taking Kaletra. However, this difference was not considered statistically significant (AP/Boston Globe, 10/22). Side effects of Prezista include diarrhea, headache, nausea, skin rash and, in some cases, hepatitis and liver failure (Reuters, 10/22).
HIV/AIDS Drug Access Problems in Mozambique Cannot Be Solved Solely Through Antiretroviral Plant, Health Official Says
A pharmaceutical plant in Mozambique's capital of Maputo that will produce generic antiretroviral drugs cannot be the sole solution to problems associated with access to treatment, Health Minister Ivo Garrido said recently, AIM/AllAfrica.com reports. According to Garrido, the plant, which is being funded by Brazil, will alleviate the government's financial burden of purchasing the drugs but will not reduce all barriers to treatment.
Garrido said that there "are a number of steps related to procurement" of antiretrovirals, "which are removed when there is a factory in the country," adding that the "plant will ease matters for the government since, rather than having to wait for medicines and go through all the process of clearing them through customs, now the government will just collect them." However, he added that some problems associated with antiretroviral access will remain because most HIV-positive people are not aware of their status and thus do not seek treatment. Garrido said, "It would be nice and easy if the problem was just limited to the availability of" antiretrovirals, adding that if "that was the case, we would simply buy medicines and the problem would be solved." Instead, he said that "the problem is more serious and deep and is related with society. It's false to claim that people don't have access to" antiretrovirals "because the drugs are not available. The main reason is that most people are unaware that they are ill."
According to Garrido, there are no shortages of antiretrovirals in Mozambique, although he added that "eventually this could happen in the future due to the increase in the number of beneficiaries." Instead, he said that low antiretroviral coverage rates are the result of other factors, such as a shortage of medical workers and individuals' lack of knowledge about their HIV status. It is estimated that more than 300,000 people in Mozambique are in need of antiretrovirals, but less than half have access to the drugs (AIM/AllAfrica.com, 10/21).
Garrido said that there "are a number of steps related to procurement" of antiretrovirals, "which are removed when there is a factory in the country," adding that the "plant will ease matters for the government since, rather than having to wait for medicines and go through all the process of clearing them through customs, now the government will just collect them." However, he added that some problems associated with antiretroviral access will remain because most HIV-positive people are not aware of their status and thus do not seek treatment. Garrido said, "It would be nice and easy if the problem was just limited to the availability of" antiretrovirals, adding that if "that was the case, we would simply buy medicines and the problem would be solved." Instead, he said that "the problem is more serious and deep and is related with society. It's false to claim that people don't have access to" antiretrovirals "because the drugs are not available. The main reason is that most people are unaware that they are ill."
According to Garrido, there are no shortages of antiretrovirals in Mozambique, although he added that "eventually this could happen in the future due to the increase in the number of beneficiaries." Instead, he said that low antiretroviral coverage rates are the result of other factors, such as a shortage of medical workers and individuals' lack of knowledge about their HIV status. It is estimated that more than 300,000 people in Mozambique are in need of antiretrovirals, but less than half have access to the drugs (AIM/AllAfrica.com, 10/21).
Urbanization Among Native Youth Can Increase HIV Rates Amongst the Native Population
Aboriginal youth from northern parts of the Canadian province of British Columbia recently gathered for a three-day conference on HIV/AIDS in an effort to curb the spread of the disease in their communities, the CP/Prince George Citizen reports. Conference attendees, ages 15 to 22, were selected by the First Nations chiefs, councils and health directors.
Emma Palmantier, chair of the Northern B.C. Aboriginal HIV/AIDS Task Force, said that youth attending the conference are expected to take knowledge back to their communities. She added the goal of the training is to give young people basic knowledge about HIV/AIDS, in addition to lessons on sexuality and teen pregnancy, lectures, workshops and group discussions. The CP/Citizen reports that at the end of the conference, the attendees will make recommendations to the task force, chiefs and councils, which will then be used to develop community action plans.
Palmantier said that because many youth who move to urban areas like Prince George and Vancouver come from low-income families, they often turn to commercial sex work and drug trafficking as ways to survive. She said, "The governments need to come up with funds to train these youth in trades and jobs so they can live normal lives. There's a big door of opportunity for training" (Trick, CP/Prince George Citizen, 10/21).
For access to ARV's please visit www.aids-drugs-online.com
Emma Palmantier, chair of the Northern B.C. Aboriginal HIV/AIDS Task Force, said that youth attending the conference are expected to take knowledge back to their communities. She added the goal of the training is to give young people basic knowledge about HIV/AIDS, in addition to lessons on sexuality and teen pregnancy, lectures, workshops and group discussions. The CP/Citizen reports that at the end of the conference, the attendees will make recommendations to the task force, chiefs and councils, which will then be used to develop community action plans.
Palmantier said that because many youth who move to urban areas like Prince George and Vancouver come from low-income families, they often turn to commercial sex work and drug trafficking as ways to survive. She said, "The governments need to come up with funds to train these youth in trades and jobs so they can live normal lives. There's a big door of opportunity for training" (Trick, CP/Prince George Citizen, 10/21).
For access to ARV's please visit www.aids-drugs-online.com
Monday, October 06, 2008
Jury selection begins in HIV murder trial
The jury selection in the trial of an HIV-positive man charged with first-degree murder in the death of two of his sex partners is scheduled to begin in Hamilton, Ont., on Monday.
Johnson Aziga, 52, is believed to be the first HIV-positive person in Canada to be charged with murder after allegedly having unprotected sex and passing on the deadly virus that causes AIDS.
Two women he allegedly had unprotected sex with died of AIDS-related complications. One of the Toronto women died in December 2003 and the other died in May 2004.
Ugandan-born Aziga is also accused of 13 counts of aggravated sexual assault, which includes 11 other women he allegedly had sex with and with whom he did not disclose he was HIV positive.
The Supreme Court of Canada has ruled one partner cannot give true consent for sexual relations if the other fails to tell partners about an HIV infection.
As a result, the deaths of the two women are considered to have resulted from sexual assaults, which automatically calls for first-degree murder charges that carry an automatic life sentence.
The aggravated sexual assault charges carry a maximum sentence of 14 years in prison.
Aziga's trial has been delayed many times due to adjournments sought by the defence. Aziga has fired three legal teams leading up to the trial.
Aziga's trial now is expected to begin on Oct. 20.
Johnson Aziga, 52, is believed to be the first HIV-positive person in Canada to be charged with murder after allegedly having unprotected sex and passing on the deadly virus that causes AIDS.
Two women he allegedly had unprotected sex with died of AIDS-related complications. One of the Toronto women died in December 2003 and the other died in May 2004.
Ugandan-born Aziga is also accused of 13 counts of aggravated sexual assault, which includes 11 other women he allegedly had sex with and with whom he did not disclose he was HIV positive.
The Supreme Court of Canada has ruled one partner cannot give true consent for sexual relations if the other fails to tell partners about an HIV infection.
As a result, the deaths of the two women are considered to have resulted from sexual assaults, which automatically calls for first-degree murder charges that carry an automatic life sentence.
The aggravated sexual assault charges carry a maximum sentence of 14 years in prison.
Aziga's trial has been delayed many times due to adjournments sought by the defence. Aziga has fired three legal teams leading up to the trial.
Aziga's trial now is expected to begin on Oct. 20.
Saturday, September 20, 2008
Gray's Anatomy helped increase awareness
Many viewers of an episode of ABC's prime-time medical drama "Grey's Anatomy" that included a story about mother-to-child HIV transmission gained awareness of the issue, according to a survey released on Tuesday by the Kaiser Family Foundation, USA Today reports.
For the study, the Foundation worked with writers of the show to embed in the episode the story of an HIV-positive pregnant woman. According to USA Today, the woman is "distraught" before being told by her physician that with proper treatment, her child has a 98% chance of being born HIV-negative. The Foundation conducted three national random surveys of regular viewers of the show one week before, one week after and six weeks after the episode. The surveys combined had 1,505 respondents.
Victoria Rideout, vice president and director of the Foundation's program for the Study of Media and Health, said the goal of the survey was to measure the "impact of the message about mother-to-child HIV transmission" (Marcus, USA Today, 9/17). One week before the show, 15% of the viewers surveyed said that they were aware of the mother-to-child HIV transmission risk. One week after the show, 61% of viewers of the episode were aware of the risk. Six weeks after the show, 45% of viewers remembered the information correctly (Childs, ABC News, 9/17). According to the survey, the increase from 15% to 61% awareness of the risk of mother-to-child HIV transmission translates to more than eight million people learning correct information on the issue from watching the episode. The survey also found that the percentage of viewers who said it was "irresponsible for a woman who knows she is HIV-positive to have a baby" dropped from 61% to 34% after the episode aired, and then increased to 47% six weeks after the show (Kaiser Family Foundation release, 9/16). Rideout said she was "astounded" by the number of viewers who "picked up on factual health info about HIV embedded in the show, and that they remembered it weeks later."
The Foundation and the University of Southern California's Annenberg Norman Lear Center also released a second study of top-10 prime time television shows, finding that six out of 10 episodes from 2004 to 2006 included at least one health-related storyline. "People are very hungry for information about health," Linda Rosenstock, dean of the University of California-Los Angeles School of Public Health, said, adding that entertainment media do "societal good" by putting accurate health information into shows. Jay Bernhardt of CDC said that embedding information accurately into TV content could "help change behaviors about health" (USA Today, 9/17).
Online The studies, and a Kaisernetwork.org webcast of a briefing discussing them, are available online.
For the study, the Foundation worked with writers of the show to embed in the episode the story of an HIV-positive pregnant woman. According to USA Today, the woman is "distraught" before being told by her physician that with proper treatment, her child has a 98% chance of being born HIV-negative. The Foundation conducted three national random surveys of regular viewers of the show one week before, one week after and six weeks after the episode. The surveys combined had 1,505 respondents.
Victoria Rideout, vice president and director of the Foundation's program for the Study of Media and Health, said the goal of the survey was to measure the "impact of the message about mother-to-child HIV transmission" (Marcus, USA Today, 9/17). One week before the show, 15% of the viewers surveyed said that they were aware of the mother-to-child HIV transmission risk. One week after the show, 61% of viewers of the episode were aware of the risk. Six weeks after the show, 45% of viewers remembered the information correctly (Childs, ABC News, 9/17). According to the survey, the increase from 15% to 61% awareness of the risk of mother-to-child HIV transmission translates to more than eight million people learning correct information on the issue from watching the episode. The survey also found that the percentage of viewers who said it was "irresponsible for a woman who knows she is HIV-positive to have a baby" dropped from 61% to 34% after the episode aired, and then increased to 47% six weeks after the show (Kaiser Family Foundation release, 9/16). Rideout said she was "astounded" by the number of viewers who "picked up on factual health info about HIV embedded in the show, and that they remembered it weeks later."
The Foundation and the University of Southern California's Annenberg Norman Lear Center also released a second study of top-10 prime time television shows, finding that six out of 10 episodes from 2004 to 2006 included at least one health-related storyline. "People are very hungry for information about health," Linda Rosenstock, dean of the University of California-Los Angeles School of Public Health, said, adding that entertainment media do "societal good" by putting accurate health information into shows. Jay Bernhardt of CDC said that embedding information accurately into TV content could "help change behaviors about health" (USA Today, 9/17).
Online The studies, and a Kaisernetwork.org webcast of a briefing discussing them, are available online.
More money needed to reduce the number of new U.S. infections
CDC officials on Tuesday at a House Government Reform and Oversight Committee hearing said they would need an additional $4.8 billion dollars over the next five years to reduce the annual number of new HIV infections in the U.S., CQ HealthBeat reports (Stanchak, CQ HealthBeat, 9/16).
According to the Los Angeles Times, the hearing came after CDC released a study last month that found that about 56,300 new HIV infections occur annually in the U.S. (Dizikes, Los Angeles Times, 9/17).
CDC Director Julie Gerberding based on the new estimates the agency would need an additional $877 million in 2009 to reduce the number of new HIV infections. According to the Times, the fiscal year 2009 budget request for HIV prevention funding is $892 million, which includes $752.6 million requested by CDC. Waxman said that he would try to work with the House Appropriations Committee to increase funding for domestic HIV prevention efforts but added that he is "not very optimistic" the Bush administration will increase funding (Los Angeles Times, 9/17).
Gerberding; Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention; and Anthony Fauci, director of the National Institute for Allergy and Infectious Disease, told the committee that although the additional amount of money requested is high, it could reduce the HIV transmission rate by 50% over 12 years. In addition, the increased funding could help reduce the number of HIV-positive people who are unaware of their status by 50% and help reduce racial disparities.
Gerberding said that the agency would use the increased funding to expand HIV testing, research new prevention techniques and evaluate prevention programs. Fauci added that increased funding also would allow research into new areas of HIV prevention research, such as preventing coinfection with other sexually transmitted infections, providing antiretroviral drugs to HIV-negative people as a preventive measure, testing microbicides and vaccine development.
Although the $4.8 billion request is a significant amount of money, it would be more expensive not to treat HIV, Fauci said. A "professional judgment budget" (.pdf) released by the panelists noted that each HIV infection costs more than $1 million in treatment and lost productivity and that if CDC can prevent 4,800 new infections over five years, the programs established with increased funding would be "cost saving to society."
Gerberding said the request is "not just about funding, it's about needing new tools," adding, "AIDS is a social disease as well as a viral disease ... if we don't address the underpinning issues, we'll never get to where we need to be" (CQ HealthBeat, 9/16). She said that the U.S. "need[s] to do so much more than we're doing right now" to prevent new HIV infections, adding that public health workers "need to get AIDS back on the radar screen" because HIV/AIDS "is still posing a threat to college students and to young men and women across our nation's fabric."
Panelists also called for additional HIV prevention and education programs that target blacks, Hispanics and men who have sex with men. George Ayala of AIDS Project Los Angeles told committee members that only four of CDC's 49 recommended intervention programs specifically target MSM and only one targets minority MSM. He said, "Serious HIV-related health disparities, often fueled by stigma and discrimination, continue to undermine HIV prevention efforts in communities of color" (Los Angeles Times, 9/17).
According to the Los Angeles Times, the hearing came after CDC released a study last month that found that about 56,300 new HIV infections occur annually in the U.S. (Dizikes, Los Angeles Times, 9/17).
CDC Director Julie Gerberding based on the new estimates the agency would need an additional $877 million in 2009 to reduce the number of new HIV infections. According to the Times, the fiscal year 2009 budget request for HIV prevention funding is $892 million, which includes $752.6 million requested by CDC. Waxman said that he would try to work with the House Appropriations Committee to increase funding for domestic HIV prevention efforts but added that he is "not very optimistic" the Bush administration will increase funding (Los Angeles Times, 9/17).
Gerberding; Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention; and Anthony Fauci, director of the National Institute for Allergy and Infectious Disease, told the committee that although the additional amount of money requested is high, it could reduce the HIV transmission rate by 50% over 12 years. In addition, the increased funding could help reduce the number of HIV-positive people who are unaware of their status by 50% and help reduce racial disparities.
Gerberding said that the agency would use the increased funding to expand HIV testing, research new prevention techniques and evaluate prevention programs. Fauci added that increased funding also would allow research into new areas of HIV prevention research, such as preventing coinfection with other sexually transmitted infections, providing antiretroviral drugs to HIV-negative people as a preventive measure, testing microbicides and vaccine development.
Although the $4.8 billion request is a significant amount of money, it would be more expensive not to treat HIV, Fauci said. A "professional judgment budget" (.pdf) released by the panelists noted that each HIV infection costs more than $1 million in treatment and lost productivity and that if CDC can prevent 4,800 new infections over five years, the programs established with increased funding would be "cost saving to society."
Gerberding said the request is "not just about funding, it's about needing new tools," adding, "AIDS is a social disease as well as a viral disease ... if we don't address the underpinning issues, we'll never get to where we need to be" (CQ HealthBeat, 9/16). She said that the U.S. "need[s] to do so much more than we're doing right now" to prevent new HIV infections, adding that public health workers "need to get AIDS back on the radar screen" because HIV/AIDS "is still posing a threat to college students and to young men and women across our nation's fabric."
Panelists also called for additional HIV prevention and education programs that target blacks, Hispanics and men who have sex with men. George Ayala of AIDS Project Los Angeles told committee members that only four of CDC's 49 recommended intervention programs specifically target MSM and only one targets minority MSM. He said, "Serious HIV-related health disparities, often fueled by stigma and discrimination, continue to undermine HIV prevention efforts in communities of color" (Los Angeles Times, 9/17).
Imprisonment of Physicians Who 'Pioneered' Treatment of HIV-Positive Iranians
If Iranian President Mahmoud Ahmadinejad holds a news conference during his visit to the United Nations General Assembly next week, he should be asked why two physicians who started a broad HIV/AIDS awareness campaign in Iran and "pioneered the treatment of Iranian victims of HIV/AIDS" have been imprisoned, Philadelphia Inquirer columnist Trudy Rubin writes in an opinion piece.
According to Rubin, Arash Alaei and his brother, Kamiar -- whom Rubin interviewed in spring 2007 -- started a grass-roots campaign in Iran to treat people living with HIV/AIDS and raise awareness about the epidemic. The brothers were jailed in Iran in late June and, according to Iranian news reports, have been charged with fomenting "a velvet revolution," Rubin writes, adding that the phrase is "shorthand for trying to organize civil society against the regime."
The "irony" of the charges, Rubin writes, is that the brothers were "hoping to increase scientific collaboration with U.S. medical experts in a way that avoids politics." Is "this what scares Iranian officials?" Rubin asks, adding that officials also might fear medical cooperation with the U.S. would threaten the population's fear of a U.S. attack. Ahmadinejad also might be concerned of public unrest before the country's 2009 presidential election, Rubin writes. "[N]one of this explains arresting the doctors Alaei," Rubin writes, concluding it "indicates a government that fears the best and the brightest of its own people" (Rubin, Philadelphia Inquirer, 9/17).
According to Rubin, Arash Alaei and his brother, Kamiar -- whom Rubin interviewed in spring 2007 -- started a grass-roots campaign in Iran to treat people living with HIV/AIDS and raise awareness about the epidemic. The brothers were jailed in Iran in late June and, according to Iranian news reports, have been charged with fomenting "a velvet revolution," Rubin writes, adding that the phrase is "shorthand for trying to organize civil society against the regime."
The "irony" of the charges, Rubin writes, is that the brothers were "hoping to increase scientific collaboration with U.S. medical experts in a way that avoids politics." Is "this what scares Iranian officials?" Rubin asks, adding that officials also might fear medical cooperation with the U.S. would threaten the population's fear of a U.S. attack. Ahmadinejad also might be concerned of public unrest before the country's 2009 presidential election, Rubin writes. "[N]one of this explains arresting the doctors Alaei," Rubin writes, concluding it "indicates a government that fears the best and the brightest of its own people" (Rubin, Philadelphia Inquirer, 9/17).
Rising HIV Prevalence Among MSM in Hong Kong
The senior medical director of Hong Kong's Centre for Health Protection, Raymond Ho Lei-ming, on Tuesday warned residents that HIV prevalence in the region is increasing among men who have sex with men, Hong Kong's Standard reports (Chui, The Standard, 9/17).
According to Ho, a study released last year found that HIV prevalence among MSM in Hong Kong is about 4%, up from a 1% HIV prevalence rate in previous years. Ho said prevalence among MSM in the region could top 30% by 2020 if current trends continue. According to Ho, sex parties and low condom use have been attributed to the increased number of cases. "If we don't do anything, we are looking at a worst-case scenario," Ho said (Benitez, South China Morning Post, 9/17). He called for people at risk of HIV infection to get tested and for greater condom use and other HIV prevention measures (Standard, 9/17).
Loretta Wong Wai-kwan, the CEO of AIDS Concern, a volunteer organization offering HIV/AIDS support and prevention programs in Hong Kong, said that the number of HIV/AIDS clinics in Hong Kong has remained stagnant over the past decade. She added, "How do the existing human resources or facilities cope with the increasing case load?" (South China Morning Post, 9/17).
www.aids-drugs-online.com
According to Ho, a study released last year found that HIV prevalence among MSM in Hong Kong is about 4%, up from a 1% HIV prevalence rate in previous years. Ho said prevalence among MSM in the region could top 30% by 2020 if current trends continue. According to Ho, sex parties and low condom use have been attributed to the increased number of cases. "If we don't do anything, we are looking at a worst-case scenario," Ho said (Benitez, South China Morning Post, 9/17). He called for people at risk of HIV infection to get tested and for greater condom use and other HIV prevention measures (Standard, 9/17).
Loretta Wong Wai-kwan, the CEO of AIDS Concern, a volunteer organization offering HIV/AIDS support and prevention programs in Hong Kong, said that the number of HIV/AIDS clinics in Hong Kong has remained stagnant over the past decade. She added, "How do the existing human resources or facilities cope with the increasing case load?" (South China Morning Post, 9/17).
www.aids-drugs-online.com
Rising HIV Prevalence Among MSM in Hong Kong
The senior medical director of Hong Kong's Centre for Health Protection, Raymond Ho Lei-ming, on Tuesday warned residents that HIV prevalence in the region is increasing among men who have sex with men, Hong Kong's Standard reports (Chui, The Standard, 9/17).
According to Ho, a study released last year found that HIV prevalence among MSM in Hong Kong is about 4%, up from a 1% HIV prevalence rate in previous years. Ho said prevalence among MSM in the region could top 30% by 2020 if current trends continue. According to Ho, sex parties and low condom use have been attributed to the increased number of cases. "If we don't do anything, we are looking at a worst-case scenario," Ho said (Benitez, South China Morning Post, 9/17). He called for people at risk of HIV infection to get tested and for greater condom use and other HIV prevention measures (Standard, 9/17).
Loretta Wong Wai-kwan, the CEO of AIDS Concern, a volunteer organization offering HIV/AIDS support and prevention programs in Hong Kong, said that the number of HIV/AIDS clinics in Hong Kong has remained stagnant over the past decade. She added, "How do the existing human resources or facilities cope with the increasing case load?" (South China Morning Post, 9/17).
http://www.aids-drugs-online.com
According to Ho, a study released last year found that HIV prevalence among MSM in Hong Kong is about 4%, up from a 1% HIV prevalence rate in previous years. Ho said prevalence among MSM in the region could top 30% by 2020 if current trends continue. According to Ho, sex parties and low condom use have been attributed to the increased number of cases. "If we don't do anything, we are looking at a worst-case scenario," Ho said (Benitez, South China Morning Post, 9/17). He called for people at risk of HIV infection to get tested and for greater condom use and other HIV prevention measures (Standard, 9/17).
Loretta Wong Wai-kwan, the CEO of AIDS Concern, a volunteer organization offering HIV/AIDS support and prevention programs in Hong Kong, said that the number of HIV/AIDS clinics in Hong Kong has remained stagnant over the past decade. She added, "How do the existing human resources or facilities cope with the increasing case load?" (South China Morning Post, 9/17).
http://www.aids-drugs-online.com
Saturday, August 30, 2008
HIV Spreading in New York City at About Three Times the National Rate
HIV is spreading in New York City at about three times the national rate, with an incidence of 72 new HIV infections per 100,000 people, compared with 23 new infections per 100,000 people nationwide, according to a study released Wednesday by the New York City Department of Health and Mental Hygiene, the New York Times reports (Chan, New York Times, 8/28).
The study's findings are based on a new HIV testing method developed by CDC that can determine when an HIV infection occurred. Previous data did not distinguish recent infections from those that occurred years earlier, according to the health department. About 100,000 New York residents are living with HIV, health officials said (Honan, Reuters, 8/27). According to the study, 4,762 New York residents contracted HIV in 2006 (New York Times, 8/28). Health officials attributed the higher rate of new HIV infections in the city to large populations of blacks, men who have sex with men and other high-risk groups (AP/Google.com, 8/27). According to the health department, it is unclear whether the number of new infections that occurred in the city in 2006 had increased or decreased over previous years because the testing method is new.
According to the study, men accounted for 76% of new HIV infections while women accounted for 25%. Blacks accounted for 46% of new infections, Hispanics for 32% and whites for 21%. Whites living in the city contracted HIV at four times the national rate, Hispanics at three times the national rate, and blacks in the city contracted the virus at almost twice the national rate. The study found that 4% of new infections were among people younger than age 20, while people ages 20 to 29 accounted for 24% of new infections. People ages 30 to 39 and those ages 40 to 49 each accounted for 29% of new infections, while people older than age 50 accounted for 15%. People younger than age 30 accounted for 28% of new infections in New York City, compared with 41% nationwide.
The primary mode of HIV transmission was sex between men, which accounted for 50% of new infections. High-risk heterosexual sex accounted for 22% of new infections, and injection drug use accounted for 8%. The mode of transmission was unknown in 18% of new cases, the study found (New York Times, 8/28).
In addition, the study found that blacks living in the city contracted HIV at three times the rate of whites and that blacks accounted for almost half of new infections (Reuters, 8/27). Of new HIV infections among MSM younger than age 30, 77% occurred in black and Hispanic men. Black and Hispanic MSM ages 30 to 50 also accounted for 59% of new infections among MSM in that age group (New York Times, 8/28).
Assistant Health Commissioner Monica Sweeney said the study's findings reinforce the need to continue promoting HIV testing and prevention throughout the city (AP/Google.com, 8/27). The department in a statement added that "even a rough gauge of HIV incidence is a valuable tool for understanding -- and combating -- the spread of HIV." The department said that by using the same testing method in future years, "researchers may be able to discern increases and decreases [in HIV incidence] over time and target prevention efforts accordingly" (New York Times, 8/28).
The study's findings are based on a new HIV testing method developed by CDC that can determine when an HIV infection occurred. Previous data did not distinguish recent infections from those that occurred years earlier, according to the health department. About 100,000 New York residents are living with HIV, health officials said (Honan, Reuters, 8/27). According to the study, 4,762 New York residents contracted HIV in 2006 (New York Times, 8/28). Health officials attributed the higher rate of new HIV infections in the city to large populations of blacks, men who have sex with men and other high-risk groups (AP/Google.com, 8/27). According to the health department, it is unclear whether the number of new infections that occurred in the city in 2006 had increased or decreased over previous years because the testing method is new.
According to the study, men accounted for 76% of new HIV infections while women accounted for 25%. Blacks accounted for 46% of new infections, Hispanics for 32% and whites for 21%. Whites living in the city contracted HIV at four times the national rate, Hispanics at three times the national rate, and blacks in the city contracted the virus at almost twice the national rate. The study found that 4% of new infections were among people younger than age 20, while people ages 20 to 29 accounted for 24% of new infections. People ages 30 to 39 and those ages 40 to 49 each accounted for 29% of new infections, while people older than age 50 accounted for 15%. People younger than age 30 accounted for 28% of new infections in New York City, compared with 41% nationwide.
The primary mode of HIV transmission was sex between men, which accounted for 50% of new infections. High-risk heterosexual sex accounted for 22% of new infections, and injection drug use accounted for 8%. The mode of transmission was unknown in 18% of new cases, the study found (New York Times, 8/28).
In addition, the study found that blacks living in the city contracted HIV at three times the rate of whites and that blacks accounted for almost half of new infections (Reuters, 8/27). Of new HIV infections among MSM younger than age 30, 77% occurred in black and Hispanic men. Black and Hispanic MSM ages 30 to 50 also accounted for 59% of new infections among MSM in that age group (New York Times, 8/28).
Assistant Health Commissioner Monica Sweeney said the study's findings reinforce the need to continue promoting HIV testing and prevention throughout the city (AP/Google.com, 8/27). The department in a statement added that "even a rough gauge of HIV incidence is a valuable tool for understanding -- and combating -- the spread of HIV." The department said that by using the same testing method in future years, "researchers may be able to discern increases and decreases [in HIV incidence] over time and target prevention efforts accordingly" (New York Times, 8/28).
Monday, August 18, 2008
FDA Gives Tentative Approval to New Generic AIDS Drug
The Food and Drug Administration (FDA) today announced the tentative approval of a generic AIDS drug - abacavir (a-BAK-a-veer) sulfate tablets manufactured by Aurobindo Pharma LTD. of Hyderabad, India. Abacavir sulfate tablets are the first generic version of the already approved Ziagen Tablets, an anti-HIV medication manufactured by GlaxoSmithKline. This product will now be available for consideration for purchase under the President's Emergency Plan for AIDS Relief.
"FDA's action adds yet another anti-HIV product to those available for purchase under the President's Plan and demonstrates our continuing commitment to ensuring that safe, effective, and quality manufactured medications are available for purchase under the President's Plan," said Murray M. Lumpkin, M.D., Deputy Commissioner for International and Special Programs.
The President's Emergency Plan for AIDSRelief, which President Bush first announced in his 2003 State of the Union Address, is currently providing $15 billion to fight the HIV/AIDS pandemic over five years, with a special focus on 15 of the hardest hit countries. The President's plan is designed to prevent seven million new HIV infections, treat at least two million HIV-infected people, and care for ten million HIV-affected individuals, AIDS orphans and vulnerable children. It targets three specific areas related to HIV/AIDS:
Prevention of HIV transmission;
Treatment of AIDS and associated conditions;
Care, including palliative care for HIV infected-individuals, and care for orphans and vulnerable children.
Abacavir is one of the nucleoside reverse transcriptase inhibitors (NRTIs), a class of drugs that helps keep the AIDS virus from reproducing. It is used in combination with other antiretroviral agents for the treatment of HIV-1 infection.
The agency's tentative approval of this product means that Aurobindo's product meets all of FDA's manufacturing quality and clinical safety and efficacy standards. Although existing patents and/or exclusivity prevent its marketing in the United States, the product can be marketed abroad and used under the PEPFAR plan.
More information on HIV and AIDS is available online at FDA's website:http://www.fda.gov/oashi/aids/hiv.html
"FDA's action adds yet another anti-HIV product to those available for purchase under the President's Plan and demonstrates our continuing commitment to ensuring that safe, effective, and quality manufactured medications are available for purchase under the President's Plan," said Murray M. Lumpkin, M.D., Deputy Commissioner for International and Special Programs.
The President's Emergency Plan for AIDSRelief, which President Bush first announced in his 2003 State of the Union Address, is currently providing $15 billion to fight the HIV/AIDS pandemic over five years, with a special focus on 15 of the hardest hit countries. The President's plan is designed to prevent seven million new HIV infections, treat at least two million HIV-infected people, and care for ten million HIV-affected individuals, AIDS orphans and vulnerable children. It targets three specific areas related to HIV/AIDS:
Prevention of HIV transmission;
Treatment of AIDS and associated conditions;
Care, including palliative care for HIV infected-individuals, and care for orphans and vulnerable children.
Abacavir is one of the nucleoside reverse transcriptase inhibitors (NRTIs), a class of drugs that helps keep the AIDS virus from reproducing. It is used in combination with other antiretroviral agents for the treatment of HIV-1 infection.
The agency's tentative approval of this product means that Aurobindo's product meets all of FDA's manufacturing quality and clinical safety and efficacy standards. Although existing patents and/or exclusivity prevent its marketing in the United States, the product can be marketed abroad and used under the PEPFAR plan.
More information on HIV and AIDS is available online at FDA's website:http://www.fda.gov/oashi/aids/hiv.html
Saturday, August 16, 2008
Free Condoms to Olympic Visitors in China
BEIJING: Beijing authorities are distributing 400,000 free condoms to visitors during the Olympic Games to promote safe sex and prevent the risk of AIDS infection in Beijing and four other co-host cities in China.
Jin Dapeng, a senior official of the health bureau said the condoms had been put in more than 90,000 rooms of 424 hotels rated three stars and above. They included 119 contract hotels in which rooms have been rented by the Olympic Games organisers and Olympic committees of different countries.
An additional 100,000 condoms of "high quality" have been made available for distribution at the health clinic in the Games village, where athletes and some of the sports officials are living.
Free AIDS testing and counselling is being made available in 40 clinics in Beijing's 18 districts and counties. Besides condoms, the bureau is also distributing 250,000 pamphlets in English, French and Chinese to propagate the idea of AIDS prevention and control in different hotels.
Assisting the distributing of these material are hundreds of trained volunteers, who are acting on advice from the United Nations Program on HIV/AIDS and the International Olympic Committee, UNAIDS and IOC are actively involved in the drive to ensure safe sex during the Games.
Jin said 180 college students and 500 community volunteers are involved in the task
Jin Dapeng, a senior official of the health bureau said the condoms had been put in more than 90,000 rooms of 424 hotels rated three stars and above. They included 119 contract hotels in which rooms have been rented by the Olympic Games organisers and Olympic committees of different countries.
An additional 100,000 condoms of "high quality" have been made available for distribution at the health clinic in the Games village, where athletes and some of the sports officials are living.
Free AIDS testing and counselling is being made available in 40 clinics in Beijing's 18 districts and counties. Besides condoms, the bureau is also distributing 250,000 pamphlets in English, French and Chinese to propagate the idea of AIDS prevention and control in different hotels.
Assisting the distributing of these material are hundreds of trained volunteers, who are acting on advice from the United Nations Program on HIV/AIDS and the International Olympic Committee, UNAIDS and IOC are actively involved in the drive to ensure safe sex during the Games.
Jin said 180 college students and 500 community volunteers are involved in the task
Phase One of HIV Vaccine Completed
CHENNAI: The successful completion of phase-1 of clinical trials of the ASIDS vaccine developed here has indicated that it had acceptable levels of safety and was well tolerated, say the Indian Council of Medical Research (ICMR), National AIDS Control Organisation (NACO) and International AIDS Vaccine Initiative (IAVI).
The trial relied on an Modified Vaccinia Ankara (MVA) based AIDS vaccine candidate (TBC-M4). The response levels of volunteers suggested that it holds promise, the three organisations said in a joint statement.
The trial used two doses of the MVA. After three injections, 82 percent of the volunteers who received a low dose and 100 percent of those who received a high dose registered immune responses to the vaccine.
The 100 percent response rate is greater than that seen with the majority of AIDS vaccine candidates tested in humans to date. However the strength and diversity of these immune responses were modest.
It may be possible to boost the immune response, if this vaccine is used in combination with other candidate AIDS vaccines.
"We are pleased to see that the MVA-based candidate tested in Chennai was safe and showed promising initial immune responses. We do not know whether these observed responses will ultimately translate into an effective vaccine ... but hope to learn more through further testing," said S.K. Bhattacharya, additional director general of ICMR.
"India is playing a significant role in global AIDS vaccine discovery efforts given our strong medical and scientific capabilities. There is a need for continued efforts for the creation of novel, reliable mechanisms for long-term research on AIDS vaccines and other new prevention technologies," he added.
The phase I clinical trial was started in January 2006 at the Tuberculosis Research Centre (TRC), an ICMR institute in Chennai, and was completed in February 2008.
This trial was conducted under the aegis of a MoU between the central government through ICMR and NACO and IAVI. YRG CARE, based in Chennai, collaborated with TRC to mobilise the community around the phase I trial.
The trial relied on an Modified Vaccinia Ankara (MVA) based AIDS vaccine candidate (TBC-M4). The response levels of volunteers suggested that it holds promise, the three organisations said in a joint statement.
The trial used two doses of the MVA. After three injections, 82 percent of the volunteers who received a low dose and 100 percent of those who received a high dose registered immune responses to the vaccine.
The 100 percent response rate is greater than that seen with the majority of AIDS vaccine candidates tested in humans to date. However the strength and diversity of these immune responses were modest.
It may be possible to boost the immune response, if this vaccine is used in combination with other candidate AIDS vaccines.
"We are pleased to see that the MVA-based candidate tested in Chennai was safe and showed promising initial immune responses. We do not know whether these observed responses will ultimately translate into an effective vaccine ... but hope to learn more through further testing," said S.K. Bhattacharya, additional director general of ICMR.
"India is playing a significant role in global AIDS vaccine discovery efforts given our strong medical and scientific capabilities. There is a need for continued efforts for the creation of novel, reliable mechanisms for long-term research on AIDS vaccines and other new prevention technologies," he added.
The phase I clinical trial was started in January 2006 at the Tuberculosis Research Centre (TRC), an ICMR institute in Chennai, and was completed in February 2008.
This trial was conducted under the aegis of a MoU between the central government through ICMR and NACO and IAVI. YRG CARE, based in Chennai, collaborated with TRC to mobilise the community around the phase I trial.
Friday, July 18, 2008
Doctor's advice on Viraday - Taken from thebody.com
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Monday, June 30, 2008
The Bronx to Test Everyone for HIV/AIDS
The New York City Department of Health and Mental Hygiene on Friday will begin a three-year effort to test every adult living in the Bronx -- which has the highest rate of HIV/AIDS-related deaths in the city -- for HIV, the New York Times reports. According to the Times, the campaign will initially work to make voluntary testing routine in emergency rooms and storefront clinics, where city officials say that state consent procedures deter physicians from offering the tests. City Health Commissioner Thomas Frieden said that routine testing "would mean if you came into the emergency room for asthma or a broken leg, we test everyone for HIV, if they're willing."
Although Manhattan has the highest incidence of HIV/AIDS cases in the city, the Bronx, which has a lower-income population, reports more deaths from the disease. Public health officials say the high mortality rate is associated with people not getting tested until it is too late to effectively treat the virus. According to city officials, 40% of the borough's 830,000 people ages 18 to 64 have undergone HIV testing in the past year, and half of the remainder, about 250,000, have never been tested. The campaign intends to first test this group at 40 designated sites, including clinics, community centers, churches and emergency rooms. Monica Sweeney, an assistant health commissioner for HIV prevention, said the city has not set aside money specifically for the program, but that it would absorb the $12 cost of each test.
The Times reports that several HIV/AIDS experts have described the effort as the most aggressive in the country. Donna Futterman -- director of Montefiore Medical Center's Adolescent AIDS Program in the Bronx, which helped New York City develop the program -- said, "What's new here is that we are implementing it on this large a level," adding, "The Bronx has 1.3 million people. It's bigger than most cities, bigger than Boston, bigger than Washington. We're talking about a significant urban population." Frieden -- who has enlisted the support of Bronx elected officials, health care providers and clergy members -- said the health department chose the Bronx because it has good relationships with clinics and hospitals there. City officials also said that Bronx residents already are more likely to be tested than adults in other boroughs.
However, Frieden said the efforts come after years of lobbying to overhaul strict state regulations -- which have changed little since HIV/AIDS was first discovered in the 1980s -- that require patients to give written permission for testing after being counseled on the process. According to Frieden, New York's consent law is one of the strictest in the country; CDC recommends that written consent and pretest counseling requirements be dropped.
Futterman said that she hopes that making HIV testing routine by including the test as part of a patient's blood work will change the mentality surrounding the test and spur state legislators to ease consent rules. "Everything in AIDS has changed except the old testing paradigm," she said, adding, "Old school was that you had to tell them everything that could happen. That starts to seem cruel. If you go for cancer diagnosis, they don't make the doctor say what you're going to do if your mammogram is positive."
According to the Times, under the new initiative, hospital administrators in the Bronx have agreed to test in emergency departments, where physicians have felt the requirement interferes with more immediate health needs, but still follow state consent laws. Futterman said she has carefully constructed a script for physicians that follows state law but condenses what is typically a 20-minute counseling and consent process into five minutes. She added that using the process has helped her increase the proportion of her patients being tested to between 20% and 25%, up from 10%.
In an attempt to make HIV testing less intimidating, the city also will issue public service announcements and information on its 311 hotline. It also is posting tear-off sheets with addresses of testing centers in places like check-cashing stores, where residents can discreetly slip them into pockets. Sweeney said, "It's not about one group doing it, it's about everybody doing it." Community organizations, universities, churches and politicians are going to have all their constituents that come to them for other services, they're going to use it as an opportunity to say, 'Get your HIV test'" (Hartocollis, New York Times, 6/26).
Although Manhattan has the highest incidence of HIV/AIDS cases in the city, the Bronx, which has a lower-income population, reports more deaths from the disease. Public health officials say the high mortality rate is associated with people not getting tested until it is too late to effectively treat the virus. According to city officials, 40% of the borough's 830,000 people ages 18 to 64 have undergone HIV testing in the past year, and half of the remainder, about 250,000, have never been tested. The campaign intends to first test this group at 40 designated sites, including clinics, community centers, churches and emergency rooms. Monica Sweeney, an assistant health commissioner for HIV prevention, said the city has not set aside money specifically for the program, but that it would absorb the $12 cost of each test.
The Times reports that several HIV/AIDS experts have described the effort as the most aggressive in the country. Donna Futterman -- director of Montefiore Medical Center's Adolescent AIDS Program in the Bronx, which helped New York City develop the program -- said, "What's new here is that we are implementing it on this large a level," adding, "The Bronx has 1.3 million people. It's bigger than most cities, bigger than Boston, bigger than Washington. We're talking about a significant urban population." Frieden -- who has enlisted the support of Bronx elected officials, health care providers and clergy members -- said the health department chose the Bronx because it has good relationships with clinics and hospitals there. City officials also said that Bronx residents already are more likely to be tested than adults in other boroughs.
However, Frieden said the efforts come after years of lobbying to overhaul strict state regulations -- which have changed little since HIV/AIDS was first discovered in the 1980s -- that require patients to give written permission for testing after being counseled on the process. According to Frieden, New York's consent law is one of the strictest in the country; CDC recommends that written consent and pretest counseling requirements be dropped.
Futterman said that she hopes that making HIV testing routine by including the test as part of a patient's blood work will change the mentality surrounding the test and spur state legislators to ease consent rules. "Everything in AIDS has changed except the old testing paradigm," she said, adding, "Old school was that you had to tell them everything that could happen. That starts to seem cruel. If you go for cancer diagnosis, they don't make the doctor say what you're going to do if your mammogram is positive."
According to the Times, under the new initiative, hospital administrators in the Bronx have agreed to test in emergency departments, where physicians have felt the requirement interferes with more immediate health needs, but still follow state consent laws. Futterman said she has carefully constructed a script for physicians that follows state law but condenses what is typically a 20-minute counseling and consent process into five minutes. She added that using the process has helped her increase the proportion of her patients being tested to between 20% and 25%, up from 10%.
In an attempt to make HIV testing less intimidating, the city also will issue public service announcements and information on its 311 hotline. It also is posting tear-off sheets with addresses of testing centers in places like check-cashing stores, where residents can discreetly slip them into pockets. Sweeney said, "It's not about one group doing it, it's about everybody doing it." Community organizations, universities, churches and politicians are going to have all their constituents that come to them for other services, they're going to use it as an opportunity to say, 'Get your HIV test'" (Hartocollis, New York Times, 6/26).
Monday, June 09, 2008
Drug Access | Boehringer, Gilead Freeze Antiretroviral Prices for Some U.S. Agencies
[Jun 05, 2008]
Pharmaceutical companies Boehringer Ingelheim and Gilead Sciences are freezing the prices of their antiretroviral drugs for select agencies in the U.S., the AIDS Healthcare Foundation announced on Tuesday, Bloomberg reports. Gilead will freeze the prices on its antiretrovirals Viread, Truvada and Emtriva for the U.S. Public Health Service, the Federal Supply Service and state AIDS Drug Assistance Programs, according to company spokesperson Amy Flood. The price freeze will be effective through Dec. 31, 2010, according to AHF. The wholesale acquisition cost is $552 monthly for Viread, $329 monthly for Emtriva and $840 monthly for Truvada, Flood said. She added that government purchasers generally receive partial rebates from the prices. "We share your concern regarding antiretroviral cost pressures faced by government payers, particularly during times of limited budget access and flat funding," Gregg Alton, senior vice president and general counsel at Gilead, said in a letter to AHF.
Boehringer will freeze the price of its antiretroviral Aptivus for ADAPs through May 1, 2009, according to AHF. The price freeze became effective May 1, according to a Boehringer letter to AHF. Boehringer spokesperson Judith von Gordon did not return calls for comment, Bloomberg reports.
"We urge the other drug companies to follow [Boehringer's] and Gilead's lead and to freeze price increases that create an unnecessary burden on an already overburdened public health system and keep lifesaving drugs out of reach for those who need them," AHF President Michael Weinstein said. AHF called on companies to freeze their prices because of issues government agencies have had in increasing access to antiretrovirals (Lauerman, Bloomberg, 6/3). Reponses from Abbott Laboratories, Bristol-Myers Squibb, GlaxoSmithKline, Merck, Pfizer, Roche and Johnson & Johnson subsidiary Tibotec Therapeutics "reiterated the companies' commitment to increasing access but made no specific pledge with regard to" price freezes, according to an AHF release (AHF release, 6/3).
For access to low cost generics, please visit:
www.aids-drugs-online.com
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