AIDS, AIDS Drugs, and HIV

Pornography a target for safe sex push

2010-03-22T05:16:00.000-07:00

One of the Health Safety Boards in California, decided to study a new requirement for the pornography industry, which was recommended by the AIDS Healthcare Foundation. The current California law states that porn stars must not test positive for HIV and other sexually related diseases, in a time span of 30 days before filming begins. The managers of this industry believe the present requirement is enough. Some years ago the porno industry was shut down for a while because one of its stars tested positive for AIDS.

The porno industry is not happy with this study being pushed by the AIDS Healthcare Foundation. The porno industry like many others has been hit hard by the downturn in the economy. They are claiming that the wearing of condoms will lose customers who want to see it all, not a condom taking away from their view and action. The wearing of a condom will practically nullify some raunchier areas of the industry, where proof of something actually happening, is necessary to satisfy certain porno watchers.

A big decision might be on the horizon for the porn industry. To fight this measure if it passes, or to accept it. It comes down to the decision of which is more important, life or the bottom line.

http://www.ecanadanow.com/health/2010/03/21/health-group-recommends-condoms-required-in-porn-industr/

Drug Resistance Lowering

2010-01-11T05:08:00.000-08:00

VANCOUVER — A new B.C. study shows a dramatic decrease in the number of HIV patients developing resistance to anti-retroviral drugs.

“This is good news, with big implications,” said the study’s author, Dr. Richard Harrigan.

The BC Centre for Excellence in HIV/AIDS research shows a dramatic decrease in the number of HIV patients in B.C. developing resistance to anti-retroviral drugs.

When treatments keep the virus from replicating, the disease doesn’t progress, said Harrigan. “If you develop resistance, you’re in trouble.”

HIV positive Vancouver artist Tiko Kerr was near death five years ago because of drug resistance.

“You can’t imagine what it’s like to be given your life back,” said Kerr, who has been HIV positive for 25 years.

Kerr was one of five seriously ill B.C. HIV patients who had to fight to get what were then experimental treatments — their last chance for survival.

“Within the first five days of my new treatment in 2006, my viral load was reduced 90 per cent.”

Harrigan attributed the decline in new cases of drug resistance to “steady improvement” over the years.

“In the early days, people would have to take 30 pills a day,” said Harrigan. “Now it’s often just one pill a day.”

The study, published in the Jan. 1 edition of Clinical Infections Diseases, reports that from 1996-2008 there has been a 12-fold decrease in drug resistance.

“The main thing that we saw is that the HAART therapies (highly active antiretroviral therapy) are becoming more successful every year in keeping the level of virus in patients down below the level we can even detect.

“That prevents the virus from replicating, from making copies of itself and the disease doesn’t progress,” Harrigan said.

It also means less drug-resistant HIV is being passed on “from patient A to patient B.”

The 10-year-long study involved 5,500 patients.

Vancouver Sun

HIV-related Memory Loss Linked To Alzheimer's Protein

2009-12-10T04:52:00.000-08:00

New research published in Neurology suggests that amyloid, one of the proteins associated with Alzheimer's disease, may also play a role in the memory loss of people with HIV.

Researchers examined cerebrospinal fluid (CSF) and found that the amount of amyloid was lower in Alzheimer's patients and HIV patients with memory problems, when compared to HIV patients without memory problems and healthy people. The other protein associated with Alzheimer's, Tau, was unchanged. Lower amounts of amyloid in the CSF suggest that amyloid processing in the brain is also affected.

'Alzheimer's like symptoms experienced by people with HIV can be frightening and confusing but this research builds on our understanding of why these symptoms occur and may help people get a more accurate diagnosis.

'Using spinal fluid techniques to diagnose dementia adds great value to research yet the UK lags far behind other countries who routinely use them. We must invest more in dementia research and increase the use of spinal fluid techniques if the UK is to lead the fight against dementia.'

Dr Susanne Sorensen
Head of Research

Source
Alzheimer's Society

Hospital-Acquired HIV In Africa

2009-12-10T04:51:00.000-08:00

PlusNews examines several recent reports that highlight how unsanitary hospital procedures can create an environment conducive to the spread of HIV/AIDS.

"One study of HIV-positive Swazi children aged between 2 and 12, which relied on data from the 2006-2007 Swaziland Demographic and Health Survey, found that one in five of the children had HIV-negative mothers. Discounting the possibility that child sexual abuse could account for such a significant share of paediatric infections, the authors suggested that contaminated needles used to administer vaccinations and injections were to blame," the news service writes. "This argument was supported by evidence from a Kenyan study, which found that HIV-infected children with HIV-negative mothers had experienced more potential blood exposures during malaria treatment, dental surgery and vaccinations than their uninfected siblings."

The news service continues: "Another study in the journal published by the British Association of Sexual Health and HIV, found that clients at voluntary HIV counselling and testing centres run by the University of Calabar Teaching Hospital in southeastern Nigeria, who contracted HIV, were significantly more likely to have had blood tests, vaccinations, blood transfusions or surgical procedures than those who remained negative."

The article includes comments by study researchers, who say HIV prevention programs should improve blood screening and equipment sterilization in addition to addressing sexual behavior, and outside experts who say the studies raise interesting questions, but warn that more research is needed to fully grasp the extent of the problem (12/7).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

Medicare Expands List Of Covered Preventive Services To Include HIV Screening Tests

2009-12-10T04:50:00.000-08:00

The Centers for Medicare & Medicaid Services (CMS) today announced its final decision to cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including women who are pregnant and Medicare beneficiaries of any age who voluntarily request the service. The decision is effective immediately.

Under the recently passed Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), CMS now has the flexibility of adding to Medicare's list of covered preventive services, if certain requirements are met. Prior to this law, Medicare could only cover additional preventive screening tests when Congress authorized it to do so.

"Today's decision marks an important milestone in the history of the Medicare program," said HHS Secretary Kathleen Sebelius. "Beginning with expanding coverage for HIV screening, we can now work proactively as a program to help keep Medicare beneficiaries healthy and take a more active role in evaluating the evidence for preventive services."

Under MIPPA, CMS can consider whether Medicare should cover preventive services that Congress has not already deemed as covered or non-covered by law. Among other requirements, the new services must have been "strongly recommended" or "recommended" by the U.S. Preventive Services Task Force. For instance, the Task Force graded HIV screening as "strongly recommended" for certain groups. More information about the Task Force is available online here.

"Every adult should know their HIV status," said Dr. Howard K. Koh, HHS assistant secretary for health. "This decision by Medicare should help promote screening and save lives."

CMS uses the national coverage determination (NCD) process to make decisions on these types of preventive services. This process provides transparency about the evidence that CMS considers when making its decisions and allows opportunity for the public to comment on CMS' proposals.

"Medicare's coverage of HIV screening tests is an important step forward in protecting beneficiaries from the potentially devastating and life-threatening complications of HIV and Acquired immunodeficiency Syndrome (AIDS)," said CMS Acting Administrator Charlene Frizzera.

AIDS is diagnosed when an HIV-infected person's immune system becomes severely compromised or a person becomes ill with an HIV-related infection. Of the more than one million estimated to have the HIV infection, the Centers for Disease Control and Prevention has estimated that about a quarter of them do not realize they are infected. Without treatment, AIDS develops within 8 to 10 years. While there is presently no cure for HIV, screening can help identify infected patients so that they can receive medical treatment that could help delay the onset of AIDS for years.

More information about Medicare's new HIV screening benefit is available in CMS' final decision memorandum. Read the final decision online here.

Source
HHS

Pharma manufacturers have 97 new HIV/AIDS medications in the pipeline

2009-12-07T04:51:00.000-08:00

Chemistry World recently highlighted a new report published by the Pharmaceutical Research and Manufacturers of America (PhRMA) that identifies 97 new drugs and vaccines in development for HIV/AIDS and related conditions.

The report found that the 97 products in development include 23 vaccines and 54 antivirals. These drugs are either in human clinical trials or awaiting approval by the U.S. Food and Drug Administration (FDA).

"We are greatly encouraged by these critically important medicines and vaccines in development to treat and prevent HIV infection," said PhRMA President and CEO Billy Tauzin. "Pharmaceutical researchers are continuing their efforts to develop new therapies and vaccines to improve and lengthen the lives of HIV-infected patients."

"As a result of HIV/AIDS medicines, a disease that was once a virtual death sentence can now be controlled and treated as if it were a chronic disease," stated Tauzin. "And the new medicines our scientists are working on right now bring hope for even more promising results in the future."

December 1 marks the 21st anniversary of "World AIDS Day" - a global awareness campaign that originated at the 1988 World Summit of Ministers of Health on Programmes for AIDS Prevention.

Source: Pharmaceutical Research and Manufacturers of America

Chinese AIDS activists demand more access to treatment

2009-12-01T05:06:00.000-08:00

A small group of uninvited Chinese activists took over an official World AIDS Day event Tuesday, demanding more government recognition and help.

The action at the Chinese railway's massive South Station in Beijing came as volunteers passed out AIDS leaflets to passengers as part of a campaign by China's Red Cross.

Wearing white face masks scrawled with the words "Infected blood transfusions causes AIDS," the group or 20 or so activists mounted the stage to speak through tears.

"Our fight for free treatment has continued for the past eight years with no luck," one protester, Liu Xiurong, said afterward.

Liu, from northern Harbin, said her son became infected with the HIV virus by tainted plasma several years ago. She received compensation from the Shanghai company that supplied the blood but the money wasn't enough to help her family with its medical costs.

"The money we got is not even close to the amount that we need to live. My son still needs treatment," she told Associated Press Television News.

"Now that we've put ourselves out there, there is a chance that we'll be beaten or arrested in the future," Liu said. "It's OK because we have nothing left to lose and maybe by doing this, we can inspire others who are afraid to come out united for our cause."

The HIV virus that causes AIDS gained a foothold in China largely due to unsanitary blood plasma-buying schemes and tainted transfusions in hospitals.

AIDS was the top killer among infectious diseases in China for the first time last year, a fact that may reflect improved reporting of HIV/AIDS statistics in recent years as the country slowly acknowledges the problem.

By the end of October, the number of Chinese confirmed with HIV-AIDS was 319,877, according to China's Health Ministry, up from 264,302 last year and 135,630 in 2005. Health Minister Chen Zhu said the actual level of infections is probably closer to 740,000.

On Monday, President Hu Jintao publicly pledged to mobilize the whole society in tackling the growing AIDS problem in the China.

State broadcaster China Central Television showed footage Tuesday of Hu, wearing a crimson ribbon pinned to his shirt, talking through a videophone to AIDS patients, doctors and researchers at Ditan Hospital. It was a move aimed at improving awareness and helping reduce stigma for HIV-positive people.

On Tuesday, dozens of railway workers and about 100 volunteers, some with stickers of a red ribbon or a red cross on their cheeks, helped pass out free pamphlets on disease prevention and reducing social stigma. Free condoms were also available to passers-by.

The event, co-hosted by the Railways Ministry, was aimed at promoting AIDS and HIV messages on the country's massive rail network to target the public, in particular migrant workers who crisscross the country in search of jobs.

Globally, there were about 33.4 million people with HIV last year, according to UNAIDS in a report issued last week. About 4.7 million of those were in the Asia-Pacific region.

There were about 350,000 new infections last year across the Asia-Pacific, including 21,000 children. And about 330,000 people died from complications related to AIDS.

The epidemic continues to be fueled in most countries by high-risk groups, such as intravenous drug users, sex workers and their clients. Though China is believed to have the world's largest number of injecting drug users, the main mode of HIV transmission has changed from infected needles from drug use to heterosexual sex.

Data show that 40 percent of new HIV cases diagnosed in China were infected through heterosexual contact, with homosexual sex accounting for 32 percent and the remainder related to drug abuse.

_____

Associated Press Medical Writer Margie Mason in Hanoi contributed to this report.

Important Label Update for Norvir (Ritonavir)

2009-11-27T05:08:00.000-08:00

November 23, 2009

On November 23, 2009, FDA approved changes to the Norvir package insert (product label) to include drug-drug interaction information for concurrent ritonavir administration with:

inhaled medicines such as salmeterol or salmeterol in combination with fluticasone propionate (Serevent, Advair)
sildenafil (Revatio)

Also other revisions to the Contraindications, Warnings, Precautions: Drug Interactions and Dosage and Administration as follows.

The CONTRAINDICATIONS was updated as follows:
When co-administering NORVIR with other protease inhibitors, see the full prescribing information for that protease inhibitor including contraindication information.
NORVIR is contraindicated in patients with known hypersensitivity to ritonavir or any of its ingredients.
Co-administration of NORVIR is contraindicated with the drugs listed in Table 4 (also see PRECAUTIONS -- Table 5. Drugs that Should Not be Co-administered with NORVIR) because ritonavir mediated CYP3A inhibition can result in serious and/or life-threatening reactions. Voriconazole and St. John's Wort are exceptions in that co-administration of NORVIR and voriconazole results in a significant decrease in plasma concentrations of voriconazole, and co-administration of NORVIR with St. John's Wort may result in decreased ritonavir plasma concentrations.

Table 4. Drugs that are Contraindicated with NORVIR
Drug Class	Drugs Within Class That Are CONTRAINDICATED With NORVIR**
Alpha1-adrenoreceptor antagonist	Alfuzosin HCL
Antiarrhythmics	Amiodarone, bepridil, flecainide, propafenone, quinidine
Antifungal	Voriconazole
Ergot Derivatives	Dihydroergotamine, ergonovine, ergotamine, methylergonovine
GI Motility Agent	Cisapride
Herbal Products	St. John's Wort (hypericum perforatum)
HMG-CoA Reductase Inhibitors:	Lovastatin, simvastatin
Neuroleptic	Pimozide
PDE5 enzyme inhibitor	Sildenafil* (Revatio®) only when used for the treatment of pulmonary arterial hypertension (PAH)
Sedative/hypnotics	Oral midazolam, triazolam
* see WARNINGS - Drug Interactions and PRECAUTIONS -- Table 6. Established and Other Potentially Significant Drug Interactions for coadministration of sildenafil in patients with erectile dysfunction. ** For additional information for these contraindicated drugs, see also PRECAUTIONS -- Table 5. Drugs that Should Not be Co-administered with NORVIR.

The WARNINGS section for Drug Interactions was updated as follows
Drug Interactions
See CONTRAINDICATIONS- Table 4 for a listing of drugs that are contraindicated with NORVIR due to potentially life-threatening adverse events, significant drug interactions, or loss of virologic activity. Also, see PRECAUTIONS -- Table 5 and Table 6 for drugs that should not be co-administered with NORVIR and for a listing of drugs with established and other significant drug interactions.

The PRECAUTIONS section with regard to drug interactions was updated as follows:

Table 5. Drugs that Should Not be Co-administered with NORVIR
Drug Class: Drug Name	Clinical Comment
Alpha Adrenergic Antagonist: alfuzosin	CONTRAINDICATED due to potential for serious reactions such as hypotension.
Antiarrhythmics: amiodarone, bepridil, flecainide, propafenone, quinidine	CONTRAINDICATED due to potential for serious and/or life threatening reactions such as cardiac arrhythmias.
Antifungal: voriconazole	CONTRAINDICATED due to significant decreases in voriconazole plasma concentrations and may lead to loss of antifungal response.
Ergot Derivatives: dihydroergotamine, ergonovine, ergotamine, methylergonovine	CONTRAINDICATED due to potential for serious and/or life-threatening reactions such as acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues including the central nervous system.
GI Motility Agent: cisapride	CONTRAINDICATED due to potential for serious and/or life-threatening reactions such as cardiac arrhythmias.
Herbal Products: St. John's wort (hypericum perforatum)	CONTRAINDICATED as the combination may lead to loss of virologic response and possible resistance to NORVIR or to the class of protease inhibitors.
HMG-CoA Reductase Inhibitors: lovastatin, simvastatin	CONTRAINDICATED due to potential for serious reactions such as risk of myopathy including rhabdomyolysis.
Neuroleptic: pimozide	CONTRAINDICATED due to the potential for serious and/or life-threatening reactions such as cardiac arrhythmias.
PDE5 enzyme inhibitor: Sildenafil* (Revatio®)	CONTRAINDICATED in the treatment of pulmonary arterial hypertension (PAH). A safe and effective dose has not been established when used with ritonavir. There is an increased potential for sildenafil-associated adverse events, including visual abnormalities, hypotension, prolonged erection, and syncope.
Sedative/hypnotics: oral midazolam, triazolam	CONTRAINDICATED due to potential for serious and/or life-threatening reactions such as prolonged or increased sedation or respiratory depression.

Table 6 below was revised to include updated information on coadministration with darunavir, tipranavir, maravoric, voriconazole, PDE5 inhibitor for pulmonary arterial hypertension (sildenafil (Revatio)) and parenteral midazolam

Table 6. Established and Other Potentially Significant Drug Interactions: Alteration in Dose or Regimen Recommended Based on Drug Interaction Studies or Predicted Interaction (see CLINICAL PHARMACOLOGY -- Table 2 and Table 3 for Magnitude of Interaction)
Concomitant Drug Class: Drug Name	Effect on Concentration of Ritonavir or Concomitant Drug	Clinical Comment
HIV-Antiviral Agents
HIV Protease Inhibitor: darunavir	When co-administered with reduced doses of ritonavir ↑ darunavir (↑ AUC, ↑ Cmax, ↑ Cmin)	See the complete prescribing information for Prezista® (darunavir) for details on co-administration of darunavir 600 mg b.i.d with ritonavir 100 mg b.i.d. or darunavir 800 mg q.d. with ritonavir 100 mg q.d.
HIV Protease Inhibitor: tipranavir	When co-administered with reduced doses of ritonavir ↑ tipranavir (↑ AUC, ↑ Cmax, ↑ Cmin)	See the complete prescribing information for Aptivus® (tipranavir) for details on co-administration of tipranavir 500 mg b.i.d with ritonavir 200 mg b.i.d. There have been reports of clinical hepatitis and hepatic decompensation including some fatalities. All patients should be followed closely with clinical and laboratory monitoring, especially those with chronic hepatitis B or C co-infection, as these patients have an increased risk of hepatotoxicity. Liver function tests should be performed prior to initiating therapy with tipranavir/ritonavir, and frequently throughout the duration of treatment.
HIV Protease Inhibitor: fosamprenavir	When co-administered with reduced doses of ritonavir ↑ amprenavir (↑ AUC, ↑ Cmax, ↑ Cmin)	See the complete prescribing information for Lexiva® (fosamprenavir) for details on co administration fosamprenavir 700 mg b.i.d with ritonavir 100 mg b.i.d., fosamprenavir 1400 mg q.d. with ritonavir 200 mg q.d. or fosamprenavir 1400 mg q.d. with 100 mg q.d.
HIV CCR5 -- antagonist: maraviroc	↑ maraviroc	Concurrent administration of maraviroc with ritonavir will increase plasma levels of maraviroc. For specific dosage adjustment recommendations, please refer to the complete prescribing information for Selzentry® (maraviroc).
Other Agents
Antifungal: voriconazole	↓ voriconazole	Coadministration of voriconazole and ritonavir doses of 400 mg every 12 hours or greater is contraindicated. Coadministration of voriconazole and ritonavir 100 mg should be avoided, unless an assessment of the benefit/risk to the patient justifies the use of voriconazole.
Long-acting beta-adrenoceptor agonist: salmeterol	↑ salmeterol	Concurrent administration of salmeterol and ritonavir is not recommended. The combination may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations and sinus tachycardia.
PDE5 Inhibitors: sildenafil, tadalafil, vardenafil	↑ sildenafil ↑ tadalafil ↑ vardenafil	Particular caution should be used when prescribing sildenafil, tadalafil or vardenafil in patients receiving ritonavir. Coadministration of ritonavir with sildenafil is expected to substantially increase sildenafil concentrations (11-fold increase in AUC). Use of sildenafil, tadalafil or vardenafil may result in an increase in associated adverse events, including hypotension, syncope, visual changes, and prolonged erection. Use of PDE5 inhibitors for pulmonary arterial hypertension (PAH): Sildenafil (Revatio®) is contraindicated when used for the treatment of pulmonary arterial hypertension (PAH) because a safe and effective dose has not been established when used with ritonavir (see CONTRAINDICATIONS and PRECAUTIONS -- Drug Interactions, Table 5). Use of PDE5 inhibitors for erectile dysfunction: Sildenafil: The starting does should not, in any case, exceed 25 mg in a 48-hour period in patients receiving concomitant ritonavir therapy (see WARNINGS). Tadalafil: Use tadalafil with caution at reduced doses of no more than 10 mg every 72 hours with increased monitoring for adverse events(see WARNINGS). Vardenafil: Use vardenafil with caution at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse events(see WARNINGS).
Sedative/hypnotics: Parenteral midazolam	↑ midazolam	Co-administration of oral midazolam with NORVIR is CONTRAINDICATED. Concomitant use of parenteral midazolam with NORVIR may increase plasma concentrations of midazolam. Co-administration should be done in a setting which ensures close clinical monitoring and appropriate medical management in case of respiratory depression and/or prolonged sedation. Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered.

The DOSAGE AND ADMINISTRATION section was revised to include the following statement.

Adults
Dose modification for NORVIR
Dose reduction of NORVIR is necessary when used with other protease inhibitors: amprenavir, atazanavir, darunavir, fosamprenavir, saquinavir, and tipranavir. Prescribers should consult the full prescribing information and clinical study information of these protease inhibitors if they are co-administered with a reduced dose of ritonavir.

The complete revised labeling will be available at Drugs@FDA.

Norvir is a protease inhibitor, marketed by Abbott Laboratories.

Despite Gains, HIV/AIDS Remains Public-Health Priority, UNAIDS, WHO Say

2009-11-26T04:58:00.001-08:00

November 25, 2009

News outlets continued to examine the 2009 AIDS epidemic update released Tuesday by the WHO and UNAIDS:

"The U.N. report said 'AIDS continues to be a major public-health priority' and called for more funds to support efforts to curb the epidemic and to distribute lifesaving drugs," the Wall Street Journal reports. "The U.N. report also suggested that health authorities need to focus resources on those most at risk" (Fairclough, 11/25).

Los Angeles Times: "About 4 million people were receiving AIDS drugs at the end of 2008, compared with 3 million the previous year. Nonetheless, an additional '5 million people need treatment and are not receiving it,' Dr. Teguest Guerma, acting director of the WHO's HIV/AIDS department, said at a Tuesday news conference. She said that about 2.9 million lives had been saved so far by increased access to the drugs as a result of the U.S. President's Emergency Plan for AIDS Relief and other international assistance programs" (Maugh, 11/25).

VOA News examines the U.S. contributions towards the global fight against HIV/AIDS. The article includes comments by Anthony Fauci, of the National Institute of Allergy and Infectious Diseases, and Michele Moloney-Kitts, assistant coordinator in the office of the global AIDS coordinator. According to Fauci, the National Institutes of Health have "spent about $42 billion from 1982 through fiscal year 2009 on HIV/AIDS research," funding Fauci credited to having helped improve the lives of people living with HIV/AIDS, the news service writes.

"Michele Moloney-Kitts ... said the U.S. government to date has provided about $25 billion, making it the largest donor in the global fight against AIDS, tuberculosis and malaria." The article also includes Moloney-Kitts' comments about the future of PEPFAR under the Obama administration (Butty, 11/24).

"The update cautions that prevention programs often fail to target the populations that are most at risk," Science's "ScienceInsider" blog reports. "Specifically, stigma and local laws prevent many countries from tailoring prevention outreach to highly vulnerable groups like injecting drug users, men who have sex with men, commercial sex workers, and longterm couples in which only one partner is infected. And the sobering bottom line is that five people continue to be infected for every two who start treatment with anti-HIV drugs" (Cohen, 11/24).

Epidemics in Russia, Eastern Europe, China

RIA Novosti examines the findings of the report that "[o]ver 1% of Russian residents are HIV-positive," with the primary route of transmission being injecting drug use. "According to the report, about 37% of Russia's estimated 1.8 million drug users are HIV-infected. Young people account for a considerable number of infections among injecting drug users in the region," the news service writes (11/25).

KyivPost: "'With an adult HIV prevalence of 1.6%, Ukraine has the highest prevalence in all of Europe,' UNAIDS and WHO experts said." The report also found "the estimated number of adults and children living with HIV in Eastern Europe and Central Asia has grown by 66% to 1.5 million since 2001," according to the newspaper (11/25).

The Associated Press examines the report's findings that HIV "is now spreading fastest in China through heterosexual sex, a trend demanding new strategies to stave off a rebound in the epidemic after years of progress in containing it ..." UNAIDS head Michel Sidibe said, "We are seeing a shift in the nature of the epidemic. ... We need to ensure resource allocation is responding to that change."

The article includes details about how "[t]he government remains sensitive about [HIV/AIDS]" and stories of patients living with HIV/AIDS seeking additional support from the government (Kurtenbach, 11/25).

Xinhua/People's Daily Online also reports on the Chinese health minister's response to the UNAIDS report and highlights the efforts of the Chinese government to stop the spread of HIV/AIDS in the country (11/24). In a UNAIDS press release that lauded China's progress on HIV/AIDS Sibide's said, "The world eagerly anticipates China's enhanced role in global governance -- and its leadership in the global response to AIDS" (11/24).

HIV - Up Close and Personal

2009-11-23T05:00:00.000-08:00

Since the discovery in 2007 that a component of human semen called SEVI boosts infectivity of the virus that causes AIDS, researchers have been trying to learn more about SEVI and how it works, in hopes of thwarting its infection-promoting activity.

Now, scientists at the University of Michigan have determined the atomic-level, three-dimensional structure of a SEVI precursor known as PAP248-286 and discovered how it damages cell membranes to make them more vulnerable to infection with HIV. The work is described in two new papers. The most recent, describing the structure, was published online Nov. 17 in the Journal of the American Chemical Society. The paper describing how PAP248-286 interacts with cell membranes appeared in the Nov. 4 issue of Biophysical Journal.

PAP248-286 is a peptide---a chain of amino acids not long enough to be considered a protein. Individual PAP248-286 peptides have a tendency to clump together to form amyloid fibers called SEVI (semen enhancer of viral infection). Amyloid fibers are of great interest because they are the calling cards of many neurodegenerative diseases, such as Alzheimer's and Parkinson's, and aging-related diseases like type-2 diabetes. Using NMR (nuclear magnetic resonance) spectroscopy, a technique that not only yields atomic-level details of a molecule's structure, but also shows how the molecule nestles into the membrane with which it interacts, researcher Ayyalusamy Ramamoorthy and coworkers found that the structure of PAP248-286 is unlike that of most other amyloid-forming peptides and proteins.

In solution, SEVI is completely unstructured or has no definite shape and is therefore ineffective. On the other hand, "when bound to the membrane, it's in a spaghetti-like arrangement---a disorganized, loose coil," said Ramamoorthy, a professor of chemistry and of biophysics. In contrast, most other amyloid proteins assume a more ordered, helical configuration. Also unlike other amyloid peptides, SEVI does not penetrate deep into the greasy region of the cell membrane, but is located near the surface. Ramamoorthy and coauthors believe the spread-out, disordered configuration and its location in the cell membrane may explain the ability of SEVI fibers to enhance HIV infection, as the arrangement provides more surface area with which the virus can interact.

A key finding of the second study is that PAP248-286 "shocks" the membrane, inducing a structural change---a kind of dimple that allows HIV to attach to and enter the cell.

Next, Ramamoorthy and colleagues hope to discern more structural details of PAP248-286 and SEVI. They also plan to screen antioxidant compounds such as green tea extract, curcumin and resveratrol (found in red wine) to see if such compounds are capable of blocking SEVI's HIV-enhancing activity.

Ramamoorthy's coauthors on the Journal of the American Chemical Society paper are graduate student Ravi Nanga, post-doctoral fellows Jeffrey Brender and Nataliya Popovych and NMR specialist Subramanian Vivekanandan. His coauthors on the Biophysical Journal paper are Brender, graduate student Kevin Hartman, former post-doctoral fellow Lindsey Gottler, former graduate student Marchello Cavitt and biophysics undergraduate student Daniel Youngstrom.

This research was supported by funds from the National Institutes of Health.

Source: Nancy Ross-Flanigan
University of Michigan

AIDS Virus in this Lifetime?

2009-11-17T05:02:00.001-08:00

Experts at an international HIV/AIDS conference in Winnipeg say researchers around the world are closer than ever to finding a vaccine against the virus.

Frank Plummer, director of Winnipeg's National Microbiology Laboratory, said he expects to see a vaccine in his lifetime.

"I'm confident that we will get there eventually," Plummer said. "It's not a simple problem. If it was, we would have done it already."

He said there are cases around the world of people who have had contact with the virus but haven't become infected. Plummer said some of that is luck, but it may also be due to natural immunity.

Case studies shared

Case studies were shared at a gathering of about 75 international experts at the conference.

Researchers at the conference pointed out that many breastfeeding infants who are born to HIV-positive women escape infection. Some groups of sex-trade workers who are repeatedly exposed to the virus also appear to be immune.

'We don't understand it fully yet and that needs to be expanded. We don't understand how to produce it artificially, which is what a vaccine is all about.'—Frank Plummer

"Sometimes that's because of luck but sometimes that's because, I believe, they're immune in some way to HIV," Plummer said. "We don't understand it fully yet and that needs to be expanded. We don't understand how to produce it artificially, which is what a vaccine is all about."

In September, researchers announced that a two-vaccine combination cut the risk of becoming infected with HIV by more than 31 per cent in a trial of more than 16,000 volunteers in Thailand.

Canada's chief public health officer, David Butler-Jones, said some of the greatest vaccine discoveries have come from figuring out natural immunity.

"The original vaccine for smallpox was a recognition that milk maids who had cowpox were not susceptible to smallpox," he said.

Although some of the world's great minds are grappling with the virus, Butler-Jones said it is a very difficult illness to crack. People are capable of developing antibodies to HIV/AIDS but they aren't enough to protect against the virus, he said.

"It is one of the great scientific and medical challenges moving forward. Every day we are one day closer but exactly when that day will come, it's impossible to predict," Butler-Jones said. "The sooner, the better."

According to a 2008 United Nations report on the global AIDS epidemic, 33 million people were living with HIV in 2007. Two million people died of causes related to the disease that year.

Indian patent laws prevent "Evergreening" of medicine

2009-10-19T08:44:00.000-07:00

Indian authorities have rejected patent requests from US pharmaceutical company Gilead Sciences on two life-saving HIV/AIDS drugs, Tenofovir and Darunavir, as they were considered to be in infringement with the patent law. According to the decision, the patents violated section 3(d) of the Indian patent law, which prohibits ‘evergreening’ — the practice of multinational pharmaceutical companies of making small, trivial changes to existing medicines in order to extend the period of patent monopoly on a drug, thereby preventing the entry of generic competitors into the market and keeping drug prices high.

“This is a really important day for HIV patients in developing countries. The rejection of the patents on Tenofovir opens up the market for new generic competitors to drive down the price of this key HIV/AIDS drug,” says Michelle Childs, Director of Policy at Doctors Without Borders/Médecins Sans Frontières (MSF)’s Access to Essential Medicines Campaign and continues “Gilead now needs to remove any remaining contractual provisions that stop some generic companies from supplying Tenofovir to other countries where there is no patent, for example Brazil where the patent on Tenofovir has also been rejected. The decision regarding Darunavir is significant because the drug is one of the newest and most expensive of HIV/AIDS drugs. These decisions highlight the success and importance of Section 3(d) and opposition procedures in India’s patent law to safeguard public health. Other countries which need access to affordable essential drugs should look at India and build similar public health safeguards into their own patent law.”

Tenofovir is a key HIV/AIDS drug recommended by the World Health Organization for improved first-line treatment of HIV/AIDS. Darunavir is a new and expensive HIV/AIDS drug that is needed by patients failing on their existing treatments. Access to both medicines is currently limited by their high price.

http://doctorswithoutborders.org/news/article.cfm?id=3912&cat=field-news

Canada Drops the Ball on its HIV/AIDS Assistance Commitments

2009-07-29T05:26:00.000-07:00

Ottawa's Cheshire cat grin to the global AIDS pandemic will vanish in September when the last, small shipment of drugs produced under Canada's Access to Medicines Regime leaves the country for Rwanda.

Virtually no one outside the federal government expects there will be more – a gloomy backdrop to the indictments of the world's wealthiest nations at this week's international AIDS conference in Cape Town, South Africa, for a chain of broken promises on helping poorer countries to obtain life-saving treatment.

In the five years that the Canadian legislation, CAMR – initially dubbed the Jean Chrétien Pledge to Africa Act – has been in place, only one allotment of low-cost medicine has been arranged: for 21,000 Rwandans for one year. The first shipment went last year; the last lot will go at the summer's end.

The consensus among AIDS activists and generic drug manufacturers is that CAMR is so overwhelmingly flawed and cumbersome that no developing country will use it again to apply for assistance, and no generic pharmaceutical company will use it to manufacture anti-retroviral drugs.

“We're still where we were five or six years ago, and the system needs to get fixed,” said Elie Betito, director of public and government affairs for Apotex Inc. in Toronto, which made the Rwandan anti-retroviral product at cost after long and expensive legal negotiations with three pharmaceutical companies holding patents on components of the medication.

“But I don't think this government wants to change [CAMR], because it's not their legislation,” he added. It was introduced by a Liberal government, although passed unanimously by Parliament.

Apotex, one of the world's largest generic drug manufacturers, has said its one and only experience working under CAMR was so bad that it won't seek a new licensing agreement using the legislation, although it's ready to produce a desperately needed pediatric formulation that it says would both meet high Canadian standards and be globally cost competitive.

The CAMR legislation was designed to allow generic pharmaceutical companies to produce and export affordable drugs that are under patent to developing countries facing public health emergencies.

But it requires countries on an approved list to go through a mountain of red tape to apply for assistance and tender for manufacturers, and generic manufacturers to negotiate new licensing agreements with patent holders on each contract and with each country.

Thus, if Apotex was to have won a contract from Rwanda for another year of supplying drugs to the same 21,000 patients, it would have had to go through the same negotiations as before with the patent holders.

“You're looking at 65-page contracts,” Mr. Betito said.

Tony Clement, while national health minister in 2006, told the international AIDS conference, held that year in Toronto, that the legislation was flawed. But since becoming Minister of Industry – with responsibility for the legislation – in 2008, he has not given any intention of amending it.

A government review concluded in 2007 that it would be premature to change the legislation. The patent-holding pharmaceutical manufacturers have said there's nothing wrong with the legislation as it stands, and have lobbied strenuously against changes.

A Senate bill being shepherded by Manitoba Liberal Senator Sharon Carstairs and a House of Commons private member's bill introduced by Manitoba New Democrat Judy Wasylycia-Leis would require only a single licence.

Apotex would prefer the government take over the whole process and simply hand compulsory licences to generic manufacturers.

Laura Esmail, a University of Toronto doctoral candidate in pharmacy whose academic research is on CAMR and affordable AIDS drugs, said the one-licence proposal would allow Canadian companies, such as Apotex, to develop affordable global drugs using economies of scale.

She also said developing countries find themselves pressured by international corporations and other governments not to apply for drugs under legislation such as CAMR, and they need wealthy countries like Canada to make it easier for them to do so.

Michael Valpy
Globe and Mail

AIDS Treatment as a form of Prevention

2009-07-29T05:24:00.000-07:00

A lot of people thought Julio Montaner was a little crazy when he first suggested that the best way to eliminate the AIDS epidemic would be a massive scheme to give AIDS medicine to every infected person.

What about the huge financial cost? What about the moral issues, the human-rights issues, the overwhelming number of tests and drugs that would be required? Wouldn't it undermine years of lecturing on monogamy and abstinence? Wouldn't it promote "condom-free sex," as some critics said?

Faced with a host of objections, the Canadian scientist was a lone voice in the wilderness for the past three years, unable to win support from the global AIDS establishment.

But this year, Dr. Montaner's solitary crusade - the controversial notion of "treatment as prevention" - has suddenly become one of the hottest issues in AIDS science. And yesterday, at the International AIDS Society conference in Cape Town, his once-ridiculed idea was endorsed by experts from around the world.

Among the latest support for his proposal is a model by World Health Organization researchers that predicts a 95-per-cent reduction in new HIV cases within 10 years if his idea is adopted.

The proposed new strategy - universal voluntary testing for HIV, combined with immediate anti-retroviral drug treatment for those who have the virus, even in its earliest stages - could save more than seven million lives by 2050, the model says.

The WHO, which had resisted the treatment-as-prevention concept for years, is now organizing a special conference this November to discuss the "feasibility and acceptability" of the concept.

"Treatment as prevention is the topic of the year," Swiss scientist Bernard Hirschel told the AIDS conference yesterday.

"I think Julio deserves a lot of credit for this. Is treatment going to be the answer? We don't know, but we'd better find out."

Dr. Montaner, president of the International AIDS Society and director of the B.C. Centre for Excellence in HIV/AIDS, has been a prominent scientific researcher on AIDS since 1981, before the virus was even identified. A pioneer in the use of anti-retrovirals and other AIDS drugs, he has been campaigning for the treatment-as-prevention strategy since 2006.

Willy Rozenbaum, one of the early discoverers of the AIDS virus and now the president of France's National AIDS Council, was another scientist who lent his support to Dr. Montaner yesterday. Providing proper treatment to those who have the AIDS virus "sharply reduces the chances that they will transmit the virus," he told the conference.

Dr. Rozenbaum acknowledged that researchers must study whether the use of medical treatment as a prevention strategy would encourage "risky" behaviour by those who think that the AIDS virus has been virtually eliminated from their bodies. But medical treatment and condom use can coexist, he said.

In an interview, Dr. Rozenbaum said the notion of treatment as prevention is being resisted by many governments because they are afraid of the cost and reluctant to admit the failure of the traditional prescription of condoms and monogamy. "They've been promoting condoms as the answer for 20 years," he said.

After initial progress in reducing AIDS in the developed world, the condom strategy has failed to make further progress in recent years, he said. "I'm not happy with a plateau. We can't accept just a stabilization of the problem."

As for the short-term financial cost of a massive expansion in AIDS medicine, it would be outweighed by savings within five or 10 years as the transmission rate is swiftly reduced, he said.

The new WHO model of how this strategy could work, presented at the conference by WHO researcher Reuben Granich, says the treatment strategy would drive up costs at first, but "may provide cost savings" in the long run as it increasingly prevents new HIV cases.

Dr. Montaner conceded that some "recalcitrant" people with the AIDS virus will refuse to be tested or treated. His plan would not force them to be tested, but this would not weaken the strategy, he said.

"A person who is appropriately treated becomes dramatically less likely to transmit," he said. "The more you treat, the more you reduce the cases. ... When we first suggested this in 2006, people thought we were a little loony. But it's now fully accepted. We just need to get started."

The notion of treatment as prevention "creates a powerful new rationale" for the expanded use of anti-retrovirals and other AIDS drugs, he said. "We have transformed treatment from being merely a life-saving tool. Now it means we are protecting society, we are protecting our children."

The Harper government in Ottawa is still resisting the proposed new strategy, even as global experts are accepting it, Dr. Montaner said. When he suggested the strategy in a letter to the federal Health Minister, he received only a form letter in response. "It's been increasingly adopted around the world, but where is Canada on this?"

*****

The global AIDS battle

World health leaders are gathering in South Africa to discuss ways to fight the disease

PEOPLE WITH HIV/AIDS AROUND THE WORLD

PERCENTAGE OF WORLD TOTAL/ 2007

Latin America and the Caribbean/ 5.0%

High-income countries/ 5.4%

Eastern Europe and Central Asia/ 3.9%

Asia/ 21.4%

Africa/ 64.4%

The overwhelming majority of people with HIV/AIDS, 95%, live in the developing world.

MONEY AVAILABLE FOR GLOBAL AIDS FIGHT, IN BILLIONS $ US

'05/ $7.9

'06/ $8.8

'07/ $11.3

"08/ $13.8

THE GLOBE AND MAIL / SOURCE: UNAIDS, AVERT.ORG

Engineered antibodies fight AIDS virus

2009-07-07T06:18:00.001-07:00

Researchers may have discovered a technique that will eventually lead to a way to vaccinate against the AIDS virus, by creating an artificial antibody carried into the body by a virus.

This synthetic immune system molecule protected monkeys against an animal version of HIV called SIV, the researchers reported in the journal Nature Medicine.

While it will be years before the concept could be tested in humans, it opens up the possibility of protecting people against the fatal and incurable virus.

"Six of nine immunized monkeys were protected against infection by the SIV challenge, and all nine were protected from AIDS," Philip Johnson of Children's Hospital of Philadelphia and colleagues wrote.

Several attempts to create a vaccine against the human immunodeficiency virus that causes AIDS have failed.

AIDS not only attacks the immune cells that usually defend against viruses, but it quickly hides out in an as-yet undiscovered "reservoir" so the immune system must be primed to capture virtually every single virus.

In addition, people do not usually make antibodies against the virus. Antibodies are immune system particles that latch on to invaders so killer cells can destroy them.

Johnson's team engineered an artificial piece of DNA that would make artificial antibodies, called antibody-like proteins or immunoadhesins. They made three different versions.

This stretch of DNA was spliced into a virus, called an adeno-associated virus or AAV, that infects people and monkeys with little effect.

PROTECTED MONKEYS

They injected the monkeys with their lab-engineered AAV, which started cranking out antibodies in the blood of the monkeys. Then they injected the monkeys with SIV.

One injection protected the monkeys -- six never became infected at all -- and the three that did never developed AIDS, the immune system destruction caused by HIV, they reported.

One of the three appeared to work better than the other two but more testing is needed. "To ultimately succeed, more and better molecules that work against HIV, including human monoclonal antibodies, will be needed," they wrote.

"As a concept, I think this is very promising," Dr. Peggy Johnston, head of the HIV Vaccine Research Branch at the National Institute of Allergy and Infectious Diseases, which helped pay for the study, said in a telephone interview.

She said the monkeys had an immune response to the AAV virus and the approach would have to be carefully tested to ensure it was safe. In addition, the monkeys were infected by injection and tests would be needed to show the vaccine protected against HIV acquired sexually.

"We need to make the genes as humanized as possible so that the human body doesn't react to that," she added.

"I don't see this going into humans for years."

Most AIDS experts agree the only hope of controlling the pandemic of HIV is to develop a vaccine. The virus has killed 25 million people since the early 1980s and infects 33 million people now.

Drugs can control infection but often are expensive, have side-effects and often stop working after a time, forcing patients to switch to new drugs.

HIV Vaccine Ready for Human Tests

2009-07-01T09:29:00.000-07:00

An HIV/AIDS vaccine developed in Canada has passed safety tests in animals and the researchers are awaiting approval to begin human trials in the U.S.

"It is a very important milestone for us," said Yong Kang, a professor of microbiology at the University of Western Ontario in London who has been working on the vaccine for 20 years.

Kang said he expects to get the go-ahead soon from the U.S. Food and Drug Administration to begin human toxicology tests and two phases of clinical trials in the United States.

If all three trials are successful, the vaccine should be available within the next decade, Kang told CBC News on the phone while attending a meeting in South Korea.

According to a 2008 United Nations report on the global AIDS epidemic, 33 million people were living with HIV in 2007. Two million people died of causes related to the disease that year.

Dozens of HIV vaccines have already been developed and tested in animal models, but few have been tested in humans, none successfully. A promising trial in 2007 by pharmaceutical giant Merck and Co. was shut down after those receiving the vaccine contracted HIV at a higher rate than those who received the placebo.

Kang has partnered with a Curacom, a South Korean holding company, that has agreed to open an office in London, Ont., to help fund research in Kang's lab and commercialize the vaccine.

A test vaccine is being manufactured in a lab in Maryland near Washington, D.C.

Lab tests showed the vaccine produced no adverse effects or safety risks during immunology tests on animals.

The toxicology tests are expected to include 40 to 50 HIV-positive volunteers in the U.S., and will be designed to test whether the vaccine is toxic in humans.

http://www.cbc.ca/health/story/2009/07/01/health-canadian-aids-hiv-vaccine-kang.html

Chicago Gay Men Unaware of HIV Poz Status

2009-06-13T07:55:00.002-07:00

More than 17 percent of gay men in Chicago have HIV, and 39 percent went untested in the last 12 months because of fear of the results, according to a study of nearly 600 gay men in the city by the Chicago Department of Health, the Chi-Town Daily News reports. The study also found that gay black men had an infection rate that was more than twice the rates of gay white and Hispanic men. Jim Pickett, director of advocacy for the AIDS Foundation of Chicago, said the findings indicate that, "We need to incorporate HIV into a broader or more holistic framework (covering) gay men's health needs from top to toe." The city will formally release the study’s results next week (Parker, Chi-Town Daily News, 6/2).

HIV Cases Among Women in Wisconsin Increasing

2009-06-13T07:55:00.001-07:00

While the number of new cases of HIV in Wisconsin has stabilized over the last decade, women now represent more of the overall number of cases, the AP/Chicago Tribune reports (AP/Chicago Tribune, 6/2). According to Mike Gifford, CEO of the AIDS Resource Center of Wisconsin (ARCW), 21 percent of new infections are women, compared with 16 percent in the 1990s and 6 percent in the1980s. Gifford says that women need to be better informed about their risk of contracting HIV. Christina Colon, ARCW's associate director of prevention, said the organization is targeting women's health fairs to raise awareness (Simonson, Wisconsin Public Radio, 6/1).

HIV/AIDS Awareness Campaign in Western North Carolina Addresses Stigma

2009-06-13T07:54:00.000-07:00

The Western North Carolina AIDS Project recently launched a media campaign that seeks to raise awareness about the stigma associated with HIV/AIDS and its effect on those living with the virus, as well as the community, the Asheville Citizen-Times reports. The "I Need You to Know" campaign, which will include a set of commercials featuring area residents talking about HIV/AIDS, will serve as a starting point for other prevention efforts (Boyd, Asheville Citizen-Times, 6/3).

Washington, D.C. Officials To Boost HIV Awareness Efforts

2009-06-13T07:53:00.002-07:00

The Washington, D.C. HIV/AIDS Administration (HAA) will increase its HIV-related media efforts targeting those at risk for the virus amid a recent finding by the agency that 3% of the district's residents are living with HIV/AIDS, the Washington Post reports. Mayor Adrian Fenty recently committed $500,000 annually for a five-year marketing campaign, Shannon Hader, director of HAA said. Advertising experts say that millions more would be needed in order for the agency to have an "effective" campaign, or that local media, billboard companies and the district's Metro system need to provide more free advertising space, according to the Post. Next month HAA plans to announce a campaign targeting heterosexual couples that will encourage HIV testing (Fears, Washington Post, 6/2).

California HIV Services Center Forced To Close

2009-06-13T07:53:00.001-07:00

Declining private and public financial support has forced Vital Life Services, an Oakland, Calif.-based nonprofit that provided support, case management, mental health counseling and other services to roughly 400 low-income and homeless clients with HIV, to shut down, the Oakland Tribune reports. According to the Tribune, the 25-year-old center -- which also provided "unique" services such as daily meals and emergency housing assistance -- "has become a victim of the recession" (Burt, Oakland Tribune, 5/30).

New York Lawmakers Should Pass Bill Capping Amount Low-Income Residents With HIV Pay for Housing, Columnist Says

2009-06-13T07:51:00.000-07:00

Some New York City residents with HIV pay as much as 70% of their income on housing because of the financial assistance they receive through the New York City HIV/AIDS Services Administration, New York Daily News columnist Errol Louis writes. According to Louis, lawmakers should pass a bill that would cap the rent contribution of low-income people with HIV/AIDS at 30% of their income, "the standard used for most rent-subsidy programs." The bill is currently before the state’s Assembly Ways and Means Committee. Louis adds that ensuring that people living with HIV are in "stable housing … makes them less likely to run up big taxpayer bills by using public hospital emergency rooms for basic health care." He concludes, "Albany has a choice: do what's cheap and quick in the short run, or do what makes long-term sense and saves lives" (Louis, New York Daily News, 5/31).

HIV Cases in Iowa Increasing

2009-05-15T09:59:00.002-07:00

Health officials announced recently that the number of newly recorded HIV cases among Iowans ages 15 to 24 increased by 45% in 2008 to 16, despite the widespread availability of condoms and other prevention methods, the Iowa Press-Citizen reports. In 2008, a total of 128 new HIV cases were reported, which is the highest number recorded since reporting began in 1998. The Iowa Department of Public Health reports that people ages 20 to 29 accounted for 25% of new cases in 2008.

According to the Press-Citizen, unsafe sexual practices among the state's young adult population have contributed to the spread of HIV and the number of sexually transmitted infections. Jeff Meier, associate director of the AIDS Clinical Trial Unit at University Hospitals, said that most of the cases among young people are in the non-student population. "HIV tends to run in circles of poverty, drugs and commercial sex," he said, adding, "There is obviously much less of that in the student population." Meier added that promoting condom use is just a part of a necessary comprehensive prevention strategy.

Randy Mayer -- chief of the Bureau of HIV, STD and Hepatitis at the department of public health -- said that HIV testing at publicly funded sites in the state has decreased since 1992, although HIV prevalence has increased over the same time. For 10 years, about 30% of people in the state have reported ever receiving an HIV test. One reason young people might not be getting tested is a lack of information about cost and availability, the Press-Citizen reports. Tricia Kitzmann, deputy director of the Johnson County health department, said that she hopes to see an increase in testing as the department adheres more closely to state recommendations that encourage frequent HIV testing for the entire population, instead of only populations considered to be high-risk (Carney, Iowa Press-Citizen, 5/11).

Africa Should Manufacture Its Own Antiretrovirals

2009-05-15T09:59:00.001-07:00

African countries should produce their own generic antiretroviral drugs in order to continue the fight against HIV/AIDS during the global economic crisis, African Union Commissioner for Social Affairs Bience Gawanas said recently during a conference for health ministers in Ethiopia, Reuters UK reports. "Africa shouldn't just import drugs all the time," Gawanas said, adding, "Most of our HIV/AIDS drugs come from sources outside Africa. How can we be sure this will continue during the financial crisis?"

According to Gawanas, economies in Africa would benefit from the local production of generic antiretrovirals. She added although a large portion of HIV-positive people in Africa do not have drug access, a few countries have made progress in terms of treatment. "Some countries in Africa now have 80% of people with HIV/AIDS on antiretroviral drugs," Gawanas said, adding, "But if there are cuts (in support from donor countries) can that progress continue? We need to mobilize local production" (Malone, Reuters UK, 5/7).

Researchers Developing Pasteurization Technique To Help HIV-Positive Women Breastfeed

2009-05-15T09:49:00.000-07:00

VOA News on Thursday examined a project to help HIV-positive women in developing countries breastfeed their infants and reduce the risk of mother-to-child transmission. According to VOA News, some HIV-positive women often face a difficult decision of whether to breastfeed their children, especially in resource-limited countries where formula feeding presents health risks.

In an effort to help make breastmilk safer for infants born to HIV-positive women, Sera Young of the University of California-Davis is working with about 100 women in Tanzania and teaching them to pasteurize their milk at home through flash heating, or a double-boiling method. Young said that "as soon as the water boils, the milk has reached a hot enough temperature -- about 70 degrees Celsius -- to kill all of the HIV but maintain most of the integrity of the nutrients and the immunological properties." She adds that she hopes to learn whether women would be willing and able follow every step in the technique. According to Young, she has observed that women are able to follow it but added that women who feared revealing their HIV-positive status had more issues with the process, as people wondered why they were boiling their breastmilk.

According to Young, although the World Health Organization recommends that HIV-positive women self-pasteurize their milk, it previously was not known whether women found it feasible or acceptable to do so. She noted that researchers are planning to conduct a large clinical study that will provide the "statistical power to look at the differences between those children who received flash-heated milk and those who haven't," adding that knowing the health implications is crucial for HIV-positive women and their children (Hoban, VOA News, 5/7).

HIV Cases Increasing in Britain, UNICEF Report Says

2009-05-15T09:47:00.000-07:00

Recent figures from UNICEF indicate that Britain recorded 7,734 new HIV cases in 2007 -- almost twice the number of cases recorded around 2000 -- London's Metro reports. According to the report, Britain has double the number of recorded HIV cases than any other Western European country. Metro reports that the country now has a record number of 77,000 HIV-positive people and that more than one-quarter of people living with the virus are unaware of their status. The highest numbers of new cases in 2007 were recorded among men who have sex with men and immigrants from sub-Saharan Africa, according to UNICEF. The group's United Kingdom executive director, Anita Tiessen, said that the increase in cases is not "simply a case of people coming here with HIV -- there's a behavior issue."

One in 10 new HIV cases in 2007 was recorded among young people ages 16 to 24, and this group also accounted for nearly half of the 40,000 new sexually transmitted infection cases recorded that year. More than four in 10 new HIV cases were recorded among MSM, and Metro reports that cases recorded among this group continue to increase. Tiessen said that Britain's "sizeable" immigrant population from sub-Saharan African might be contributing to the country HIV/AIDS figures; however, she added that sexual behavior among young people also is a key factor and urged government officials to lead "youth-friendly" prevention campaigns. The Department of Health said it will continue funding for organizations such as the Terrance Higgins Trust and the African HIV Policy Network, which target at-risk groups such as MSM and immigrants (Attewill, Metro, 5/7).

Eliminate HIV

2009-05-09T06:55:00.000-07:00

‘UNIVERSAL VOLUNTARY HIV TESTING WITH IMMEDIATE ANTIRETROVIRAL THERAPY AS A STRATEGY FOR ELIMINATION OF HIV TRANSMISSION: A MATHEMATICAL MODEL’

In November 2008, an article was published in the renowned medical journal, the Lancet. The article is co-authored by Reuben Granich, Kevin de Cock and Charlie Gilks. The authors of the article are leading members of World Health Organization (WHO) HIV and TB team, but the study is an independent work that has not been endorsed by the WHO. Based on computer modeling, the authors argued that universal HIV testing, followed by the immediate initiation of ART for those who were HIV-positive, could virtually eliminate HIV transmission in the future and reduce the number of people developing AIDS by 95%.

The article aroused heated debate amongst HIV activists, healthcare workers, scientists and officials at organizations like UNAIDS and the World Health Organization (WHO). The debate focused on the human rights implications of the implementation of universal mandatory testing, the potential criminalisation of HIV transmission, and the lack of consideration given to the negative outcomes proven to be associated with universal mandatory HIV testing. However debaters agreed that it is essential that new information that presents the possibility of a solution to HIV epidemic must be seriously considered and researched.

The WHO will hold a consultation in Geneva to discuss the implications of the article. From 28 – 30 April, TAC representatives attended a meeting organized by the AIDS and Rights Alliance of Southern Africa (ARASA) and the Open Society Initiative for Southern Africa (OSISA) in Johannesburg to discuss the article and to formulate a position with other Southern African HIV activists. This position will be presented at the WHO meeting in Geneva. TAC’s briefing on the article is being finalized, and district workshops are planned to discuss the contents of the article and the responses of TAC members to the strategies it proposes. Please click here for TAC’s full brief and response.

HIV-Positive People at Increased Risk of New Flu Strain

2009-05-09T06:39:00.002-07:00

HIV-positive people worldwide are at an increased risk of the H1N1 flu strain, the World Health Organization said on Saturday in guidelines for health workers published on its Web site, Reuters India reports. According to WHO, people with immodeficiency diseases, such as HIV/AIDS, likely will be vulnerable to complications related to the flu strain, just as they are from the seasonal flu, which results in about 250,000 to 500,000 deaths annually. According to WHO, the H1N1 strain and HIV could prove to be a hazardous combination, similar to HIV and tuberculosis. "Although there are inadequate data to predict the impact of a possible human influenza pandemic on HIV-affected populations, interactions between HIV and A(H1N1) influenza could be significant," WHO said, adding that HIV-positive people "should be considered as a high risk and a priority population for preventive and therapeutic strategies against influenza, including emerging influenza A(H1N1) virus infection."

According to WHO, countries with high HIV/AIDS burdens, many of which are in Africa, should ensure that vulnerable people have drug access, including to medicines such as Tamiflu and Relenza. The agency added that it is best if people with the flu strain take antiviral drugs within 48 hours of the onset of symptoms. In addition, there are no known issues with taking flu medications with antiretroviral drugs, according to WHO (MacInnis, Reuters India, 5/2).

Life Insurance for HIV-Positive People

2009-05-09T06:39:00.001-07:00

The insurance company Prudential will begin to offer life insurance policies to HIV-positive people in the United Kingdom, London's Daily Telegraph reports. According to the Telegraph, PruProtect -- a partnership between Prudential and a South African firm -- initially will offer the insurance to 7% of HIV-positive people and hopes to extend coverage to 20% of HIV-positive people. The policy will offer up to 250,000 British pounds -- or about $368,000 -- for a maximum of 10 years. The policy premiums will be higher than standard premiums for life insurance "to accurately and fairly reflect the risks involved." Premiums will be determined on an individual basis and dependent on medical history, the Telegraph reports.

Kevin Carr, director of protection development at PruProtect, said, "We are pleased to be the first mainstream insurer to provide life cover for people living with HIV," adding "I believe it is better to provide some cover for some people than nothing at all." The Terrence Higgins Trust said, "We welcome this move from PruProtect and are glad to see an insurer who recognizes the reality of living with HIV in the U.K. in the 21st century." The group added that it "hope[s]" the program "will be the start of a wider move to offer appropriate financial products to people with HIV" (Simon, Daily Telegraph, 4/29).

Australia Harm Reduction Strategies Serve as Model for Other Countries

2009-05-09T06:38:00.001-07:00

The Australian government's efforts to curb the spread of HIV by advocating harm-reduction initiatives, such as needle-exchange programs and drug substitution therapy, for injection drug users serve as a model for other countries throughout the region, UNAIDS Asia Pacific Director Prasada Rao said recently, the AAP/Sydney Morning Herald reports.

Rao said that Australia has called on Asian states to increase harm-reduction programs and examine current drug laws, especially in those states where penalties for drug users can include the death penalty. Rao said, "Australia is a good model for harm reduction programs and also for looking at drug laws and revamping them. In fact, quite a few countries in Asia have learned their harm reduction strategies in good examples from Australia." Parliamentary Secretary for International Development Assistance Bob McMullan said that it is still possible for countries to adopt effective prevention and harm reduction strategies to combat HIV without encouraging drug use. He said that a "very big important part of the Australian government policy" is working "strongly" with drug users. He added that "in terms of reducing the spread of HIV, we have to focus on prevention." Rao's comments came as McMullan announced an additional 640,000 Australian dollars, or about $470,000, for nongovernmental organizations working in Asia (Corben, AAP/Sydney Morning Herald, 5/3).

HIV-Positive People in Wales Denied Treatment

2009-05-09T06:36:00.000-07:00

Some HIV-positive people in Wales are being denied medical treatment for common illnesses, Olwen Williams, a physician specializing in sexually transmitted infections, said recently, BBC News reports. Williams noted that primary care physicians often refer HIV-positive people to hospitals or HIV specialists for common conditions, such as colds.

The British Medical Association denied that physicians are discriminating against people living with HIV/AIDS and said that some physicians might be more cautious in referring HIV-positive people to specialists. However, Williams said that HIV-positive people are experiencing "very subtle" discrimination, adding that they might disclose their HIV status to a provider and be told they need to visit their HIV specialist. "If I was someone with cancer and I went to a [PCP] with common cold and I was told, 'Sorry, I can't deal with that' because I've got cancer I'd be so amazed -- that's what our patients our experiencing," Williams said, adding that such practices "den[y]" care to HIV-positive people "at a point where they actually need it." Williams added, "My concern here is that we've still got fear and prejudice and ignorance that's actually driving discrimination and stigma in Wales. And I think this is something major that we have to tackle."

Andrew Dearden, chair of the British Medical Association's Welsh council, said it is "unprofessional and unethical" for physicians to discriminate because of an illness. Dearden added that some physicians might not feel they have adequate training to treat some conditions. "Remember that doctors always refer patients to other doctors ... when they feel there's a need for extra information, diagnosis, tests or treatment," Dearden said. A recent study found that about half of HIV-positive people in the United Kingdom had experience discrimination from a health worker in the previous year, according to a spokesperson from the Terrence Higgins Trust (BBC News, 5/1).

Economic Downturn Likely To Threaten HIV Treatment

2009-05-09T06:35:00.000-07:00

IRIN/PlusNews on Wednesday examined a World Bank report published last week that suggests the current economic downturn could threaten antiretroviral treatment access for about 1.7 million HIV-positive people by the end of 2009. According to the report, developing countries could face drug shortages, treatment interruptions and an increase in HIV prevalence as a result of the global economic situation.

According to IRIN/PlusNews, the downturn is likely to have the greatest impact on programs in Southern and Eastern Africa. In addition, many HIV/AIDS programs in this region are heavily reliant on donor funding and have limited support from local governments, IRIN/PlusNews reports.

Joy Phumaphi, World Bank vice-president for human development, said that "[s]ocial services are likely to suffer as governments cut back on spending, currencies devalue and external aid donors come under pressure to maintain existing levels of foreign assistance." Tanzania this year announced plans to reduce its national HIV/AIDS budget by 25%, and similar actions in Kenya and Sudan already have led to medical supply shortages. According to the report, funding reductions might lead countries to reduce emphasis on prevention programs and instead allocate money for treatment initiatives, which produce short-term, easily measurable benefits. According to IRIN/PlusNews, groups such as commercial sex workers, injection drug users and men who have sex with men will likely be the hardest hit by reductions in prevention programs.

Although many countries will face difficult choices during the economic downturn, the report recommends that nations receiving substantial amounts of international assistance use early warning systems to identify any potential drug and funding shortages and avoid treatment interruptions (IRIN/PlusNews, 4/29).

The report is available online (.pdf).

Early HAART Initiation Improves Vaccine Response Among HIV-Positive Children

2009-05-09T06:34:00.000-07:00

HIV-positive infants who begin treatment with highly active antiretroviral therapy within the first year of life can develop normal immune responses to childhood vaccines, according to a study published online Monday in the Proceedings of the National Academy of Sciences, Reuters Health reports. Vaccines function by stimulating the production of antibodies for a particular disease, but HIV causes a decline in these antibody-producing cells and therefore reduces immunity. Prior to the new study, researchers were unsure whether the timing of HAART initiation could help preserve these cells and promote normal immune responses to vaccines among children.

For the study, Paolo Rossi of the University of Tor Vergata in Rome and colleagues examined 70 children who contracted HIV through mother-to-child transmission and 50 HIV-negative control participants. Of the HIV-positive children, 13 received HAART during their first year, six received no treatment and the remaining children received therapy later in life. All of the children in the study group received the recommended vaccinations for measles and tetanus. According to the study's findings, children who received HAART during their first year maintained normal levels of antibody producing cells, while children in the other groups had lower levels of these cells.

According to Rossi, the timing of HAART initiation is a key factor in determining whether HIV-positive children will develop normal vaccine responses and how long the response will last. The authors write that their findings support early HAART initiation for the purpose of preserving normal immune responses among HIV-positive infants. However, they add that health officials might need to revise vaccine schedules for HIV-positive children who begin treatment after the first year of life (Reuters Health, 4/29).

An abstract of the study is available online.

HIV becoming more virulent?

2009-04-26T07:38:00.001-07:00

A study in the May issue of Clinical Infectious Diseases found a decline in the initial CD4+ T cell counts reported at diagnosis among some HIV-positive people in the U.S. from 1985 to 2007 -- a finding that suggests HIV may be adapting and becoming more virulent -- Reuters reports. The report analyzed data for 2,174 HIV-positive people who were enrolled in the TriService AIDS Clinical Consortium HIV Natural History Study. None of the participants previously had taken antiretroviral therapy, and all had their CD4+ cell counts measured within six months of HIV diagnosis.

The average initial CD4+ cell counts during the periods from 1985 to 1990, 1991 to 1995, 1996 to 2001, and 2002 to 2007 were 632, 553, 493 and 514, respectively. According to the report, the percentage of subjects with initial CD4+ cell counts less than 350 were 12%, 21%, 26% and 25%, respectively, during the same periods. Similar CD4+ cell count reductions were seen in black and white participants, and the report also noted that similar trends were seen in the CD4+ cell count percentage and the total lymphocyte count. Lead author Nancy Crum-Cianflone of the Naval Medical Center-San Diego said the study's findings "agree with those of other investigators" who report that "patients starting HIV care more recently may be presenting with lower initial CD4+ cell counts and requiring antiretroviral therapy initiation earlier in the disease course."

In an accompanying editorial, Maria Dorrucci of Rome's Istituto Superiore di Sanita and Andrew Phillips of London's University College Medical School write that although some current studies suggest that HIV virulence is rising, there have been other studies that report either stable or declining HIV virulence. Dorrucci and Phillips write that the differences may relate to how virulence is determined and that "it is unclear whether simple immunological or virological proxies for virulence can be expected to adequately capture the whole complexity of HIV virulence and host susceptibility" (Reuters, 4/15).

An abstract of the report is available online. A citation of the accompanying editorial is also available online.

Africa Should Manufacture Generic HIV/AIDS Drugs

2009-04-26T07:37:00.000-07:00

Africa should produce its own generic antiretroviral drugs in order to fight HIV/AIDS and ensure that the global financial crisis does not hinder treatment access, UNAIDS Executive Director Michel Sidibe said on Wednesday in Addis Ababa, Ethiopia, Reuters reports. "We should facilitate a discussion around how we can build a business case for producing generic drugs in Africa so that it can increase coverage but can, at the same time, be a profitable business," he said, adding, "It's important politically, it's important economically, it's important for the integration of Africa in the global market."

According to Sidibe, increased production of generic drugs in Africa needs to occur soon because most people living with HIV on the continent do not have drug access. He said that during his tenure as UNAIDS executive director, he will focus on ensuring universal drug access worldwide. Sidibe added that the current economic situation could hinder this goal. "Governments need to start anticipating minimum spending on social services so we don't have a breakdown in our respective systems," he said, adding, "My worry about the crisis is that if we are not careful, we could face a breakdown in our caring society"

New Jersey Legislature Examining Ways To Avoid HIV/AIDS Medication Copayments in State Budget

2009-04-26T07:35:00.000-07:00

New Jersey lawmakers on Tuesday indicated that they are examining ways to avoid proposed co-payments for some people living with HIV/AIDS who receive medications though the state, NorthJersey.com reports. The copayments are part of Gov. Jon Corzine's (D) $29.8 billion spending proposal for the state's new fiscal year and would collect $1.36 million by creating co-payments for HIV/AIDS drugs based on a sliding scale determined by income (Reitmeyer, NorthJersey.com, 4/21). The copayments would affect 9,000 people living with HIV/AIDS who have obtained no-cost medicine from the state because they do not qualify for other assistance programs. Advocates said that the copayments will hurt patients who are already struggling because of the poor economy (Kaiser Daily HIV/AIDS Report, 3/26).

According to NorthJersey.com, Heather Howard, commissioner of the state Department of Health and Senior Services, met with the Assembly budget committee to review the agency's spending plan and policies. During the meeting, committee Chair Lou Greenwald (D) suggested that state funding for a transportation program that benefits HIV-positive people could be pulled instead of implementing the proposed copayments. Howard said that the department is willing to examine all possibilities. The copayments would not be assessed for the largest group of patients who benefit from the state program because of their low incomes. The proposal is part of a larger effort by Corzine to remove $3 billion in spending from the budget that the Legislature approved in 2008. The Legislature has until June 30 to pass a balanced budget (NorthJersey.com, 4/21).

HIV/AIDS in Washington, D.C., a Critical Issue

2009-04-26T07:34:00.000-07:00

The recent report that 3% of Washington, D.C., residents are living with HIV/AIDS "evokes an array of reactions that speak to the complexity of this compelling public health issue," Guy Weston -- former director of Data and Research at the district's HIV/AIDS Administration -- writes in a Washington Informer opinion piece. He adds that the statistic is "'quite serious'" when one realizes that it "translates into life-altering impact on 15,120 district residents," their spouses, partners and family members. The district's HIV/AIDS rate is a "critical issue for a significant proportion of [the city's] population," Weston writes, adding that the report "tells us that the highest rates of HIV are among residents aged 40 to 49 and among African-American male residents."

It also is "critical to confront findings of the city's report that frequently escape public discourse," Weston writes, adding that heterosexual sex "is emerging as the leading mode of HIV transmission in recent years, according to the report's analysis." He notes that this "becomes a sticky subject in the world of HIV funding and politics, where discussions of the dynamics of HIV transmission frequently lead to stigma and blame. The fact that such findings affect resource allocation complicates the discussion further." Weston adds that there is no data to suggest that "one transmission mode ... is the primary transmission mode to the exclusion of all others." Therefore, "HIV prevention messages that exclude potential transmission modes will not effectively protect our communities from HIV," he writes. He adds that there is a "'modern, generalized and critical' epidemic that affects a number of populations, albeit in different proportions," concluding, "In addition to the health department's promotion of early testing and condom availability, we, as affected communities, must deal with the message of statistics frankly, so that persons at risk can feel vulnerable enough to know that the testing and condom messages apply to them" (Weston, Washington Informer, 4/16).

HIV Infection Rates in Minnesota Rising

2009-04-26T07:33:00.000-07:00

Minnesota saw an increase in the number of newly reported HIV cases in 2008 to 326, the Minnesota Department of Health reported Wednesday, the Minneapolis Star Tribune reports. According to the Star Tribune, it was the third consecutive annual increase in newly recorded HIV cases. Peter Carr -- director of the sexually transmitted infections and HIV section of the department -- said that Minnesota has had an average of 320 new cases reported for the last three years, up from an average of 300 in 2001.

According to the Star Tribune, the increase in the number of cases among men ages 13 to 24 and men who have sex with men is causing concern among public health officials. Young men accounted for 42 new cases in 2008, up from 18 in 2002. Some health experts point to better HIV treatment, which has led some people to believe that the disease is manageable, and apathy toward the disease as a reason for the increase. According to the report, minorities are disproportionately affected by HIV/AIDS, with minority men, who represent 12% of the male population, accounting for 39% of new cases among all men. Minority women, who make up 11% of the female population, accounted for 70% of new cases among all women, according to the report. Carr said, "Socioeconomic status appears to be the most important factor in communities and neighborhoods where higher rates" of HIV were reported, adding that low economic status could result in a lack of insurance and limited access to health care, among other factors such as homelessness and stigma.

The report also showed that the number of HIV cases among immigrants has increased from 19 in 1990 to 62 in 2008, driven mostly by an increase in African-born immigrants and immigrants from Central and South America, the Star Tribune reports. An estimated 6,220 people are living with HIV in the state, health officials said, adding that there could be an additional 2,000 people who are unaware of their HIV-positive status (Marcotty, Minneapolis Star Tribune, 4/15).

Canadian Prison Tattoo Program Reduced Risk of HIV

2009-04-26T07:32:00.000-07:00

A Canadian prison tattoo parlor program that was canceled by the government was cost-effective and successful in raising awareness and reducing the risk of bloodborne diseases such as HIV and hepatitis C, according to a new report from the Correctional Service of Canada, the Alberta Daily Herald-Tribune reports. The 70-page report -- dated January 2009 but just publicly released -- said that early results of the federal pilot program "indicate potential to reduce harm, reduce exposure to health risk, and enhance the health and safety of staff members, inmates and the general public." The program -- which cost about one million Canadian dollars, or about $820,000 -- was launched at six federal prisons across Canada in 2005 but was canceled by then Public Safety Minister Stockwell Day in 2006. According to the Herald-Tribune, the move was hailed by some taxpayers and other groups but condemned by prisoners' advocates, who argued the decision was made based on ideology rather than pragmatism.

Among its 11 key findings, the report said that under the program, there was a reduction in seized tattoo contraband and "illicit" tattooing in medium-security prisons, which suggests a decreased risk of contact with previously used needles. Additionally, the report said that cost of the program was "low" when compared with its potential benefits and that it provided work skills that could be used in the community after inmates are released. Although there are some issues related to the program's implementation -- such as providing sufficient skill level, training and availability for the sessions -- the report concluded that the program was "consistent with the goals and objective of the federal initiative to address HIV/AIDS in Canada." The prevalence of HIV is 10 times higher in Canadian prisons than in the general population, and the prevalence of hepatitis C is 20 times higher, the Canadian HIV/AIDS Legal Network said. Christopher McCluskey, a spokesperson for Public Safety Minister Peter Van Loan, said the federal government has no intention to reinstate the program. He said CSC "continues to provide education and information to inmates on the risks of disease transmission from needles for drugs or any other purpose" (Harris, Daily Herald-Tribune, 4/15).

Canada Should Pass Bill That Would Expedite Export of Low-Cost Drugs for HIV

2009-04-20T07:16:00.002-07:00

"For many years, countries such as Canada have avoided the uncomfortable truth that millions are dying in the developing world due partly to legal barriers that render access to medicines unaffordable," Michael Geist, chair of Internet and E-commerce law at the University of Ottawa, writes in a Toronto Star opinion piece in response to a recently introduced bill that would reform Canada's Access to Medicines Regime by expediting the process of exporting generic drugs for diseases such as HIV to developing countries. According to Geist, Canada "became an early adopter" of a 2003 World Trade Organization agreement aimed at easing the export of drugs. However, "[s]everal years later, most agree the policy has been a near-total failure," he adds. According to Geist, the law "has only been used once, and the company involved in the process found it so burdensome that it has vowed not to repeat it."

The new bill, introduced by Sen. Yoine Goldstein, "includes important reforms to" Canada's Patent Act, Geist writes, adding that it "would not remove all barriers, but it would help to streamline the process of obtaining the necessary approvals." He adds, "Most importantly, it would establish a 'one-license solution' to enable generic pharmaceutical manufacturers to send shipments of the same medication to multiple countries without needing new approvals for each shipment." In addition, current law allows only governments to "buy medicines on behalf of citizens," Geist writes, concluding that the bill "would make it easier for the many nongovernmental organizations focused on access to medicines to buy and distribute generic medications" (Geist, Toronto Star, 4/13).

GSK, Pfizer Announce Combined HIV/AIDS Drug Business

2009-04-20T07:16:00.001-07:00

Pharmaceutical companies GlaxoSmithKline and Pfizer have announced that they will combine their HIV/AIDS drug businesses into a new, single company, the Wall Street Journal reports. Under the deal, GSK initially will hold 85% of the joint venture, while Pfizer will hold 15%, the Journal reports (Whalen/Cimilluca, Wall Street Journal, 4/16). The new company will hold a 19% share of the global HIV market and include 11 products already on the market, Reuters reports. In addition, the new company will include a pipeline of six new drugs, four of which are in mid-stage Phase II development (Hirschler, Reuters, 4/16).

The new company also will have 17 molecules it can use for the development of fixed-dose combination therapies. The research services to develop the medicines will be contracted directly from GSK and Pfizer (Kelley, Bloomberg, 4/16). The Journal reports that Dominique Limet -- senior vice president at GSK -- will be the new CEO of the joint venture.

According to the Journal, the companies expect that they will cut costs and create a broader business with more long-term growth potential by combining their products (Wall Street Journal, 4/16). Pfizer CEO Jeff Kindler said in a statement, "With the strength of the companies' current products, as well as the complementary fit of Pfizer's pipeline and Glaxo's global distribution capabilities, the new company is well positioned to bring new and improved medicines to patients with more speed and efficiency."

According to UNAIDS data, an estimated 33 million people were living with HIV in 2008, of whom about four million were taking HIV/AIDS medications. In 2008, the market for branded HIV medications was worth about $13 billion (Bloomberg, 4/16).

Time.com Examines Efforts To Curb HIV/AIDS in China

2009-04-20T07:14:00.001-07:00

Time.com on Wednesday examined China's efforts to curb the spread of HIV/AIDS and address the rising number of related deaths in the country. China announced in February that HIV/AIDS was the country's No. 1 deadly infectious disease in 2008, resulting in almost 7,000 deaths in the first nine months of last year. Time.com reports that the "fact that HIV ... is a significant and increasing cause of death" in the country "shows that government programs are not reaching enough people." Bernhard Schwartlander, coordinator of UNAIDS in China, said that it is "very difficult" to discuss sex in China's schools, workplaces and relationships. He added, "If they don't know about it, how can they protect themselves?"

According to Time.com, UNAIDS reports that at the end of 2007, about 700,000 people were living with HIV in China, with about 85,000 cases having progressed to AIDS. Although that statistic "isn't staggering ... the potential for things to get worse is alarming," Time.com reports. Schwartlander said, "For a long time China missed the opportunity to tackle AIDS head on. They tried to avoid it and I think they really ignored the problem." UNAIDS estimates that China's AIDS awareness programs currently reach between 20% and 40% of the country's at-risk communities, such as commercial sex workers, injection drug users and men who have sex with men. Schwartlander said that the "big question" regarding China's HIV/AIDS efforts is how to "make sure these good, sensible policies and ideas are really implemented throughout the whole country," which has a population of about 1.3 billion. He said policies that are implemented in China's urban areas, such as Beijing, have to be effectively implemented in the country's rural areas and communities, where 60% of the population lives. "Unless you understand how you can translate the policies into the realities of where the people are living, you will not succeed," Schwartlander said, adding, "There's an opportunity here to make sure 50 million people don't become infected" (Webley, Time.com, 4/8).

HIV/AIDS Hindering Namibia's Progress in Improving Child Health

2009-04-20T07:13:00.000-07:00

The spread of HIV/AIDS in Namibia over the past decade has halted the country's gains in improving children's health, and some organizations are calling for improved access to health care services and programs addressing poverty and hunger, South Africa's Mail and Guardian reports. Namibia was on track to reduce its child mortality rates until 2000, when child mortality rates began to increase. Ian McCleod, Namibia's representative for UNICEF, said that 50% of all child deaths among children under age five are because of HIV-related conditions such as malnutrition, low birthweight, premature births, immune deficiency, pneumonia and diarrhea.

Some experts say that HIV/AIDS will cause at least a six-year delay in the country's child health development. According to the Mail and Guardian, this makes it unlikely that the country will decrease child mortality by two-thirds by 2015 -- a target in the United Nations Millennium Development Goals. McCleod said it will take "at least until 2021" for Namibia to reach MDG targets for child mortality. He said the country's goal would have been met "if particular attention had been paid to neonatal health once the HIV pandemic hit the country." According to the consortium of nongovernmental organizations NANGOF, the impact of HIV on children's health is especially strong because of high levels of poverty and lack of access to health care services. Anna Beukes, executive director of NANGOF, said Namibia has a "good health policy framework" but that the country's "failure is to translate it into practice and enforce it," causing the country to "[lose] all the good work that has been done so far." She added that socioeconomic factors like poverty and inequality "have a gender and age dimension, affecting women and children more severely."

Although Namibia spends about 6% of its gross domestic product -- about $77 per capita -- on health care, the majority of the Health Department's budget is spent on administration, the Mail and Guardian reports. Beukes said that only about 3,000 of the country's 10,000 health workers are doctors and nurses, leaving about 7,000 people employed as ancillary staff and administrators. She said that the country's health sector is "deteriorating" and that people living in rural areas -- about 85% of the population -- do not have access to basic and maternal health care.

The Mail and Guardian reports that Namibia, which has a population of two million, had about 250,000 orphans and vulnerable children in 2006. About 50% of orphans in Namibia have lost a parent to AIDS. Beukes said that NANGOF is calling for improved social services and safety nets for communities impacted by HIV/AIDS. She said that if a person's "basic needs are fulfilled ... there [is] a basis for health development," adding that if a "child is integrated in a strong community structure, it has much higher chances to survive" (Palitza, Mail and Guardian, 4/9).

Delaying HAART Might Prevent Complete Immune System Recuperation

2009-04-15T05:30:00.000-07:00

People living with HIV who do not start highly active antiretroviral treatment until their CD4+ T cell counts drop below 200 might not be able to reach a normal CD4 cell count, even after 10 years of otherwise effective treatment, according to a study in the March 15 issue of Clinical Infectious Diseases, Reuters reports. According to Reuters, an HIV-positive person is considered to have a normalized immune status after CD4 counts are maintained above 500.

For the study, researchers examined 366 HIV-positive people who had maintained plasma HIV RNA levels of no more than 1,000 copies per milliliter of blood for at least four years after starting therapy. About 25% of the study's participants were followed for more than 10 years, with a median follow-up of 7.5 years. Reuters reports that 95% of the participants who started therapy with a CD4 cell count of at least 300 were able to reach a normalized CD4 cell count of at least 500. The researchers reported that 44% of participants who began treatment with a CD4 cell count of less than 100 -- as well as 25% who began treatment with a CD4 cell count of between 100 and 200 -- were not able to reach a CD4 cell count higher than 500.

Lead author Steven Deeks of the University of California-San Francisco and colleagues wrote that a "persistently low CD4 cell count during treatment is associated with increased risk of both AIDS and non-AIDS related events," such as liver disease, cardiovascular disease and cancer. They added that "novel immune-based therapeutic approaches may be necessary to restore immunocompetence in these individuals." In a related editorial, Boris Julg and Bruce Walker, both of Massachusetts General Hospital, wrote that major treatment guidelines recommend beginning antiretroviral therapy when CD4 cell counts drop below 350, adding that it can be difficult for developing and low-income countries to follow such advice. Julg and Walker wrote that "adequate early therapy, leading to more-complete immune reconstitution, may save resources because of the resulting lower incidence of opportunistic infections and reduced need for medical care" (Reuters, 4/7).

An abstract of the study is available online. An abstract of the accompanying editorial also is available online.

U.S. Launches HIV/AIDS Awareness Campaign

2009-04-15T05:29:00.000-07:00

White House, HHS and CDC officials on Tuesday announced the launch of a five-year, $45 million campaign to increase HIV/AIDS awareness in the U.S, the Washington Post reports. The campaign, titled Act Against AIDS, aims to address complacency about the disease by informing the public that one person in the U.S. contracts HIV every nine-and-a-half minutes. Kevin Fenton -- director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at CDC -- said the goal "is to put the HIV epidemic back on the front burner, on the radar screen." He explained the first phase of the communication campaign also will focus on reaching black communities, which are disproportionately affected by HIV/AIDS (Fears, Washington Post, 4/8). According to CDC, blacks represent 12% of the U.S. population but account for nearly half of new HIV cases and more than half of AIDS-related deaths each year (McKay, Wall Street Journal, 4/8). A separate phase of the campaign will target Latinos, who make up 15% of the U.S. population and 17% of new HIV infections. Melody Barnes, director of the White House's Domestic Policy Council, added that HIV/AIDS in Washington, D.C., is of concern. A recent report found that 3% of district residents are living with the disease. According to Fenton, an estimated one in five people in the U.S. who have HIV are not aware of their status (Washington Post, 4/8). CDC will provide funding for the campaign out of the agency's existing budget (Wall Street Journal, 4/8).

Act Against AIDS will promote HIV awareness through public service announcements, text messages and advertising on several modes of public transportation (Washington Post, 4/8). According to USA Today, the campaign also will include radio advertisements, airport dioramas, online banner ads, and online videos in English and Spanish (Sternberg, USA Today, 4/8). The campaign's Web site, also launched Tuesday, includes prevention information and provides users with HIV testing locations. According to CDC, the agency plans to work with the Kaiser Family Foundation to encourage major entertainment and media outlets to promote the campaign messages (Wall Street Journal, 4/8). "The media and entertainment industries are powerful forces in breaking through complacency and focusing national attention on important issues," Kaiser Family Foundation President and CEO Drew Altman said. The campaign also includes other community and public health partners from around the country, including national African-American groups, that will help spread message of Act Against AIDS (CDC release, 4/7). According to USA Today, the campaign aims to "recapture some of the urgency" from the early days of the HIV/AIDS epidemic (USA Today, 4/8).

Fenton said that health officials "need to create a basic core awareness and a national dialogue" about HIV/AIDS (Wall Street Journal, 4/8). According to Barnes, the campaign's goal is "to remind Americans that HIV/AIDS continues to pose a serious health threat in the United States and encourage them to get the facts they need to take action for themselves and their communities" (Fox, Reuters, 4/7). Jeffrey Crowley, director of the White House Office of National AIDS Policy, said the administration will shape campaign messages based on "what works and what doesn't" for a national HIV/AIDS strategy. This strategy might include several initiatives that President Obama supports, including needle-exchange programs, contraceptive distribution and age-appropriate sex education that includes information about contraception, USA Today reports (USA Today, 4/8).

However, some HIV/AIDS advocates have expressed concern that the campaign's approach will be inadequate. Michael Weinstein, president of the AIDS Healthcare Foundation, said that of the more than one million HIV-positive people in the U.S., more than 300,000 have never taken an HIV test. Weinstein said, "A $45 million communications plan, no matter how well-intended, will do little to help identify those 300,000" HIV-positive people who unknowingly could be spreading the disease (Washington Post, 4/8). David Holtgrave of Johns Hopkins University said that an "investment of $9 million a year isn't going to reduce HIV" cases in the U.S. He said, "It's an important piece of the puzzle, but not the whole puzzle." According to Holtgrave, CDC's HIV prevention budget would have to increase to $1.3 billion annually from $800 million to reduce new HIV cases by 50%, potentially through initiatives such as large-scale counseling, testing programs, preventive services and programs targeting high-risk groups (USA Today, 4/8).

Miami Herald Examines Issues Surrounding HIV Status Disclosure Among MSM

2009-04-15T05:27:00.002-07:00

The Miami Herald on Monday examined issues that some HIV-positive men who have sex with men face when determining when to reveal their status to potential partners. According to the Herald, a recent study from the Gay Men's Health Crisis found that half of U.S. residents surveyed said they believe that HIV/AIDS contributes to discrimination against MSM. In addition, discrimination in the MSM community toward HIV-positive MSM is not discussed widely, according to the Herald. This stigma often leads to a fear of disclosure among HIV-positive MSM, which can contribute to high-risk sexual activity and the spread of HIV.

Spencer Lieb, senior epidemiologist at the Florida Department of Health Bureau of HIV/AIDS, said, "Non-disclosure is one of the challenges of HIV prevention." Reports in Florida show a 48% increase in newly recorded HIV cases in Miami-Dade County from 2006 to 2008, as well as a 74% increase in Broward County. Lieb said these figures could point to an enhanced reporting system. However, the Herald reports that the increase in new cases also could be in part because of increased HIV/AIDS complacency. Linda Simon, a psychotherapist with the Miami Beach Community Health Center, said that among some MSM, disclosing their HIV-positive status is a "struggle," because "on the one hand they want to be responsible, but on the other they want to protect themselves from breaching confidentiality and rejection" (Roth, Miami Herald, 4/6).

The Gay Men's Health Crisis study is available online.

California HIV/AIDS Group Launches Internet-Based Program Aimed at MSM

2009-04-15T05:27:00.001-07:00

The Palm Springs, Calif.-based Desert AIDS Project has launched an Internet-based education and prevention program aimed at men who have sex with men, the Desert Sun reports. The program was launched ahead of the area's White Party Easter weekend, according to the Sun. "With the White Party literally in our backyard, we feel a responsibility each year to get out the message about safer sex while not throwing the proverbial wet blanket on the fun people are here for," David Brinkman, AIDS Project executive director, said.

The program, called "I-Connect," allows project staff to distribute information about safer sex, HIV testing, mental health and substance abuse counseling on several Web sites, according to a release. In addition, some staff plan to be in the lobby of the host hotel for the White Party throughout the weekend, according to Brinkman. The AIDS Project aims to reach about 3,000 people during the program's first year. MSM are the primary attendees of the White Party, and Palm Springs has one of the largest MSM populations per capita in the U.S., according to the Sun (Brambila, Desert Sun, 4/3).

Protein Grown in Tobacco Plant Could Result in Low-Cost Microbicide

2009-04-15T05:25:00.002-07:00

Researchers on Monday announced that tobacco plants in Kentucky have been used in a study to develop a low-cost drug that inhibits HIV, providing hope for the eventual development of a vaginal microbicide, the Louisville Courier-Journal reports (Kenning, Louisville Courier-Journal, 3/31). The study, published Tuesday in the Proceedings of the National Academy of Sciences, was a collaborative effort between scientists at the Owensboro Cancer Research Program; the National Cancer Institute; Kentucky-based biotech companies Intrucept Biomedicine and Kentucky Bioprocessing; and researchers at Duke University and the University of London (Adkins, Business First of Louisville, 3/30).

According to the Courier-Journal, the researchers used a manufacturing process that utilized an existing protein called Giffithsin, which can inhibit HIV transmission during sexual activity. Kenneth Palmer, lead researcher and senior scientist at the University of Louisville, said that he used a method to grow large amounts of the protein in a relative of the tobacco plant at a low cost, producing 500,000 doses from a 5,000 square-foot greenhouse, the Courier-Journal reports. Palmer said the process resulted in a product that could be more effective than previous microbicide efforts.

According to Palmer, many scientists are pursuing HIV prevention methods, mostly in gel forms that attack the virus, but some have had side effects and were expensive to produce. The Courier-Journal reports that Palmer's product did not appear to cause inflammation in users and that a vaginal gel made through the process "could potentially cost just a few cents." Palmer said that the end-product, likely a gel, could be available as early as 2015 if clinical trials are successful (Louisville Courier-Journal, 3/31). He estimated that "tens of millions" of dollars would be needed to continue the project through the third phase of clinical testing. Donald Miller, director of the James Graham Brown Cancer Center, said that international donors might be interested in assisting in funding the research. Miller said the new study is a "very important piece of work." He added, "We think this is a validation of our belief that this is going to be a very viable, cost-effective way to produce new drugs" (Business First of Louisville, 3/30). According to Palmer, condoms are the only product currently available and "they're obviously not enthusiastically embraced by all users." He added that there is "a big need for an effective, female-controlled intervention to protect from HIV" (Louisville Courier-Journal, 3/31).

160,000 Children in Ghana Orphaned by HIV/AIDS, Commission Says

2009-04-15T05:25:00.001-07:00

Recent data compiled by the Ghana AIDS Commission indicate that about 160,000 children have been orphaned by the disease in the country, Ghana's GNA/My Joy Online reports. According to Damien Punguyire, medical superintendent of the country's Kintampo Hospital, without adequate care, more people will be affected by the pandemic and more children will be orphaned within the next five years.

Punguyire also expressed concern about HIV/AIDS prevalence among young people and those of reproductive age, saying that the situation could negatively affect Ghana's economy and national development. "There is the need for increased education to create more awareness for the people to become cautious about their sexual practices, and that would help minimize spread of the pandemic," Punguyire said. In addition, he urged teachers to educate students about HIV/AIDS prevention methods in an effort to maintain awareness about the epidemic. He also called for an end to stigma and discrimination against HIV-positive people to help curb the spread of the virus (GNA/My Joy Online, 3/31).

HIV/AIDS Advocates Voice Opposition to Medication Co-Payments Included in Proposed New Jersey Budget

2009-03-30T08:22:00.000-07:00

People living with HIV/AIDS in New Jersey could be negatively affected by prescription drug co-payments included in Gov. Jon Corzine's (D) proposed $29.8 billion budget, advocates told state lawmakers on Tuesday, the Newark Star-Ledger reports. The budget would collect $1.4 million from 9,000 people living with HIV/AIDS who have obtained no-cost medicine from the state because they do not qualify for other assistance programs. Advocates said that the co-payments will hurt patients who are already struggling because of the poor economy. John Covello, director of government and public affairs for the Independent Pharmacy Association of New Jersey, said, "From talking to stores, they know their patients will not have the ability to pay this and the consequences will be dire." He added that HIV/AIDS medications are "very, very expensive drugs."

In addition, the proposed budget would raise $4.6 million through $2 Medicaid prescription drug co-payments, capped at $10 monthly. Phil Lubitz, director of advocacy for the National Association of Mental Illness of New Jersey, said the proposal "really acts as a disincentive for people to go and fill their prescriptions." The Star-Ledger reports that a similar co-payment schedule was included in Corzine's proposed 2008 budget but was removed by lawmakers before the final budget was passed. While requesting Medicaid co-payments "has become an annual rite of the state's budget season," this is the first year co-payments from people living with HIV/AIDS have been included, the Star-Ledger reports.

While discussing the budget proposal at a New Jersey home, Corzine said that there is a "very low probability" that the Medicaid co-payments would be included in the final budget, adding that it "almost always gets adjusted by the Legislature." However, he did not give a direct response when asked about the HIV/AIDS medication co-payments. Corzine said there are "a lot of concerns" but "what we take out we have to put something else back in" (Reitmeyer/Young, Newark Star-Ledger, 3/25).

Tenn. Lawmaker Proposes Bill That Would Require HIV Testing Among Prison Inmates Prior to Release

2009-03-30T08:21:00.000-07:00

Tennessee state Rep. Brenda Gilmore (D) has introduced a bill (H.B. 52) that would require HIV tests for prison inmates before their release as part of a larger plan to address the spread of HIV/AIDS in the state, WSMV.com reports. According to Gilmore, the plan will focus on blacks, who comprise 64% of new HIV cases in the state but only 13% of the population.

According to Gilmore, the bill will allow former inmates to become more aware of HIV/AIDS issues and take precautionary measures, WSMV.com reports. She said that a recent report showed that many prison inmates return to prison within three years, adding that "this revolving door creates a culture" of HIV/AIDS that particularly affects black women. Last year, Gilmore proposed similar legislation to require HIV testing among inmates prior to release, and the bill passed in the House. However, the Senate did not take action on the bill. According to WSMV.com, Gilmore is waiting for a hearing on the current bill (Kumari, WSMV.com, 3/24).

Latin American HIV/AIDS Magazine for Women

2009-03-30T08:20:00.000-07:00

The Inter Press Service on Monday examined a new magazine published by the Latin American branch of the International Community of Women Living with HIV/AIDS. The magazine -- called "No Estas Sola," or "You Are Not Alone" -- focuses on providing HIV-positive women in Latin America with information about the virus, stigma, their rights and empowerment. Maria Mansilla, the editor in charge of the publication, said, "What we are trying to do through the magazine is to break with the weepy approach, where there is only room for complaints or for the scientific-medical perspective." The magazine is a quarterly publication that is distributed in the 20 Latin American countries where ICW Latina has national chapters. Daniel Barberis, media officer for ICW Latina, said the magazine could be published more frequently in the future.

Mansilla said the magazine's audience ranges from women who were diagnosed as HIV-positive 20 years ago to "others who just found out," adding that "the agenda has to be balanced and built by all of us together." Design and media professionals were invited to help work on the publication, according to Mansilla. She said that the "idea was not to produce a publication showing what our organization does, but to have a new tool for our work." Mansilla added, "Magazines in doctors' offices often show HIV-positive women in the role of victims, leading tragic lives. But the ones I know are happy, full of energy and living healthy smoking-free lives, keeping close track of their immune systems" (Inter Press Service, 3/23).

HIV, STI Data for Maryland County

2009-03-30T08:19:00.002-07:00

Prince George's County in Maryland has the second-highest rate of reported HIV/AIDS cases statewide, County Health Officer Donald Shell announced on Tuesday, the Washington Post reports. The county also has the second-highest rate of sexually transmitted infections, Shell said, adding that only Baltimore is higher in both categories.

Prince George's County reported 5,240 HIV/AIDS cases in 2007, the most recent year for which data are available, according to Shell. He added that the county's proximity to Washington, D.C. -- which recently reported an HIV/AIDS prevalence of 3% -- has affected Prince George's. "There is no border line," he said, adding, "Our proximity puts us at greater risk." In addition, many county residents do not have access to health care -- about 151,000 do not have health coverage, and about 102,000 are on Medicaid, Shell said.

According to Shell, the county also has seen a "resurgence" in syphilis cases. In 1998, the county reported 6.6 cases per 100,000 people, compared with 11.2 cases per 100,000 people in 2007. Although Shell reported rates for several STIs, the department did not provide data to support the claim that the county has Maryland's second-highest rate overall, the Post reports.

According to Shell, the rates of HIV/AIDS and other STIs in Prince George's County can be attributed in part to a lack of safer-sex practices, particularly during heterosexual intercourse. Shell said that he has been surprised by the response he receives from college students. "They don't care about condom usage or about their partners," he said, adding, "There is a blatant disregard that anything is going to happen to them" (Wiggins, Washington Post, 3/25).

Kansas House Committee Approves Bill Requiring HIV Testing For Pregnant Women

2009-03-30T08:19:00.001-07:00

The Kansas House Committee on Health and Human Services last week approved a bill (S.B. 147) that would require doctors to test pregnant women and some infants for HIV, the Kansas Health Institute News reports. Committee chair Rep. Brenda Landwehr (R) said that there were "some questions" about the bill "raised early on, but they've been answered." Landwehr previously asked for clarification about whether the bill could lead to HIV-positive infants being denied health insurance because of a "pre-existing condition." Supporters of the bill, including the Kansas Department of Health and Environment, told committee members that the benefits of preventing mother-to-child HIV transmission outweighed concerns about health insurance. The bill passed in the Senate earlier this month and now goes to the full House for consideration (Ranney, Kansas Health Institute News, 3/19).

According to the Kansas Health Institute News, the bill would require that doctors test women in the first trimester of pregnancy for HIV, with those testing negative but at a high-risk for HIV being tested again in the third trimester. The bill also would allow pregnant women to opt out of testing. In addition, infants born to women who have not been tested or who are unaware of their HIV status would be tested under the bill. According to KDHE data, about 4,400 pregnant women in the state do not receive HIV tests each year. William Lyons, director of the HIV/AIDS program within KDHE's Division of Disease Control and Prevention, told the committee that 89% of pregnant women are being tested for HIV in Kansas, meaning that 11% are not. He noted that the cost of a course of medication to prevent MTCT costs "about $17," while the cost of caring for an HIV-positive child often exceeds $250,000 (Ranney, Kansas Health Institute News, 3/18).

New Zealand Reports Record Number of HIV Diagnoses

2009-03-30T08:18:00.001-07:00

New Zealand reported 184 HIV diagnoses last year, the highest on record, according to recently released statistics from University of Otago's AIDS Epidemiology Group, the NZPA/New Zealand Herald reports. The previous record high was 183 diagnoses in 2005. According to the epidemiology group, 152 people contracted the virus through sexual contact, including 91 men who have sex with men, and 39 men and 22 women who were exposed through heterosexual contact. Two cases involved injection drug use, and another two cases involved blood transfusions that occurred overseas. According to the statistics, four infants contracted HIV through mother-to-child transmission. In addition, the statistics indicate that 43 people received AIDS diagnoses. According to the report, safer-sex practices, HIV testing, and the prevention and treatment of other sexually transmitted infections should be emphasized to reduce the spread of HIV. In addition, it said that prevention efforts should focus on minority groups (NZPA/New Zealand Herald, 3/20).

Texas Senate Approves Bill To Allow Needle-Exchange Programs

2009-03-30T08:16:00.002-07:00

The Texas Senate on Wednesday voted 23-7 to approve a bill (S.B. 188) that would allow local state health agencies to run needle-exchange programs to help curb the spread of HIV and other bloodborne diseases among injection drug users, the Dallas Morning News reports. Texas is the only state that currently prohibits needle-exchange programs, according to the Morning News .

Under the bill, sponsored by Sen. Bob Duell (R), health officials would be allowed to charge participants, who would be asked to turn in used needles to program officials in exchange for clean ones. According to the Morning News, there are numerous studies showing that exchange programs have health benefits "not only for drug users but also their children and those they come in contact with, such as medical providers."

Duell said that a needle-exchange program decreases the spread of HIV and hepatitis, as well as "saves the state money without costing the state any money." He added that he "understood" that the bill was a difficult vote for some senators because of misconceptions about needle-exchange programs, noting that national studies have shown the programs do not increase drug use but reduce HIV cases among IDUs by about 30%, the Morning News reports. According to the Morning News, Gov. Rick Perry (R) has indicated he does not support needle-exchange programs. The Senate was scheduled to vote on the bill one more time before it can proceed to the House for consideration, according to the Morning News (Stutz, Dallas Morning News, 3/19).

HIV/AIDS in Washington, D.C.

2009-03-30T08:16:00.001-07:00

A recent report finding that HIV/AIDS prevalence in Washington, D.C., has reached 3% is "raising alarm bells" in South Carolina's Lowcountry region, the Charleston Post and Courier reports. Although South Carolina's prevalence has not reached the same level as the district's, it is "still one of the riskiest states in the nation for unprotected sex," according to the Post and Courier. "We've made a lot of progress, but we can't be complacent," Tony Price, the HIV prevention program manager at the Department of Health and Environmental Control, said. Virginia King, director of Lowcountry AIDS Services, said that the district report should serve as a warning for South Carolina. "It could become more of a problem here if people don't start to pay attention to what they do," she said.

According to the Post and Courier, blacks are at an increased risk of contracting HIV/AIDS. In South Carolina, blacks comprise 29% of the population but account for 73% of HIV cases, according to the health department. The health department also reports that men who have sex with men, particularly black MSM, are at an increased risk, as well as injection drug users and women, who are increasingly affected through heterosexual intercourse. According to the health department, the percentage of HIV-positive blacks in South Carolina has decreased over the past 10 years, which health workers attribute to increased HIV/AIDS education and testing efforts (Munday, Charleston Post and Courier, 3/18).

Advocates, Vatican Respond to Pope Statement That Condom Distribution Will Not Curb HIV/AIDS in Africa

2009-03-30T08:15:00.001-07:00

Pope Benedict XVI's statement on Tuesday that condom distribution will not curb the spread of HIV/AIDS in Africa has "sparked an international outcry" among HIV/AIDS advocates and prompted a response from the Vatican, AFP/Google.com reports (AFP/Google.com, 3/18). While heading to Yaounde, Cameroon, as part of a seven-day pilgrimage to Africa, the pope said, "You can't resolve it with the distribution of condoms," adding, "On the contrary, it increases the problem" (Simpson, AP/Washington Times, 3/18). He added that addressing the disease will require a "spiritual and human awakening" and "friendship for those who suffer" (AFP/Google.com, 3/18).

The Rev. Federico Lombardi, a spokesperson for the pope, called the criticism of Benedict's remarks the "echoes caused by some words by the pope on the AIDS problem." He added that the Roman Catholic Church's "essential principles" regarding HIV/AIDS prevention are "education about people's responsibility in the use of sexuality" and the "essential role of marriage and family." At the end of the second day of Benedict's African tour, Lombardi issued a written statement indicating that the church emphasizes treatment for "the widest number of sick" and "human and spiritual assistance" to people living with HIV/AIDS (AP/Washington Times, 3/18). Lombardi also said that Benedict was stating a long-standing Vatican position against artificial contraception, including condoms, adding that the pope aimed to emphasize that relying on condoms takes away from a needed focus on sexual conduct education (Charlton, AP/Seattle Times, 3/18). According to London's Guardian, the Vatican posted a version of the pope's comments on the Holy See's Web site that said, "The scourge cannot be resolved with the distribution of prophylactics; on the contrary, this risk is of increasing the problem" (Butt/Hooper, Guardian, 3/19).

Michel Kazatchkine -- head of the Global Fund To Fight AIDS, Tuberculosis and Malaria -- called for the pope to retract his "unacceptable" statement, which he called "a denial of the epidemic." According to Kazatchkine, for the pope "to make these remarks on a continent that unfortunately is a continent where 70% of people who have AIDS die, it's absolutely unbelievable" (AFP/Google.com, 3/18). He said, "I think Africa, which is hit so hard (by AIDS), did not need this message," adding, "Negationist statements are terribly harmful" (AP/Seattle Times, 3/18). In addition, UNAIDS called condoms an "essential part of combination prevention," adding, "With more than 7,400 new infections each day, the world cannot stop the AIDS epidemic without stopping new HIV" transmissions (AFP/Google.com, 3/18). Although UNAIDS did not mention the pope in its comments, the agency released its statement the day after Benedict's remarks (AP/Seattle Times, 3/18).

According to the Guardian, several foreign governments also criticized the Vatican, which is a "rare" occurrence that "reflects the strength of feeling against the pope's comments." Eric Chevallier, spokesperson for the French foreign ministry, said in an online briefing, "France voices extremely sharp concern over the consequences of Benedict XVI's comments." He added, "While it is not up to us to pass judgment on church doctrine, we consider that such comments are a threat to public health policies and the duty to protect human life." According to Chevallier, condom distribution is "a fundamental element of actions" to prevent HIV transmission. Laurette Onkelinx, health minister of Belgium, said the pope's remarks reflect "a dangerous doctrinaire vision." Onkelinx added that Benedict's statements on condoms "could demolish years of prevention and education and endanger many human lives." In addition, German Health Minister Ulla Schmidt and Minister of Development Heidemarie Wieczorek-Zeul issued a joint statement criticizing the pope's remarks. "Condoms save lives," they said, adding, "Modern assistance to the developing world today must make access to family planning available to the poorest of the poor, especially the use of condoms. Anything else would be irresponsible" (Guardian, 3/19).

In addition to international agencies and foreign governments, many HIV/AIDS advocates joined the recent criticism against the pope's comments. Alain Fogue, spokesperson for Cameroon's treatment campaign MOCPAT, said, "To claim that condoms 'aggravate' the problem of AIDS goes totally against all the efforts made by the Cameroonian government." Advocates in Angola, where Benedict will arrive Friday, added that the pope's statements should relate to church doctrine and not public health. "Condoms are a method of preventing AIDS, not just in Africa but in all the world," Delma Monteiro, head of an HIV program, said. She added that officials "have to use all forms of prevention that we can against this disease." Mohga Kamal-Yanni, an HIV/AIDS specialist for Oxfam International, said "access to condoms is absolutely essential to combat HIV." Kamal-Yanni added that in order to prevent new HIV cases, particularly among young people, "we need to expand the use of condoms, not decrease it." Judith Melby, an Africa specialist at the United Kingdom's Christian Aid, added that the pope's statements "are not very helpful." She added that his position is "sending a confusing message to Africa, in those countries where the Catholic church is very important" (AFP/Google.com, 3/18).

Related Editorial
Although "[i]n a perfect world, people would abstain from having sex until they were married or would be monogamous in committed relationships, ... the world isn't perfect," a Washington Post editorial states, adding that "neither is Pope Benedict's pronouncement on the effectiveness of condoms in the battle against HIV/AIDS. The evidence says so." The editorial asks, "Are condoms foolproof protection against infection by HIV, which causes AIDS? No." However, even though condoms sometimes break or are used incorrectly, "doctors on the front lines of the fight against the AIDS epidemic established long ago that the use of condoms greatly diminishes the transmission of HIV," according to the editorial. It says that it is "troubling" that Benedict "chose to question the value of condoms in fighting the nearly 28-year-old scourge while heading to the continent whose people are most affected by it." Sub-Saharan Africa accounts for 67% of people living with HIV in the world and 75% of all AIDS deaths, according to UNAIDS, the editorial states. It adds that "[h]eterosexual intercourse is the 'driving force' of the epidemic."

The editorial continues that the pope's remarks were "especially discordant to us coming a day after" a report about HIV/AIDS prevalence in Washington, D.C. The editorial notes that the "startling" report showed that 3% of D.C. residents are living with HIV/AIDS and that UNAIDS and CDC define a "severe" epidemic in a specific area as infection in at least 1% of the population. According to the editorial, "To halt the march of HIV/AIDS, those who have the infection must be treated. Those who do not have it need all the information and tools possible to remain HIV-negative." It concludes, "The pope's denunciation of condoms is of no help" (Washington Post, 3/19).

Increase in Heroin Availability in Australia Posing Risk of HIV

2009-03-30T08:12:00.000-07:00

The Australian National Council on Drugs on Monday said that increased amounts of heroin entering the country from the Middle East and Asia could contribute to the spread of HIV among injection drug users, the Sydney Morning Herald reports. The council's Asia-Pacific Committee reported that heroin trafficking has increased and that border detections of the drug were the highest on record in 2006 and 2007.

According to committee chair Robert Ali, heroin use and overdose deaths in Australia have decreased since 2001, but overall global production has increased, creating new risks. He said that an increase in the availability of heroin could result in "recruitment of new drug users," adding, "It's recruiting a new group of users into injecting who think there is no HIV and don't know much about hepatitis C and just feeling that it's not risky. There's a perception that all of this has gone away, that it's no longer a problem." He added that there is "a real risk" of HIV and hepatitis C among IDUs. ANCD reports that heroin imported from Afghanistan also is being more heavily processed to allow for easier injection (Sydney Morning Herald, 3/17). Ali warned that authorities should not become complacent, according to the West Australian. He said, "When we look at the global drug problem, the threat that is causing the most concern is the risk of HIV, and there are now 128 countries that have detected HIV among drug users." He added that one-third of all HIV cases outside of Sub-Saharan Africa are transmitted through injection drug use (O'Leary, West Australian, 3/17). According to Ali, Australia should work with neighboring countries to address the issue. "We need to get ahead of the game, we need to work with our near-neighboring countries ... to help implement things that work because that will be in our long-term domestic security interest" (Sydney Morning Herald, 3/17).

Antibodies Present in Long-Term HIV Survivors Could Contribute to Vaccine Development

2009-03-30T08:11:00.000-07:00

HIV-positive people who do not develop AIDS and do not require antiretroviral medication could provide insight for new strategies in vaccine development, according to a study published Sunday in the journal Nature, London's Independent reports. Michel Nussenzweig -- head of Rockefeller University's Laboratory of Molecular Immunology and author of the study -- said his research aimed to harness natural mechanisms to target HIV rather than use synthetically produced antibodies, some of which have failed in earlier HIV vaccine trials.

For the study, Rockefeller University researchers examined antibodies present in the blood of six long-term HIV survivors who appeared to have a degree of natural immunity to the virus (Connor, Independent, 3/16). The researchers isolated 433 antibodies from the patients, all of which targeted HIV's protective outer coating, or "envelope." The researchers then cloned the antibodies and observed which elements of the envelope each antibody targeted and how effectively it neutralized HIV. During the research, Johannes Scheid, a doctoral student at Rockefeller University, identified a new structure on the HIV envelope that scientists previously had not recognized as an antibody target. Although the researchers determined that each antibody individually had a weak effect on HIV, they also found that the antibodies as a group effectively targeted the virus (PA/Google.com, 3/15). In addition, the researchers determined that a prototype vaccine developed from several of the antibodies can prevent the growth of HIV in human cells in a test tube.

Nussenzweig said the study identified "many different antibodies that individually have limited neutralizing ability but together are quite powerful." According to Nussenzweig, only about one in every 1,000 HIV-positive people produces the neutralizing antibodies. He said the research attempts a new approach to HIV vaccine development by "copying what exists in nature and that we know can work because of the long-term survivors." He added, "Instead of inventing something that doesn't exist, it's trying to copy something that does exist." Nussenzweig said the study's results "should make people think about what an effective vaccine should look like." According to the Independent, the researchers next plan to conduct further trials of vaccine candidates on laboratory animals and human volunteers.

The Independent also profiled Kai Brothers, a San Francisco man who has been living with HIV for 28 years without developing AIDS or requiring antiretroviral medications. The Independent reports that Brothers, who did not participate in the new study, might be one of "a few -- perhaps as few as one in 5,000" -- HIV-positive people who have natural immunity to the virus. Brothers said he has participated in HIV research for 10 years, adding, "I feel dedicated to giving back something because of my good fortune" (Independent, 3/16).

An abstract of the study is available online.

Native HIV/AIDS Awareness Day

2009-03-30T08:10:00.000-07:00

An American Indian youth theater group on Friday will perform in Minneapolis to mark National Native HIV/AIDS Awareness Day, which is scheduled for March 20, the AP/Minneapolis Star-Tribune reports. The Ogitchi-dag Players from the Indigenous Peoples Task Force will perform at the city's American Indian Center. According to Minnesota health officials, 193 HIV cases and 81 AIDS-related deaths have been recorded among American Indians in the state since the beginning of the epidemic, and about 100 HIV-positive American Indians live in Minnesota. Mitchell Davis, director of the state minority health office, called for frequent HIV tests and safer-sex practices among the population. He also warned against sharing needles for injection drug use and body art (AP/Minneapolis Star-Tribune, 3/15).

Anthony Fauci, head of NIH'S National Institute of Allergy and Infectious Diseases, ahead of the awareness day said, "Lack of access to basic health care services, stigma associated with homosexuality and HIV/AIDS, barriers to effective mental health care, and high rates of substance abuse, sexually transmitted infections and poverty all increase the risk of HIV/AIDS in native communities and create obstacles to HIV prevention and treatment." He added, "Consequently, as a proportion of their population, more American Indians and Alaska Natives became infected with HIV than whites in 2006. American Indians and Alaska Natives acquired new HIV infections at a rate of 14.6 cases per 100,000 people, while whites became newly infected at a rate of 11.5 cases per 100,000. Moreover, American Indian and Alaska Native women became infected with HIV at more than three times the rate of white women in 2006" (NIAID release, 3/13).

Chicago Tribune Examines Program That Offers No-Cost HIV Tests in Hospital ED

2009-03-13T07:12:00.002-07:00

The Chicago Tribune on Wednesday examined a CDC-funded program in four Chicago hospitals that offers no-cost HIV tests to emergency department patients. CDC in 2007 gave $35 million in grants to 23 state and local health departments to implement the no-cost HIV testing programs with a goal of testing one million people, particularly blacks who account for about 50% of the estimated one million HIV-positive Americans.

The Chicago Department of Public Health received $3.8 million for the program and distributed $1.3 million to Advocate Trinity, Stroger, Mt. Sinai and Provident hospitals. According to Cathy Yanda, director of HIV Counseling, Testing and Partner Services in Chicago, by the end of last year, 19,907 people had received no-cost HIV tests through the program, and 143 people were found to be HIV-positive.

Donna Sinclair -- health education coordinator for the Rapid HIV Testing Project at Advocate Trinity Hospital, which received about $190,000 for the program -- said the hospital's initial goal was to administer 8,000 HIV tests to ED patients but that the target was increased to 10,000 after so many people responded. Sinclair said that some patients were reluctant to be tested when the program began in May 2008 but that the refusal rate decreased from 65% to 20% as the health workers administering the tests became more comfortable asking people to be tested. She added that the test administrators last summer began offering HIV tests to family and friends of ED patients. People who test positive for HIV are offered counseling, while people who test negative receive information about how to prevent contracting the virus in the future. In addition, staff provide brochures and no-cost condoms.

According to the Tribune, more than 21,000 Chicago residents were living with HIV/AIDS in 2006, and the health department estimates that thousands more people do not know they are HIV-positive (Stone, Chicago Tribune, 3/11).

Female Migrants From Asia at an Increased Risk of HIV, U.N. Report Says

2009-03-13T07:12:00.001-07:00

Female migrants from Asia have become "highly vulnerable" to HIV during the global financial crisis, according to a United Nations Development Programme report released in Manila, the Philippines, on Tuesday, AFP/Nasdaq.com reports. According to the report, the economic crisis has resulted in widespread job cuts and the "situation of migrant workers is under threat." It added, "When demand for labor wanes, those in the weakest bargaining position, usually temporary migrant workers and particularly the undocumented, will accept almost any conditions to hold on to their jobs."

Between 70% and 80% of migrant workers from Sri Lanka and the Philippines to Arab states are women, and 60% of female migrants from Bangladesh were employed in the region between 1991 and 2007, according to the report. It added that these women now face harsh conditions. Many are heavily indebted when they leave their home countries, and others experience sexual abuse by their employers or are kidnapped by human traffickers. "Conditions are expected to become harsher for even the employed migrant workers as they try to hang on to their jobs," UNDP country representative Renaud Meyer said, adding that undocumented workers are among the most vulnerable and might "accept almost any circumstances to hold on to their jobs." Meyer said, "Worst still, during the present turmoil, desperation for work may lead to migration under unsafe conditions, sexual exploitation and increased vulnerability to HIV infections" (AFP/Nasdaq.com, 3/10).

Prasada Rao, regional director for UNAIDS, said that although "migration itself is not a risk factor to HIV infection, the conditions under which some workers migrate and their living conditions in the host countries make them highly vulnerable to HIV." Ajay Chhibber, UNDP regional director for Asia and the Pacific, said that migrants found to be HIV-positive often face deportation and that they are unable to find work and experience discrimination once they return to their home countries (AP/MSNBC.com, 3/10).

According to AFP/Nasdaq.com, although some countries require HIV/AIDS education for migrants prior to departure, many workers do not receive such education. For example, 96% of Bangladeshi domestic workers in the Middle East said that they did not receive HIV/AIDS orientation before departure. "While half of them have heard of HIV through the media or from co-workers, none had in-depth knowledge of HIV prevention" and safer-sex methods, the report said, adding that the combination of recruitment fees and low wages can force female migrants into "debt traps, which in turn, could lead to sexual exploitation." In addition, workers who "flee abusive working conditions are immediately rendered illegal by host countries, exposing them to greater risk of abuse, including sexual exploitation and increased vulnerability to HIV," the study said. It was based on more than 600 interviews with migrant workers from Bangladesh, Pakistan, the Philippines and Sri Lanka, which supply workers to countries such as Bahrain, Lebanon and the United Arab Emirates (AFP/Nasdaq.com, 3/10).

The report is available online.

National HIV/AIDS Day for Women, Girls

2009-03-13T07:11:00.002-07:00

The New York City-based HIV/AIDS group Gay Men's Health Crisis on Tuesday will join other advocates, officials, teachers and clergy members outside City Hall to bring attention to what it calls the "alarming" impact of HIV/AIDS on women and girls on the occasion of National Women and Girls HIV/AIDS Awareness Day, the AP/USA Today reports. The group plans to call for improved sex education in schools and increased HIV prevention and treatment services (AP/USA Today, 3/9). The 2009 theme for the day is "HIV is Right Here at Home" (HHS Web site, 3/10).

According to New York City's Department of Health and Mental Hygiene, the city remains at the "epicenter" of HIV/AIDS in the U.S. Currently, one in three HIV-positive residents is female, an increase from one in 10 in the early years of the epidemic. In addition, almost 90% of HIV-positive women and 94% of teenage girls who recently contracted the disease are black or Hispanic, the AP/USA Today reports (AP/USA Today, 3/9). In the U.S., women accounted for 26% of new AIDS diagnoses in 2005, an increase from 11% in 1990. In addition, HIV/AIDS currently is the leading cause of death among black women ages 25 to 34. According to HHS, most women contract HIV through heterosexual contact or injection drug use (HHS Web site, 3/10).

HIV/AIDS Assistance

2009-03-13T07:11:00.001-07:00

Sacramento County, Calif., has received an $870,775 grant from HHS to assist some of the estimated 5,000 people living with HIV/AIDS in the county, Rep. Doris Matsui (D) announced recently, the Sacramento Bee reports. The money will go to the county's Department of Health and Human Services to help HIV-positive residents who do not have health insurance and are financially struggling because of the economic situation. The grant will be used to fund emergency care and expand emergency services for people in the greatest need. "This grant helps those who need it most and shows our commitment to helping those living with HIV/AIDS," Matsui said (Lindelof, Sacramento Bee, 3/8).

HIV/AIDS Outreach Efforts in Atlanta, Buffalo, N.Y., Target Black Community

2009-03-13T05:47:00.000-07:00

The following summarizes two recent events that seek to raise HIV/AIDS awareness in the black community.

Atlanta: The African-American Outreach Initiative will hold its 10th annual conference on HIV/AIDS in Atlanta March 15, the Atlanta Journal-Constitution reports. AIDS is the leading cause of death among black women ages 24 to 34 and the second leading cause of death among black men ages 35 to 44. The two-day conference will seek to identify people who are HIV-positive and encourage them to seek care, Michael Banner, chair of the planning committee, said. According to Banner, the conference attracts between 500 and 600 people who are HIV-positive. Banner said the conference "gives people who are HIV-positive a safe place to come and get information and see role models who are living with HIV but not living in the shadows" (Bonds Staples, Atlanta Journal-Constitution, 3/8).
Buffalo, N.Y.: The Buffalo division of the National Black Leadership Commission on AIDS on Saturday as part of an effort to commemorate "Black Church Week of Prayer for the Healing of AIDS" sponsored a series of HIV/AIDS prevention workshops at a local church, the Buffalo News reports. The highest rates of new HIV infections are among black men who have sex with men and heterosexual women, Donna Chapman, the Buffalo coordinator of NBLCA, said. "The purpose of (the commission) is to mobilize the indigenous, African-American leadership in whatever city we go to help them make an intelligent and meaningful response to the HIV pandemic," Chapman said. The workshops were aimed at "demystifying issues surrounding the disease while also allowing participants to deal with the issue from a faith perspective," the News reports. The commission also held a breakfast for local pastors and their wives as part of its outreach mission targeting black religious leaders (McNeil, Buffalo News, 3/7).

Microbicide Containing Natural Compound Provides Protection in Monkeys Against Simian Version of HIV

2009-03-08T07:17:00.000-07:00

An experimental microbicide containing a naturally occurring compound provides protection in monkeys against the simian version of HIV by diminishing immune responses to the virus, according to a study published Wednesday in the journal Nature, the Los Angeles Times reports. HIV typically spreads in the body by entering CD4+ T cells, which the immune system sends out to attack the virus after exposure. The compound -- called glycerol monolaurate, or GML -- works by inhibiting immune signals that dispatch the T cells to attack the infection. It is those T cells that HIV infects and uses to proliferate throughout the body (Engel, Los Angeles Times, 3/5). GML occurs naturally in the human body and already is approved for use as an antimicrobial and anti-inflammatory ingredient in cosmetics and toiletries, as well as an emulsifier in foods. In addition, each dose of GML used in the study costs less than one cent. According to the researchers, the study's findings have promising implications for the development of effective microbicides to prevent HIV (AFP/Google.com, 3/4).

For the study -- led by Ashley Haase, head of the microbiology department at the University of Minnesota Medical School, and microbiologist Patrick Schlievert -- researchers administered the GML gel vaginally to five rhesus monkeys and then repeatedly exposed them to the simian version of HIV, or SIV. After two weeks, all of the five monkeys tested negative for the virus. However, four out of five monkeys that did not receive the GML gel contracted SIV. According to the researchers, five months after the experiment, they learned that one of the monkeys treated with GML tested positive for the virus. The researchers said they are unsure how this monkey contracted SIV, but they suggested that a small amount of the virus might have spread in the body undetected or the monkey might have been exposed to SIV after the study ended (Lerner, Minneapolis Star Tribune , 3/4).

Haase said the current research is "a relatively preliminary study but worth sharing because it establishes a novel approach." The researchers added that a mathematical model suggests that even if the microbicide were 60% effective and used 20% of the time, it still could prevent about 2.3 million HIV cases over a three-year period. According to the study authors, researchers will need to conduct further animal studies to determine whether the microbicide should be administered over a longer period of time to provide long-term protection against the virus (Los Angeles Times, 3/5). Further study also will be needed to demonstrate whether GML prevents HIV transmission among humans, they added. The researchers said they plan to undertake a larger study with monkeys, followed by a study with female volunteers. In addition, the University of Minnesota has applied for patents for the new compound combining GML with a personal lubricant, which currently is not available commercially. According to Schlievert, the ultimate goal will be to develop a gel that can be used for both men and women (Minneapolis Star Tribune, 3/4).

According to the study authors, the research "represents a highly encouraging new lead in the search for an effective microbicide to prevent HIV transmission that meets the criteria of safety, affordability and efficacy" (Fox, Reuters, 3/4). Haase said that although the research "sounds counter-intuitive, halting the body's natural defense system might actually prevent transmission and rapid spread of the infection" (AFP/Google.com, 3/4). Charlene Dezzutti, laboratory network director of the Microbicides Trial Network at the University of Pittsburgh, said the research illustrates "a new approach to thinking about microbicides." She added that she believes scientists "definitely" could develop an effective microbicide before developing an HIV/AIDS vaccine. "It's just a matter of getting all the right pieces together," she said (Lauerman, Bloomberg, 3/4). Rowena Johnston, vice president of research for the Foundation for AIDS Research, said that if further studies confirm these results, "then this is really a fabulous new finding." She said that although future microbicide research could encounter setbacks, the study is "absolutely a great beginning to a research project."

According to Schlievert, women could apply the GML microbicide "an hour or so before they had sex" to protect against HIV transmission. In addition, the gel might provide protection against other sexually transmitted infections, such as chlamydia, he said (Minneapolis Star Tribune, 3/4). According to AFP/Google.com, Schlievert first identified the microbicidal properties of GML when studying the use of the compound in preventing toxic shock syndrome associated with tampons. He said research repeatedly has found that the compound is safe and has no effect on beneficial vaginal bacteria (AFP/Google.com, 3/4). Lorraine Teel, executive director of the Minnesota AIDS Project, said the gel could provide women with a way to prevent disease transmission in areas of the world where many people do not use condoms because of cultural or other pressures. The research has "absolutely enormous implications" for women worldwide, she said (Minneapolis Star Tribune, 3/4). Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said an effective microbicide would "empower women to protect themselves in a sexual situation in which they may not have complete control" (Los Angeles Times, 3/5).

An abstract of the study is available online.

Texas Bill To Make HIV Screening Part of Routine Care Would Help Efforts To Curb Virus

2009-03-08T07:16:00.000-07:00

"More than two years after" CDC "recommended routine HIV screening, two state lawmakers" in Texas have proposed a bill to align the state with the federal recommendations, a Lubbock Avalanche-Journal editorial says. It adds that between 2003 and 2007, "more than one-fourth of Texans with HIV were diagnosed late in the course of the disease and were diagnosed with AIDS within a month." According to Ed Sherwood, chair of the Texas Medical Association Committee on Infectious Diseases, making HIV tests a part of routine care "would help avoid situations where patients assume they couldn't be infected and decide not to get tested," the editorial says. In addition, if the legislation "passes, it will be a model for other states," according to bill sponsor Sen. Rodney Ellis (D), the editorial says, adding, "California and Illinois are the only other states to pass HIV screening legislation, but not as comprehensive."

The state "already has legislation requiring inmates in Texas prisons to be tested for HIV when they enter and leave the system," according to the editorial. It adds that state law "also requires doctors to offer HIV screening at checkups for pregnant" women. The editorial concludes that the bill is a "good idea ... as long as people can opt out" (Lubbock Avalanche-Journal, 3/4).

New York Times Examines Web Site on Male Circumcision

2009-03-08T07:15:00.000-07:00

The New York Times on Tuesday examined a new Web site -- launched by the World Health Organization, UNAIDS, the AIDS Vaccine Advocacy Coalition, Family Health International, and several U.S. and British public health schools -- that aims to serve as a resource on male circumcision and HIV/AIDS. According to the Times, since WHO and UNAIDS two years ago recommended that male circumcision be made available in countries highly affected by HIV/AIDS to help reduce transmission of the virus through heterosexual sex, much "misinformation has circulated" regarding the procedure in some countries. In addition, there has been a "dangerous surge in complications as traditional healers without sterile instruments began offering cheap circumcisions," the Times reports.

The Web site includes scientific studies, policy documents and news articles and aims to address some popular myths, including one that circumcision provides complete protection from HIV, so circumcised men do not need to use condoms, according to Kim Eva Dickson, a WHO medical officer who oversaw the creation of the Web site. It also includes a handbook that demonstrates surgical techniques, although Dickson said that it is not meant to train traditional healers or surgeons. She added that the handbook could help at some small hospitals in rural areas by demonstrating new methods for further investigation and teaching that men need pain management, sex advice and condoms in addition to surgery. According to Dickson, the Web site in its first week has had visitors from the U.S., Switzerland and the United Kingdom, as well as India, Kenya, Namibia, South Africa and Turkey (McNeil, New York Times, 3/3).

New Blog at AIDS-Drugs-Online.com

2009-03-05T06:35:00.000-08:00

The staff at www.aids-drugs-online.com have started up another blog! This blog is a great resource, and is featuring all of the latest articles and press releases that ADO.com has put out. It will contain up-to-date news and information and be a great resource (not unlike this one) for those looking for information on HIV and AIDS.

The new blog can be found at: AIDS-Drugs-Online.com/wordpress/

California Group Hosts Conference, Starts Database To Spread HIV/AIDS Awareness Among Black Teenagers

2009-02-28T04:20:00.000-08:00

Helping Our Own Destiny -- a not-for-profit group in Fresno, Calif. -- this month is launching a new HIV/AIDS awareness campaign aimed at black teenagers, the Fresno Bee reports. For the campaign's launch on Feb. 28, the group plans to host a conference for about 500 students at a local high school.

The conference will feature speakers, workshops and a dance party afterward.
Participating teenagers also will have the opportunity to enroll in a database Helping Our Own Destiny plans to use to keep track of the teens.

In Fresno County, about 6% of the population is black. Blacks in the county make up 20% of AIDS cases and 14% of HIV cases, according to Jena Adams, a communicable-disease specialist with the county Department of Health.

Paul Copeland, president and founder of Helping Our Own Destiny, said, "Our objective is to take a proactive approach toward getting the information out there. Right now, they leave brochures, but students don't respond." He added, "There's still a stigma that [HIV/AIDS is] a gay issue. In the black community, there's a lot of stigmas. We know there's kids being affected" (Colon, Fresno Bee, 2/19).

South Carolina ADAP gets a boost

2009-02-28T04:17:00.000-08:00

The South Carolina House Ways and Means Committee on Thursday approved a proposed budget plan that would use federal stimulus funding to continue HIV/AIDS services and other health programs, the AP/Columbia State reports. The $5.6 billion budget would restore some funding that was cut in July 2008 to health care, schools and colleges, according to the AP/State. The budget includes $1 million for an HIV prevention program that funds 39 church-based education initiatives, as well as $2.4 million for South Carolina's AIDS Drug Assistance Program. South Carolina HIV/AIDS Council Executive Director Bambi Gaddist said that she had been "deeply concerned" that the funds would be eliminated. "We're elated about their incorporation," she said, adding, "We've got to have $2.4 million just to keep a lid on the epidemic. You want [HIV-positive people] to be well, working and contributing to the economy, not sick and dependent on Medicaid."

The budget plan, which health officials said would prevent more service cuts, now goes to the full House for consideration. "This is not what we'd like to have, but it's the best we can do in the circumstances," House Ways and Means Chair Dan Cooper (R) said, adding, "We're not planning to raise taxes" (Adcox, AP/Columbia State, 2/20).

For a quick link to ADAP information by state, please visit: AIDS-drugs-online.com

HIV/AIDS Funding Cuts in Connecticut

2009-02-28T04:14:00.001-08:00

The Connecticut AIDS Resource Coalition on Friday held a press conference to protest a proposed $2.7 million cut to state programs that provide HIV/AIDS services, the New Haven Register reports. Gov. M. Jodi Rell's (R) budget proposal for fiscal years 2009-2011 would allocate $4.95 million annually over the next two years to HIV/AIDS services, a 40% decrease from FY 2008-2009 funding levels. Jeffrey Beckham, spokesperson for the state Office of Policy and Management, said the proposed cuts would reverse an additional $2.51 million in FY 2007-2008 and $3.09 million in FY 2008-2009 in state HIV/AIDS funding following a $3.3 million reduction in federal Ryan White CARE Act funding.

Beckham said, "We're more or less at a constant base amount for this AIDS services account for the last several years," adding the proposal brings HIV/AIDS funding back to traditional levels. Leif Mitchell, co-chair of CARC's AIDS Legislative Initiative and Funding Effort, said that a 40% reduction in funding is "absolutely unacceptable," adding that HIV advocates in the state had said they were "willing to suffer a 10% cut." Christopher Cole, executive director of AIDS Project New Haven, said the agency could lose about 6% of its budget, or $66,000, that will affect transportation, mental health and substance abuse programs for HIV-positive people.

According to CARC, about 10,860 people are living with AIDS in the state. In addition, there are more AIDS cases among injection drug users in Connecticut than in any other state, the Register reports (Stannard, New Haven Register, 2/21).

When HIV Funding services are cut and alternative treatment methods are required, please visit www.aids-drugs-online.com for other treatment options.

Higher Mortality Seen Among HIV-Positive People Who Miss Clinic Appointments

2009-02-21T07:36:00.001-08:00

People living with HIV who do not go to scheduled clinical appointments during their first year of treatment are more likely to die over the long term than people with perfect attendance, according to a study conducted by researchers at the University of Alabama-Birmingham and recently published in Clinical Infectious Diseases, Reuters reports. The study involved 543 HIV-positive people who began outpatient care between 2000 and 2005, of whom 60% missed scheduled office visits during the first year. After controlling for initial immune system function and drug therapy during the first year of care, the study found that the mortality rate for people who missed visits in the first year was 2.3 deaths per 100 people annually, compared with one death per 100 people annually for those who attended all scheduled visits. A similar increased risk of death occurred whether people missed only one or two or more visits.

Michael Mugavero, lead study author, said that missed visits shortly after beginning outpatient care can give providers a "marker indentifying patients at higher risk for poor clinical outcomes -- patients who may require closer monitoring." He also said the "extrapolation of our findings to the general population level has profound public health implications," particularly when considering the number of annual new HIV infections in the U.S. (Douglas, Reuters, 2/11).

Chicago Hospital Continues Program Offering No-Cost HIV Tests

2009-02-21T07:35:00.002-08:00

Advocate Trinity Hospital in Chicago will continue a program offering no-cost oral HIV tests to patients waiting to be seen in its emergency department, the Chicago Sun-Times reports. The hospital launched the program in May 2008 with a $150,000 grant from CDC and received an additional $180,000 this year to continue the program.

According to the Sun-Times, Trinity offers the program to all ED patients between ages 14 and 64. Of the patients offered the test, less than 20% decline to take it, Donna Sinclair, HIV coordinator for the hospital's ED, said. Health workers administer the tests in a private area, and patients receive results in about 20 minutes. More than 5,000 people have taken the no-cost tests since the program's launch. However, data on the number of positive test results are not available, the Sun-Times reports.

According to the Sun-Times, Trinity's efforts are part of an "unusual program" aimed at encouraging more people to take HIV tests. "We don't wait for patients to come to us," Sinclair said, adding that Trinity's "health educators go to each patient awaiting treatment and provide them with a wealth of information -- everything from how the virus is spread, to who is at risk, to what they need to know about the test." According to Andrea Poicus, Trinity spokesperson, the hospital received funding for the program because it is located in an area with a high HIV prevalence. In addition, most of Trinity's patients are black, which is a group that has been disproportionately affected by HIV/AIDS, the Sun-Times reports (Thomas, Chicago Sun-Times, 2/13).

Latin America Media Companies Announce HIV/AIDS Partnership

2009-02-21T07:35:00.001-08:00

"Iniciativa de Medios Latinoamericanos Sobre el SIDA," Global Media AIDS Initiative/Kaiser Family Foundation: Executives from leading media companies in Latin America recently announced the Iniciativa de Medios Latinoamericanos Sobre el SIDA, or IMLAS -- the first Latin American HIV/AIDS media partnership. The announcement follows a meeting last month held in conjunction with the National Association of Television Program Executives Conference. IMLAS was organized in response to the Global Media AIDS Initiative -- a United Nations-supported effort launched in 2004 by the Kaiser Family Foundation together with UNAIDS to mobilize media around the world in response to the pandemic. The new partnership promotes collaboration and leverages resources among media across the region to increase knowledge and reduce stigma (GMAI/Kaiser Family Foundation release, 2/18).

GSK Announces Plan To Reduce Drug Prices in Developing Countries

2009-02-21T07:34:00.001-08:00

GlaxoSmithKline CEO Andrew Witty on Friday announced a plan to reduce the prices of several of its patented medications in 50 of the lowest-income countries worldwide and invest 20% of its profits from low-income countries into health clinics and other infrastructure, the Wall Street Journal reports.

Under the plan, GSK will reduce the price of its patented medications for some diseases -- including asthma, hepatitis B and malaria -- to no more than 25% of the price of such medications in developed countries. According to a GSK spokesperson, GSK's antiretroviral drugs already are sold at reduced prices in developing countries; however, the cost of such drugs will be reduced further if they currently are priced higher than 25% of the price in developed countries (Whalen, Wall Street Journal, 2/14). The plan also would make GSK's drugs more affordable in middle-income countries such as Brazil and India. In addition, GSK will invite scientists from other companies, nongovernmental organizations and governments to conduct research on treatments for tropical diseases at its facility in Tres Cantos, Spain (Boseley, Guardian, 2/14).

Witty also proposed the creation of a voluntary patent pool to fuel development of new treatments for neglected diseases and said that GSK would contribute its patents that could lead to the development of new treatments for malaria, tuberculosis and other diseases. He called on other pharmaceutical companies to make patents available to third-party researchers working on treatments for neglected diseases. According to Reuters, GSK did not include its HIV/AIDS research in the patent pool. Witty said the intent of the patent pool is to focus on diseases that do not have treatments and that other efforts are addressing the need for antiretrovirals (Richwine, Reuters, 2/13).

Witty in an interview before the announcement said the price reductions and investments in infrastructure would not cost much for the company. According to the Journal, GSK's total sales in the lowest-income countries are about $43 million annually. Witty said that 20% of the company's profits from developing countries likely would be about $1.4 million to $2.8 million per year (Wall Street Journal, 2/14).

Obama, U.S. Foreign Policy, and HIV

2009-01-28T08:50:00.000-08:00

Some advocates are calling on President Obama's administration to change the nation's approach to global social and health issues, including HIV/AIDS, the Washington Post reports. According to the Post, the efforts are part of a push by advocates to "transform the way the United States deals with matters of sex, marriage and religious values in the international arena," which "will play out in upcoming United Nations conferences and meetings that set international norms on issues including human rights, public health, family planning and HIV/AIDS." Joseph Amon, head of the HIV/AIDS and Human Rights Program at Human Rights Watch, said that although President George W. Bush made significant investment in global efforts against HIV/AIDS, the programs relied too heavily on abstinence-based initiatives. Amon said, "If we want to have an impact on the AIDS epidemic, we cannot allow moral ideological consideration to trump scientific evidence and human rights." The Post reports that some liberal advocates anticipate the Obama administration will "pursue a cautious pace" in making global policy changes and some social conservatives "are bracing for a long period in the political wilderness" (Lynch, Washington Post, 1/18).

Sugar Molecule to Protect Against HIV/AIDS

2009-01-28T08:49:00.000-08:00

A sugar molecule called the Pk blood group antigen might provide a defense against HIV, according to a study published last week in the journal Blood, Toronto's Globe and Mail reports. Researchers from Toronto's Hospital for Sick Children and Lund University in Sweden studied the sugar molecule, which is found on the surfaces of some red and white blood cells. They found that Pk antigens act as magnets for HIV, neutralizing the virus once it attaches to the antigen and stopping its spread to other immune cells, the Globe and Mail reports.

The study's findings indicate that "the higher the level of [Pk] blood type you have, the less susceptible you are to HIV," according to Donald Branch of Canadian Blood Services, who led the study. Although most people have a certain amount of Pk in their blood supply, only about one in one million people have very high levels, making them "very resistant" to HIV, Branch said. The study "represents a breakthrough," he said, adding that he hopes other people could acquire the same protection against HIV by artificially boosting the Pk level in their blood. Researchers already have developed an artificial version of the antigen for possible use "to sop up the HIV," Branch said. Once the approach is tested in animals, Branch said researchers could move to clinical trials in humans (Taylor, Globe and Mail, 1/16).

An abstract of the study is available online.

Hispanic and Haitian Youth Targeted for HIV Awareness

2009-01-28T08:48:00.000-08:00

The Farmworker Association of Florida next month will begin a survey targeting Hispanic and Haitian youth that is designed to identify the best ways to educate teenagers and their families about HIV and sexually transmitted infection prevention, the Daytona Beach News-Journal reports. The program, funded with a more than $700,000, three-year grant from the Florida Department of Health, will cover seven counties in the state.

From February through March, Hispanics will be surveyed in Pierson and Fellsmere, Fla., as well as in Indian River County. Haitians will be surveyed from other counties, according to Holly Baker, grants coordinator for the association. In addition, the association later this year will offer no-cost HIV tests and condoms and distribute educational material to all communities, Baker said. FWAF also plans to develop a Web site and a blog and create pages on social networking sites such as MySpace to further reach Hispanics and Haitians with awareness and educational information.

Baker said, "We are dealing with a lot of cultural and generational gaps, but mostly cultural differences between parents who may be immigrants to this country" and their children who were born in the U.S. (Fernandez, Daytona Beach News-Journal, 1/20).

Drug Companies "Block" Cheap Medicine

2009-01-19T04:35:00.000-08:00

Their actions cost EU healthcare providers 3bn euros ($3.9bn; £2.5bn) in savings between 2000 and 2007, it said. It added that drug firms used legal action and multiple patents to stop rivals getting to market.Drug firms said the "perfectly lawful" measures were justified to protect investment in research and development.

Market access

Generic drug companies - which sell cheaper versions of drugs once the patent has expired - have long complained that it is difficult to get their drugs to market in Europe. The Commission said that innovators filed multiple applications to stop generic drugs getting to market - in one case, there were 1,300 patents for a single drug.

The report found that owners of original drugs often intervened in national approval procedures for generic medicines. There were nearly 700 cases of reported patent litigation and more than 200 settlements between brand name drug companies and generic companies. More than 10% of these settlements limited the entry of the generic drug to the market.

Fine threat

"Market entry of generic companies and the development of new and more affordable medicines is sometimes blocked or delayed, at significant cost to healthcare systems, consumers and taxpayers," said Competition Commissioner Neelie Kroes. "It is still early days but the Commission will not hesitate to open antitrust cases against companies where there are indications that the antitrust rules may have been breached," she added.The Commission could impose large fines on drug companies if they have engaged in unfair practices. In 2005, AstraZeneca was fined 60m euros for blocking cheaper rivals to Losec, its heartburn and ulcer pill.

Pressure mounts

Drug firms use "perfectly lawful practices - such as patent portfolios, patent litigation and the release of improved medicines," the European Federation of Pharmaceutical Industries and Associations (EFPIA) said.

"These [practices] are essential for innovators to protect their huge investment in R&D [research and development]," it said, adding that the 17% of turnover industry spent on R&D exceeds any other sector in Europe. The EFPIA - which said the Commission's report missed the opportunity to tackle the real issues facing the industry - called for a more competitive market for generic drugs, pointing out that Europeans pay more for generic drugs than US citizens.

In response to claims that the delayed or blocked sale of generic drugs was pushing up healthcare costs, the EFPIA said: "A single member state, the Netherlands, achieved greater savings - up to 400m euros - in one year, on only 33 medicines, simply by promoting greater price competition between generics."

The Commission report increases the pressure on the global pharmaceuticals industry.

Barack Obama, the US President-elect, is also expected to try to cut costs as part of the reform of healthcare coverage in the US.

More information on the Woman Burned at the Stake in Papua New Guinea

2009-01-16T04:44:00.000-08:00

A woman in rural Papua New Guinea was bound and gagged, tied to a log and set ablaze on a pile of tires this week, possibly because villagers suspected her of being a witch, police said Thursday.

Her death adds to a growing list of men and women who have been accused of sorcery and then tortured or killed in the South Pacific island nation, where traditional beliefs hold sway in many regions.

The victims are often scapegoats for someone else's unexplained death, and bands of tribesmen collude to mete out justice to them for their supposed magical powers, police said.

"We have had difficulties in a number of previous incidents convincing people to come forward with information," said Simon Kauba, assistant commissioner of police and commander of the Highlands region, where the killing occurred.

"We are trying to persuade them to help. Somebody lost their mother or daughter or sister Tuesday morning."

Early Tuesday, a group of people dragged the woman, believed to be in her late teens to early 20s, to a dumping ground outside the city of Mount Hagen. They stripped her naked, bound her hands and legs, stuffed a cloth in her mouth, tied her to a log and set her on fire, Kauba said.

"When the people living nearby went to the dump site to investigate what caused the fire, they found a human being burning in the flames," he said. "It was ugly."

The country's Post-Courier newspaper reported Thursday that more than 50 people were killed in two Highlands provinces last year for allegedly practicing sorcery.

In a well-publicized case last year, a pregnant woman gave birth to a baby girl while struggling to free herself from a tree. Villagers had dragged the woman from her house and hung her from the tree, accusing her of sorcery after her neighbor suddenly died.

She and the baby survived, according to media reports.

The killing of witches, or sangumas, is not a new phenomenon in rural areas of the country.

Emory University anthropology professor Bruce Knauft, who lived in a village in the western province of Papua New Guinea in the early 1980s, traced family histories for 42 years and found that one in three adult deaths were homicides -- "the bulk of these being collective killings of suspected sorcerers," he wrote in his book, "From Primitive to Postcolonial in Melanesia and Anthropology."

In recent years, as AIDS has taken a toll in the nation of 6.7 million people, villagers have blamed suspected witches -- and not the virus -- for the deaths.

According to the United Nations, Papua New Guinea accounts for 90 percent of the Pacific region's HIV cases and is one of four Asia-Pacific countries with an epidemic.

"We've had a number of cases where people were killed because they were accused of spreading HIV or AIDS," Kauba said.

While there is plenty of speculation why Tuesday's victim was killed, police said they are focused more on who committed the crime.

"If it is phobias about alleged HIV/AIDS or claims of a sexual affair, we must urge the police and judiciary to throw the book at the offenders," the Post-Courier wrote in an editorial.

"There are remedies far, far better than to torture and immolate a young woman before she can be judged by a lawful system."

Spreading Witchcraft and HIV in Papua New Guinea Causes a Repeat of the Salem Witch Trials

2009-01-10T06:33:00.000-08:00

Officials in Papua New Guinea on Wednesday reported that a woman had been burnt alive at the stake after reportedly being accused of witchcraft, which often is linked to AIDS-related deaths in the country, AFP/Arab Times reports (AFP/Arab Times, 1/7). Papua New Guinea's Post Courier reports that there was speculation the woman was practicing sorcery or adultery, or had transmitted HIV to one of the suspects (Muri, Post Courier, 1/7). According to AFP/Arab Times, reports in recent years of women being tortured and killed after being accused of witchcraft have been linked with increasing AIDS-related deaths in the country. Witchcraft often is cited as the cause of death among some young people that village residents "have seen as otherwise inexplicable," AFP/Arab Times reports (AFP/Arab Times, 1/7).

Researchers with the Australian Center for Independent Studies in 2007 released a report that found that many women were being accused of practicing witchcraft to cause AIDS-related deaths among young people and, as a result, the women were tortured or murdered. The report estimated that there had been 500 such attacks in the previous year. According to a 2007 United Nations report, Papua New Guinea accounts for 90% of HIV cases in the Oceania region. High levels of sexual violence against women and inadequate access to sex education has contributed to the spread of the virus, according to the U.N. report. An estimated 60,000 people in the country were living with HIV in 2005 (Kaiser Daily HIV/AIDS Report, 7/25/07).

According to Reuters, women in Papua New Guinea's Highlands often are blamed for spreading HIV, killed for having extramarital affairs and accused of practicing sorcery. Witnesses reported that the woman was between ages 16 and 20 (Perry, Reuters, 1/6).

Increased HIV Risk Linked to Binge Drinking Among MSM in New York City

2009-01-10T06:31:00.000-08:00

Binge drinking -- or the consumption of five or more alcoholic beverages on one occasion -- may be contributing to an increased risk of HIV among men who have sex with men in New York City, according to a study released Monday by the city's Department of Health and Mental Hygiene, the New York Times' "City Room" reports. For the study, titled "Alcohol Use and Risky Sex in New York City," the city's health department used data from its 2007 Community Health Survey and the National HIV Behavioral Surveillance project (Chan, "City Room," New York Times, 1/5).

According to the study, 24% of MSM in New York reported engaging in binge drinking at least once monthly, compared with a rate of 15% among the city's total adult population (Bindrim, Crain's New York Business, 1/5). The study found that binge drinkers were 50% more likely than non-binge drinkers -- and three times more likely than non-drinkers -- to report having two to four sexual partners in the previous year. In addition, 40% of MSM who engaged in binge drinking reported having five or more sexual partners in the past year, compared with 21% of non-binge drinking MSM. The report also used data from the surveillance study, which is based on interviews with MSM at gay bars and is not necessarily "representative of the gay population as a whole," according to the "City Room." This data indicate that 27% of MSM who had casual partners reported being under the influence of alcohol during their last sexual encounter, and 12% reported being under the influence of both alcohol and drugs. In addition, 48% of MSM who reported having 20 or more sexual partners in the past year reported being under the influence of alcohol during their last sexual encounter. The study also found that 65% of MSM who consumed alcohol were likely to use a condom during receptive anal intercourse, while 86% of non-drinking MSM were likely to use a condom during receptive anal sex.

Thomas Frieden, New York City's health commissioner, said, "Heavy drinkers are more likely to have multiple partners -- increasing their risk of HIV, [STIs] and unplanned pregnancy." According to Frieden, the prevalence of HIV and syphilis is rising among MSM in New York City ("City Room," New York Times, 1/5). Frieden added, "Many New Yorkers recognize that drinking increases the risk of injuries and auto accidents, but they may not recognize these other risks." Sean Cahill -- managing director of public policy, research and community health at Gay Men's Health Crisis -- said there is a "wide body of evidence" that consuming alcohol can lead to "lowered inhibitions and impaired judgment." He added that "people forget" that a "legal substance" such as alcohol can lead to an increased risk of HIV. According to Cahill, addressing binge drinking among MSM in New York City might prove difficult, because "gay bars are a site of social interaction and a site of community" among many MSM in the city.

The study also reported on binge drinking among teenagers and found that more than 25% of teens who drank alcohol in the last month reported having multiple sexual partners, compared with 11% of teens who did not drink. In addition, 60% of teens reported using condoms during sex while under the influence of drugs or alcohol, compared with 72% of teens not under the influence. About 14% of teens reported binge drinking during the past month (Crain's New York Business, 1/5).

Cell Phone Soap Opera's are Helping to Promote Condom use an HIV Awareness

2009-01-10T06:30:00.000-08:00

A new campaign aims to provide women with messages about HIV awareness, safer sex and condom use through a series of 12 soap opera vignettes that can be viewed on a cell phone, the AP/Atlanta Journal-Constitution reports. Rachel Jones, an educator at Rutgers University's College of Nursing, developed the campaign using professional actors and scripts based on focus groups with women in Newark and Jersey City, N.J.

The soap opera's 20-minute episodes feature "nitty gritty stories of risk and risk reduction" with which women can identify, Jones said. She added that cell phones allow women to have privacy when viewing the episodes and enables them to watch them repeatedly. Jones said she believes that "knowledge alone is not effective at changing behaviors" but that woman in the targeted communities might change their behaviors if they identify with characters in the videos. According to Jones, many women experience pressure from their partners to have unprotected sex, and "[t]hese relationship concerns can feel much more important in the moment for some women than reducing HIV/AIDS, which can feel more distant." She added that the videos aim to "normalize condom use." According to Jones, 82% of new HIV infections affecting people ages 18 to 29 are transmitted through heterosexual sex with an HIV-positive partner. Jones said the percentage of HIV cases transmitted through heterosexual sex is "astounding" because the virus is a "completely preventable infection."

The Healthcare Foundation of New Jersey provided funding for the project and NIH recently granted $2 million for a study assessing the effectiveness of the campaign. For the NIH study, which will involve 250 women, one group of participants will watch the soap operas on their cell phones. Researchers will then measure their risk-reduction behavior against a control group receiving text messages, but no video, encouraging condom use. At the end of the study, all participants will receive a DVD of the soap opera episodes, which also will be available online (Delli Santi, AP/Atlanta Journal-Constitution, 1/5).

State of California Court Ordered to Provide care for HIV Positive

2009-01-10T06:27:00.000-08:00

A Superior Court judge in Los Angeles late last month ruled that the California Department of Health Care Services must provide medical care to low-income state residents living with HIV in compliance with a 2002 state law, the AIDS Healthcare Foundation announced, Bloomberg reports (Pettersson, Bloomberg, 12/23/08). The ruling follows a Dec. 5 decision by the Los Angeles County Superior Court that said DHCS failed to enact the 2002 state law (AB 2197) that calls for the implementation of a program to provide medical care to low-income HIV-positive people. The Dec. 5 ruling came in response to a lawsuit filed last year by AHF claiming that DHCS failed to expand coverage under Medi-Cal, the state's Medicaid program, to HIV-positive residents who had not developed AIDS.

The law, signed by former Gov. Gray Davis (D) in September 2002, calls for the state to provide full Medi-Cal benefits to HIV-positive people who already are enrolled in the state's AIDS Drug Assistance Program, "who are not disabled and who would otherwise qualify for benefits under the Medi-Cal program." Before the law was passed, only people with an AIDS diagnosis who were considered disabled were eligible for benefits under Medi-Cal. To fund the program's expansion, the law suggested moving Medi-Cal beneficiaries with AIDS from the current fee-for-service system to a less expensive managed care program. The money saved would go toward financing the expansion of Medi-Cal benefits to people with HIV (Kaiser Daily HIV/AIDS Report, 12/5/08).

In a statement, AHF President Michael Weinstein said, "Despite an excellent record on AIDS issues," Gov. Arnold Schwarzenegger (R) "has been ill-served by his administration, which for six years has failed to enact this crucial -- and ultimately cost-saving -- health care legislation." DHCS spokesperson Anthony Cava said it was not possible to implement the law in a "cost-neutral environment" and that the law was "very clear that it should not be implemented if the costs could not be offset by savings." Cava added that DHCS "will continue to work with its partners to implement the law in a cost-neutral manner, just as the legislature intended" (Bloomberg, 12/23/08).

Southern U.S. Needs To Do More To Address HIV/AIDS Among Hispanics, Opinion Piece Says

2008-12-27T03:26:00.000-08:00

"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

South Carolina Medicaid Cuts $61 Million in Services, Ends Enrollment in HIV/AIDS

2008-12-27T03:25:00.000-08:00

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).

Medicare Part D and Ryan White

2008-12-27T03:23:00.000-08:00

"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

2008-12-27T03:20:00.000-08:00

"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

Women More Susceptible to HIV/AIDS than Originally Thought

2008-12-18T19:27:00.002-08:00

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).

Two-Thirds of HIV-Positive Kenyan Children Do Not Have Access to Antiretroviral Treatment, Report Says

2008-12-18T19:27:00.001-08:00

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.

Ryan White Funding Delays

2008-12-18T19:23:00.000-08:00

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

Government of Indonesian Province Rejects Plan To Implant Microchips in Some HIV-Positive People

2008-12-18T19:22:00.002-08:00

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).

Violence Against Women Contributes to Spread of HIV in Ghana

2008-12-18T19:22:00.001-08:00

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).

Needle-Exchange Programs 'Save' Lives, Money

2008-12-18T19:21:00.000-08:00

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).

HIV/AIDS Envoy Calls on Caribbean Governments To Decriminalize Homosexuality

2008-12-18T19:19:00.000-08:00

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).

Experimental Treatment Lengthens Lifespan of Monkeys With Simian Version of HIV

2008-12-18T19:18:00.000-08:00

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.

Microchips for Poz People?

2008-12-06T03:36:00.002-08:00

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.

Poor Grades for Developed Nations

2008-12-06T03:36:00.001-08:00

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).