HIV becoming more virulent?

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

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

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

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

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

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

"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

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

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

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

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

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

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

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

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

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).