CDC HIV/Hepatitis/STD/TB Prevention News Update
For Thursday, March 18, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• SOUTH CAROLINA: Hundreds Protest HIV Funding Cuts

INTERNATIONAL NEWS

• CANADA: Free Needles, Crack Pipes Considered at Victoria Clinic
• CANADA: City Can't Wait Any Longer for Needle-Exchange Site, Victoria Councilor Says
• AUSTRALIA: Spike in Sexual Infection Cases in Newcastle

MEDICAL NEWS

• SWEDEN: Sexual Risk-Taking in the General Population of Sweden (1989-2007)

LOCAL AND COMMUNITY NEWS

• NEW JERSEY: Symposium Infects HIV Awareness Within University
• ARIZONA: Kyrene School District Parents Review Lesson Plans for Sex Education Program

NEWS BRIEFS

• UNITED STATES: New Price for AIDS Drug: $30,600 a Year
• UNITED STATES: Social Networking for the HIV+
• CALIFORNIA: Marin AIDS Project Offers Home- Based Health Care

   NATIONAL NEWS SOUTH CAROLINA: Hundreds Protest HIV Funding Cuts

Gina Smith

The State (Columbia, S.C.) (03.18.10) - Thursday, March 18, 2010 South Carolina's dwindling revenues are wreaking havoc on its budget, prompting cuts to many state agencies and programs. On Wednesday, hundreds of advocates rallied at the Capitol to protest a spending plan that would eliminate all state funds for HIV/AIDS. South Carolina is believed to be the first state in the nation to consider such a move.
The current version of the state budget for the 2010-11 fiscal year starting July 1 cuts out all funding for the AIDS Drug Assistance Program (ADAP) as well as for statewide HIV prevention efforts. And without state money, matching prevention funds from the federal government would also be in jeopardy.
"These are difficult [budget] times. But even in the midst of that, we have to find the resources to battle this disease," said Rep. Joe Neal (D-Richland), adding that a growing body of research indicates the South is where most new HIV/AIDS cases are occurring.
South Carolina ranks eighth among states in its rate of new AIDS cases annually, Kaiser Family Foundation data show. Columbia's AIDS rate places it ninth among US cities.
The cut would affect 2,055 low-income patients who rely on ADAP for life-saving medicines. Neal has proposed a budget amendment that would restore $2.2 million in state funds for the $5.9 million ADAP program.
But a partial restoration of ADAP is not enough, advocates maintain. Without the full $5.9 million, some clients will be dropped and will go without their medicines, and newly eligible patients will be placed on a waiting list.
"The waiting list means people will be delayed in treatment," said Johanna Hayes, director of an HIV/AIDS advocacy group. "Delayed treatment means they get sicker and end up in the hospital," eventually costing taxpayers more.
   INTERNATIONAL NEWS CANADA: Free Needles, Crack Pipes Considered at Victoria Clinic

Richard Watts, Times Colonist

Vancouver Sun (03.17.10) - Thursday, March 18, 2010 The Vancouver Island Health Authority (VIHA) is considering about 60 potential sites across the island from which to provide sterile needles and other supplies for drug users. A final decision could be made by late June or early July.
One proposed site, the Addiction Outpatient Treatment office in downtown Victoria, would place addiction treatment and harm-reduction services under one roof.
"I can't imagine anybody would have such poor insight as to think that's a reasonable thing to do," said Neal Berger, executive director of the Cedars addiction recovery center in Cobble Hills. "Just the sight of a needle, just the thought of it. [Addiction] is a brain disease and the brain starts playing tricks on people."
There is a process in place for excluding the outpatient office from the final list of sites if the two functions are irreconcilable, said Suzanne Germain, VIHA's spokesperson.
The fixed-site needle exchange in Victoria closed in 2008 after neighbors complained about public disturbances and dangers. Since then, public anger has prevented the establishment of another fixed-site needle exchange in the city.
CANADA: City Can't Wait Any Longer for Needle-Exchange Site, Victoria Councilor Says

Bill Cleverley, Times Colonist

Vancouver Sun (03.17.10) - Thursday, March 18, 2010 Victoria needs a fixed-site needle exchange and cannot wait on regional health plans that would help establish a Vancouver Island-wide system, City Councilor Philippe Lucas says. The city has not had a fixed-site exchange for two years.
"There's absolutely no reason and no excuse for us to wait for an island-wide model to be put in place before this municipality takes action in trying to reduce the spread of disease and improve the public health of our region," Lucas said.
The council approved Lucas' proposal that city staff members compile a history of harm-reduction initiatives and solicit stakeholders' advice in devising a report on possible courses of action and costs. Lucas also supports one or more supervised consumption facilities in the Capital Region.
"We hear from tourists and businesses alike that the visible drug use is a concern for our community and the best way to deal with that is to actually give people a place to go and a safe place to use the substances that they are addicted to," Lucas said.
AUSTRALIA: Spike in Sexual Infection Cases in Newcastle

Danny Rose

Australian Associated Press (03.15.10) - Thursday, March 18, 2010 Officials in the New South Wales city of Newcastle are concerned about a recent spike in gonorrhea cases. So far this year, Newcastle-based sexual health services have recorded 41 cases of the STD, more than four times the nine cases logged during the same timeframe last year. The port city registered 29 cases for the same period in 2008 and 13 in 2007.
Cases are increasingly being seen in teenagers and people in their 20s, said Dr. Treeny Ooi, director of sexual health at Hunter New England Health.
"Men who have sex with men have been identified as a group particularly at risk," said Ooi. "However, heterosexual people have also been infected."
"Gonorrhea often causes no symptoms and people may not be aware that they are infected," Ooi said. "Too many people are unwittingly infecting their partners, and the only way to ensure that you do not have an [STD] such as gonorrhea is to have a sexual health check at your doctor."
"Untreated, gonorrhea can cause serious and permanent health problems in men and women," said Ooi. "It can cause painful infection in the testicles or fallopian tubes that connect the womb to the ovaries and may result in infertility."
Fortunately, testing for gonorrhea is easy and can be arranged through a general practitioner or sexual health clinic, Ooi said. "There is a high awareness about the benefits of condom use, but it can be a very different story when it comes time to put that knowledge into practice," she said.
   MEDICAL NEWS SWEDEN: Sexual Risk-Taking in the General Population of Sweden (1989-2007)

Claes Herlitz

Sexual Health (11.09) Vol. 6; No. 4: P. 272-280 (11..09) - Thursday, March 18, 2010 The current study aimed to examine changes in sexual behaviors and attitudes related to HIV and sexually transmitted infections (STI) during "a long period of intensive efforts by the Swedish authorities to curb the spread of HIV."
In 1989, 1994, 1997, 2000, 2003, and 2007, a total of 16,773 surveys were mailed to random samples of the general Swedish population. Each sample included 4,000 to 6,000 persons ages 16 to 44, stratified by age: 16-17, 18-19, 20-24, 25-34, and 35-44. Participation rates were 53.5 percent for men and 69.9 percent for women, for an overall participation rate of 61.6 percent.
During 1989-1994, the proportion of respondents holding a restrictive view on sexual intercourse outside a stable relationship decreased significantly. The surveys since 1994 show no change in that respect. Throughout the period, the prevalence of casual sexual partners increased significantly. Casual sexual intercourse without a condom increased significantly from 1989 to 2003, then decreased slightly from 2003 to 2007 - a behavior change that was more common among women than men. Compared to older age cohorts, prevalence of several sexual partners and casual intercourse without a condom was significantly higher among younger cohorts.
"This study demonstrates the need for a continuous preventive campaign against HIV/STI in the general population in Sweden, particularly among young people," the author concluded.
   LOCAL AND COMMUNITY NEWS NEW JERSEY: Symposium Infects HIV Awareness Within University

Henna Kathiya

Daily Targum (Rutgers University-New Brunswick) (03.15.10) - Thursday, March 18, 2010 Rutgers Health Services' Health Outreach, Promotion and Education on HIV/AIDS (HOPE) hosted a March 10 symposium to raise students' awareness about the disease. The event was held on National Women and Girls HIV/AIDS Awareness Day.
At the HIV/AIDS Interactive Symposium, students could walk around to different stations and learn about topics like safe-sex practices and drug and alcohol use. One station run by HOPE's Wellness Learning Community invited students to send inspirational postcards to friends and family.
The event also featured a photo exhibit titled "Faces of Awareness." The images of people affected by HIV/AIDS are part of a traveling exhibit originally started on the Douglass campus.
For some students, the information provided served either to refresh their memories or boost their knowledge of HIV/AIDS. "I feel like I already knew a lot of this stuff, but it reinforced what I knew. This event served as a reminder for me," said Hieu Phung, a senior. "If everybody here at least learns about how to use a condom and what types of contraceptives there are, I think it would help and maybe lower birth rates and help protect against diseases," said sophomore Sofya Andemicael.
ARIZONA: Kyrene School District Parents Review Lesson Plans for Sex Education Program

Kerry Fehr-Snyder

Arizona Republic (Phoenix) (03.12.10) - Thursday, March 18, 2010 Lesson plans for Kyrene School District's sex education curriculum, among other topics, are now being reviewed by parents, administrators, and community members. The KSD board adopted the human growth, development, and sex education curriculum last year. Lesson plans will also be reviewed by the district's health steering committee, which may make recommendations to the board by mid-April.
About seven parents have visited KSD offices to peruse three 15- to 18-minute sex education videos, which deal with puberty; HIV/AIDS; and physical, emotional, and sexual abuse. Course materials are available for review on Tuesday and Wednesday evenings through March 26.
The curriculum will include lessons for fourth-graders about learning to recognize and report sexual abuse. Fifth-graders will learn about HIV/AIDS in video presentations. Seventh- and eighth-graders will be taught about reducing the risk of pregnancy and STDs through PowerPoint presentations. The latter two grades will also learn about condoms.
"We expect seventh- and eighth-graders to be abstinent," said Sue Yost, KSD's health curriculum coordinator. "Condoms are not going to be handed out, there's not going to be a demonstration."
Still, students who are not abstinent should be prepared with information, Yost said. "We don't want our kids having sex, obviously," she said. "We don't think it's appropriate for kids that age."
Because studies show rates of pregnancy and STDs jump between middle and high school, Yost said initiating sex education in high school would be too late.
   NEWS BRIEFS UNITED STATES: New Price for AIDS Drug: $30,600 a Year News and Observer (Raleigh NC) (03.17.10) - Thursday, March 18, 2010 In a filing this week with the Securities and Exchange Commission, Durham-based Trimeris disclosed that the price of its AIDS drug Fuzeon has been increased by 3 percent, to $30,600 for a one-year supply. The new price is 50 percent higher than the drug cost when it was rolled out in 2003. Fuzeon's sales have been hurt by its high price, side effects, and the availability of newer medicines. Trimeris said the responsibility of setting the product's price is solely that of Swiss drug maker Roche, which markets it.
UNITED STATES: Social Networking for the HIV+

Deaidre Newby

Q Notes (Charlotte) (03.15.10) - Thursday, March 18, 2010 Thanks to online social networks, people with HIV are finding it easier to access support services and make new friends. In 2007, Robert Breining launched POZIAM, a site where HIV-positive people can link up to share their experiences and resources. It also offers a weekly online radio broadcast hosted by Breining, Jeromy Dunn of Charlotte, and "Project Runway" star Jack Mackenroth. Visit www.community.poziam.com. Similar services are offered by www.beonecity.com.
CALIFORNIA: Marin AIDS Project Offers Home-Based Health Care

Cynthia Laird

Bay Area Reporter (San Francisco) (03.11.10) - Thursday, March 18, 2010 Home-based health care has been added to the Marin AIDS Project's slate of comprehensive services. To help clients transition from hospital to home, MAP offers nursing care, attendant care, and medical case management. It also assists seriously ill AIDS patients so they can be cared for at home instead of at a skilled nursing facility. Patients are referred by their physician; qualification is determined by health status. MAP's services are free to low-income Marin County residents. For more information, telephone 415-457-2487.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Russia - 1 in 4 with TB develop resistance

Health-e News - March 18, 2010

http://www.aegis.org/news/healthe/2010/HE100314.html

In some areas of the world, one in four people with tuberculosis (TB) becomes ill with a resistant form of the disease that can no longer be treated with standard drug regimens, a World Health Organization (WHO) report says.

The report reveals that in one region of north-western Russia 28% of all people newly diagnosed with TB had the multidrug-resistant form of the disease (MDR-TB) in 2008. This is the highest level ever reported. Previously, the highest recorded level was 22% in Baku City, Azerbaijan, in 2007.

The WHO report Multidrug and Extensively Drug-Resistant Tuberculosis: 2010 Global Report on Surveillance and Response, estimates that 440 000 people had MDR-TB worldwide in 2008 and that a third of them died.

In sheer numbers, Asia bears the brunt of the epidemic. Almost 50% of MDR-TB cases worldwide are estimated to occur in China and India. In Africa, estimates show 69 000 cases emerged, the vast majority of which went undiagnosed.

Tuberculosis programmes face tremendous challenges in reducing MDR-TB rates. But there are encouraging signs that even in the presence of severe epidemics, governments and partners can turn around MDR-TB by strengthening efforts to control the disease and implementing WHO recommendations.

Two regions in the Russian Federation - Orel and Tomsk - have achieved a remarkable decline in MDR-TB in about five years. These regions join two countries - Estonia and Latvia - which have reversed rising high rates of MDR-TB, ultimately achieving a decline. The United States of America and China, Hong Kong Special Administrative Region (SAR), have achieved sustained successes in controlling MDR-TB.

Progress remains slow in most other countries. Worldwide, of those patients receiving treatment, 60% were reported as cured. However, only an estimated 7% of all MDR-TB patients are diagnosed. "This points to the urgent need for improvements in laboratory facilities, access to rapid diagnosis and treatment with more effective drugs and regimens shorter than the current two years," a WHO statement said.

WHO is engaged in a five year project to strengthen TB laboratories with rapid tests in nearly 30 countries. This will ensure more people benefit early from life-saving treatments. It is also working closely with the Global Fund to fight AIDS, Tuberculosis and Malaria and the international community on increasing access to treatment.

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Copyright © 2010 - Health-e is a news service reporting on public health issues. They are therefore only able to respond to e-mails concerning specific stories or radio programmes that they have published or broadcast. Related comments or suggestions can be addressed to the editor or the relevant journalists. They are unable to respond to e-mails of a medical nature or other queries unrelated to our specific work. For more information, please Contact Health-e. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through Health-e News Service.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

SA launches massive HIV testing campaign

Health-e News - March 18, 2010
Kerry Cullinan and Khopotso Bodibe

http://www.aegis.org/news/healthe/2010/HE100313.html

From April 15, everyone attending a clinic or hospital will be offered an HIV test, regardless of whether they have symptoms of the disease or not.

Dubbed the HIV Counselling and Testing campaign, or HCT, this is the most ambitious HIV testing campaign in the world, according to SA National AIDS Council (SANAC) co-chairperson Mark Heywood.

The HCT's target is to have 15 million South Africans tested for HIV by June next year at any of the country's 4 300 health facilities.

HCT's launch was scheduled to be announced at a press conference this week but it was delayed until March 25 to allow the Health Minister time to canvas support for the campaign from a wide range of organisations and ensure that South Africa's health facilities will be ready to provide HIV testing services when the campaign kicks off.

"This is a special campaign of SANAC and the government, so we will be raising funds from our development partners for testing kits. Health facilities won't be expected to provide those," Health Minister Dr Aaron Motsoaledi told a gathering of the SANAC leadership forum in Durban yesterday (17 March).

But he stressed that he expected very health facility to be in a position to test people by mid-April and to use their own staff and facilities to do so.

All health workers have already received a letter from the Health Minister explaining the campaign.

It has four objectives: to increase health-seeking behaviour; to encourage South Africans to know their HIV status; to equip those who test HIV-negative with ways of ensuring that they don't get HIV; and to create a quick and easy entry point to accessing wellness and treatment services for those who test HIV-positive

"The mainstay of the fight against any disease is to prevent it from happening," said Motsoaledi. " You don't have to be a scientist to know that. We grew up knowing that 'prevention is better than cure' at all times. But if you have failed to prevent it and it has happened, you have to treat it. We do accept that the fact that we have got so many people on treatment, might be the failure of prevention."

The HCT campaign will run until the end 2011, which is when the current National Strategic Plan on HIV and AIDS is due to end.

The campaign was first mentioned on World AIDS Day 2009 when President Jacob Zuma announced new protocols for the prevention of mother-to-child HIV transmission and the treatment of HIV, effective as of April 01.

"I don't have a feeling that South Africans understand that the biggest weapon [against HIV] must be prevention," said the Minister.

"In the budget read by Minister Pravin Gordhan, the HIV/AIDS budget increased by 33% over the previous year. If you look at the budgetary items which the government has done, whether it's education, housing, water, electricity, 33% is the highest increment of any of the other budgetary items," said Dr Motsoaledi.

"We can't keep on increasing by 33%. We have got to cut the rate of infection. That's where the issue of prevention comes in. If we keep on increasing that by 33% we will reach a situation in South Africa where the whole budget must go to treatment of HIV/AIDS, and I don't think any country can afford that. So, our war of prevention is extraordinarily important.

The HCT be based on a routine HIV test offered to all patients who will have the option to refuse it. Until now, only pregnant women and people showing HIV symptoms have been offered HIV tests. However, Motsoaledi stressed that, while in the past people we asked to volunteer for an HIV test while during the campaign people would be encouraged to test, "no one can force any human being to test."

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Copyright © 2010 - Health-e is a news service reporting on public health issues. They are therefore only able to respond to e-mails concerning specific stories or radio programmes that they have published or broadcast. Related comments or suggestions can be addressed to the editor or the relevant journalists. They are unable to respond to e-mails of a medical nature or other queries unrelated to our specific work. For more information, please Contact Health-e. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through Health-e News Service.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Disproportionate impact of HIV on men who have sex with men in US underlines need for better outreach

UNAIDS - 18 March 2010

http://www.aegis.org/news/unaids/2010/UN100324.html

New data analysis released on 10 March by the United States Centers for Disease Control and Prevention (CDC) highlights that HIV and syphilis disproportionately impact men who have sex with men in the United States (U.S.).

The data, presented at CDC's 2010 National STD Prevention Conference, found that the rate of new HIV diagnoses among men who have sex with men (MSM) in the U.S. is more than 44 times that of other men and more than 40 times that of women.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said Kevin Fenton, M.D., Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

According to CDC many aspects contribute to the high rates of HIV and syphilis among gay and bisexual men in this country. Homophobia and stigma can prevent MSM from seeking prevention, HIV testing and counselling, and treatment services. Other causes include limited access to prevention services, unsafe sex practices and complacency about HIV risk due to existence of treatment, particularly among young gay and bisexual men. Also, the risk of HIV transmission through anal sex is much greater than the risk of transmission via other sexual activities.

"It seems like we have come full circle in the United States," said UNAIDS Executive Director Michel Sidibe. "Efforts must be redoubled to include gay and bisexual men in AIDS programming and reach out to and address the HIV prevention needs of all men who have sex with men."

Prevention programmes

According to UNAIDS, HIV prevention measures for men who have sex with men should include consistent and proper use of condoms, and access to water-based lubricants. High quality HIV-related services, like voluntary counseling and testing in a non-discriminatory environment,, should be made available as well as specific and targeted information on prevention and risk reduction strategies designed to appeal to and meet the needs of men who have sex with men. Further quality treatment for sexually transmitted infections with referral for HIV services must be made available.

The U.S. Department of Health and Human Services notes that in the United States men as a whole, are less likely to use the health care system than women. Men often seek care when they are experiencing critical health problems. Men who have sex with men who do not access health care may not know they are infected with HIV or an STD, thus compromising their own health status. The persistence of stigma and homophobia compounds the situation still further.

CDC officials noted that the new analysis underscores the importance of the HIV and STD prevention efforts to reach gay and bisexual men recently announced as part of the U.S. President's fiscal year 2011 national budget proposal.

The new analysis is the first step in more fully assessing the extent of HIV among MSM and other populations in the United States. The CDC is developing more detailed estimates of infection rates among MSM by race and age, as well as among injection drug users. Ultimately, these data can be used to better inform national and local approaches to HIV and STD prevention to ensure that efforts are reaching the populations in greatest need.

Resources:

Policy and guidance:

Men who have sex with men - Technical policies of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance/Techpolicies/men_men_sex_technical_policies.asp  

Men who have sex with men: Key operational guidelines of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance/OperationGuidelines/men_men_sex_operational_guidelines.asp  

Sexual Minorities - UNAIDS Guidance for Applicants to the Global fund to Fight AIDS, TB and Malaria Round 8 Call for proposals (pdf,127 Kb.) - http://data.unaids.org/pub/BaseDocument/2008/20080228_Rd8_SexualMinorities_en.pdf

Related information:

Men who have sex with men - http://www.unaids.org/en/PolicyAndPractice/KeyPopulations/MenSexMen/default.asp

Speeches:

Speech by UNAIDS Executive Director ôUniversal access for men who have sex with men: winds of change; signs of hopeö (pdf,34.8 Kb.) - http://data.unaids.org/pub/SpeechEXD/2009/20090916_sp_ms_msmwashingtondc_en.pdf

Feature stories:

Universal access in the Caribbean must include men who have sex with men (16 March 2010) - http://www.aegis.org/news/unaids/2010/UN100323.html  

External links:

Centers for Disease Control and Prevention - http://www.cdc.gov/hiv/  

Publications:

UNAIDS Action Framework: Universal Access for Men who have Sex with Men (pdf, 324 Kb) - http://data.unaids.org/pub/Report/2009/jc1720_action_framework_msm_en.pdf

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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

South Africa: HIV testing and mental illness

Integrated Regional Information Networks - March 17, 2010

http://www.aegis.org/news/irin/2010/IR100318.html

JOHANNESBURG, 17 March 2010 (PlusNews) - As more HIV-positive people access treatment and live longer, the number of people suffering from HIV-related mental disorders is growing, but mental health remains an ethical, legal and clinical minefield, where many doctors and nurses fear to tread - and fear to test.

"We're moving away from seeing patients on their death beds towards patients who are living longer, and are being affected by mental disorders that have real impacts on their life and work," said Dr Greg Jonsson, a psychiatrist at the Luthando Psychiatric HIV Clinic at the Chris Hani Baragwanath Hospital, in Johannesburg.

Various studies have shown a higher than average prevalence of mental illness among people living with HIV. A 2005 study by South Africa's Human Sciences Research Council found that about 44 percent of the 900 HIV-positive individuals surveyed suffered from a mental disorder.

The links between HIV and mental illness are complex, but factors include the effects of the virus on the central nervous system, as well as difficulties in dealing with HIV-related stigma and discrimination.

South Africa has the world's largest ARV programme to counter an HIV prevalence rate of about 18 percent, according to UNAIDS, and about 920,000 people are on ARV treatment.

No easy choices

Doctors and nurses in clinics often find it daunting to test mental health patients for HIV. "People who are not trained in psychiatric disorders are scared of getting consent from patients with mental disorders," Jonsson told IRIN/PlusNews. "People should not assume that mentally ill or even psychotic patients are incapable of understanding [testing] and consenting."

But Jonsson added that there would be times where doctors would need to make tough calls about testing severely mentally ill patients who could not consent to HIV testing and whose families may not be approachable to consent on their behalf.

"If you can't obtain informed consent, you need to weigh up the potential harm and benefit to the patient - ask yourself whether this test is going to change your diagnoses or your treatment," he suggested to health workers at an annual symposium held by the Aurum Institute, a non-profit medical research organization.

"I think if the answer is 'yes' to either, then go for it. It is really the right of the patient to be offered effective HIV treatment," said Jonsson, who pointed out that doctors should be aware of possible interactions between mental health medications and antiretroviral (ARV) drugs.

He advised doctors to document the process and counsel patients throughout, especially about how to reduce risk, given the prevalence of substance abuse among mental health as well as HIV patients.

"Psych is hard because the 'three ticks equal this' approach doesn't really work, and that's why people are so scared of it," Jonsson told IRIN/PlusNews.

No right answers

Once a mental health patient started taking ARVs, healthcare providers would have to evaluate whether mandating a "treatment supporter" - a friend or family member to help the patient adhere to treatment - would be appropriate. Again, there may not be a right answer.

"We need to draw up protocols and put them in primary healthcare, but the problem with protocol-based system is that people don't think outside the box - with mental health patients it really is on a case-by-case basis," Jonsson told the symposium audience.

"I tell most of my patients, 'If you can get treatment support, go for it', but I don't insist on it - disclosing to a patient's family is difficult and ... at my clinic, our patients on treatment are already so stigmatized and victimized."

The Luthando Psychiatric HIV Clinic has a treatment default rate - patients who discontinue ARVs - that is the same as institutions in Johannesburg that mandate treatment supporters, Jonsson added.

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Africa: Mapping truckers' route to the health centre

Integrated Regional Information Networks - March 16, 2010

http://www.aegis.org/news/irin/2010/IR100316.html

NAIROBI/DAR ES SALAAM, 16 March 2010 (PlusNews) - New maps pin-pointing the exact location of "wellness centres" in sub-Saharan Africa are improving truck drivers' access to treatment and care for HIV and other sexually transmitted infections (STIs).

Oil giant Shell, with risk specialist Maplecroft and the North Star Alliance, which builds roadside clinics at truck stops, have developed and printed 20,000 maps for distribution to truck drivers in Kenya, South Africa, Cote d'Ivoire, Burkina Faso, Togo, Tanzania, Uganda, Botswana, Guinea, Mali and Namibia. The maps show the locations of more than 160 clinics.

"Many of us want treatment but at times you might not know where to get it when you are on the road but these maps can help us now," Eliud Musili told IRIN/PlusNews at Mlolongo, a truck stop in the Kenyan capital, Nairobi. "Now you can even advise other drivers where to get [health services]."

In East and Central Africa, the maps are being distributed to truckers at "SafeTStops" where wellness centres provide a range of services, including screening of STIs, HIV testing and counselling and tuberculosis screening, for truck drivers and communities with whom they interact.

"The wellness centres have been put up in areas where these high-risk groups converge to provide information about HIV and other STIs, prevention methods like condoms, diagnosis of STIs and testing and counselling," says Dorothy Muroki, project director for the Regional Outreach Addressing AIDS through Development Strategies II, a project of the NGO, Family Health International (FHI). "For high-risk groups, information is critical."

FHI runs sites in Uganda, Tanzania and Rwanda in partnership with North Star Alliance, the Solidarity Centre and local transport unions; so far, the map distribution has not been rolled out at these sites.

Living dangerously

For more than six years now, Julius Mwapele*, 35, a father of five, has worked as a loader at Dar es Salaam port; three months ago, he visited a clinic to treat a persistent rash on his penis.

"At first I wanted to [ignore] it but when it continued, I decided to go to a clinic here at the port," he told IRIN/PlusNews. "At the clinic, they told me I had gonorrhoea; I was afraid but they told me it can be treated."

While his job is not particularly well paid, compared with many of the residents around the port, Mwapele is well-to-do. He suspects that he contracted the STI from a local woman.

"I have three mistresses here - I buy food from them," he said. "I get into sexual relationships with them so that at times I can get free food when I don't have money but when I get money, it is my turn to give them a treat."

Sex stops

Sex work is widespread at truck stops along sub-Saharan Africa's transport corridors; a 2006 University of Manitoba study found an estimated 8,000 female sex workers on the trans-Africa highway from Kenya's coastal city of Mombasa to the Ugandan capital, Kampala. It also reported that truckers and their assistants had high rates of reported STIs and many exhibited high-risk sexual behaviour.

The SafeTStops aim to provide truck drivers and sex workers with information and other services in a non-judgmental way. "Women do not get into commercial sex work for fun but due to economic needs, just like truck drivers seek sexual services from commercial sex workers because they are rarely with their spouses," said FHI's Muroki.

The centres are also a source of entertainment. "We provide facilities like pool and offer reading material and TV so when one walks in, nobody knows for sure what has brought them except the clinic personnel," said Victoria Jonathan, head of the wellness centre in the port of Dar es Salaam. "This gives a sense of privacy; the uptake of the services is very impressive.

Alcohol a factor

"The centres are alcohol-free to send the message that alcohol abuse is one of the key drivers for risky sexual behaviour," she added.

Ben Manyala, an HIV-positive trucker in Dar es Salaam, agreed that alcohol was an important factor in HIV transmission among truck drivers.

"Alcohol is contributing [to the spread of HIV]; we have a joke that after five bottles of beer, every woman is beautiful," he said.

* Not his real name

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

New Research by VGTI Florida Science Director Demonstrates How HIV Disables the Immune System

Business Wire - March 16, 2010

http://www.aegis.org/news/bw/2010/BW100315.html

Research Helps Focus Future Studies to Specifically Target the Series of Cellular Interactions That Cause the Body to Drop Its Guard

PORT ST. LUCIE, Fla. - New research conducted by the scientific director for VGTI Florida and his colleagues at the University of Montreal, in collaboration with scientists from the NIH and the McGill University Hospital center, may soon lead to an expansion of the drug arsenal used to fight HIV. The research sheds new light on how HIV gradually weakens the body's immune system and highlights the need for new research into therapies that will target the chain of events that cause the progression of the disease.

The study, published in the journal Nature Medicine, describes the pivotal role of two molecules, PD-1 and IL-10, in impairing the function of disease-fighting T-cells known as CD4 T-cells û a phenomenon that weakens the body's immune system.

Specifically, the researchers found that when HIV invades the body, bacterial products are released from the gut and white blood cells respond by releasing a protein on the surface of the cell called PD-1. Heightened levels of PD-1 lead to the activation of a gene that produces another protein called IL-10. Both of these proteins (PD-1 and IL-10) are known to appear at increased levels during HIV infection.

"We are the first to show that these two molecules work together to shut down the function of CD4 T-cells in HIV patients. This in turn, may lead to paralysis of the immune system and an accelerated disease progression," said Dr. Rafick-Pierre Sekaly, scientific director of VGTI Florida, a professor at the University of Montreal and researcher at the Research Center of the University of Montreal Hospital Center.

"Our results suggest that it is important to block both IL-10 and PD-1 interactions to restore the immune response during HIV infection," said Dr. Sekaly. "We believe that immunotherapies that target PD-1 and IL-10 should be part of the arsenal used to restore immune function in HIV-infected subjects."

About the study:

The article "PD-1 Induced IL-10 Production by Monocytes Impairs CD4 T-Cell Activation during HIV Infection," published in Nature, was authored by Elias A. Said, Franck P. Dupuy, Lydie Trautmann, Yuwei Zhang, Yu Shi, Mohamed El-Far, Brenna J. Hill, Alessandra Noto, Petronela Ancuta, Yoav Peretz, Simone G. Fonseca, Julien Van Grevenynghe, Mohamed R. Boulassel, Julie Bruneau, Naglaa H. Shoukry, Jean-Pierre Routy, Daniel C. Douek, Elias K. Haddad, and Rafick P. Sekaly.

About VGTI Florida:

VGTI Florida is the Florida-funded expansion of Oregon Health & Science University's highly successful Vaccine and Gene Therapy Institute. Research at the facility will focus on vaccine development with a special focus on vaccines and therapeutics that protect the aging population, which is the most vulnerable to disease.

Contacts

For VGTI Florida

Ryan Banfill, 850-222-1996

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Copyright © 2010 - Business Wire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Business Wire, Permissions Desk, Business Wire, 1185 Avenue of the Americas, 3rd Floor, New York, NY 10036; Tel: (212) 575-8822; FAX: (212) 575-1854. http://www.businesswire.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Bananas against AIDS?

afrol News - March 15, 2010

http://www.aegis.org/news/afrol/2010/AO100302.html

Scientists have found a special protein in the banana that could help women prevent being infected by HIV during sexual intercourse. They hope this may open the door to new and cheaper treatments to prevent the spread of AIDS.

The researchers, from the US University of Michigan Medical School, have an emerging interest in lectins, a type of proteins naturally occurring chemicals in plants, because of their ability to halt the chain of reaction that leads to a variety of infections.

"In laboratory tests, BanLec, the lectin found in bananas, was as potent as two current anti-HIV drugs," according to the study. Based on the findings published this month in the scientific 'Journal of Biological Chemistry,' "BanLec may become a less expensive new component of applied vaginal microbicides," researchers say.

Although condom use is quite effective, condoms are most successful in preventing infection if used consistently and correctly, which is often not the case.

"That is particularly true in developing countries where women have little control over sexual encounters so development of a long-lasting, self-applied microbicide is very attractive," says study senior author David Marvovitz.

Some of the most promising compounds for inhibiting vaginal and rectal HIV transmission are agents that block HIV prior to integration into its target cell, according to the study.

The new research describes the complex actions of lectins and their ability to outsmart HIV. Lectins are sugar-binding proteins. They can identify foreign invaders, like a virus, and attach themselves to the pathogen.

The researcher team discovered BanLec, the lectin in bananas, can inhibit HIV infection by binding to the sugar-rich HIV-1 envelope protein, gp120, and blocking its entry to the body.

"Therapies using BanLec could be cheaper to create than current anti-retroviral medications which use synthetically produced components, plus BanLec may provide a wider range of protection," the US researchers say.

"The problem with some HIV drugs is that the virus can mutate and become resistant, but that is much harder to do in the presence of lectins," says lead author Michael Swanson.

By staff writer

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Copyright © 2010 - afrol News. All rights reserved. Reproducing or buying afrol News' articles. Reproduction of this article (other than one copy for personal reference) must be cleared through afrol News.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

California Embarks on Setting 'Condoms in Porn' Health Regulations

Business Wire - March 17, 2010

http://www.aegis.org/news/bw/2010/BW100319.html

Former Adult Film Actors, Public Health Advocates to Testify at March 18th Cal/OSHA Standards Board Meeting in Costa Mesa; Board to Consider Creating Advisory Panel to Revisit Adult Film Worker Safety

In December, AHF Filed Petition Seeking Amendment to State's "Bloodborne Pathogens" Regulation to Better Encompass Adult Film Industry, Expressly Requiring Condoms to Protect Performers

LOS ANGELES - California's Department of Occupational Safety and Health (Cal/OSHA) will explore strengthening adult film worker safety regulations in California during its next regularly scheduled Standards Board meeting (Item # IV "B") on Thursday, March 18th in Costa Mesa. The action comes in response to a petition filed in December by AIDS Healthcare Foundation (AHF) seeking an amendment to broaden the Cal/OSHA's "bloodborne pathogens" workplace safety regulations to better encompass adult film industry worksites.

"I was a porn star living the glamorous life. Drug overdoses, herpes, suicide attempts and abuse at the hands of the porn industry"

At Thursday's meeting, state officials will consider Cal/OSHA's own staff's recommendation to create an advisory panel to determine whether--and how--to amend state health statutes to better protect adult film workers. Several former adult entertainment actresses, a current producer/director/performer as well as several public health advocates will testify at the meeting in support of Cal/OSHA's creation of an advisory panel as well as ultimately changing state health regulations.

WHAT:

PUBLIC HEARING & TESTIMONY--10am (Item #IV "B")

Cal/OSHA to consider creating advisory panel on adult film worker safety

WHEN:

THURSDAY, March 18th 2010---10:00 AM Pacific

WHERE: Meeting: Costa Mesa City Council Chambers, 77 Fair Drive, Costa Mesa, CA 92626

WHO:

Shelley Lubben, former adult entertainment actress and founder of Pink Cross Foundation

Jan (Meza) Merritt, former adult entertainment actress and member of Pink Cross Foundation

Madelyne Hernandez, former adult entertainment actress and member of Pink Cross Foundation

Dave Pounder, Producer/Director/Performer, President, Dave Pounder Productions

Tim Tritch, Former Laboratory Representative/Account Manager; clients includes AIM Clinic

Robert Kim-Farley, MD, MPH, Director, Communicable Disease Control and Prevention Program, Los Angeles County Department of Public Health

Mark McGrath, Adult Film Industry Subcommittee, Reproductive Health Interest Group, UCLA School of Public Health, UC Berkeley Research Fellow

Michael Weinstein, AIDS Healthcare Foundation, President

Brian Chase, Assistant General Counsel, AIDS Healthcare Foundation

CONTACT:

Ged Kenslea, AHF Dir. of Communications (323) 791-5526 cell (323) 308-1833 office

Also:

WHAT:

POST Cal/OSHA HEARING TELECONFERENCEû12:30 PM Pacific

Advocates respond after Cal/OSHA hearing on adult film health and safety

WHEN:

THURSDAY, March 18th 2010---12:30 PM Pacific

Teleconference Dial in information: +1.877.411.9748 participant code #7931503

WHERE: Hilton Hotel Orange County/Costa Mesa, 3050 Bristol Street, Costa Mesa, CA 92626

Late last week, Cal/OSHA officials released its staff evaluation of AHF's petition as well as a proposed decision that the Cal/OSHA's Standards Board is expected to evaluate and act on during Thursday's meeting. In its proposed decision (http://www.dir.ca.gov/oshsb/petition513.html), Cal/OSHA officials wrote:

"In light of the evaluations, it is apparent to the Board that serious consideration should be given to the possible amendment of Section 5193 in order to give greater protection to employees in the adult film industry."(Emphasis added)

"This is a huge step in the right direction toward protecting the health and safety of adult film workers here in California, and I want to thank Cal/OSHA officials for their work on this and urge its Standards Board members to vote in favor of convening an advisory panel on this issue," said Michael Weinstein, President of AIDS Healthcare Foundation. "Although workers in adult films should enjoy protections under the current phrasing of Cal/OSHA's regulations, the adult film industry has steadfastly refused to take any steps to protect its workers from diseases spread by bloodborne pathogens, resulting in thousands of employees becoming infected with sexually transmitted diseases. AHF filed this petition because adult film industry producers were unwilling or unable to comply with current Cal/OSHA regulations and to take steps necessary to protect performers by providing and enforcing the use of condoms during filming."

"I was a porn star living the glamorous life. Drug overdoses, herpes, suicide attempts and abuse at the hands of the porn industry," said Shelley Lubben, former porn actress and founder of the Pink Cross Foundation, an IRS approved 501(c)(3) public charity dedicated to offering adult industry workers emotional, financial and transitional support for those who want out of the adult industry. "In my time in the industry, I did some very hardcore movies, and only drugs and alcohol could get me through them. I played a crazy game of Russian roulette with my life. The industry did not and still does NOT enforce condom usage, so STDs and HIV were--and still are--a high risk among porn actors and actresses. While my own life has taken an entirely new and profoundly fulfilling direction and I now work to help performers leave the industry altogether, I wholeheartedly support the call to amend Cal/OSHA regulations to better protect those still involved in the ongoing production of adult films in California."

"It breaks my heart to acknowledge that during my time as a porn star, I've done a scene with 25 men and even though I was assured that all of the STD testing had been taken care of by the producers, in my heart I realize now that this was probably a lie because I never saw the tests for myself," said Jan (Meza) Merritt, former porn actress and member of the Pink Cross Foundation. "There are thousands of porn stars actively working in the adult industry. How much higher is the risk of getting HIV and other STDs in an industry where you have not only one sexual partner per day, but several or more and condoms are looked at as an unnecessary, negative component of this industry? I urge Cal/OSHA to convene an advisory panel to thoroughly consider amending California safety and health regulations covering the industry."

Background on AHF's Petition to Cal/OSHA

AHF filed its petition at the final 2009 meeting of the California Occupational Safety and Health Standards Board (Cal/OSHA) in mid-December in Sacramento. The petition sought an amendment to California Code of Regulations, Title 8, Section 5193 "Bloodborne Pathogens" and asked Cal/OSHA to clarify protections for workers in the adult film industry and to explicitly include a condom requirement. As reported by the Associated Press at the time, ("AIDS group wants rule requiring condoms in porn" AP, 12/16/09) AHF said, "regulations to prevent the spread of bloodborne diseases in hospitals should extend to adult film sets. The current regulations aren't clear enough."

Cal/OSHA's proposed decision also noted:

"In view of the fact that the Petitioner does not represent all stakeholders and in view of the complexity of the issues, the possibly differing approaches to potential rulemaking and possible issues regarding federal equivalence, the Board concludes that an advisory committee would be of great benefit in determining the manner (if any) in which Section 5193 should be amended. Labor Code Section 147.1(c) provides, in effect, that the Division is to take the lead in developing and presenting proposed health standards to the Board, in which case, it is appropriate that the Division take the lead with respect to the advisory committee discussed herein." (Emphasis added)

"In view of the foregoing, the Board grants the Petition that is the subject of Petition File No. 513 to the extent that the Division is requested to convene an advisory committee representing stakeholders in order to consider possible amendments of California Code of Regulations, Title 8, Section 5193 as it pertains to employees in the adult film industry. If determined necessary, regulatory language or amendments should be developed for the Board's consideration at a future public hearing."

Background on STDs--including HIV--in the Adult film Industry and AHF's Ongoing Advocacy

AHF's action was prompted by the ongoing epidemic of sexually transmitted diseases (STDs) in California's adult film industry. According to the Los Angeles County Department of Public Health (LADPH), workers in the adult film industry are ten times more likely to be infected with a sexually transmitted disease than members of the population at large. LADPH documented 2,013 individual cases of chlamydia and 965 cases of gonorrhea among workers between the years 2003 and 2007. LADPH has observed that many workers suffer multiple infections, with some performers having four or more separate infections over the course of a year. In addition, LADPH has stated that as many as 25 industry-related cases of HIV have been reported since 2004. Included in the presentation will be two PowerPoint slideshows created by Peter R. Kerndt, MD, MPH, Director, Sexually Transmitted Disease Program for LADPH detailing the rampant epidemic of STDs in Los Angeles' adult film industry and the need for condoms to prevent disease transmission.

This past August, AHF filed sixteen worker-safety complaints with Cal/OSHA over the lack of condom use in adult films made in California. AHF supported its complaints with the submission of nearly 60 adult DVDs filmed in California and in which the performers do not wear condoms. The complaints asserted that the films demonstrated unsafe--potentially life-threatening--behavior in a California workplace, as the sexual acts filmed without participating performers using condoms depict the unprotected exchange of bodily fluids.

AIDS Healthcare Foundation (AHF) is the largest global AIDS organization. AHF currently provides medical care and/or services to more than 130,000 individuals in 22 countries worldwide in the US, Africa, Latin America/Caribbean and the Asia Pacific Region. www.aidshealth.org  

The Pink Cross Foundation is an IRS approved 501(c)(3) public charity dedicated to offering adult industry workers emotional, financial and transitional support for those who want out of the adult industry. www.thepinkcross.org and www.shelleylubben.com  

Contacts

AHF Dir. of Communications

Ged Kenslea

Telephone: 323-308-1833, Mobile: 323-791-5526

gedk@aidshealth.org

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Copyright © 2010 - Business Wire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Business Wire, Permissions Desk, Business Wire, 1185 Avenue of the Americas, 3rd Floor, New York, NY 10036; Tel: (212) 575-8822; FAX: (212) 575-1854. http://www.businesswire.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Universal access in the Caribbean must include men who have sex with men

UNAIDS - 16 March 2010

http://www.aegis.org/news/unaids/2010/UN100323.html

Although the Caribbean as a region has the second highest HIV prevalence after sub-Saharan Africa, most countries have concentrated epidemics which disproportionately affect certain groups including gay men and other men who have sex with men (MSM). In many countries men who have sex with men experience considerable social stigma and are not reached with vital HIV prevention, treatment, care and support services. Not only are men afraid of disclosing their sexual activity, they are also deterred from finding out what they need to know to reduce their risk or to buy condoms.

An environment of homophobia is often reinforced by anti-sodomy legislation which exists in 11 of 16 Caribbean countries*. This can contribute to an intolerant cultural and social environment which risks keeping men who have sex with men away from accessing HIV testing and counselling and education services that would reduce the vulnerability to HIV infection.

In Jamaica--a country with anti-sodomy laws--there is 32% HIV prevalence among MSM, versus 1.6% in the general population. In Trinidad & Tobago and Guyana, countries which also criminalize sex between men, the HIV prevalence ranges from 20% to 32%. While in Cuba, Suriname, the Bahamas, Dominican Republic, countries without such legislation, the HIV prevalence in MSM ranges from 1% to 8%.

According to 2007 UNGASS Country Progress reports less than 40% of MSM in the Caribbean are reached by prevention programmes. Local groups in many countries in the Caribbean have been urging civil society and government programmes to include MSM issues and organizations within the AIDS response. These efforts have been supported by regional networks including PANCAP.

UNAIDS Executive Director Michel Sidibe has called for an end to punitive laws which hamper the AIDS response in this region.

"In most of the countries in the Caribbean that don't have repressive laws, HIV prevalence is between 1% and 8% among men who have sex with men," said UNAIDS Executive Director Michel Sidibe. "This contrasts sharply with a range of between 20% and 32% in countries which outlaw sex between men."

"Reducing homophobia and removing punitive laws that criminalize sex between men creates the right conditions for achieving universal access," Mr Sidibe continued.

A collaborative effort is underway between UNAIDS, UNDP and PAHO/WHO to develop strategies for Latin America and the Caribbean on human rights and improvement of access to health services for MSM and other sexual minorities.

UNAIDS will lead a regional effort in the Caribbean to strengthen HIV prevention programmes among these groups, to bring together the human rights and service provision components for their improved health, human rights and well-being.

* Countries in the Caribbean with laws that criminalize men who have sex with men: Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago. Countries in the Caribbean with no laws criminalizing men who have sex with men: Bahamas, Cuba, Dominican Republic, Haiti, Suriname. According to ILGA web site accessed 16 March 2010

Resources:

Related information:

Caribbean - http://www.unaids.org/en/CountryResponses/Regions/Caribbean.asp  

Feature stories:

Fiji first Pacific Island nation with colonial-era sodomy laws to formally to decriminalize homosexuality (04 March 2010) - http://www.aegis.org/news/unaids/2010/UN100306.html  

Publications:

Keeping Score II (pdf, 2.87 Mb) - http://data.unaids.org/pub/Report/2008/20081206_keepingscoreii_en.pdf  

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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Mississippi Stops Segregating Prisoners With HIV: Alabama and South Carolina Last States to Maintain Discriminatory Policy

Human Rights Watch - March 17, 2010

http://www.aegis.org/news/hrw/2010/HRW100301.html

(Jackson) - The Mississippi Department of Corrections (MDOC) has agreed to end the segregation of prisoners with HIV, Human Rights Watch and the American Civil Liberties Union (ACLU) said today. This longstanding discriminatory policy, reversed after two decades of advocacy by the ACLU, Human Rights Watch, and others, prevented prisoners from accessing key resources that facilitate their successful transition back into the community.

The decision by Mississippi's corrections commissioner Christopher Epps, prompted by recent advocacy by the ACLU and Human Rights Watch, leaves Alabama and South Carolina as the only states in the nation that segregate prisoners based on their HIV status. Epps made the decision ahead of a forthcoming report by the ACLU and Human Rights Watch analyzing the harmful impact segregation policies have had in the three states.

"Commissioner Epps deserves a tremendous amount of credit for making this courageous decision to replace a policy based on irrational HIV prejudice with a policy based on science, sound correctional practice, and respect for human rights," said Margaret Winter, associate director of the ACLU National Prison Project. "The remaining segregation policies in South Carolina and Alabama are a remnant of the early days of the HIV epidemic and continue to stigmatize prisoners and inflict them and their families with a tremendous amount of needless suffering."

Public and correctional health experts agree that there is no medical basis for segregating HIV-positive prisoners within correctional facilities or for limiting access to jobs, vocational training and educational programs available to others. Since 1987, however, MDOC has performed mandatory HIV tests on all prisoners entering the state prison system, and has permanently housed all male prisoners who test positive in a segregated unit at the Mississippi State Penitentiary, the state's highest security prison. As a result, prisoners with HIV have been faced with unjustified isolation, exclusion, and marginalization, and low-custody prisoners have been forced unnecessarily to serve their sentences in more violent, more expensive prisons.

The change in policy will enable prisoners with HIV to participate in jobs, training programs, and other services to which they were previously denied access because of their HIV status and which are designed to prepare prisoners for a productive return to society. Prisoners with HIV will now be able to participate in kitchen work, for example, which can be beneficial to them in many ways. Many prisoners worked in kitchens, cafes, or restaurants prior to their incarceration, and continued employment in that area can help them upon re-entry. According to the US Centers for Disease Control, there is no medical basis for preventing persons with HIV from working in kitchens or other food service employment.

Additionally, prisoners with HIV will no longer be assigned to a segregated HIV unit, which resulted in the public disclosure of their HIV status and left them at risk of being ostracized and subjected to hostility and violence at the hands of other prisoners. Epps said he will phase in the new desegregation policy gradually for prisoners currently housed in the HIV unit, and will form a committee to make individualized placement decisions for these prisoners. Starting immediately, incoming prisoners will be housed using only criteria set out in the state classification plan such as criminal history, length of sentence and other factors unrelated to their HIV status.

"Prisoners with HIV were often forced to live in cruel, inhuman, and degrading conditions, and we're delighted that Mississippi has changed its policy," said Megan McLemore, health researcher at Human Rights Watch. "Integrating prisoners with HIV is the norm across the United States and MDOC deserves significant credit for making this decision."

Mississippi's decision to change its segregation policy to comply with civil and human rights standards is the latest in a series of reforms prompted by ongoing dialogue between the ACLU, Human Rights Watch, and MDOC officials. In 2001, based on the recommendations of a task force convened by the MDOC commissioner and comprised of MDOC security staff, public health officials, ACLU staff, and other HIV advocates, MDOC ended its policy of excluding prisoners with HIV from in-prison vocational, educational and religious programs. And in 2004, as a result of a class action lawsuit filed by the ACLU on behalf of all Mississippi prisoners with HIV, MDOC ended its policy of excluding prisoners with HIV from the state's work release and community corrections programs.

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Copyright © 2010 - Human Rights Watch. Reproduction of this article (other than one copy for personal reference) must be cleared through the Human Rights Watch - Contact Us.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

CDC HIV/Hepatitis/STD/TB Prevention News Update
For Wednesday, March 17, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• RHODE ISLAND: Money Woes Curtail Free Cancer Tests

INTERNATIONAL NEWS

• AFRICA: New Maps Guide African Truckers to AIDS Clinics
• AUSTRALIA: High Time to Clean Up Prisoner Drug Use: Anex

MEDICAL NEWS

• NETHERLANDS: Home 'Cervical Cancer' Test Hope

LOCAL AND COMMUNITY NEWS

• ILLINOIS: 'Sexpert' Lauds Benefits of Updated Female Condom
• ARIZONA: HIV Clinic Augments Cardiology Practice

NEWS BRIEFS

• UNITED STATES: Former Surgeon General Koop Honored for AIDS Work
• GEORGIA: Nearly 360 Students, Staff to Get TB Test Friday in Gwinnett School
• CANADA: Blood Tests Urged for Tattoo Clients

   NATIONAL NEWS RHODE ISLAND: Money Woes Curtail Free Cancer Tests

Felice J. Freyer

Providence Journal (03.12.10) - Wednesday, March 17, 2010 A Rhode Island cancer screening program that helps uninsured low-income women access Pap smears, mammograms, office visits and follow-up testing will be suspended from March 15 through June. The CDC-funded Women's Cancer Screening Program (WCSP) is operated by the state Department of Health and has a $1.5 million annual budget. Though flat-funded, the program has seen its number of clients grow by more than 50 percent this fiscal year, as more women who lost health insurance in the economic downturn sought its free services.
A 16-week testing delay would not usually make much of a difference, but nearly one in five WCSP patients have abnormal results requiring follow-up. Women needing biopsies, which should not be delayed, will have to apply to Medicaid or make arrangements with their physician. Either way, federal rules require that the women receive timely follow-up, said Nikki Hayes, assistant branch chief in CDC's division of cancer prevention and control.
Most of the 115 contracting service providers - medical practices, hospitals, labs, health and imaging centers - were surprised by the March 1 announcement of WCSP's suspension.
WCSP ran through 90 percent of its budget halfway through the current fiscal year, or by Dec. 31, said Annemarie Beardsworth, a Department of Health spokesperson. The department had no reason to alert providers earlier because there was nothing WCSP contractors could do to cut costs, she said. In January, the program lowered reimbursements. When WCSP services resume on July 1, patients will be screened every other year instead of annually, in line with recommendations by the US Preventive Services Task Force.
Rhode Island will seek an additional $300,000 for WCSP next fiscal year.
   INTERNATIONAL NEWS AFRICA: New Maps Guide African Truckers to AIDS Clinics Agence France Presse (03.10.10) - Wednesday, March 17, 2010 Approximately 20,000 maps detailing HIV/AIDS clinic locations are being distributed to truck drivers across Africa, thanks to a new initiative.
African trucking routes have long served to spread the virus across borders. The maps - in English for east and southern Africa, and in English and French for west Africa - pinpoint 160 clinics run by more than 40 governments and charities that provide free AIDS services.
"For the first time, truckers can see where they can access health services along major trucking corridors and transport hubs on the subcontinent," said Paul Matthew, Africa director for North Star Alliance, which sets up clinics on highways and at border posts. NSA is a partnership started by the courier company TNT and the UN World Food Program.
NSA's foundation initiated the project, working with risk-mapping firm Maplecroft and petroleum giant Royal Dutch Shell. "Our research showed categorically that the spread of HIV moved down transportation routes," said Maplecroft spokesperson Jason McGeown. Shell, which funded the project, said truck drivers' health directly impacts their business in Africa. Organizers hope to distribute the maps to truckers across the continent.
AUSTRALIA: High Time to Clean Up Prisoner Drug Use: Anex

Danny Rose

Australian Associated Press (03.16.10) - Wednesday, March 17, 2010 Australia should allow controlled needle and syringe programs (NSPs) in prisons to prevent hepatitis C and HIV transmission among incarcerated needle-sharing injection drug users, a harm-reduction group says. Such an NSP would require prisoners to store a used syringe inside a protective container before swapping it for a clean one in a container, said the Association for Prevention and Harm Reduction Programs Australia (Anex).
Australian researchers have found that almost 40 percent of inmates report injection drug use (IDU) while imprisoned, and about 70 percent of them shared needles. Some prisoners reported a needle being reused by as many as 100 inmates, with needles being re-sharpened by grinding them on cell walls. Two-thirds of corrections officers reported finding contraband needles, which is a potential risk during cell and prisoner searches. About 35 percent of inmates are infected with hepatitis C virus, and 0.5 percent have HIV.
"It is irrefutable that prison authorities owe a duty of care to prisoners, to protect them from foreseeable harm while they are in custody," said John Ryan, executive director of Anex. Such programs "have been operating for up to 10 years in Switzerland, Germany, Luxembourg, Spain, Moldova, Kyrgyzstan, and Belarus."
"The introduction of prison-regulated and controlled NSPs in these countries has not resulted in instances of syringes being used as weapons," Ryan said. "In fact, international experience shows that prison-regulated and controlled NSPs actually can increase institutional safety."
   MEDICAL NEWS NETHERLANDS: Home 'Cervical Cancer' Test Hope BBC (03.12.10) - Wednesday, March 17, 2010 A new study suggests that home-testing kits for human papillomavirus (HPV) could lead to the earlier detection of more cases of cervical cancer.
"While it's important for women to attend cervical screening appointments, some find it difficult to do so for cultural or other reasons," said Professor Stephen Duffy of Cancer Research UK.
The subjects of the research were 28,073 Dutch women who had not responded to two invitations to come in for regular cervical screening. Most (27,792) were then invited to collect a specimen sample and mail it in for evaluation; 281 were sent a third reminder to present for screening.
Adjusted rates of compliance were significantly higher among women in the self-sampling group (27.5 percent) versus the control group (16.6 percent). Among self-sampling responders, the 43 percent who had missed the previous round of screening had a higher risk of abnormal changes in the cervix than the 57 percent who had participated in the previous round.
"Offering self-sampling by sending a device for collecting cervicovaginal specimens for high-risk HPV testing to women who did not attend regular screening is a feasible and effective method of increasing coverage in a screening program," the authors concluded. "The response rate and the yield of high-grade lesions support implementation of this method for such women."
The report, "HPV Testing on Self-Collected Cervicovaginal Lavage Specimens as Screening Method for Women Who Do Not Attend Cervical Screening: Cohort Study," was published in the British Medical Journal (2010;340:c1040).
   LOCAL AND COMMUNITY NEWS ILLINOIS: 'Sexpert' Lauds Benefits of Updated Female Condom Chicago Tribune (03.15.10) - Wednesday, March 17, 2010 Last week, a coalition of organizations including Chicago Women's AIDS Project (CWAP) and AIDS Foundation of Chicago launched "Put a Ring On It," a campaign aimed at boosting awareness of the new female condom.
The Food and Drug Administration approved FC2, the second-generation female condom, in March 2009. FC2 uses a softer material than the original female condom, which came out 15 years ago, allowing it to feel more natural and cost less. Zoe Lehman, support services coordinator at CWAP and a self-described "sexpert," said a main reason the first female condom was not successful was that women did not know how to use it. FC2 has instructions on the package, unlike the old one, which had a large, unwieldy user guide packaged inside.
FC2 can be inserted up to 45 minutes before sex. It has a solid inner ring that sits around the cervix and anchors the condom behind the pubic bone, and an outer ring that "blossoms outside the vagina," Lehman said.
A key element of the campaign is peer-to-peer training. "One of the most exciting things about this campaign is that we, along with groups such as the Illinois Caucus on Adolescent Health, have spent the last two years training over a thousand people in the Chicago area who will train others on how to use it," said Lehman.
"We've been letting everyone know how easy [the female condom] is to use," said Lehman. "It's just as effective as the male condom, really pleasurable and empowers a woman because she doesn't have to request that the male partner wears the condom."
FC2 is not yet widely available in drug stores but can be picked up at Chicago Public Health Department clinics across the city. For more information, visit www.ringonit.org.
ARIZONA: HIV Clinic Augments Cardiology Practice

Angelique Soenarie

Arizona Republic (Phoenix) (03.06.10) - Wednesday, March 17, 2010 Low-income HIV patients in the Southeast Valley can now access primary care services at the Advanced Cardiac Specialists (ACS) clinic at Greenfield and Baseline roads. The practice recently became a care provider through the federal Ryan White HIV/AIDS program, which gives grants to community-based health care organizations.
The new clinic will serve east Mesa, Apache Junction, Queen Creek, Gold Canyon, and Florence. Mark Kezios, chair of the Ryan White council for Maricopa County, said an additional clinic was needed since the county is geographically one of the largest in the nation.
About 80 patients living in rural areas of Maricopa and Pinal counties drive up to three hours to Phoenix for care, said Kezios - too far for patients requiring frequent treatment.
ACS applied for the grant since several of its staff are HIV treatment experts, Kezios noted. "It's just wonderful that we have a provider that is experienced in treating HIV. So opening up in the East Valley is making the quality for people's lives much easier," he said.
The Ryan White program serves 836 HIV patients in Maricopa County, with the per-patient annual cost averaging $2,343. Sun Life Family Health Center in Casa Grande has also joined the program as a network provider.
   NEWS BRIEFS UNITED STATES: Former Surgeon General Koop Honored for AIDS Work Associated Press (03.17.10) - Wednesday, March 17, 2010 Dr. C. Everett Koop on Wednesday will receive the 2010 Ryan White Distinguished Leadership Award from Indiana University's Rural Center for AIDS/STD Prevention. Jeanne White Ginder, whose son Ryan's battle with HIV made him a national symbol in the fight against AIDS, will present the award to Koop at Dartmouth Medical School in Hanover, N.H. While serving as US surgeon general in the 1980s, Koop took important steps to fight the epidemic, including commissioning a special report and mailing a brochure about AIDS to every US household.
GEORGIA: Nearly 360 Students, Staff to Get TB Test Friday in Gwinnett School

D. Aileen Dodd

Atlanta Journal-Constitution (03.16.10) - Wednesday, March 17, 2010 On Friday at Lilburn Middle School, the Gwinnett County health department will offer TB testing to 313 students and 45 staff members in response to two students testing positive for the disease. This, the second round of testing at the school, is seen as a precaution. Previous testing in February found a student who tested positive and was treated. A second student also tested positive, though non-infectious. "There is no way of telling whether or not they are related," Suleima Salgado, spokesperson for the East Metro Health District, said of the cases. "Since this is the second case at this school at that grade level, we are erring on the side of caution and we are going to test the remaining sixth-graders who weren't tested in the first round." A letter sent Monday from Principal Gene Taylor asked the students' parents to give their consent for the testing. For more information, visit www.eastmetrohealth.com.
CANADA: Blood Tests Urged for Tattoo Clients

Paul Forsyth

Niagara This Week (Thorold, Ontario) (03.12.10) - Wednesday, March 17, 2010 Niagara Region Public Health is urging anyone who underwent tattooing or piercing at Needlez Tattoo, located at 16 Thorold Rd. East, Welland, to contact the department. The establishment, which opened in December, was ordered closed on March 5 after inspectors, responding to a complaint, found it to have improperly sterilized equipment. There is currently no evidence of infectious disease transmission as a result, said Dave Carey, a manager of environmental health for NRPH; however, the operator was unable to provide a complete, detailed client list. Anyone who received a tattoo or piercing at Needlez should visit a doctor or clinic to be tested for HIV and hepatitis B and C, said Dr. Robin Williams, NRPH's chief medical officer of health. The department also advises clients of the shop to exercise caution until they are tested to avoid possible transmission to others. For more information, telephone 888-505-6074, 905-688-8248 ext. 7330, or after hours 905-984-3690.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Kenya: The downside of door-to-door testing

Integrated Regional Information Networks - March 17, 2010

http://www.aegis.org/news/irin/2010/IR100317.html

TESO, 17 March 2010 (PlusNews) - While the public response to Kenya's national HIV testing drive has been enormous, many women are not keen to be tested, knowing that a positive result could mean the breakdown of their marriages, loss of home and more.

Isabella Omoto, who lives in western Kenya's Teso district, was recently forced by her husband of seven years to go for an HIV test; the result was positive.

"I revealed it to my husband and he just started beating me; he said I had been sleeping with other men," she told IRIN/PlusNews at her mother's home, where she now lives. "He threw my things out and told me to go back to my mother with all our children.

"He won't take me back because to him I am a prostitute," she added. "Today he has another wife and he has inherited another - I don't want to interfere with them."

According to Teso District AIDS and sexually transmitted diseases coordinator Nelson Andanje, men in the area - too afraid to go for HIV tests themselves - have been forcing their wives to get tested, believing their status will reflect their own.

"Here, like in many areas, it is women who come for HIV tests and you will see very few men," he said. "The man believes that if his wife is positive or negative then the same results apply to him."

Rights issues

In December 2009, Human Rights Watch warned of the possibility of human rights violations during the mass testing drive.

"It a gross violation of a woman's human rights to force her to go for HIV tests and then use the same tests to decide whether she should continue to live with you or not when, ridiculously, you don't even know your own status," Andanje said.

Statistics from the district AIDS coordinator's office show that over the past year, 10,838 women were tested; only 183 were accompanied by their husbands. According to the Kenya AIDS Indicator Survey, an estimated 45 percent of women have been tested for HIV, against just 25 percent of men.

"The high number of women who test more than men could be attributed to antenatal testing, but even in this you never see their husbands accompanying them, which should ideally be the case," he noted.

Teso district's HIV prevalence is 24 percent; health authorities have identified high levels of polygamy and wife inheritance, aided by strong cultural beliefs, as some of the key drivers of HIV transmission.

"Strong cultural beliefs make men believe it is beneath them to go for voluntary counselling and testing and women are solely responsible for HIV transmission," Andanje said.

Discordance

"Many people still do not know about discordance," he added.

An estimated 6 percent of Kenyan couples - about 344,000 - are HIV discordant, while just 22 percent of couples know the HIV status of their sexual partners.

According to the Kenya National Strategic Plan for HIV/AIDS, "social norms regarding relationships, gender roles/imbalances, stigma and discrimination, fear and risk-perception, and fertility intentions present difficult prevention challenges".

Andanje says the district authorities are trying to sensitise the community about discordance and to encourage women to speak out if they are being forced to take a test.

"We are using the local administration to reach out to men and let them know the benefits of individually going for an HIV test; we want them to know that they may be in a discordant union," he said. "When a woman comes alone or a man comes alone, it is difficult to know whether they are in a discordant union and you can't therefore give them services adequately.

"Men must be made to know that there is nothing feminine or masculine in testing for HIV. It is purely a health issue," he added.

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Insurer targeted HIV patients to drop coverage

Reuters NewMedia - March 17, 2010
Murray Waas

http://www.aegis.org/news/re/2010/RE100309.html

WASHINGTON (Reuters) - In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance.

Shortly after his diagnosis, however, his insurance company, Fortis, revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that.

So he hired an attorney -- not because he wanted to sue anyone; on the contrary, the shy African-American teenager expected his insurance was canceled by mistake and would be reinstated once he set the company straight.

But Fortis, now known as Assurant Health, ignored his attorney's letters, as they had earlier inquiries from a case worker at a local clinic who was helping him. So Mitchell sued.

In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc, to pay Mitchell $15 million for wrongly revoking his heath insurance policy. In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million.

By winning the verdict against Fortis, Mitchell not only obtained a measure of justice for himself; he also helped expose wrongdoing on the part of Fortis that could have repercussions for the entire health insurance industry.

Previously undisclosed records from Mitchell's case reveal that Fortis had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators.

The revelations come at a time when President Barack Obama, in his frantic push to rescue the administration's health care plan, has stepped up his criticism of insurers. The U.S. House of Representatives is expected to vote later this week on an overhaul of the health system, which Obama has said is essential to do away controversial and unpopular industry practices.

Insurance companies have long engaged in the practice of "rescission," whereby they investigate policyholders shortly after they've been diagnosed with life-threatening illnesses. But government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

In his previously undisclosed court ruling, the judge in the Mitchell case also criticized what he said were the company's efforts to cover its tracks.

Assurant Health said that as a matter of policy it did not comment on individual customer claims.

"We disagree with certain of the court's characterizations of Assurant Health's policies and procedures in the Mitchell case," it said in a statement provided by spokesman Peter Duckler, adding: "The case continues to progress through the appellate process."

"REPREHENSIBLE" CONDUCT

Much of the trial record of the Mitchell case is bound by a confidentiality order and not available to the public. But two orders written by the presiding judge, Michael G. Nettles, a state circuit judge for the 12th Judicial District of South Carolina, of Florence County, describe the case in detail. Judge Nettles wrote the orders in response to motions by Assurant that the jury's verdict be set aside or reduced.

In the motions, Nettles not only strongly denied Fortis' claims but condemned the corporation's conduct.

"There was evidence that Fortis' general counsel insisted years ago that members of the rescission committee not record the identity of the persons present and involved in the process of making a decision to rescind a Fortis health insurance policy," Nettles wrote.

Elsewhere in his order, Nettles noted that there were no "minutes of actions, votes, or any business conducted during the rescission committee's meeting."

The South Carolina Supreme Court, in upholding the jury's verdict in the case in a unanimous 5-0 opinion, said that it agreed with the lower court's finding that Fortis destroyed records to hide the corporation's misconduct. Supreme Court Chief Justice Jean Hoefer Toal wrote: "The lack of written rescission policies, the lack of information available regarding appealing rights or procedures, the separate policies for rescission documents" as well as the "omission" of other records regarding the decision to revoke Mitchell's insurance, constituted "evidence that Fortis tried to conceal the actions it took in rescinding his policy."

In affirming the trial verdict and Nettles' order, Toal was as harsh in her criticism of the company as Judge Nettles had been. "We find ample support in the record that Fortis' conduct was reprehensible," she wrote. "Fortis demonstrated an indifference to Mitchell's life and a reckless disregard to his health and safety."

Fortis canceled Mitchell's health insurance based on a single erroneous note from a nurse in his medical records that indicated that he might have been diagnosed prior to his obtaining his insurance policy. When the company's investigators discovered the note, they ceased further review of Mitchell's records for evidence to the contrary, including the records containing the doctor's diagnosis.

Nettles also suggested that Fortis should have realized the date in the note was incorrect: "Not only did Fortis choose to rely on one false and unreliable snippet of information containing an erroneous date to the exclusion of other information which would have revealed that date to be erroneous, Fortis refused to conduct any further investigation even after it was on notice the evidence which aroused its suspicion to be false," the judge noted.

Fortis "gambled" with Mitchell's life, Nettles wrote.

Their motive, according to the judge, was obvious: "The court finds that Fortis wrongfully elevated its concerns for maximizing profits over the rights and interest of its customer." In upholding Nettles' verdict, the South Carolina Supreme Court similarly ruled that "Fortis was motivated to avoid the losses it would undoubtedly incur in supporting Mitchell's costly medical condition."

While declining to comment on specific cases, Assurant said in the statement: "All insurance companies have processes to review claims to ensure their accuracy, completeness and compliance with policy provisions and we evaluate all claims on an individual basis."

CEO DEFENDED RESCISSION

On June 16, 2009, the House Energy and Commerce Committee, held a hearing on the practice of rescission by health insurance companies, and among the industry executives who testified was Don Hamm, the CEO and President of Assurant Health.

Hamm insisted before the committee that rescission was a necessary tool for Assurant and other health insurance companies to hold the cost of premiums down for other policyholders. Hamm asserted that rescission was "one of many protections supporting the affordability and viability of individual health insurance in the United States under our present system."

He also suggested that those who had their policies rescinded by Assurant had attempted to intentionally mislead his company: "Unfortunately, there are times when we discover that an applicant did not provide complete or accurate medical information when we underwrote the risk," Hamm said.

But state regulators, federal and congressional investigators, and consumer advocates say that in only a tiny percentage of cases of people who have had their health insurance canceled was there a legitimate reason.

A 2007 investigation by a California state regulatory agency, the California Department of Managed Health Care, bore this out. The DMHC randomly selected 90 instances in which Anthem Blue Cross of California, one of WellPoint's largest subsidiaries, canceled the insurance of policy holders after diagnoses with costly or life-threatening illnesses to determine how many were legally justified.

The result: The agency concluded that Anthem Blue Cross lacked legal grounds for canceling policies in every single instance.

"In all 90 files, there was no evidence (that Blue Cross), before rescinding coverage, investigated or established that the applicant's omission/misrepresentation was willful," the DMHC report said.

WRONG DATE

The Fortis underwriter who recommended Mitchell's policy be rescinded had her own doubts that it was correct to do so, according to records the company did produce at trial.

In a reference to the nurse's note with the wrong date, the underwriter wrote to her superiors: "Technically, we do not have the results of the HIV test. This is the only entry in the medical records regarding HIV status. Is this sufficient?"

Relying on the note was dubious, Judge Nettles wrote, because it was included in records from 2002, when Mitchell was in fact diagnosed with HIV, and not in 2001, when he purchased his policy. "The chronological sequence of those records raises an inference that the date on the handwritten note may be erroneous," he wrote.

Moreover, Nettles said, if Mitchell's HIV diagnosis had been a year earlier, as the erroneous note said, Mitchell's medical records would have shown other references to that diagnosis and treatment and he would have sought reimbursement for expenses related to them.

Sallie Phelan, an attorney who represented Mitchell, says her client was bewildered as to why his insurance was canceled -- at first not even contemplating the possibility that there was anything improper going on: "We began representing Jerome when he was still just a boy, really," she said. "He was just this sweet kid with all these drives and ambitions."

Then Mitchell felt betrayed, Phelan says. "He had done everything he was supposed to. He went out and got insurance on his own, at 17. He was a trusting person, perhaps too trustful. And as they kept slamming doors in his face, he thought at first there was some misunderstanding. He couldn't understand what was going on, because he is such an honest person himself. And when they accused him of lying, that was the most harmful to him. He didn't understand why they were accusing them. He didn't understand why people weren't listening to him."

Like other major health insurance companies, Fortis has a "rescission committee" that reviews recommendations to cancel a policyholder's insurance. But in the case of Fortis, Nettles wrote, the committee rarely did more than "rubber stamp" already flawed recommendations.

"There were no rules, no minutes, no notes, and, in accordance with instructions from general counsel not even a record of who was present," the judge wrote about the committee.

During the meeting in which Mitchell's insurance was rescinded, "there were more than 40 other customers, whose cases appeared before the rescission committee for review in no more than one and one half to two hours, representing an average of three minutes or less per customer," he wrote.

According to Nettles, Fortis concealed information through its document retention practice. The company's "stated policy for the last nine years has been to microfilm and destroy all documents," the judge said. "There was also evidence that documents and/or records regarding (Mitchell's) policy were deleted; and that telephone logs and recordings contained key omissions." Fortis also "shredded" documents, he said.

Regarding another piece of key evidence, the judge concluded that "a jury could easily infer that Fortis destroyed and/or concealed" crucial evidence.

Overall, Nettles asserted, a "pattern of secrecy and concealment by Fortis in this case ... supports a high award of punitive damages."

After his insurance was canceled, a case worker with a social agency who works with HIV patients named Mary Wiggins worked tirelessly for Mitchell to find him medical care and to have Fortis reinstate his insurance. Despite deluging Fortis with records and information that should have led to a reversal of the decision, the insurance company simply ignored her. Wiggins found a local clinic that agreed to provide care for Mitchell, in the process very likely saving his life.

Eventually, Mitchell retained legal counsel to have his health insurance reinstated, but Fortis ignored them as well. It was only after the insurance company was sued -- some 22 months after his HIV diagnosis -- that Mitchell's insurance was reinstated.

COST CONTAINMENT

In his order, Nettles said Mitchell's treatment was typical of how Fortis treated patients recently diagnosed with HIV and other life-threatening diseases.

"In addition to these acts toward (Mitchell) there was evidence that Fortis has for some time been making recommendations for rescission, and acting on those recommendations, without good-faith investigation conducted fairly and objectively ... Fortis pre-programed its computer to recognize the billing codes for expensive health conditions, which triggers an automatic fraud investigation by its "Cost Containment" division whenever such a code is recognized."

A federal investigator who has reviewed Assurant's remaining records says that they showed that once a person with HIV was targeted with a fraud investigation, the company made a greater effort than usual to cancel the person's insurance. Policies and medical records were scrutinized to a greater extent than others being scrutinized, he said.

The investigator, who spoke on condition of anonymity, said that the motive for focusing on people with HIV was simply the high cost of treating the illness: "We are talking a lifetime of therapy, a lifetime of care ... a lot of bills. Nowadays someone with HIV can live a normal life for decades. This was about money."

No evidence has emerged that any other major American company purged policyholders simply because they had HIV. But an investigation this summer by the House Energy and Commerce Committee as well as earlier ones by state regulators in California, New York and Connecticut, found that thousands of vulnerable and seriously ill policyholders have had their coverage canceled by many of the nation's largest insurance companies without any legal basis. The congressional committee found that three insurance companies alone saved at least $300 million over five years from rescission. One of those three companies was Assurant.

The committee estimated that Assurant alone profited by more than $150 million between 2003 and 2007 from rescission.

During his appearance on June 16 before the House Energy and Commerce Committee, Hamm, the CEO and President of Assurant, urged Congress to pass the new health care legislation, in part, to prevent such practices.

"We can achieve the goal we share -- providing health care coverage for all Americans," Hamm said. "If a system can be created where coverage is available to everyone and all Americans are required to participate, the process we are addressing today, rescission, becomes unnecessary."

(Additional reporting by Lewis Krauskopf, editing by Jim Impoco and Claudia Parsons)

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RE100309

Copyright © 2010 - Reuters, Ltd. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.   Contact Reuters.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

New highly active antiretroviral therapy study results from Mahidol University, Medical Department described

AIDSWEEKLY Plus; Monday, March 15, 2010
Staff Medical Writers

http://www.aegis.org/pubs/aidswkly/2010/AW2010-03-06.html

2010 MAR 15 - (NewsRx.com) -- "Immune reconstitution inflammatory syndrome (IRIS) is an important adverse event among human immunodeficiency virus (HIV)-infected patients taking highly active antiretroviral therapy (HAART). The epidemiology of IRIS in Thailand has not been well examined, especially among adult HIV-infected patients," scientists in Bangkok, Thailand report (see also Highly Active Antiretroviral Therapy).

"In the present Study, we reviewed the medical records of 174 HIV-infected, antiretroviral therapy-naive patients older than 15 years (the median CD4 count at commencement of HAART was 37 cells/mm(3)) and compared characteristics of patients with and without IRIS. During a 12-month follow-up period after commencement of HAART, 11 cases (6.3%) of IRIS were identified (4.2/100 patient years HAART). The cases included nine cases with mycobacterial infection, one with cytomegalovirus retinitis and one with cryptococcal meningitis. The patients with IRIS were significantly Younger than those without IRIS (29 vs 36 on medians, p=0.022). The median interval between commencement of HAART and the onset of IRIS was 22 days. Although all patients with IRIS improved with or without corticosteroids, they were more frequently hospitalized during a 12-month folllow-up period while taking HAART (1 vs 0 on medians, p<0.001)," wrote M. Aramaki and colleagues, Mahidol University, Medical Department.

The researchers concluded: "The incidence of IRIS in advanced adult HIV-infected patients in Thailand was lower than that reported from Europe and the United States, which may be attributable to deferment of HAART after diagnosing opportunistic infections."

Aramaki and colleagues published their study in Southeast Asian Journal of Tropical Medicine and Public Health (IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME IN ADULT HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS IN THAILAND. Southeast Asian Journal of Tropical Medicine and Public Health, 2010;41(1):138-145).

For additional information, contact U. Silachamroon, Mahidol University, Fac Trop Medical, Dept. of Clin Trop Medical, 420-6 Ratchawithi Rd., Bangkok 10400, Thailand.

The publisher's contact information for the Southeast Asian Journal of Tropical Medicine and Public Health is: Southeast Asian Ministers Education Organization, Seameo-Tropmed, 420-6 Rajvithi Rd., Bangkok 10400, Thailand.

Keywords: City:Bangkok, Country:Thailand, AIDS/HIV, Antivirals, Cryptococcal Meningitis, Cytomegalovirus, Epidemiology, HAART, Highly Active Antiretroviral Therapy, Immune Reconstitution Inflammatory Syndrome, Immunodeficiency, Immunology, Opportunistic Infections, Public Health, Treatment, Viral, Virus

This article was prepared by AIDS Weekly editors from staff and other reports.

2010-03-15
AW2010-03-06

Copyright © 2010 - Charles Henderson, Publisher. All rights Reserved. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA. Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633-4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX: (205) 995-1588 http://www.newsrx.net

AEGiS is made possible through unrestricted grants from the Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Reports summarize HIV/AIDS research from S.L. Hodder and co-authors

AIDSWEEKLY Plus; Monday, March 15, 2010
Staff Medical Writers

http://www.aegis.org/pubs/aidswkly/2010/AW2010-03-05.html

2010 MAR 15 - (NewsRx.com) -- According to a study from the United States, "A randomized, open-label, multicenter study was conducted to evaluate the therapeutic switch to a single-tablet formulation of efavirenz/emtricitabine/tenofovir DF (EFV/FTC/TDF) among virologically suppressed, HIV-1-infected subjects. Eligible subjects on stable antiretroviral therapy (ART) with HIV-1 RNA less than 200 copies per milliliter for 3 months or more were stratified by prior protease inhibitor (PI)- or non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapy and randomized (2:1) to EFV/FTC/TDF or to stay on their baseline regimen (SBR)."

"Reported measures were quality of life (QOL; SF-36 [version 2]), treatment adherence (visual analogue scale), preference of medication (POM), perceived ease of the regimen for condition (PERC), and a 20-item HIV symptom index. Overall, 203 subjects were randomized to EFV/FTC/TDF and 97 to SBR. Fifty-three percent of subjects had previously received a PI-based regimen; 47% an NNRTI-based therapy. Throughout the study, SF-36 summary scores did not differ significantly from baseline, regardless of previous ART or treatment allocation. Adherence was 96% or more in both groups at baseline and all subsequent study visits. At study conclusion, the EFV/FTC/TDF regimen was considered easier to follow than prior regimens by 97% and 96% of subjects previously receiving PI-based and NNRTI-based therapies, respectively. Overall, 91% of subjects switched to EFV/FTC/TDF indicated a preference over their prior therapy. Switching to EFV/FTC/TDF was associated with transient worsening/emergence of dizziness and sustained improvements in several other HIV-related symptoms," wrote S.L. Hodder and colleagues (see also HIV/AIDS).

The researchers concluded: "Switching virologically suppressed, HIV-1-infected subjects from PI-based or NNRTI-based regimens to EFV/FTC/TDF was associated with maintained QOL and treatment adherence, and improved ease of use and treatment satisfaction."

Hodder and colleagues published their study in AIDS Patient Care and Stds (Patient-Reported Outcomes in Virologically Suppressed, HIV-1-Infected Subjects After Switching to a Simplified, Single-Tablet Regimen of Efavirenz, Emtricitabine, and Tenofovir DF. AIDS Patient Care STDS. 2010 Feb;24(2):87-96.

For more information, contact S.L. Hodder, Medical & Dental University New Jersey, Dept. of Medical, MSB I520, 185 S Orange Ave, Newark, NJ 07101, USA.

Publisher contact information for the journal AIDS Patient Care and Stds is: Mary Ann Liebert Inc., 140 Huguenot Street, 3RD FL, New Rochelle, NY 10801, USA.

Keywords: City:Newark, State:NJ, Country:United States, AIDS/HIV, Anti-HIV, Antivirals, Drugs, Efavirenz, Emtricitabine, Enzymes, HIV/AIDS, Nucleoside and Nucleotide Reverse Transcriptase InhibitorsAntiretroviral, Pharmaceuticals, Protease Inhibitors, Proteins, Proteomics, Quality of Life, Tenofovir, Therapy, Transcriptase, Treatment

This article was prepared by AIDS Weekly editors from staff and other reports.

2010-03-15
AW2010-03-05

Copyright © 2010 - Charles Henderson, Publisher. All rights Reserved. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA. Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633-4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX: (205) 995-1588 http://www.newsrx.net

AEGiS is made possible through unrestricted grants from the Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

AEGiS Toolbar - Create Donations by Shopping and Searching

AEGiS.org - March 16, 2010

We have something new and exciting we'd like to share with you! It's the new AEGiS toolbar – once added to IE or Firefox, each time you shop at more than 1,300 stores (from Amazon to Zazzle) a percentage of your purchase will automatically be donated to AEGiS at no cost to you (and you may even save money as the toolbar provides coupons and deals as well). The toolbar also has a search box and each time you search the Internet, about a penny is donated to AEGiS.

And please pass this along to all of your friends. The two minutes it takes to add this toolbar to your browser can make a lifetime of difference!

To get the toolbar now, please go to: http://www.goodsearch.com/toolbar/aegis-aids-education-global-information-system

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AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine,and donations from users like you.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980,2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

CDC HIV/Hepatitis/STD/TB Prevention News Update
For Tuesday, March 16, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• ALASKA: Gonorrhea Cases Spike in Alaska

INTERNATIONAL NEWS

• GLOBAL: New HIV Infections Increasing Among Homosexuals
• CHINA: NGOs in China Say Threatened by New Donor Rules

MEDICAL NEWS

• UNITED KINGDOM: Do Needle-Exchange Programs Really Work?

LOCAL AND COMMUNITY NEWS

• CALIFORNIA: Black Churches Mounting AIDS Campaign
• GEORGIA: Positive Impact Now Offers Free STD Screenings

NEWS BRIEFS

• SOUTH CAROLINA: S.C. Lawmakers Ponder Plan to Eliminate Health Cuts
• FLORIDA: Perdido Bay Tribe to Join National Native HIV/AIDS Day
• FLORIDA: Candlelight Vigil on March 18 for HIV/AIDS Victims

   NATIONAL NEWS ALASKA: Gonorrhea Cases Spike in Alaska

Dan Joling

Associated Press (03.16.10) - Tuesday, March 16, 2010 State health officials are urging providers to be on the lookout for gonorrhea, following a 69 percent increase in reported cases in Alaska last year.
According to Department of Health and Social Services (DHSS) data, 997 cases of genital gonorrhea were logged in 2009, up from 578 in 2008. Alaska Natives accounted for 68 percent of last year's cases, while females accounted for more than half. The highest rates for males and females alike were found among those ages 20-24.
Susan Jones, manager of the DHSS Epidemiology Section's STD program, said 2009 saw the largest single-year increase in gonorrhea in Alaska since the 1970s. She said reports from providers offer a clue as to why.
"In some cases, the symptoms are mild enough, or not annoying enough, that people are not coming in to seek care, or delaying coming in," said Jones. "So that means they have gonorrhea for a longer period of time and are able to transmit it more."
DHSS recommends prompt treatment for patients and is encouraging them to take part in "partner services activities." "It's a process in which sexual partners are identified and notified that they could be a part of the disease investigation," explained Jones.
"Providers should screen sexually active women younger than 25 years of age, those with multiple or new sex partners, those who have had gonorrhea or chlamydia infection in the past 12 months, and those who have been told they were exposed to gonorrhea," said Dr. Joe McLaughlin, state epidemiologist.
The bulletin noted that almost 300 people diagnosed with gonorrhea last year were co-infected with chlamydia.
   INTERNATIONAL NEWS GLOBAL: New HIV Infections Increasing Among Homosexuals

Edith M. Lederer

Associated Press (03.16.10) - Tuesday, March 16, 2010 Laws that criminalize their behaviors are driving up HIV infections among persons in high-risk groups, the UNAIDS chief said Monday. Eighty-five countries criminalize consensual same-sex relations between adults, including seven that apply the death penalty, said Michel Sidibe. Repressive laws also make it hard for sex workers and injection drug users to access HIV prevention and treatment services, he said.
In China, Kenya, Malawi, and other countries, about 33 percent of new HIV infections are in men who have sex with men, representing a major increase, Sidibe said.
Even in the United States, "It seems like we have come full circle," Sidibe told journalists at a UN Foundation luncheon in New York City. More than 50 percent of new US HIV infections last year occurred among MSM, and the infection rate was even higher for those ages 19-25, he said. Sidibe blamed this on the failure to deliver appropriate HIV prevention messages, complacency, and treatment optimism. Treatment optimism also affects Europe and Africa, he noted.
"You have 70 percent of new infections occurring in Eastern Europe and Central Asia among drug users, but they are criminalized," Sidibe said. "They don't have access to services. They have to hide themselves and go underground."
Of the estimated 16 million injection drug users worldwide, almost 3 million are HIV-positive, and of these less than 4 percent have access to HIV treatment, Sidibe said. "It's the same for [MSM]," he said.
In Nigeria, over 30 percent of 1,000 the new infections daily are among high-risk groups including drug users, sex workers, and MSM, Sidibe said.
Sidibe called for prevention campaigns in major cities worldwide to jump-start "a prevention revolution."
CHINA: NGOs in China Say Threatened by New Donor Rules

Cara Anna

Associated Press (03.12.10) - Tuesday, March 16, 2010 New rules that came into effect March 1 require non-governmental organizations working in China to show proof that overseas donors are registered in their home countries. Faith-based groups also must get approval from the State Religious Affairs Bureau for any donation exceeding 1 million yuan (US $146,000). The rules were posted on the Web site of the State Administration of Foreign Exchange, which normally has little to do with NGOs.
Wan Yanhai, a Beijing-based AIDS activist, said the new requirements will affect tens of thousands of groups that rely primarily on overseas money. However, that figure cannot be verified, in part because no one knows how many NGOs are working in China. According to the Ministry of Civil Affairs, approximately 400,000 groups are registered. But a report published by the Chinese Academy of Social Sciences has estimated the total number could be 3 million.
"No government official knows how to regulate them," and they do not know what most NGOs are doing, explained Wang Liwei, CEO of China Charity Media Group.
"I think it's inevitable that they were going to start tightening the noose on NGOs," said Meg Davis, executive director of Asia Catalyst, a New York-based group that works on AIDS-related projects in China. "There's a sense at the top that they're suspicious of NGO powers."
In the Yunnan province, Davis' group works with 90 HIV-infected women. The new regulations are complicating overseas funding efforts, she said. "Stopping work is not an option. These women are working with a population that is sick and dying. The only thing we can attempt to do is comply as best as we can," she added.
   MEDICAL NEWS UNITED KINGDOM: Do Needle-Exchange Programs Really Work?

Amy Norton

Reuters Health (03.11.10) - Tuesday, March 16, 2010 The evidence that needle and syringe programs (NSPs) are effective in preventing HIV and hepatitis C virus (HCV) is weaker than acknowledged in the current scientific literature, a new analysis of research suggests. The new review of English-language literature to March 2007 included for analysis three high-quality "core" reviews and two supplementary ones.
The metareview found sufficient evidence that NSPs reduce self-reported injecting risk behavior (IRB), and tentative evidence that alternative pharmacy NSPs have an additional impact on IRB. UK researchers found only tentative evidence that NSPs are effective in preventing HIV and insufficient support for their preventing HCV. However, of the five reviews, three did not examine HCV "in any depth," noted Norah Palmateer, of Health Protection Scotland, and colleagues.
"Insufficient or weak evidence of an effect is not evidence of no effect," said Palmateer. "It is more a reflection of the studies and evidence available."
Part of the problem is that the studies have been observational, rather than randomized controlled clinical trials, Palmateer said. Observational studies are open to "selection bias," she said. For example, if those at greatest risk for HIV tended to use an NSP, a study might find higher HIV prevalence associated with the program. In addition, the NSPs studied had strict limits on the number of syringes and needles they could give clients, she said.
Of 10 HIV-focused NSP studies reviewed in 2004 by the World Health Organization, five had positive findings. However, four of the five had design weaknesses that limit the conclusions that can be drawn. Two of the reviews analyzed by Palmateer's team included many of the same studies in the WHO report. One research group agreed with WHO, while the other more guardedly found "modest" evidence that NSP's prevent HIV transmission.
"The main public health implications of the findings are that a higher level of coverage of interventions, including [NSPs], is likely required to reduce blood-borne virus transmission," said Palmateer.
The full meta-analysis, "Evidence for the Effectiveness of Sterile Injecting Equipment Provision in Preventing Hepatitis C and Human Immunodeficiency Virus Transmission Among Injecting Drug Users: A Review of Reviews," was published in Addiction (2010;doi:10.1111/j.1360-0443.2009.02888.x).
   LOCAL AND COMMUNITY NEWS CALIFORNIA: Black Churches Mounting AIDS Campaign

Leonel Sanchez

San Diego Union-Tribune (03.12.10) - Tuesday, March 16, 2010 Nearly 40 area black churches were holding services to commemorate National Week of Prayer for the Healing of AIDS, March 7-13.
In addition to providing free HIV screenings, churches are working to overcome stigma associated with the disease. "It's the life of the person who's got it that's more important than how they got it," said the Rev. Ikenna Kokayi, president of the United African-American Ministerial Action Council. The southeast San Diego-based group sponsored a campaign-related outreach earlier in the month and has tested almost 200 high-risk people for HIV so far this year.
In San Diego County, African Americans make up about 5 percent of the population but roughly 13 percent of AIDS cases.
"If you want to reach African Americans, you have to go through African-American churches," said Clovis Honore of the San Diego Region Kemet Coalition, a group of HIV service organizations that aid black residents.
During a service at Mt. Moriah Christian Church in Mira Mesa, the Rev. Alpha Dority called for a "healing of AIDS." "Look here, oh God, we ask if there's anybody who is infected, then we ask right now that they get tested so they're able not to spread this disease," he said.
Though participation in the commemoration has grown at the national and local level, Kokayi said more churches need to come on board. Many black churches continue to struggle with addressing issues surrounding HIV/AIDS, including homosexuality, drug use, and sex. "But we shouldn't have a challenge in loving people and that's all people," said Kokayi.
GEORGIA: Positive Impact Now Offers Free STD Screenings

Mike Fleming

Project Q Atlanta (03.03.10) - Tuesday, March 16, 2010 An Atlanta mental health agency for people with HIV/AIDS recently began offering free screenings for syphilis, gonorrhea, and chlamydia, courtesy of a grant from the Elton John AIDS Foundation.
Positive Impact now offers the tests on a walk-in basis to men who have sex with men, with results available at a follow-up visit. The agency also provides free rapid HIV screening with same-day results for men and women. Those needing STD/HIV treatment will be referred to partner agencies.
"We are now able to assess for potential high-risk behaviors in clients, and engage those clients simultaneously through both HIV and STD screening, and then make appropriate referrals into one of several of the agency's HIV prevention programs," said Danny Sprouse, Positive Impact's prevention director. "We believe that the effectiveness of the combined STD screening, HIV testing and the additional prevention programs will be increased because of this unique opportunity, thanks to the Elton John Foundation."
For information about testing hours, visit http://www.positiveimpact-atl.org/ and follow the M.I.S.T.E.R. Project menu.
   NEWS BRIEFS SOUTH CAROLINA: S.C. Lawmakers Ponder Plan to Eliminate Health Cuts Associated Press (03.15.10) - Tuesday, March 16, 2010 As the state House continues debating a $5 billion budget for the coming year, lawmakers are discussing a measure that would avoid all cuts to health and medical programs. The House hopes to use almost $200 million in federal Medicaid funds to eliminate planned reductions to prescription drug programs and the Department of Disabilities and Special Needs, Rep. Tracy Edge (R-North Myrtle Beach) said Monday. The proposed spending plan, Edge said, would fund those efforts, reverse a $10 million cut to drug programs that would have limited patients to a maximum of three prescriptions per month, and continue paying for HIV/AIDS drugs.
FLORIDA: Perdido Bay Tribe to Join National Native HIV/AIDS Day Pensacola News Journal (03.13.10) - Tuesday, March 16, 2010 Friday is designated National Native HIV/AIDS Awareness Day, and representatives from many of Florida's 307 Native tribes, bands, and clans are expected to take part in a rally at the state Capitol. The Bureau of HIV/AIDS will host the gathering, and its director is to receive a special proclamation from Chief Bobby Johns Bearheart. The public is invited to attend the 11 a.m. event, which will feature drummers and dancers. The day is set aside to encourage awareness of the HIV/AIDS threat to American Indians, Alaska Natives, and Native Hawaiians. For more on the national commemoration, visit http://www.hhs.gov/aidsawarenessdays/days/native/index.html.
FLORIDA: Candlelight Vigil on March 18 for HIV/AIDS Victims Vero Beach Press (02.26.10) - Tuesday, March 16, 2010 A candlelight vigil to raise awareness about HIV/AIDS and its local impact will be held at 7:30 p.m. on March 18 in the Memorial Garden of the Universalist Fellowship of Vero Beach. "This evening we will recall friends and loved ones whose lives have been changed and sometimes ended by HIV/AIDS, as well as showing our support for individuals and communities affected now," said the Rev. Maureen Killoran, interim pastor. "Although this is a heart-focused vigil, we will also provide information about the local situation and how individuals might be able to help." The event is the result of efforts on behalf of the HIV/AIDS Awareness Network, whose motto is "Pass the message, not the disease." The church is located at 16th Street and 27th Avenue. Telephone 772-778-5880 for more information.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

UNAIDS and Private sector meet to explore collaboration towards virtual elimination of mother-to-child transmission

UNAIDS - 16 March 2010

http://www.aegis.org/news/unaids/2010/UN100321.html

On 15 March 2010, UNAIDS Executive Director, Michel Sidibe met with more than 15 private sector companies affiliated with the Global Business Coalition on AIDS, Tuberculosis and Malaria (GBC). Mr Sidibe highlighted UNAIDS' priorities for 2010-11 and reiterated his call for the virtual elimination of mother-to-child transmission by 2015.

Across the world, each year more than a million pregnant women risk passing along HIV to their child. In 2008, approximately 45% of pregnant women known to be living with HIV received antiretroviral drugs to prevent HIV transmission to their children.

"Ending mother-to-child transmission is everyone's business and I urge the private sector to leverage their core competencies, resources and advocacy muscle to prevent all babies from becoming infected with HIV" said Mr Sidibe.

The impact of AIDS on the labour force impacts both the public and private sectors. The epidemic is eroding productivity at a time developing countries need to become more competitive to cope with rapid globalization. In the private sector, this raises the costs of doing business and deters investment.

The virtual elimination of mother-to-child transmission would tackle one of the three ways of transmission of HIV (sexual, blood related and vertical). It also represents a positive difference on the health of women and children contributing to Millennium Development Goals 4, 5 and 6. Above all, it is doable in a business time frame i.e. by 2012 in the 13 highest burden countries and globally by 2015.

UNAIDS is convinced that mother-to-child transmission is an issue that the private sector can effectively tackle. The private sector has core competencies which can be of use: financial and accounting skills, technical know-how, understanding of communications products, marketing and selling of products and services, and valuable knowledge to reach and change opinions and behaviours of large number of people.

The meeting included companies such as Abbott, BD, Boehringer Ingelheim, Bristol-Myers Squibb, Booz & Co., Colgate-Palmolive, Johnson & Johnson, Mylan, the National Basketball Association, OraSure, Pfizer, Premier Medical Corporation, Spike DDB, Standard Bank, Standard Chartered Bank, Unilever and Vestergaard.

"As we move into an era which is shaped by new and unexpected resource challenges and which prioritizes more sustainable responses to HIV and other global health challenges, it is more important than ever that we are all part of a unified team," said John Tedstrom, President & CEO of GBC. "Our partnership with UNAIDS generally and our joint commitment to combating mother-to-child transmission of HIV expressed in today's meeting is part of the Coalition's effort to ensure alignment on all our global health priorities."

Several international companies have made public and global commitments in support of virtual elimination of Mother-to-Child Transmission of HIV. Johnson & Johnson in South Africa, Bristol-Myers Squibb, Bayer College of Medicine in Africa, Boeringer's Viramune donation programme to developing countries, and Chevron in Angola.

The meeting laid an effective platform to develop a follow-up plan for the development of public-private partnerships in order to strengthen the AIDS response. Over the next 24 months, UNAIDS, GBC and their partners will intensify efforts to save mothers and babies as an achievable and inspirational step toward helping countries achieve their universal access goals to HIV prevention, treatment, care and support.

Resources:

Policy and guidance:

Prevention of mother-to-child transmission of HIV - Umbrella policies - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance/UmbrellaPolicies/Prev_mother_Umbrella_Policies.asp  

Related information:

Partnership with private sector - http://www.unaids.org/en/Partnerships/Private+sector/default.asp  

Feature stories:

New UN-business website to bring about private sector partnerships (29 January 2010) - http://www.aegis.org/news/unaids/2010/UN100113.html  

Business coalitions on AIDS strengthen the private sector response to AIDS in Asia (23 November 2009) - http://www.aegis.org/news/unaids/2009/UN091119.html  

Private sector in West and Central Africa explore strategic partnerships for improved health outcomes (27 October 2009) - http://www.aegis.org/news/unaids/2009/UN091019.html  

Public-private partnerships strengthen health systems and AIDS response (27 July 2009) - http://www.aegis.org/news/unaids/2009/UN090726.html  

Coalition of global business gathers to turn knowledge into action on AIDS (23 June 2009) - http://www.aegis.org/news/unaids/2009/UN090622.html  

External links:

Global Business Coalition on AIDS, Tuberculosis and Malaria web site - http://business.un.org/en  

Publications:

UNAIDS Guidelines for working in partnership with the Private Sector (pdf, 38.8 Kb.) - http://data.unaids.org/pub/Manual/2007/unaids_guidelines_august2007_draft4_en.pdf

Partnerships with the Private Sector: A Collection of Case Studies from UNAIDS (pdf, 1.35 Mb.) - http://data.unaids.org/pub/Report/2007/unaids_private_sector_case_studies_en.pdf
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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

HIV Vaccine Strategy Expands Immune Responses: Mosaic vaccines show promise in reducing the spread of deadly virus

PRNewswire - March 15, 2010

http://www.aegis.org/news/pr/2010/PR100318.html 

LOS ALAMOS, N.M., March 15 /PRNewswire-USNewswire/ -- Two teams of researchers -- including Los Alamos National Laboratory theoretical biologists Bette Korber, Will Fischer, Sydeaka Watson, and James Szinger -- have announced an HIV vaccination strategy that has been shown to expand the breadth and depth of immune responses in rhesus monkeys. Rhesus monkeys provide the best animal model currently available for testing HIV vaccines.

The research appeared in two back-to-back articles in Nature Medicine this week, and outlines a strategy, called "mosaic vaccines," for reducing the spread of HIV, the virus that causes AIDS.

HIV is an extremely variable virus. One of the most daunting challenges for developing an effective HIV vaccine is designing one that stimulates immune responses that will protect an individual from the highly diverse spectrum of strains of the circulating virus. The mosaic vaccine design uses computational methods developed at Los Alamos to create small sets of highly variable artificial viral proteins. These proteins, in combination, provide nearly optimal coverage of the diverse forms of HIV circulating in the world today.

In one of the two papers, Dr. Dan Barouch of Beth Israel Deaconess Medical Center at Harvard University reported very promising results when HIV mosaic vaccines were embedded in specialized vectors -- organisms that transmit pathogens to a host -- that were designed in his laboratory specifically to make strong "Killer T cell" responses. Killer T cells enable our immune system to recognize and kill virally infected cells, and they help clear or contain viral infections.

When this vaccine was used to immunize rhesus monkeys against HIV-1, the most predominant and transmittable type of the virus, the researchers observed up to four-fold improvement in the monkeys' immune response to HIV-1, compared with natural vaccine strains similar to those that have been used in the past. In the other, complementary study, Drs. Norman Letvin and Sampa Santra, also affiliated with the Beth Israel Deaconess Medical Center, and Dr. Barton Haynes of Duke University, used a distinct HIV mosaic vaccine construct that stimulated an immune response emphasizing "Helper T cells" -- the kinds of cells required to stimulate and control many aspects of an immune response. This study also showed an increased breadth and depth of anti-HIV immune responses to the vaccine. Both approaches demonstrated that mosaic vaccines improve the immune response against genetically diverse HIV-1 viruses.

"This research indicates that mosaic vaccines represent a promising strategy to expand coverage for genetically diverse pathogens such as HIV-1," Korber said. "The next step is to see whether the improved immune response found in Rhesus monkeys will hold up in humans, so small-scale human safety and immune response studies are being launched at Harvard and at Duke to explore that possibility."

About Los Alamos National Laboratory (www.lanl.gov)

Los Alamos National Laboratory, a multidisciplinary research institution engaged in strategic science on behalf of national security, is operated by Los Alamos National Security, LLC, a team composed of Bechtel National, the University of California, The Babcock & Wilcox Company, and URS for the Department of Energy's National Nuclear Security Administration.

Los Alamos enhances national security by ensuring the safety and reliability of the U.S. nuclear stockpile, developing technologies to reduce threats from weapons of mass destruction, and solving problems related to energy, environment, infrastructure, health, and global security concerns.

Source: Los Alamos National Laboratory

CONTACT: James E. Rickman of Los Alamos National Laboratory, +1-505-665-9203, jamesr@lanl.gov

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Copyright © 2010 - PRNewswire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through PRNewswire, Permissions, 810 Seventh Ave., 32nd Floor, New York, NY 10019  http://www.prnewswire.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.