Estimating the Risk of HIV Transmission from Homosexual Men Receiving Treatment to Their HIV-Uninfected Partners

The current study was designed to determine how the risk of transmission from HIV-infected gay men receiving antiretroviral treatment relates to patterns of patient monitoring and condom use.

A stochastic mathematical simulation model was developed of Netherlands men who have sex with men (MSM), defining the parameters of the model using observational cohort data. Included in the model are viral load trends during first-line treatment, patient monitoring and various scenarios for the way in which condom use may depend on recent viral load measurements. Not included was the effect of STDs on HIV transmission.

The results showed that for MSM receiving treatment, the risk of transmitting HIV to their long-term partner is 22 percent (uncertainty interval: 9-37 percent) if condoms are never used. With incomplete condom use (30 percent of sex acts), the risk is reduced to 17 percent (7-29 percent). When men receiving treatment use condoms only six months beyond their last undetectable viral load measurement, the risk is as low as 3 percent (0.2-8 percent). "The risk is further reduced when three months is the time period beyond which condoms are used," the authors wrote.

The authors stressed the following messages:
*"Intermittent use of condoms by men receiving treatment offers relatively little reduction in the chance of transmission to their partner.

*In contrast, the chance of HIV transmission can be substantially reduced if condoms are used when the last undetectable viral load measurement was not within the past three months.

*Frequent viral load measurement can maximize the potential for treatment to reduce HIV transmission."

"When condom use by HIV-infected men receiving combination treatment with antiretroviral agents is based on their last viral load measurement, the transmission risk is much lower than with incomplete condom use. The key message for patients is that although always using condoms during treatment is the best way to protect partners from the risk of HIV transmission, when such use cannot be achieved, the second-best strategy is to use condoms whenever the last undetectable viral load was measured more than three months ago," the authors concluded.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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AIDS Drug Program Has Shortfall Crisis

Florida's AIDS Drug Assistance Program (ADAP) scarcely escaped a $14 million financial crisis this month that would have seen thousands of patients go without their medication for up to two months, according to AIDS activists.

ADAP is being pressed by high unemployment and increasing numbers of people without insurance and patients who are surviving longer. "We are clearly in crisis mode and we don't know how to get this fixed," said Dr. Michael Kolber, the University of Miami's Comprehensive AIDS Program director. AIDS advocates worry the crisis will repeat itself next year.

According to Tom Liberti, who heads the Florida Department of Health's Bureau of HIV/AIDS, state officials foresaw the crisis last spring when 11,000 residents were on the ADAP rolls and the program had a budget of $94 million. Similar to other states, Florida declined new clients and began a waiting list - 6,236 remain waitlisted throughout the United States as of Feb. 10, over half in Florida, according to the National Alliance of State & Territorial AIDS Directors (NASTAD).

"Three thousand people on a waiting list doesn't sound like much, but the thing is it will cost the health care system more money and lives are at stake," Kolber said of Florida's situation.

Some 6,500 Florida ADAP clients are being temporarily transitioned to a program run by the South Carolina-based, non-profit pharmacy Welvista. Through its pharmaceutical contacts, Welvista will supply free medication. The goal is for the plan to sustain Florida's ADAP customers until federal funding starts again April 1. However, drug companies are not legally bound to stopgap individuals' needs and states' financial crises.

"We don't see this as a wave of the future. It's not sustainable," said Murray Penner, NASTAD's deputy executive director who helped broker the Welvista deal.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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US May Pay for Sex Disease Tests for Elderly

The Centers for Medicare and Medicaid Services (CMS) announced Thursday it is mulling the inclusion of certain STD tests for seniors and the disabled. Medicare currently covers HIV testing, but may include screening for diseases like syphilis and hepatitis B in its push toward preventive treatment.

Life expectancy in the United States has increased - approximately 39 million Americans age 65 or above are insured by Medicare, along with 7.6 million disabled - and studies show larger numbers of the elderly are sustaining active sex lives.

According to public health officials, early STD detection and prevention lowers costs by circumventing problems stemming from postponed care, as well as the transmission of disease to others.

CMS has been able to provide preventive coverage since 2009, and already includes pap smears, pelvic exams, and screening for colorectal cancer and diabetes. Most STD tests under consideration are for women and some are particularly for pregnant women, who are included in Medicare's disabled beneficiaries.

Medicare is deliberating including examinations for:
*chlamydia in sexually active or pregnant women 24 and under, or for older sexually active or pregnant women at higher risk.

*gonorrhea in all sexually active or pregnant women at increased risk.

*hepatitis B in pregnant women.

*syphilis in all males and females at high risk.

*intense behavior modification therapy for sexually active youth and adults at high risk for STDs.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Cleaning Vagina Linked to Increased HIV Risk, Study Finds

Data culled from 13 studies of 14,874 sub-Saharan African women, 791 of whom ended up HIV-positive, found that those cleaning, tightening or drying their vaginas using soap, cloth or paper were more at risk for contracting the virus, according to a new study.

When controlled for factors such as age, marital status, and number of sexual partners within the last three months, the study authors discovered women using cloth or paper for intravaginal cleaning were approximately 1.5 times more susceptible to HIV, and 1.25 times more susceptible if they used soap. In addition, those using soap were vulnerable to bacterial vaginosis or a disruption in the ordinarily healthful balance of vaginal microbes that stave off sickness.

Although study authors were unsuccessful delineating an express causal connection between the hygiene habits and the virus, they theorized that the women's vulnerability to HIV increased when they compromised their vaginas' safeguarding mucus, triggered inflammation or other harm, or altered the vagina's acid levels, which all increase its vulnerability to detrimental microorganisms.

The study, "Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual Participant Data Meta-Analysis," was published in PLoS Medicine (2011;doi:10.1371/journal.pmed.1000416).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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A First in Sub-Saharan Africa: Methadone Maintenance Program

Tanzania's Muhimbili Hospital in Dar es Salaam has become home to sub-Saharan Africa's first methadone clinic. It is being financed by the US President's Emergency Plan for AIDS Relief, created by former President George W. Bush.

Heroin use has recently increased in Tanzania, in part because its harbors are used to transport the drug, primarily from Afghanistan to Europe. The country now has upwards of 25,000 injection drug users, 40 percent of them HIV-positive, said the San Francisco-based Pangaea Global AIDS Foundation, which is advising Tanzanian officials on the clinic.

Last year, an American researcher reported Tanzanian drug users engaging in "flashblood," where users inject each other with their blood to share intoxication.

Methadone is more addictive than heroin, though it will be distributed in oral doses too low to get high. The American Embassy in Tanzania has said it is "fully aware that challenges will likely be encountered whilst services are being established."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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AIDS Activists Call on Public to Support New FDA HIV Drug Approval Policy

The AIDS Treatment Activists Coalition (ATAC) is asking people to sign on to a letter in support of a proposed U.S. Food and Drug Administration (FDA) policy that will hopefully make it easier for drugs to be approved for heavily treatment experienced people.

The new guidance under review at the FDA is aimed at helping companies overcome a significant hurdle in HIV drug development: proving that a new drug is effective given the potency of existing drugs.

New drugs with potential for treatment-experienced patients are typically pitted against a placebo, with both the experimental drug and placebo combined with background regimens consisting of approved drugs that may fight a person’s HIV. This study design worked relatively well in the past, because many people had fewer than two other active drugs in their background regimens and, in turn, it was easier to prove the benefits of a new drug compared with placebo in a relatively short period of time.

Today, given the range of potent treatment options, most background regimens studied in trials are highly effective. In turn, it can take many months to determine the efficacy of an experimental treatment, despite the fact that earlier studies not requiring background regimens suggest that the new agent works well against drug-resistant HIV.

What’s more, many researchers believe it is unethical to use a background regimen that has been optimized to achieve maximal viral suppression. Doing so substantially increases the likelihood of rapid resistance to the new agent.

“Demonstrating the superiority traditionally required by the agency to prove effectiveness is now virtually impossible without conducting trials in treatment-experienced patients whose virus is not fully suppressed,” explains Lynda Dee, from AIDS Action Baltimore, in her letter on behalf of ATAC.

The letter goes on to explain that “Vicriviroc, a once daily CCR5 inhibitor, and apricitabine…have recently failed to demonstrate the efficacy necessary for FDA approval even though both drugs would certainly have been a valuable addition for treatment experienced patients.”

That’s where the new guidance comes in. In the proposed trial design, the experimental drug would be given to people on top of their failing regimen for a week or two, just to measure how much it was able to reduce virus on its own. At the end of the initial trial period, people would add a new active background regimen, allowing researchers to assess the longer-term durability and safety of the experimental agent without placing people at undue risk of developing resistance to the new drug.

ATAC is also asking that the FDA shorten the duration of studies required to grant full agency approval of a new drug for heavily treatment-experienced people. Rather than granting accelerated approval after 24 weeks of study data, and then full approval after 48 weeks, ATAC is asking the FDA to begin granting full approval with only 24-week studies. The group believes that older studies have documented that rates of viral suppression at 24 weeks have always held up well enough over 48 weeks that the additional time under study is no longer necessary, though continuing post-approval safety would need to be explored.

“We firmly believe that this new paradigm will ensure ethical expedited trial design with lifesaving new drugs for treatment-experienced patients [who have] limited or no available options by providing a reasonable and prudent pathway in which to develop new ARV drugs in the HAART era,” Dee concludes.

To sign on in support of these new regulations, please visit: http://www.thepetitionsite.com/1/community-support-for-new-hiv-fda-clinical-trial-proposal.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Free In-Home Kits Help Encourage STD Testing in Young People

Public health officials nationally and in cities including Baltimore are using the Internet to address STD testing barriers among teens and young adults. Youths are accessing chlamydia, gonorrhea, and trichomoniasis testing through the "I Want the Kit" (IWTK) program, which serves to eliminate concerns about cost, confidentiality, and stigma.

Developed by Johns Hopkins University and supported by government grants, IWTK already serves people in Maryland, Washington, West Virginia, parts of Illinois and in Denver and Philadelphia. People can order free in-home testing kits from the website, www.iwantthekit.org, through Facebook or via a smartphone application that can read barcodes on IWTK brochures, which are distributed in schools and clinics. Kits mailed in plain envelopes include the swab, a questionnaire, STD information, and a consent form. Patients can access results by telephone in two weeks, using a unique identification number and passcode.

About 43 percent return the swab, yielding positive rates of up to 13 percent depending on gender and STD. Half of the 3,500 IWTK clients have been under age 23, and some have been repeat clients. Those testing positive are given local referrals for treatment, and almost everyone goes to the appointment, a scheduler says.

The number of people using IWTK should go up in April, STD Awareness Month, following federally funded newspaper and radio campaign, said Dr. Charlotte A. Gaydos, an infectious-disease professor at Hopkins who helped design IWTK. Each kit costs about $65-70, including postage, testing, and labor.

In Baltimore, schools encourage STD testing at their clinics, said Sherry Ketemepi, the city's assistant commissioner for clinical services. City health officials also sought and gained state permission to join CDC's Expedited Partner Therapy program to help treat the partners of patients with gonorrhea and chlamydia.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Senate OKs Bill to Let Pharmacies Sell Syringes

By a 28-12 vote, the New Jersey Senate on Thursday approved a measure that would allow pharmacies to sell up to 10 syringes without a prescription. Adults with a prescription could purchase more than 10 syringes. The bill, S 958, now heads to the Assembly for consideration.

Public health and drug reform advocates say such legislation can help slow the spread of HIV. According to Roseanne Scotti, director of the Drug Policy Alliance of New Jersey, at least 40 percent of the 74,000 HIV/AIDS cases reported in the state are linked to injection drug use. "This legislation will cost the state nothing and will save lives and taxpayer dollars," said Scotti.

"New Jersey is one of only two states in the entire nation where the sale of clean needles and sterile syringes is restricted under law," said S 958's co-sponsor, Sen. Loretta Weinberg (D-Bergen). "We have to look at this issue with an open mind, absent moral judgment, and recognize that what drug addicts need most in New Jersey is access to clean, safe needles and treatment to help beat their addiction."

Under the measure, pharmacies must supply syringe purchasers with English- and Spanish-language information on proper disposal of used needles as well as contact information for addiction treatment services.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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New Study Says HIV Vaccines Might Not Need to Produce Protective Blood Antibodies

new study suggests that an HIV vaccine could protect against sexual transmission of the virus without producing protective antibodies in the blood—instead, the virus would provoke the body to produce mucosal antibodies in the vagina and rectum. These findings, published online February 10 in the journal Immunity, open up new avenues of HIV vaccine research.

Most traditional vaccines work in the same way: a killed, modified or fragmented version of an infectious organism is delivered to the body, prompting the immune system to quickly produce antibodies in the blood that are able to bind to and destroy the organism if it is encountered in the future. Vaccine research in HIV, however, has largely been a bust.

For one thing, scientists have yet to identify a naturally occurring model of protection against HIV, so it’s been difficult to figure out what types of antibodies would be most likely to protect people against infection. What’s more, even if we knew what types of antibodies were most desirable, we would also need to understand the required potentency of the antibody response (in other words, how many antibodies must be present in the blood) in order to protect against infection.

Now, however, a new study has turned that thinking on its head. Rather than focus on the production of antibodies in the blood, we should look at whether a vaccine can provoke the production of HIV-protective antibodies in the anatomical sites most commonly tied to infection—the vagina and the rectum—says Morgane Bomsel, PhD, from the Institute Cochin in Paris.

Bomsel and her colleagues were intrigued by documented cases where people have stubbornly resisted HIV infection despite repeated high-risk exposures—all without producing antibodies to the virus in the blood. In such cases, researchers found evidence of antibodies in mucosal tissue, specifically an antibody called IgG.

To determine whether a vaccine delivered intranasally (via the nose) or intramuscularly (via injections) could prompt the body to produce these mucosal antibodies, Bomsel’s team gave a gp41 vaccine to five macaca mulatta moneys and a placebo to six others. All of the monkeys were then exposed vaginally to the monkey version of HIV, called simian immunodeficiency virus (SIV), and followed for six months.

The results were in line with the researchers’ hopes. All five vaccinated monkeys failed to become infected with SIV, and all five produced both IgG in mucosal tissue as well as another mucosal antibody called IgA. Whereas the mucosal antibodies blocked a pathway that HIV uses to enter the mucosa, the antibodies in the plasma of these animals completely lacked the ability to neutralize the virus.

Meanwhile, all six of the monkeys who received a placebo became infected with SIV.

The authors caution that further study will be necessary to confirm their results.

“Our results clearly challenge the paradigm that mucosal protection requires significantly high levels of antibodies with virus neutralizing capacity in the blood,” said Bomsel in a release.

“These findings may help to explain why a small population of highly exposed, but HIV-negative, women who exhibit gp41-specific IgA in their vaginal secretions are protected from infection. We may have been able to recapitulate in a vaccine what a few individuals do naturally,” she concludes.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Math Wizards Develop New HIV Drug Candidates

Using a blend of high-level math and chemical engineering, a team of researchers at Princeton University has discovered several new drugs that their colleagues at Johns Hopkins University in Baltimore say are potent against HIV. Their process for finding new drugs against diseases, outlined in a paper published online November 17 in Biophysical Journal, could significantly speed up the laborious task of searching for and testing promising chemical compounds.

Discovering a new drug is time-consuming and expensive. Typically, companies physically test their libraries of millions of chemical compounds against a biological target to look for activity. This process, if researchers are lucky, yields perhaps a half- dozen candidates. Yet it is only the first step in the process, as these candidates must not only be active against the virus or bacteria in question, but also be judged safe for humans to take—and be easily made into a pill or injectible solution. This can mean spending years and millions of dollars and ending up with no viable treatment options.

Now a doctoral student at Princeton, Meghan Bellows-Peterson, and the head of her lab, Christodoulos Floudas, PhD, are publicizing their work with noted Johns Hopkins AIDS researcher Robert Siliciano, MD, PhD, to discover and test new compounds that are similar to the HIV drug Fuzeon (enfuvirtide), but possibly more potent, cheaper to make and easier to take.

Using a combination of two forms of math and engineering—optimization theory and computational biology—Bellows-Peterson and her team calculated which of the long strings of amino acids (called peptides) in Fuzeon were most likely responsible for keeping the virus from fusing with, and entering, CD4 cells.

“The actual mechanism for [HIV] entering cells is still uncertain, but there is a lot of evidence that points to [a specific] structure on the virus,” Bellows-Peterson said. “We used the available data on the proteins that form the structure to help us predict what kind of drug might be effective against the virus.”

Reasoning that a string of peptides shorter than the 36 that make up Fuzeon would be cheaper to make and much less fragile in the body (perhaps leading to better dosing options than the twice-daily injections required for Fuzeon), Bellows-Peterson and her colleagues calculated the likelihood of millions of other peptide configurations to stop HIV entry. They found five promising candidates, each of which has strings of peptides that are two thirds shorter than Fuzeon.

The team next worked with Siliciano and his colleagues to make and test the new peptides against actual virus in the lab and found one that is particularly potent against HIV, even against HIV that has become resistant to Fuzeon.

Floudas’s lab is interested in seeking drugs based on even shorter strings of peptides, which could possibly be taken as oral drugs. While this approach could take years to produce a viable new treatment option for HIV, the success in proving its potential could open up a quicker and cheaper way to bring new drugs to the market.

“One could never test all the possible peptides to see if they are effective against HIV,” Floudas said. “But this model was able to sort through millions of possibilities and identify just a few that show promise.”

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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HIV Patients Out of Drugs, Harassed in Ukraine

Drug supply chains in Ukraine have been disrupted by corrupt government officials, threatening the provision of antiretroviral (ARV) medicines to HIV/AIDS patients, say advocates. Furthermore, government investigations of addicts on methadone therapy and of AIDS organizations risk exacerbating the country's HIV epidemic, they claim.

Some 1.3 percent of Ukrainians age 15 and older, or 360,000 people, are HIV-infected, the highest rate in Europe, UNAIDS data show. ARV treatment is run by the government, which funds about 60 percent of Ukraine's AIDS budget; the remainder is provided by international donors such as the Global Fund to Fight AIDS, TB and Malaria.

Prior to supply disruptions that began two months ago, just 20,000 of 93,000 people with AIDS or on the verge of developing it were receiving ARVs. Now even these patients are having difficulty accessing their medicines, activists say.

According to AIDS groups, the supply problems stem from officials demanding kickbacks from suppliers. "Corruption at the Health Ministry costs people their lives, and what is even more scary, children's lives," said Dmytro Sherembey of the All-Ukrainian Network of People Living with HIV. ARVs are procured at five to six times the market rate, due to middlemen who can charge higher prices thanks to their government connections, he alleged.

Last week, the Global Fund said a $305 million, five-year grant to Ukraine is in jeopardy if the government does not restore ARV supplies and stop its harassment of HIV-positive drug users and the non-governmental groups trying to help them.

Government officials acknowledge hiccups in procuring ARVs, but downplay any supply problems, saying the delays have actually allowed them to invite new bidders and lower drug costs. And they defend investigations of drug users. Interior Minister Anatoly Mohilyov said he is collecting personal information about addicts "because these people are from a risk group and we must know about them."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Teens Ask for More Sex Education, Greater Condom Availability

Hundreds of Boston teens met with officials in City Council chambers recently for a hearing requesting strengthened public high school sex education and condom distribution policies.

Councilor Ayanna Pressley, who convened the hearing, noted that the only controversial aspect of the meeting would be "not taking action .. It would also be cowardly." Harvard graduate student Maggie McLean disagreed. McLean, a member of the Catholic non-profit Pure in Heart, noted the widespread "hookup culture" of current high schoolers needs to be balanced by the provision of "tools to resist a culture of casual sexual activity." "Don't [just] say, 'Be safe. Here's a condom,'" said McLean.

A comprehensive sex education class covering the cultivation and maintenance of healthy relationships, spotting unhealthy relationships, and discussing sexual identity issues is precisely what Snowden International School senior Hung Nguyen is seeking. "They are focusing on 'Don't have sex or don't get pregnant.' There's more to it than that," said Nguyen, whose comments were echoed by several teen attendees.

According to the Boston Public Health Commission, 54 percent of city high school students are sexually active and more than half with multiple partners. Furthermore, BPHC reported that in 2007, chlamydia saw a 70 percent increase over 1999 numbers in teens 15-19. The city makes condoms available at nine high schools with community health centers, though service delivery and quality are inconsistent.

Boston Public Schools Health Education Program Director Barbara Huscher-Cohen said a collaborative of students, nurses, and social workers is drafting a new health education curriculum. The curriculum addresses sex education, and collaborators have already made nine recommendations, three of which are already in progress, said Huscher-Cohen.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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China Aims to Bring AIDS Spread Under Control by 2020

China has set 2020 as a goal to control the spread of AIDS within its boundaries, despite ignorance of how to prevent HIV and ineffective policies in some parts of the country, said the government on Wednesday.

According to Ministry of Health and UN estimates, China had between 560,000 and 920,000 HIV-positive people, and 97,000-112,000 AIDS patients in 2009.

"AIDS prevention work is a complex and long-term task," said the central government on its website. However, "experience at home and abroad proves it can be prevented and controlled."

As part of the goal, China plans to stem the escalation of cases in key areas and among certain populations by 2015. The government will bolster information campaigns, more widely distribute condoms publicly, and continue its efforts to reign in prostitution. Additional attention will also be paid to identifying those infected with the virus, the statement continued, noting that monitoring and testing measures will be implemented.

China's HIV/AIDS problem became critical in the 1990s when hundreds of thousands of poor farmers contracted the virus through bungled blood-buying scams. Initially reticent, China has in recent years heightened its HIV/AIDS fight, with senior leaders publicly meeting AIDS patients to combat pervasive stigma and discrimination.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Laws Obstruct Progress on HIV/AIDS Front in Asia, UN Says

Thirty years into the AIDS epidemic, 90 percent of the countries in the Asia-Pacific region still obstruct the rights of people with or at risk for HIV, said Michel Sidibe, executive director of UNAIDS.

"In the Asia-Pacific region, and across the world, there are too many examples of countries with laws, policies, and practices that punish, rather than protect, people in need of HIV services," Sidibe said. Same-sex relations and prostitution are illegal in 19 and 29 Asian countries, respectively, UN experts note. Several countries in the region continue to incarcerate drug addicts, while 10 sentence serious drug offenders to death.

The Global Commission of HIV and the Law, established last year by the UN as a vehicle for discussing HIV-related legal and human rights issues, will convene in Bangkok on Thursday. An estimated 150 experts from 22 countries are expected to attend the conference, which will focus on legal obstacles to widespread access of antiretroviral drugs (ARVs) in Asia.

Thailand, home to an estimated 600,000 people with HIV/AIDS, most who cannot afford ARV drugs, has been heavily criticized by the US, the EU, and various multinational pharmaceutical companies for breaking intellectual property rights laws in 2006 and 2007. Known as compulsory licensing, the breach makes importing cheaper, generic ARV drugs from India possible.

Even though the practice is sanctioned by the World Trade organization in public health emergencies, Jon Ungphakorn, a former Thai senator, said at least one-third of the people living in developing countries who need ARVs are not receiving them.

"Even now the European Union is negotiating a new trade agreement with India which may result in making it more difficult for India to produce generic drugs that are saving lives in developing countries," said Jon, who helped lead Thailand's decision to enforce compulsory licensing.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Silent STD on the Rise in Pennsylvania, Data Show

Reported chlamydia cases in Pennsylvania have more than doubled since 1998 to 47,521 in 2010, provisional state Health Department data show, despite a requirement that public high schools provide health education and regular messages to abstain or practice safe sex.

Chlamydia's rise is most pronounced among people ages 15-24, state and local health officials say. As of 2007, nearly three-quarters of cases statewide were in that age group. "That's who we're focusing on," said Steve Kowalewski, senior public health adviser for the STD program at the state Health Department. The main drivers of the bacterial infection are unprotected sex and multiple sex partners, he said.

Many people with chlamydia are unaware of their infection, since the STD is often symptomless. Because of that, chlamydia is "seriously" underreported, said Allentown Health Bureau Director Vicki Kistler.

Kowalewski said Pennsylvania's rise in chlamydia "is a true increase in the disease burden" and is not a reflection of better detection.

All sexually active young people should get tested annually for STDs, say doctors.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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New York City Launches iPhone Condom-Finder App

The New York City Department of Health and Mental Hygiene (DHMH) released a mobile phone application on Monday, Valentine's Day, to make finding free condoms easier. Based on the phone's location, the NYC Condom Finder "app" identifies and lists nearby condom distribution points and provides directions to them.

"You all call it Valentine's Day, we all call it National Condom Awareness Day," said Dr. Monica Sweeney, the agency's assistant commissioner for the Bureau of HIV Prevention and Control. "When the mind turns towards the heart . it often ends up turning towards sex. Then you need our product." The Condom Finder application is available through the Android Market or Apple's iPhone App Store.

DHMH has distributed free condoms since 1971, and it currently has 3,000 distribution points across the city. While the agency's website lists the venues, the mobile app makes taking preventive measures more convenient and up-to-date.

"We don't want not having access to be the barrier, we want condoms to be [the] barrier," said Sweeney. "What we're doing is working to make New York City the safest city in the world to have sex."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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'World's Most Ambitious HIV Testing Campaign' Launched

"First Things First," a new university-based HIV testing campaign launched Monday, is the latest initiative encouraging South Africans to know their serostatus. The public-private partners who are leading the campaign say behavior changes in young people are needed if the country is to successfully tackle HIV/AIDS.

Students should have their "first HIV test in the first weeks of first-year student life at university," said Val Beaumont, executive director of Innovative Medicines of South Africa, which joined with the government to develop the campaign. Other partners include the US President's Emergency Plan for AIDS Relief, the South African National AIDS Council, the Foundation of Professional Development, the Higher Education HIV and AIDS Program, and Higher Education South Africa.

"Knowing your status is not the only prevention strategy, but it is the most important intervention," Health Minister Aaron Motsoaledi said at the campaign's launch at Witwatersrand University. "We chose to reach out to students as they are our future leaders who can enable positive change within society."

Motsoaledi said 250 staffers from participating organizations have been trained to test students on an ongoing basis, "ensuring a lasting legacy of testing in tertiary institutions beyond the life of the campaign." Those who undergo voluntary testing are asked to sign a pledge that reads: "We, the class of 2011, pledge to know our status, to stop the HIV/AIDS stigma and to contribute to the struggle against HIV/AIDS." Testers will also view a 30-minute DVD as part of the pre-counseling process.

"First Things First" is part of what Beaumont called "the most ambitious HIV testing campaign in the world" - a nationwide effort to test 15 million South Africans by June 2011.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Foes Seek to De-Fund, Discredit Planned Parenthood

US Rep. Mike Pence (R-Ind.) has introduced a bill that would deny federal family planning funds to any organization that performs abortions, placing the more than $70 million Planned Parenthood receives annually in jeopardy. Though Title X funds cannot be used directly for abortions, Pence maintains the grants free up other funds such groups use to offer the procedure.

Lending momentum are the recently published, covertly taped videos showing a man posing as a pimp and a woman posing as a prostitute seeking health services for underage sex workers at a half-dozen Planned Parenthood clinics in New Jersey, New York, and Virginia. The tapes were released by the anti-abortion group Live Action. Planned Parenthood officials fired one clinic manager who offered advice to the pair, but said other clinic staffers responded appropriately and reported the visits to their supervisors.

For Planned Parenthood officials, these actions represent the latest attacks on women's ability to get the reproductive health services they choose. "We are a safe place where people can go and ask difficult questions about sex," said President Cecile Richards.

Abortions represent only a small fraction of the Planned Parenthood's services provided. The group primarily offers contraception, STD testing, and cancer screenings, and many of its clients are low-income women who otherwise cannot access non-emergency health care. "We've been here for the past 95 years, and we'll be here for the next 95," said Richards.

With an annual budget of $1 billion, Planned Parenthood could survive a loss of Title X grants, though it would be forced to shutter some clinics and serve fewer clients, said Richards.

On Thursday, Virginia's House of Delegates voted to ban not only state but also local government funding of the organization. Del. Robert Marshall, the measure's sponsor, objects to Planned Parenthood's role in providing abortions and he holds it responsible for broader phenomena like out-of-wedlock pregnancies and adolescent sex and STDs.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Findings in HIV/AIDS and Cytomegalovirus Reported from C.A. Silva and Co-Researchers

Scientists discuss in 'Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature' new findings in HIV/AIDS and Cytomegalovirus. According to recent research from Sao Paulo, Brazil, "Neurological disorders caused by Cytomegalovirus (CMV) in patients with Acquired Immunodeficiency Syndrome (AIDS) are rarely reported in the Highly Active Antiretroviral Therapy (HAART) period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV-related neurological complications in HIV-infected patients admitted to a referral center in Sao Paulo, Brazil."

"CMV disease requires the identification of the virus in the cerebrospinal fluid (CSF) using Polymerase Chain Reaction (PCR). Thirteen cases were identified between January, 2004 and December, 2008. The median age of patients was 38 years and nine (69%) were men. At admission all patients were aware of their HIV status and only four (31%) patients were on HAART. Patients who were not on antiretroviral therapy before admission received HAART while inpatients. CMV disease was the first AIDS-defining illness in eight (62%) patients. The neurologic syndromes identified were diffuse encephalitis (n=7; 62%), polyradiculopathy (n=7; 54%), focal encephalitis (rhombencephalitis) (n=1; 8%), and ventriculo-encephalitis (n=1; 8%). Seven (54%) patients presented extra-neural CMV disease and four (31%) had retinitis. The median of CD4+ T-cell count was 13 cells/L (range: 1-124 cells/L). Overall in-hospital mortality was 38%. Eight patients used ganciclovir or foscarnet (in-hospital morta! lity: 50%) and five patients used ganciclovir and foscarnet (in-hospital mortality: 20%). None of the patients fulfilled the diagnosis criteria of immune reconstitution inflammatory syndrome. Four patients were lost to follow-up, and three patients presented immune recovery and discontinued secondary prophylaxis. Although infrequent, distinct neurological syndromes caused by CMV continue to cause high mortality among AIDS patients," wrote C.A. Silva and colleagues.

The researchers concluded: "Survival depends upon the use of effective antiviral therapy against CMV and the early introduction of HAART."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

HOUSE REPUBLICANS PROPOSE MASSIVE CUTS TO HIV/AIDS PROGRAMS

Washington, DC– “Republicans in the House of Representatives have proposed massive cuts to both domestic and global HIV/AIDS programs that will have severe ramifications to millions of people’s lives both here in the United States and around the world,” commented Carl Schmid, Deputy Executive Director of The AIDS Institute. “While it may help achieve short term goals to reduce federal government spending, this reckless action will have long term impacts on the health and wellbeing of people living with HIV/AIDS and on efforts to prevent HIV infections in the future. In the long run, the costs to society and individual’s lives will be far greater than any short term savings”

“While there is a waiting list of over 6,000 people in ten states to receive lifesaving AIDS medications from the Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP), and thousands more are being removed from the program, the House Republican spending proposal will seriously exacerbate the crisis,” added Schmid. Low income people with HIV/AIDS were counting on an increase of at least $65 million, including continuation of $25 million that state ADAPs received this summer to help reduce the waiting lists. “Not only did the House Republicans erase any funding increase, they failed to continue to fund the $25 million in FY11 and, in effect, will be taking away medications from people. If we have long wait lists now, just imagine what the situation will be like next year with no increases in funding,” he added. Access to early quality care and treatment keep people with HIV/AIDS healthy and free from opportunistic infections, resistance to medications, and away from expensive emergency rooms.

“With over 56,000 new HIV infections annually in the U.S., now is not the time to cut CDC’s prevention funding,” said Michael Ruppal, Executive Director of The AIDS Institute. “We only spend 3 percent of our federal HIV spending on prevention. Cutting CDC’s budget by 15 percent and prohibiting scientifically proven effective prevention programs, such as syringe exchange, will lead to even more HIV infections,” he added. The bill even goes as far as preventing the District of Columbia, a place with one of the highest rates of HIV in the country, from spending its own money on syringe exchange programs. It is far more cost-effective to invest in prevention now rather than paying for care and treatment later. Preventing one infection will save approximately $355,000 in lifetime medical costs. Preventing all the new 56,000 cases in just one year would translate into an astounding $20 billion in lifetime medical costs.

The proposal authored by the House Republicans cuts research funding at the National Institutes of Health by over $1.6 billion. Investing in HIV research will help in the discovery of new medications, new tools in the prevention of HIV, including vaccines, and ultimately a cure.

The bill cuts over $500 million from the U.S. historic humanitarian commitment to treating and preventing HIV in the poorest countries in the world, where the economic downturn has crippled economies and their people.

It also seeks to derail implementation of the Affordable Care Act, which will provide health care to hundreds of thousands of people with HIV/AIDS and millions of others when implemented.

The Friends of AIDS Foundation will continue to monitor this situation and release updated information as it is made available.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

ACTION ALERT - Urge Your Representative to OPPOSE H.R. 1.

The House of Representatives is considering H.R. 1, its budget recommendations for the remainder of FY11. The bill would cut more than $5.7 billion from HUD programs compared to the FY10 enacted level of about $43.5 billion. In addition, the bill would take back more than $394 million from unobligated balances in HUD programs.

The House will begin to consider this legislation tomorrow, Tuesday, February 15. A vote will happen by February 17.

Call your Representative NOW and urge them to OPPOSE H.R. 1.

To speak with your Representative, call the congressional switchboard at 877-210-5351You can also Take Action by visiting: https://writerep.house.gov/writerep/welcome.shtml.

It is critical that your Representative hear from you.

H.R. 1 will:

Cut the public housing capital fund by $1.072 billion, more than 40%, endangering public housing households, more than half of whom are elderly and/or disabled, and more than 40% of whom have children.

NOT increase funding for HUD's homeless assistance programs, a move that would force cuts to existing programs.

Cut Section 202 elderly housing funding from $825 million to $274 million and Section 811 housing for persons with disabilities funding from $300 million to $90 million. Further, none of the programs' remaining FY11 funds could be spent on new units.

Cut the Community Development Fund from $4.45 billion to $1.5 billion. The vast majority of this spending goes to Community Development Block Grants (CDBG).


Additionally, H.R. 1 would eliminate HUD funding for:
the Sustainable Communities Initiative;
Housing counseling;
Native Hawaiian housing block grants;
Brownfields; and
The Energy Innovation Fund.

H.R. 1 would also cut:
USDA Rural Development programs by almost $500 million;
FEMA's Emergency Food and Shelter grants by 50%;
HHS funding for community health centers by 46%;
Community Service Block Grants by 46%; and
the Low Income Home Energy Assistance Program by 66%.

To avoid these massive cuts, your Representative must hear from you .The Senate is next and is expected to take up FY11 spending the week of February 28.

Thank you for your support and action. Pllease forward this information to everyone you know.


Together We Can Make A Difference & Together We Remain Strong!

United in Battling HIV/AIDS: A Guide to Understanding How Faith Communities Can Make a Difference

NASTAD, in collaboration with the HHS White House Office of Faith-Based and Neighborhood Partnerships, National Black Leadership Commission on AIDS, The Balm in Gilead, Inc. and the Latino Commission on AIDS, is pleased to release a fact sheet for faith communities, United in Battling HIV/AIDS: A Guide to Understanding How Faith Communities Can Make a Difference.

As was emphasized in the National HIV/AIDS Strategy, this fact sheet is an attempt to encourage collaboration with faith institutions and provide information and resources for faith communities to initiate, or enhance existing, health and HIV/AIDS activities.

The fact sheet can be viewed by visiting: http://www.friendsofaids.org/additionaltopics.html

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

HHS Announces $750 Million Investment in Prevention

Department of Health and Human Services Secretary Kathleen Sebelius today announced a $750 million investment in prevention and public health, funded through the Prevention and Public Health Fund created by the new health care law. Building on $500 million in investments last year, these new dollars will help prevent tobacco use, obesity, heart disease, stroke, and cancer; increase immunizations; and empower individuals and communities with tools and resources for local prevention and health initiatives.

“Prevention is something that can’t just happen in a doctor’s office. If we are to address the big health issues of our time, from physical inactivity to poor nutrition to tobacco use, it needs to happen in local communities,” said Sebelius. “This investment is going to build on the prevention work already under way to help make sure that we are working effectively across the federal government as well as with private groups and state and local governments to help Americans live longer, healthier lives.”

The Prevention and Public Health Fund, part of the Affordable Care Act, is designed to expand and sustain the necessary capacity to prevent disease, detect it early, manage conditions before they become severe, and provide states and communities the resources they need to promote healthy living. In FY2010, $500 million of the Prevention Fund was distributed to states and communities to boost prevention and public health efforts, improve health, enhance health care quality, and foster the next generation of primary health professionals. Today, HHS posted new fact sheets detailing how that $500 million was allocated in every state. Those fact sheets are available at www.HealthCare.gov/news/factsheets/prevention02092011a.html.

This year, building on the initial investment, new funds are dedicated to expanding on four critical priorities:

Community Prevention ($298 million): These funds will be used to help promote health and wellness in local communities, including efforts to prevent and reduce tobacco use; improve nutrition and increase physical activity to prevent obesity; and coordinate and focus efforts to prevent chronic diseases like diabetes, heart disease, and cancer.

Clinical Prevention ($182 million): These funds will help improve access to preventive care, including increasing awareness of the new prevention benefits provided under the new health care law. They will also help increase availability and use of immunizations, and help integrate behavioral health services into primary care settings.

Public Health Infrastructure ($137 million): These funds will help state and local health departments meet 21st century challenges, including investments in information technology and training for the public health workforce to enable detection and response to infectious disease outbreaks and other health threats.

Research and Tracking ($133 million): These funds will help collect data to monitor the impact of the Affordable Care Act on the health of Americans and identify and disseminate evidence-based recommendations on important public health challenges.

The Obama Administration recognizes the importance of a broad approach to addressing the health and well-being of our communities. Other initiatives put forth by the Obama Administration to promote prevention include:

The President’s Childhood Obesity Task Force and the First Lady’s Let’s Move! initiative aimed at combating childhood obesity.

The American Recovery and Reinvestment Act of 2009 that provides $1 billion for community-based initiatives, tobacco cessation activities, chronic disease reduction programs, and efforts to reduce healthcare-acquired infections.

The Affordable Care Act’s National Prevention, Health Promotion and Public Health Council, composed of senior government officials, charged with designing a National Prevention and Health Promotion Strategy.

For more information about the FY2011 Prevention and Public Health Fund investments, visit http://www.HealthCare.gov/news/factsheets/prevention02092011b.html.


The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

D.C. Group Will End Needle Exchange

PreventionWorks, a leading provider of sterile needles to injection drug users (IDUs) in Washington, will shut its doors on Feb. 25.

Michael Rhein, PreventionWorks' president, cited a drop in private donations, delays in city funding, and high executive turnover at the non-profit as factors in deciding to close. PreventionWorks distributes about one-third of the city's free needles, accounting for about 100,000 syringes provided to 2,200 people last year. It also provides HIV testing, condoms, and referrals for drug treatment.

PreventionWorks was the city's only needle-exchange provider until 2007 because of a decade-long federal ban on funding such programs. After Congress lifted the ban, the city's HIV/AIDS Administration provided $700,000 to four non-profits to distribute needles: PreventionWorks, Helping Individual Prostitutes Survive (HIPS), Bread for the City, and Family and Medical Counseling Services.

"They're going to be leaving a big hole in the community," said Cyndee Clay, HIPS' executive director. HIPS distributes about 50,000 needles a year and focuses most of its outreach on sex workers.

According to Rhein, PreventionWorks is often the only point of access that IDUs have to health and medical services. "We work with our clients without judgment, even though their activities may be illegal," he said. "We meet them where they're at, to improve their health."

Rhein said PreventionWorks will coordinate with the other providers to cover gaps in coverage, including turning over remaining sterile syringes upon its closure. City health department officials suggested in a Wednesday meeting that they might be able to redirect some of the money originally intended for PreventionWorks, he noted.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Dayton VA to Test 535 Dental Patients for Infections

At least 535 patients of a Veterans Affairs dental clinic in Dayton will be offered free testing for blood-borne infections after it was discovered that a dentist there failed to change gloves or sterilize instruments between patients. The veterans being contacted to screen for hepatitis B, hepatitis C, and HIV were patients at the Dayton VA Medical Center clinic between 1992 and July 2010, the center's director, Guy Richardson, said Tuesday. A clinical board will review another 150 records for additional patients to determine if they may need screening.

The risk of infection is considered "extremely low," though any veteran who is found to be infected will receive free treatment, said Dr. George Arana, acting assistant deputy undersecretary for health operations and clinical management for the VA in Washington, D.C. He and Richardson had no answer for how the alleged practices could go unaddressed for 18 years, though Richardson noted no internal reviews detected the problem.

The clinic closed on Aug. 19 after an employee conveyed worries over infection controls. Between patients, the dentist involved did not change latex gloves or sterilize the rotary cutting burs used to excavate decay, shape cavity forms, reduce tooth structures, and adjust or remove prostheses or dentures, a VA investigation found. Action against the dentist is pending.

The clinic reopened on Sept. 10 under a heightened infection control surveillance system, including random reviews of clinicians' competencies and credentials, Richardson said.

The VA has established a 24/7 hotline for veterans to call at 877-424-8214.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

HIV Spike Seen in Young Black Males in Milwaukee County

During 2001-06, new HIV diagnoses increased by 93 percent among young black men who have sex with men in 33 states with robust surveillance systems, according to CDC. In Milwaukee County, HIV diagnoses among black MSM ages 15-29 shot up 144 percent during 2000-08, state data show.

A new report suggests the local increase reflects an actual growth in HIV transmission, rather than a recent social network-based testing strategy and other intensified HIV testing efforts. An increase in syphilis diagnoses among young black MSM preceded the surge in HIV diagnoses, noted the study.

Compared to 1999-2001, new HIV diagnoses during 2006-08 among black Milwaukee County MSM ages 15-19, 20-24 and 25-29 grew by 143 percent, 245 percent and 78 percent, respectively. New diagnoses among nonblack MSM also grew, but by less, among those ages 20-24 (14 percent) and 25-29 (45 percent). Diagnoses declined among black and nonblack MSM age 30 and over by 40 percent and 1 percent, respectively.

In response, the Milwaukee Health Department last summer announced an HIV testing, anti-stigma, and prevention campaign targeting MSM. MHD partnered with LGBT health organization Diverse & Resilient (D&R), which has networked with other community-based groups to train 60 men to conduct prevention outreach.

Young black MSM are more apt to be homeless, poor and lack access to health care and information, said Gary Hollander, D&R's executive director. "It's one thing to be 17 and poor," he said. "Add to that housing that's vulnerable, being preached against at church, and being bullied at school." Communities must better address these issues, he said.

About $4 million from national sources has recently been granted to local HIV prevention efforts. However, CDC needs to re-tool its funding formula to provide Milwaukee with a sustained infusion, Mayor Tom Barrett said.
The full study, "Increase in Newly Diagnosed HIV Infections Among Young Black Men Who Have Sex with Men - Milwaukee County, Wisconsin, 1999-2008," was published in CDC's Morbidity and Mortality Weekly Report (2011;60(4):99-102).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Fear, Social Change Drive Down Zimbabwe HIV Rates

Behavioral changes that have helped drive down adult HIV prevalence in Zimbabwe appear to have been mostly due to an increased awareness of AIDS deaths and the nation's economic devastation, a new study suggests. Adult HIV prevalence in Zimbabwe dropped from an estimated 29 percent in 1997 to 16 percent in 2007.

Fear of acquiring HIV and widespread social, political, and economic disruption helped reduce extramarital, commercial, and casual sexual relations and partner concurrency, the study found. These changes likely were aided by prevention programs in the media, church, and workplace environments and in interpersonal conversations.

"The HIV epidemic is still very large, with more than one in 10 adults infected today," said study co-author Timothy Hallett of Imperial College in London. "We hope that Zimbabwe and other countries in southern Africa can learn from these lessons and strengthen programs to drive infections down even further."

"Very few other countries around the world have seen reductions in HIV infection, and of all African nations, Zimbabwe was thought least likely to see such a turnaround," said Imperial's Simon Gregson, a senior study co-author.

Last year, UNAIDS said that young Africans were leading a "revolution" in HIV prevention by having safer sex and fewer partners.

"Focusing on partner reduction, in addition to promoting condom use for casual sex and other evidence-based approaches, is crucial for developing more effective prevention programs, especially in regions with generalized HIV epidemics," the study authors wrote.

The complete study, "A Surprising Prevention Success: Why Did the HIV Epidemic Decline in Zimbabwe?" was published in the open-access Public Library of Science Medicine (2011;8(2):e1000414).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

OHIO Cuts in Aid for HIV Drugs Bring New Set of Troubles

Cuts made last July to Ohio's AIDS Drug Assistance Program resulted in nearly 1,000 people being dropped off the rolls by December. Facing a $3.9 million deficit three months into the current fiscal year, ADAP instituted a waiting list, and eliminated altogether dental care, money for travel and medications unrelated to HIV.

Although the cuts and an infusion of federal money fixed last summer's dire financial situation, 390 Ohioans remain on the waiting list, the most recent figures from the National Alliance of State & Territorial AIDS Directors show. Jay Carey, management analyst for the state Ryan White program for low-income HIV/AIDS patients, says a recently awarded federal grant for $1.2 million will remove more than 100 additional people from the list.

Meanwhile, the Ohio Department of Health is working swiftly to change state rules to serve only ADAP's sickest patients. If instituted, the changes would eliminate some clients' assistance and cover the drugs of others who are currently waitlisted.

Clinics and drug companies have worked to ensure patients are getting medicines through sources other than ADAP, said Dr. John Davis, director of Ohio State University Medical Center's infectious-diseases clinic. However, Davis wonders "how long that is going to last." Columbus AIDS Task Force President Peggy Anderson said she does not know of anyone who has stopped HIV treatment since the cuts. Both Davis and Anderson worry that demands for assistance will overwhelm drugmakers, who are lobbying the federal government to provide more money to help state ADAPs.

In addition, Anderson is concerned about people who have switched medication for financial versus medical reasons. Side effects and potencies among HIV drugs vary, and changing them for reasons other than clinical ones is not ideal, she said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Ottawa Clinic Expanded to Handle the Rising Number of Cases of Infection

Ottawa's sexual health clinic in the ByWard Market was overwhelmed by the city's dramatically rising STD rates. Last year, the clinic saw 200 more people every month than in 2006, and it still had to turn away about 45 others each month.

The clinic closed for renovations on Nov. 19, during which it saw only the most urgent cases, and it reopened Jan. 21 with two new exam rooms. Other spaces were redesigned to accommodate the interviewing and examination of patients in the same space. Dr. Vera Etches, an associate medical officer of health in Ottawa, notes the expansion is fine for now; but if clinic visits keep rising, they will have to turn people away again.

Ottawa has the highest number of chlamydia cases and HIV rates in Ontario, and gonorrhea and syphilis rates are rising considerably, especially among residents ages 15-24. With more people visiting the clinic, more diagnoses will be made, Etches said.

"People are having more sexual partners, they're not using condoms all the time, and that's how the infection spreads," said Etches.

Etches would like to hire more staff, but Ottawa is in a hiring freeze. Ottawa Public Health is seeking an 11 percent budget increase in part to fight the rise in STDs.

Dr. Hunter Handsfield, an STD expert and former head of a Seattle sexual health clinic, worries that every barrier to testing and treatment "could have a significant negative effect, because it could be that among people who otherwise would get treated there, that they delay care, maybe their symptoms are not severe so they continue sexual activity," he said. "That can't be good, especially in an environment where you've had rising rates of visits to the clinic over the last couple of years."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Global Fund Announces New Anti-Corruption Measures

The Global Fund to Fight AIDS, TB and Malaria has "zero tolerance" for fraud and corruption, Executive Director Dr. Michel Kazatchkine said recently while announcing new measures aimed at preventing such crimes.

The fund will create a high-level panel of experts to assess its ability to prevent and detect grant-related fraud; double funding for its watchdog Office of the Inspector General (OIG); hire more internal financial managers; give outside firms more responsibility for grant monitoring; and help recipient countries better oversee their grants.

"Programs supported by the fund have saved 7 million lives and are turning back the three disease pandemics around the world," said Kazatchkine. The Global Fund is the largest worldwide funder of TB and malaria control programs and provides one-fifth of all international funding to combat HIV/AIDS. It is "responding aggressively when instances of fraud or misappropriation are detected," he said.

OIG's John Parsons said there are at least 100 active cases involving possible fraud. The Global Fund will closely monitor training events - a place where investigators have uncovered high levels of corruption. In addition, investigators are following up on allegations of organized thefts of anti-malaria drugs in Malawi, Tanzania, Kenya, Nigeria, Uganda, Togo, and Ivory Coast and their sale in Nigeria, Benin, Ivory Coast, Cameroon, and Guinea.

Also on Friday, the UN Development Program announced stricter anti-corruption and anti-fraud measures. UNDP manages roughly $2.7 billion of the Global Fund's grant money, carrying out programs in 27 countries.

UNDP Administrator Helen Clark said the agency will hire an investigator to look into allegations of corruption in UNDP-managed Global Fund programs. UNDP also will strengthen its investigative and audit teams, and it has reached a deal with the Global Fund to better share information in fraud investigations.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Senior Class Project: Getting Tested for HIV

Feb. 11 will mark what is believed to be the nation's first HIV testing by an entire high school class. The 80 seniors at San Francisco's Urban School will be required to attend an information session ahead of the event; a voluntary lunchtime discussion open to all students at the private school will follow. The voluntary testing will be held in the school's gym.

"The goal is to educate on how easy it is to get tested and how important it is," said senior Oliver Hamilton, who came up with the idea.

Hamilton is counting on a build-up of peer expectation to ensure a high level of participation. Normally kids would worry that getting tested might be interpreted to suggest they are promiscuous, he said. "But if 70 kids get tested and 10 don't, people might wonder why those 10 are the ones who are scared. Critical mass is really important."

Dr. Marcus Conant, a longtime HIV/AIDS provider, agreed to help Hamilton plan the event. Hamilton has worked in the office of Conant, who also runs an HIV education foundation. Conant will oversee the mouth-swab tests, which were donated by test maker OraSure Technologies Inc. Students who participate will receive a free ice cream, thanks to a donation Hamilton secured from a local Ben & Jerry's.

School administrators were receptive to Hamilton's proposal. But Charlotte Worsley, Urban's assistant head for student life, expressed concern about protecting student privacy and ensuring students do not feel pressured to discuss their results. In response, Conant agreed to delay the results for several days, and give students the choice of receiving them by e-mail, phone or regular mail.

"We understand that one of the best ways to alleviate the stigma that can be attached to testing is to let it become just part of the normal health practice of all teens," said Worsley.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

Disparities in Diagnoses of HIV Infection Between Blacks/African Americans and Other Racial/Ethnic Populations

Since early in the HIV epidemic, blacks/African Americans have been disproportionately affected, the report authors noted. Drawing on data from the National HIV Surveillance System, they estimated numbers, percentages and rates of HIV diagnoses in blacks/African Americans during 2005-08 and described the results of those analyses.

During 2005-08, blacks/African Americans accounted for 50.3 percent of HIV diagnoses in 37 states with mature HIV surveillance systems, despite representing just 13.6 percent of the population in these states. By comparison, whites accounted for 67.9 percent of the population and 29.4 percent of diagnoses, while Hispanics/Latinos accounted for 13.4 percent of the population and 17.8 percent of diagnoses.

Among males, black/African Americans represented the largest proportion (44.8 percent) of HIV diagnoses during 2005-08. Among females, black/African Americans accounted for most (65.9 percent) diagnoses, including a majority for the South (70.9 percent), Midwest (60.9 percent) and Northeast (60.0 percent). Blacks/African Americans comprised the largest proportion of HIV diagnoses in every age group.

By transmission category, among black/African-American males, male-to-male sexual contact was most frequently reported (61.1 percent), followed by heterosexual contact (23.1 percent), injection drug use (11.9 percent) and both IDU and male-to-male (3.6 percent). Among black/African-American females, most were exposed through heterosexual contact (85.2 percent), followed by IDU (14 percent).

Males ages 13-24 accounted for the largest proportion (30.9 percent) of HIV diagnoses among black/African-American males with infection attributed to male-to-male sexual contact, followed by males ages 25-34 (28.7 percent) and 35-44 (23.7 percent). Among black/African-American female diagnoses, the largest percentages were in those ages 35-44.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


TOGETHER WE REMAIN STRONG!

How Better ARV Prices Were Won

South Africa's two-year contract with suppliers of antiretroviral therapy for its treatment program has halved drug costs, saving an estimated $685 million. While the government chose to stay with the same suppliers, increased competition from generic drug makers and a more aggressive government push for cheaper ARV prices helped extract the savings.

Before it put out a request for bids, the government worked with the Clinton Health Access Initiative (CHAI) to establish targeted, internationally competitive price ranges for the ARVs. Competing firms had to detail their costs, from active ingredients to drug formulation to shipping.

"It's a very difficult figure for companies to release - it's like their best-kept secret," said Brenda Waning, coordinator of market dynamics for
UNITAID, an international drug purchasing agency. South Africa could use the price breakdowns submitted by bidders to compare and judge their validity, she noted.

Under the new contract, a 300 mg tablet of tenofovir will cost less than $8 per month per patient, down from about $23 previously. The agreement also allows for mid-contract price adjustments, so a baseline price itemization will help in evaluating such proposals, said Vishal Brijlal, CHAI's South Africa country director.

With more than 1 million residents taking ARVs, South Africa represents about 20 percent of the global ARV market. It also funds about 60 percent of its treatment program.

The agreement was generally praised domestically, though advocates criticized the lack of transparency in scoring bidders. "We don't know how points were worked out . competitors can't tell whether or not the tender was correctly awarded," said Jonathan Berger, senior researcher for the South African rights organization Section 27. Section 27 and Treatment Action Campaign are urging that future contract proposals detail how points are awarded.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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