Young Activists Seek More Aid for Homeless

The 2011 Youth Action Institute (YAI) drew 25 youth from all around the country to Detroit for a training sponsored by the Campaign to End AIDS. On July 15, participants demonstrated outside downtown Detroit’s Coleman A. Young Municipal Center for additional appropriations for homeless youth.

Being homeless, says Detroit delegate Alfredo Smith, can result in risky sexual behaviors that lead to HIV infection. State records validate Smith’s assertion, showing homeless students in Michigan tripled to 22,673 between 2008 and 2010, and that 5,400 Michigan residents were reportedly diagnosed as HIV-positive before turning 30.

To support the trend of new diagnoses decreasing from 1,500 in 1992 to 760 last year, Smith aims to “open conversation” in his community about sex and HIV.

Another Detroit delegate, Brandon Hughes, laments that homelessness funding “is not increasing as the numbers of homeless youth are increasing.”

Repeat YAI attendee George Montgomery turned his HIV diagnosis in 2007, his freshman year in college, into a passion for youth HIV/AIDS advocacy. Montgomery attended his first institute in 2008 as a delegate from his hometown of Charlotte, N.C. “It sparked something in me,” he said. “I didn’t realize how much [HIV/AIDS] tore families apart. It tears communities apart.”

Participants in the institute, chosen based on submission of advocacy projects they view as essential to their communities,and receive training during the weeklong annual event to bolster those efforts. YAI organizer Christine Campbell likens the institute to a “boot camp for activists.”

“There’s not really one word to describe how amazing this feels,” said Montgomery. “It’s one of those awe-moments.”

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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Tarrant County AIDS Volunteers Commemorate 20 Years of Battle

Twenty years ago, despite the ignorance and stigma then surrounding HIV/AIDS, Tarrant County residents developed a grassroots support network and founded the county’s Names Project AIDS Memorial Quilt chapter

Genie Quincy recalled that, when her son was dying of AIDS in 1987, the only available assistance came from the Oak Lawn Counseling Center in Dallas. And, while many funeral homes shunned the remains of people who had died of AIDS, Guy Thompson of Thompson’s Harveson & Cole Funeral was a “very good friend” and always willing to help, she said.

According to Quincy, the county’s local response began “in a small dingy office beside a gay nightclub ... We reached out to the few people we were aware of who were sick.”

“We would visit, clean, and reach out in love and acceptance. Some of the circumstances we saw were shocking, for many had been abandoned by families,” Quincy continued. “Others were being cared for by mothers who were overwhelmed as they faced the inevitable [with] their gay sons who were often angry, depressed and withdrawn.”
Yet, joining the other 33 chapters of the memorial quilt project and “walking into a room filled with bright-colored works of art representing the lives” of loved ones provided some comfort, said Quincy. “When I made my son’s panel in 1988, I had never seen the quilt ... How little did I know that in many ways, especially in the early years, it would become him in my emotions.”

The national memorial quilt has grown to nearly 1.3 million feet, commemorating more than 44,000 individuals with 3-by-6 square-foot panels listing more than 91,000 names. The Fort Worth chapter of the quilt project plans to reunite on Saturday. For more information, contact Quincy at 940-452-2214.

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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Identifying Barriers to HIV Testing: Personal and Contextual Factors Associated with Late HIV Testing

Late diagnosis of HIV, which is associated with increased morbidity, mortality, and health care costs, continues to occur despite the availability of HIV testing. In the current study, researchers accessed the HIV/AIDS case registry of the San Francisco Department of Public Health to identify individuals who developed AIDS within 12 months of their HIV diagnosis; 41 such patients were recruited to participate in qualitative and quantitative interviews.

Among the participants, 31 were diagnosed with HIV due to symptomatic disease. Fifty percent were diagnosed with HIV and AIDS concurrently. Half the patients had never been tested for HIV prior to diagnosis.

Barriers to HIV testing included fear (cited most frequently), and being unaware of improved HIV treatment, free/low-cost care and risk for HIV. “Recommendations for health care providers to increase early diagnosis of HIV include routine ascertainment of HIV risk behaviors and testing histories, stronger recommendations for patients to be tested, and incorporating testing into routine medical care,” the authors wrote.

“Public health messages to increase testing include publicizing that (1) effective, tolerable, and low-cost/free care for HIV is readily available; (2) early diagnosis of HIV improves health outcomes; (3) HIV can be transmitted to persons who engage in unprotected oral and insertive anal sex and unprotected receptive anal intercourse without ejaculation and from HIV-infected persons whose infection is well-controlled with antiretroviral therapy; (4) persons who may be infected based upon these behaviors should be tested following exposure; (5) HIV testing information will be kept private; and (6) encouraging friends and family to get HIV tested is beneficial;” the team 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: 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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Navigating Challenges, Brazil Steps Up AIDS Response

Brazil, a longtime worldwide model for fighting HIV/AIDS, continues to ramp up its domestic and international disease-fighting efforts.

Brazil has maintained stabilized HIV infection and mortality rates since 2003 and 1998, respectively, Ministry of Health data show. In 2010, 630,000 Brazilians were estimated to be living with HIV. Some 210,000 Brazilians with HIV receive free, government-supplied antiretroviral treatment.

Brazil’s public health system has taken numerous measures to combat HIV/AIDS, including:
*Pledging $2 from every international airline ticket sold to support the UNITAID treatment-access campaign;
*Focusing education campaigns on sexual violence in the country, as well as condom use promotion among women and youth;
*Founding a locally owned condom factory in 2008 that utilizes latex from native rubber trees; and
*Seeking approval from the World Trade Organization (WTO) to take advantage of agreement provisions allowing governments to license the production or acquisition of generic drugs when public health concerns are paramount.

Although WTO sided with Brazil in the early 2000s, the European Union and the United States have continued to fight for more stringent intellectual property rights laws, a divisive issue argued during the recent UN High Level Meeting on AIDS in New York.

Minister of Health Alexandre Padilha asserts the country respects intellectual property laws, but insists these “have to be compliant to help public health priority.”

Oxfam America Senior Policy Advisor Rohit Malpani agrees with Padilha. “Brazil must continue to use flexibilities to reduce the costs of these medicines even as the country continues to evolve into a wealthier, emerging market country,” said Malpani.

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 Group Pushes Drugmakers for Relief on HIV Medicine Prices

AIDS Healthcare Foundation (AHF) is urging pharmaceutical firms to bring down the domestic price of AIDS drugs to enable patients to access treatment programs of last resort. As of July 28, 8,871 low-income HIV/AIDS patients in 13 states were on waiting lists for AIDS Drug Assistance Programs, according to the National Alliance of State & Territorial AIDS Directors (NASTAD). In addition to implementing waiting lists, many state ADAPs have tightened eligibility criteria, cut coverage, and capped enrollment due to economy-driven fiscal constraints and surges in demand.

“The fact that there are nearly 10,000 people who don’t have access to [ADAPs] is scandalous,” said Michael Weinstein, AHF’s president. “Our job as advocates is to ensure that they have access on a long-term basis.”

Firms such as Merck and Johnson & Johnson have responded over the years with heavier discounts, price freezes, and patient-assistance programs. Nonetheless, ADAPs have been struggling with funding shortfalls dating back to 2002.

“There’s increasing demand for services but relatively stable or decreasing funding,” said Murray Panner, NASTAD’s deputy executive director. “At this point, it’s sheer math.”

AHF has conducted mass-mailings in communities surrounding the corporate headquarters of Bristol-Myers Squibb, Merck, and Johnson & Johnson with the aim of gaining employee support for its price-cutting campaign.

However, Panner said a task force of ADAP directors negotiated a multi-year pricing agreement last year with drug firms to ensure pricing stability. “The companies have agreed to terms above and beyond what is required of them,” he 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.


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Pennsylvania Eases Rules for HIV Testing

Reflecting a 2006 CDC recommendation that HIV screening be a routine part of health care, Pennsylvania has revised its testing law following two years of intense legislative debate and lobbying.

Beginning Sept. 6, pretest HIV counseling will no longer be mandated, and some test results now given in person can be delivered over the phone. However, the law, signed by Gov. Tom Corbett on July 7, states that “no positive test result shall be revealed ... without affording the ... immediate opportunity for individual, face-to-face counseling” about HIV and other health-related services.

Further, providers can inform patients orally or in writing that HIV testing will be conducted unless they decline or opt out. Currently, patient consent for testing must be in writing. Under the new law, verbal or written consent must be “documented” in the patient’s health record.

“More than half of new infections are transmitted by people who don’t know they’re HIV-positive,” said Dr. Mary van den Berg-Wolf, a Temple University Hospital HIV specialist who lobbied for the changes.

On Wednesday, van den Berg-Wolf and other advocates celebrated the amendment at a meeting with Corbett.

CDC estimates that about one in five Americans who have HIV are unaware of their infection.

Supporters of updating testing laws say treatment can also reduce the risk of HIV transmission; but treatment begins with a positive test result.

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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Philippines Warns Against Gecko as AIDS Treatment

The use of geckos as treatments for AIDS, asthma, cancer, TB and impotence has no scientific basis and could be dangerous to patients, warned a statement from the Philippines’ health department.

Geckos are reportedly exported to China, Malaysia and South Korea, where they are used as aphrodisiacs and as traditional medicine for these conditions. The health department worries that patients may not seek proper treatment for their diseases as a result. “This is likely to aggravate their overall health and put them at greater risk,” the statement said. Treatments for asthma are affordable and easily available, while there are drugs to treat HIV, it noted.

Furthermore, environmental officials expressed alarm about the growing gecko trade in the Philippines, saying a healthy population of the wall-climbing, carnivorous lizards is needed to regulate pests and maintain the fragile ecosystem.

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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Gilead Sciences, Johnson & Johnson Plan HIV Collaboration

A Johnson & Johnson unit, Tibotec Pharmaceuticals, is partnering with Gilead Sciences Inc. to develop a pair of HIV combination treatments.

The companies said they have agreed to collaborate on a pill that combines J & J’s Prezista with cobicistat, a Gilead drug candidate that is designed to boost the effectiveness of other antiretroviral medicines.

In addition, the firms are negotiating on combining Prezista with Gilead’s HIV drug Emtriva, along with another Gilead candidate called GS 7340. GS 7340 is a version of Viread, an older Gilead drug. Tibotec would be responsible for formulating the first treatment as well as for manufacturing, regulatory matters and sales. Gilead would lead development and sales of the second product. The deal will not be considered complete until the companies come to an agreement on the second combination pill.

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 Hampshire Town Sued for Discrimination over HIV, AIDS

AIDS Services for the Monadnock Region, represented by Boston-based Gay & Lesbian Advocates & Defenders (GLAD), is suing the town of Gilsum to block its efforts to seize the property of a group home for people living with HIV/AIDS and hepatitis C for nonpayment of taxes.

The Cleve Jones Wellness House currently accommodates five residents and has been at the heart of several GLAD battles with Gilsum. The city has consented to forego the scheduled deed transfer until the lawsuit is decided.

AIDS Services acknowledges not filing an application for exemption in 2007 due to an administrator’s misunderstanding that the exemption was automatic. The exemption was filed one month late in 2008 and only three days late in 2009. City officials exercised their prerogative to decline accepting the late applications. The organization was taxed $11,559, which it had to borrow and has been incapable of repaying.

GLAD attorney Ben Klein maintains the home is tax exempt, should never have been charged the taxes, and is the victim of an “egregious violation of constitutional equal treatment.” The lawsuit asserts both the American Legion and the Gilsum Congregational Church failed to file for exemptions numerous years between 2004 and 2009. Yet they were exempted, along with all other nonprofits that regularly filed late if at all. The lawsuit seeks a refund on the taxes and interest AIDS Services paid to Gilsum in 2010.

GLAD previously sued Gilsum on behalf of the home in 2008 when the city “imposed conditions on who could live” there, said Klein. That case was settled and most of those restrictions were dismissed, continued Klein.

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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Relationship Characteristics and Contraceptive Use Among Young Adults

While young adults have high rates of unintended childbearing and STD infection, the authors noted that little research has examined how relationship characteristics affect their contraceptive use. Data from the 2002-05 rounds of the National Longitudinal Survey of Youth yielded a sample of 4,014 dating relationships among sexually active 18- to 26-year-olds. Associations between relationship characteristics and contraceptive use at last sex were assessed by bivariate analysis and multivariate logistic and multinomial logistic regressions.

Use of a contraceptive method at last intercourse was reported in three-quarters of the relationships. A condom only was used in 26 percent of relationships; a hormonal method only was used in 26 percent; and dual methods were used in 23 percent.

When compared with relationships in which first sex occurred within two months of starting to date, those who first had sex before dating were more likely to have used any method at last sex (odds ratio, 1.4), especially condoms or dual methods (relative risk ratio, 1.5 for each). The relative risk of using a hormonal method only, versus no method or condoms alone, grew with relationship duration (1.01) and level of intimacy (1.1-1.2).

“Discussing marriage or cohabitation was associated with reduced odds of having used any method (0.7) and a reduced relative risk of having used condoms alone or dual methods (0.6 for each),” the authors wrote. “Increasing levels of partner conflict and asymmetry were also linked to reduced odds of any method use (0.97 and 0.90, respectively).

“Prevention programs should address relationship context in contraceptive decision making, perhaps by combining relationship and sex education curricula to foster communication and negotiation skills,” the team 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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Indiana Sets Health Priorities; Unsafe Food, HIV Among Plan's Targets

Indiana health officials on Monday released a five-year plan to reduce the burden of HIV, STDs and viral hepatitis along with other priorities identified as having the most significant influence on health and illness in the state. The plan was developed partly on the basis of CDC’s “Winnable Battles” — conditions that have a large health impact and known, effective strategies to address them.

The Indiana State Health Improvement Plan (ISHIP) focuses on six health priorities, “as well as key system improvements that, when achieved, will significantly impact health in Indiana,” said Dr. Deborah McMahan, Allen County’s health commissioner and a member of the executive committee that developed the plan.

The executive committee hopes that “every public health system partner will identify activities in the plan which will enable them to contribute to the improvement of health outcomes in Indiana,” McMahan said. “[ISHIP] is founded on the premise that together, Indiana public health system partners can make a difference.”

“Successful implementation can occur only through collaboration among individuals, public, private, governmental and nonprofit organizations,” Dr. Gregory Larkin, state health commissioner, said in a news release.

To view the release, visit: http://www.in.gov/portal/news_events/71833.htm.

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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Indiana Sets Health Priorities; Unsafe Food, HIV Among Plan's Targets

Indiana health officials on Monday released a five-year plan to reduce the burden of HIV, STDs and viral hepatitis along with other priorities identified as having the most significant influence on health and illness in the state. The plan was developed partly on the basis of CDC’s “Winnable Battles” — conditions that have a large health impact and known, effective strategies to address them.

The Indiana State Health Improvement Plan (ISHIP) focuses on six health priorities, “as well as key system improvements that, when achieved, will significantly impact health in Indiana,” said Dr. Deborah McMahan, Allen County’s health commissioner and a member of the executive committee that developed the plan.

The executive committee hopes that “every public health system partner will identify activities in the plan which will enable them to contribute to the improvement of health outcomes in Indiana,” McMahan said. “[ISHIP] is founded on the premise that together, Indiana public health system partners can make a difference.”

“Successful implementation can occur only through collaboration among individuals, public, private, governmental and nonprofit organizations,” Dr. Gregory Larkin, state health commissioner, said in a news release.

To view the release, visit: http://www.in.gov/portal/news_events/71833.htm.

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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Violence Against Women & HIV Webinar

The Friends of AIDS Foundation and AIDS Alliance invite you to participate in a free webinar focusing on the impact that gender-based violence has on women and HIV/AIDS prevention, care, and treatment programs.

DATE: Wednesday, August 3, 2011
TIME: 1:00 – 2:30 p.m. ET

Stigma plays a role in the lives of women affected by violence and HIV, but it is their intersection that is often overlooked. The risk of HIV infection among women who have experienced violence is up to three times greater than for women who have not been abused. Whether you are working with HIV-positive clients or victims of violence, this webinar will examine their intersection and address how providers can better serve and support these women.


To participate in the webinar you must pre-register HERE.

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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Presidential Advisory Council on HIV/AIDS Conference Call

The Friends of AIDS Foundation wishes to extend an invitation to participate in a conference call with the Presidential Advisory Council on HIV/AIDS(PACHA).

The call will highlight PACHA’s “game changing” recommendations to curb the HIV epidemic and reach the goals of the National HIV/AIDS strategy.

DATE: Tuesday, August 2, 2011
TIME: 2PM EST

DOMESTIC CONFERENCE CALL IN NUMBER: 888-455-2653
INTERNATIONAL CONFERENCE CALL IN NUMBER: 1-210-839-8485
ACCESS CODE: 1508564

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 Items Added to CDC's HIV Web site

Several new items have recently been added to the Centers for Disease Control and Prevention web site.

Updated Slide Set: AIDS Surveillance-Trends (1985–2009)

The AIDS Surveillance – Trends slide set has been updated with information from the 2009 HIV Surveillance Report.

Updated Slide Set: HIV Surveillance in Adolescents and Young Adults

The HIV Surveillance in Adolescents and Young Adults slide set has been updated with information from the 2009 HIV Surveillance Report.

MMWR: Sexual Transmission of Hepatitis C Virus Among HIV-Infected Men Who Have Sex with Men — New York City, 2005–2010

In the United States, an estimated 3.2 million persons are living with hepatitis C virus (HCV) infection. HCV transmission occurs primarily through percutaneous exposure to blood, and persons who inject drugs are at greatest risk for infection. The role of sexual transmission of HCV has not been well defined. However, reports over the past decade, mainly from Europe, have implicated sexual transmission of HCV among human immunodeficiency virus (HIV)--infected men who have sex with men (MSM).

Updated Slide Set: Pediatric HIV Surveillance (through 2009)

The Pediatric HIV Surveillance slide set has been updated with information from the 2009 HIV Surveillance Report.


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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Findings from L.A. Wheeler and Co-Authors Broaden Understanding of HIV/AIDS

According to the authors of a study from Boston, Massachusetts, "The continued spread of the HIV epidemic underscores the need to interrupt transmission. One attractive strategy is a topical vaginal microbicide."

"Sexual transmission of herpes simplex virus type 2 (HSV-2) in mice can be inhibited by intravaginal siRNA application. To overcome the challenges of knocking down gene expression in immune cells susceptible to HIV infection, we used chimeric RNAs composed of an aptamer fused to an siRNA for targeted gene knockdown in cells bearing an aptamer-binding receptor. Here, we showed that CD4 aptamer-siRNA chimeras (CD4-AsiCs) specifically suppress gene expression in CD4(+) T cells and macrophages in vitro, in polarized cervicovaginal tissue explants, and in the female genital tract of humanized mice. CD4-AsiCs do not activate lymphocytes or stimulate innate immunity. CD4-AsiCs that knock down HIV genes and/or CCR5 inhibited HIV infection in vitro and in tissue explants. When applied intravaginally to humanized mice, CD4-AsiCs protected against HIV vaginal transmission," wrote L.A. Wheeler and colleagues.

The researchers concluded: "Thus, CD4-AsiCs could be used as the active ingredient of a microbicide to prevent HIV sexual transmission."

Wheeler and colleagues published their study in the Journal of Clinical Investigation (Inhibition of HIV transmission in human cervicovaginal explants and humanized mice using CD4 aptamer-siRNA chimeras. Journal of Clinical Investigation, 2011;121(6):2401-2412).

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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Data from G. Morineau and Colleagues Advance Knowledge in HIV/AIDS

Investigators publish new data in the report "Is the bed capture enzyme immunoassay useful for surveillance in concentrated epidemics? The case of female sex workers in Indonesia." According to the authors of recent research from Bangkok, Thailand, "Although the BED capture enzyme immunoassay (BED-CEIA) tends to over-estimate HIV incidence in general population epidemics, its limitations may be less relevant to some sub-populations in concentrated epidemics. This study assesses the plausibility of BED-CEIA estimates for female sex workers (FSWs) in Indonesia."

"Data were derived from a cross-sectional anonymous linked behavioral and biological surveillance survey. Independent samples of 2,917 direct and indirect FSWs, were gathered from seven and five cities, respectively, via three-stage time-location sampling. Participants provided behavioral information, venous blood and vaginal swabs. Specimens testing positive for HIV were subjected to BED-CEIA to identify recent infections. The median duration of sex work was 12 months. The estimated HIV prevalence was 8.2% and the incidence was 4.1 per 100 person years, slightly lower than an Asian Epidemic Model (AEM) estimate. HIV incidence was higher among: direct FSWs (p <0.001), those reporting genital ulcers in the past year (p <0.001), those with active syphilis (p=0.017), and those not receiving periodic presumptive treatment for STIs during the previous 6 months (p=0.045). Low general population HIV prevalence, short durations of sex work and low ART coverage of those eligible for treatment make it unlikely that HIV incidence estimates for FSWs in Indonesia are distorted by long-standing infections and viral suppression. External consistency with model-based estimates and internal consistency in regard to known risk factors for HIV infection add to the plausibility of the estimates," wrote G. Morineau and colleagues.

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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Perceived Financial Need and Sexual Risk Behavior Among Urban, Minority Patients Following STI Diagnosis

According to previous studies, “racial/ethnic and gender disparities in [HIV/STI] may be due in part to factors such a poverty and income-inequality,” wrote the authors, who noted the scarcity of published research on “the effect of the perception of having unmet basic needs on sexual risk behavior.”

Data were collected on perceived financial need and sexual risk as part of a behavioral intervention aimed at promoting STI partner notification and reducing sexual behavior among minority patients presenting for care at one of two STI treatment centers in Brooklyn, N.Y., between January 2002 and December 2004. Data from 528 patients obtained at the six-month follow-up visit were used for the current study.

Among participants, 43 percent were categorized as having unmet needs. These individuals were more likely (62 percent) to report unprotected anal or vaginal sex (UAVI) compared to those who had met needs (53 percent). After controlling for age, sex, site of recruitment, intervention group membership and country of origin, this association was found to be significant: adjusted odds ratio (AOR)=1.28; 95 percent confidence interval (CI)=1.04-1.53.

Stratified analyses found that, in the group that did not receive the intervention, there was a statistically significant interaction between sex and basic needs such that women with unmet needs were more likely to report any UAVI (78 percent) than those with met needs (AOR=1.18; 95 percent CI=1.07-1.24). This relationship was not detected for the men in this sample.

“The significant association between perceived unmet needs and UAVI appears to be particularly relevant for women,” the authors concluded. “These findings provide preliminary evidence that HIV/STI intervention components that seek to directly deal with issues of reduction in partner conflict might be beneficial to women with high perceived unmet basic needs, and for whom a potential dissolution of a relationship may represent a further loss in ability to meet basic needs.”

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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Study: HIV Risks Rise with Some Birth Control

Hormone-based contraception was associated with an increased risk of HIV acquisition and transmission in a study presented at the recently concluded 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. The prospective study followed 3,790 heterosexual serodiscordant couples in seven African countries for two years.

One group included nearly 2,500 HIV-infected women, of whom about one-third took hormonal contraception such as daily oral pills or an injectable form at least once, typically in the form of shots taken every few months. If the woman used hormone-based contraception, her uninfected male partner had a 2.61 percent chance of acquiring HIV within a year, compared with a 1.51 percent chance if she did not take such contraception.

In a second group of about 1,300 couples in which the men were HIV-infected but the women were not, about 20 percent of the women took hormonal contraception, mostly shots. The chance of becoming infected was 6.6 percent for women taking hormone-based contraception, compared with 3.8 percent for women who did not.

The study took into account condom use, sexual behavior and other risk factors to rule out alternate reasons for the differences in HIV risk. However, the findings still need to be confirmed in follow-up studies and should not cause women to immediately change birth control practices, the researchers said.

In many parts of the world, a potential increased risk of HIV would have to be weighed against the consequences of unintended pregnancy, including maternal mortality and poverty, the study authors said.

“Contraception is incredibly important to economic and social development of women and children worldwide,” said co-investigator Dr. Jared Baeten of the University of Washington.

To view the abstract of the study, “Hormonal Contraceptive Use and Risk of HIV-1 Transmission: A Prospective Cohort Analysis,” visit http://pag.ias2011.org/abstracts.aspx?aid=1715.

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 Drug Adds to Arsenal Against AIDS

The new HIV drug rilpivirine is safe and effective and has fewer side effects than efavirenz when used in combination therapy, two recent studies found.

Used in combination regimens, nevirapine and efavirenz (Sustiva) are equally effective in viral suppression, but they can cause severe side effects, which is why researchers are investigating possible substitutes. Like them, rilpivirine is a non-nucleoside reverse transcriptase inhibitor.

Marketed by Tibotec as Edurant, rilpivirine was compared with efavirenz in various regimens in two studies involving nearly 1,400 patients in 21 countries.

In the first study, initial response rates (viral load under 50 copies/mL, defined by intention-to-treat time to loss-of-virological-response algorithm [ITT-TLOVR]) were 86 percent for rilpivirine-based therapy and 82 percent for efavirenz-based therapy, and CD4 cell count increases were similar between the groups. Incidence of virological failure was slightly higher in the rilpivirine than efavirenz group (7 percent vs. 5 percent), though fewer discontinued treatment on rilpivirine than efavirenz due to adverse events (4 percent vs. 7 percent). Grade 2-4 treatment-related adverse events were less common with rilpivirine than efavirenz (16 percent vs. 31 percent), and lipid increases were significantly lower on rilpivirine than efavirenz (p<0.0001).

At 48 weeks, rilpivirine proved non-inferior in efficacy to efavirenz using a 12 percent margin on logistic regression analysis, the study found.

In the second study comparing rilpivirine-based with efavirenz-based therapy, response rates (less than 50 copies/mL ITT-TLOVR) were 83 percent for both confirmed at 48 weeks. Rilpivirine proved non-inferior in efficacy compared with efavirenz (also 12 percent margin), though incidence of virological failure was higher for rilpivirine (13 percent vs. 6 percent; 11 percent vs. 4 percent ITT-TLOVR). Grade 2-4 adverse events and discontinuations due to AEs were less common for rilpivirine than efavirenz (Grade 2-4: 16 percent vs. 31 percent; discontinuations: 2 percent vs. 8 percent).

Rilpivirine had a more favorable safety and tolerability profile than efavirenz, though a higher virological failure rate, and was non-inferior in efficacy, the study authors concluded.

The studies, “Rilpivirine Versus Efavirenz with Two Background Nucleoside or Nucleotide Reverse Transcriptase Inhibitors in Treatment-Naïve Adults Infected with HIV-1 (THRIVE): A Phase 3, Randomized, Non-Inferiority Trial” and “Rilpivirine Versus Efavirenz with Tenofovir and Emtricitabine in Treatment-Naïve Adults Infected with HIV-1 (ECHO): A Phase 3 Randomized Double-Blind Active-Controlled Trial,” were published in Lancet (2011;378(9787):229-237 and 238-246, respectively).

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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Substance Use Doesn’t Increase Risk of Neurocognitive Problems in HIV

Neurocognitive problems—notably HIV-associated neurocognitive disorder (HAND)—are no more likely to occur in illicit substance users compared with non-substance users, according to a report published ahead of print on the Journal of Acquired Immune Deficiency Syndromes website.

These findings are surprising, writes Desiree Byrd, PhD, of Mount Sinai School of Medicine in New York City and her colleagues, yet the results convey an important message to health care providers, notably that people with a history of substance use shouldn’t be excluded from research exploring HIV and related factors as causes of neurocognitive decline.

HIV infection, alcohol abuse and the use of illicit substances have all been independently linked to neurological problems in people living with HIV. Illicit substances have been shown to potentially suppress immune system function and increase viral replication in the central nervous system. What’s more, some research teams have confirmed that using illicit substances, on top having HIV, can exacerbate neurologic problems.

Because of the documented connection between substance use and neurocognitive problems, people with a history of using, or who are actively using, alcohol and illicit drugs may be left out of scientific research—including treatment protocols—looking specifically at the role of HIV and related factors in the development of HAND. However, not all studies have demonstrated clear links between substance use and neurocognitive decline, hence there is a need for additional research to explore any potential connections.

To address these disparities—and curtail any bias regarding substance use and neurocognitive problems in people living with HIV—Byrd and her colleagues selected cases from the federally funded CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study that differed in substance use status but were relatively free of other health complications, such as stroke or head injuries. The aim of the study, her group writes, was to determine whether people living with HIV with histories of illicit substance use needed to be viewed differently when conducting research into HAND and other neurocognitive problems.

Roughly 400 HIV-positive individuals were included in the analysis and divided into three groups: 134 had no history of illicit substance use; 134 were “syndromic substance users,” meaning a diagnosable alcohol or illicit drug abuse disorder; and 131 were non-syndromic substance users, who had self-reporting using illicit substances at least five times but could not be categorized as pathological substance abusers.

Based on the results of various neurocognitive tests conducted as part of CHARTER, Byrd’s group failed to reveal any significant differences between the three groups. While there was some evidence of associations between lifetime heroin dosage and poor recall and working memory—as well as between cannabis and cocaine use and verbal fluency—the authors pointed out these connections were weak.

“On the basis of comprehensive neurocognitive testing, HIV-positive participants with either [diagnosable substance use] disorders or self-reported histories of non-syndromic, illicit substance use performed no differently, on average, than a carefully matched group of HIV-positive participants without any indication of significant lifetime substance use,” Byrd and her colleagues conclude. “Similarly, participants with SU histories demonstrated neither a higher rate of HAND diagnoses nor more functional difficulties in everyday life.”

The researchers add: “While this finding does not suggest neurocognitive safety of past substance use, it does indicate that substance use history, even when complex, does not necessarily merit exclusion of patients in short-term analyses of cognition in [HIV-related neurolocognitive] research.”

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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PrEP Reduces HIV Risk in Two Major Studies

July 13, 2011

PrEP Reduces HIV Risk in Two Major Studies



Two African studies of pre-exposure prophylaxis (PrEP) provide additional evidence that antiretroviral (ARV) drugs can be used to prevent HIV transmission, according to early results from both clinical trials, released ahead of their full presentations at the 6th International AIDS Society Conference of HIV Pathogenesis, Treatment and Prevention next week in Rome.

Unlike the encouraging results from the iPrEx study, reported in November 2010 and enrolled men who have sex with men and transsexual women, the Partners PrEP study and TDF2 study focused on heterosexual men and women at risk of HIV Infection.

“This is an extremely exciting finding for the field of HIV prevention,” said Jared Baeten, MD, of the University of Washington and a lead investigators of the Partners PrEP study, conducted in Kenya and Uganda. “Now, more than ever, the priority for HIV prevention research must be on how to deliver successful prevention strategies, like PrEP, to populations in greatest need.”

“Our biggest challenge now is how do we move from research to getting things out to the general public where they’re most needed,” said Lynn Paxton, PhD, of the U.S. Centers of Disease Control and Prevention (CDC), according to the Washington Post. Paxton was a lead investigator of the TDF2 clinical trial, conducted in Francistown and Gaborne, Botswana.

The Partners PrEP study in enrolled 4,758 heterosexual couples in which one partner was HIV-positive and the other HIV-negative. The study was discontinued 18 months early, in light of an interim review suggesting favorable results.

The trial showed that both tenofovir (sold as Viread) and tenofovir plus emtricitabine (sold as Truvada), taken once daily by the uninfected partner, reduced the risk of HIV transmission by 62 percent and 73 percent, respectively, when compared to a placebo. The reported risk reductions were highly statistically significant, meaning they were too great to have occurred by chance, and both drugs were effective in both men and women.

A total of 78 infection were reported by the researchers: 18 in the Viread group, 13 in the Truvada group and 47 in the placebo group. The relatively low number of infections all three groups, given the size of the study, can partly be explained by the provision of HIV transmission counseling and condoms provided to all clinical trial participants.

The study authors also noted remarkably high adherence rates. More than 97 percent of the prescribed doses were taken correctly and 95 percent of those who entered the study remained in the trial.

No significant safety problems were reported by the researchers.

The TDF2 study enrolled roughly 1,200 sexually active men and women between the ages of 18 and 39. While it was not designed as an efficacy trial—the goal was to look for potential safety problems—the researchers announced that Truvada reduced the risk of HIV infection in both men and women by nearly 63 percent, compared with those who received the placebo.

Interestingly, the results of the Partners PrEP study and TDF2 contrast those of the FEM-PReP study, which failed to demonstrate that Truvada was an effective PrEP strategy among at-risk women in Kenya, Tanzania and South Africa.

Complete results from the Partners PreP and TDF2 studies are to be presented in Rome and will likely be discussed in the context of similar studies, notably iPrEx and FEM-PREP.

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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Funds Imperil HIV Testing

With the loss of Nassau County funding, the Long Island Minority AIDS Coalition says it will not be able to conduct free, anonymous HIV testing on a half-dozen local college campuses. In April, LIMAC lost its $110,000 annual county allocation, one-quarter of its budget, amid a wave of county cuts. Other services also are at risk, and LIMAC now is turning to the private sector, including foundations, for support.

“We’re hoping something comes up soon,” said Rabia Aziz, LIMAC’s executive director, noting the county had provided the allocation annually since 1992.

LIMAC organizes the testing events and provides a van for the screenings, which are conducted by the state’s Anonymous Counseling and Testing program. Campuses served include Hofstra, Adelphi, State University of New York (SUNY)-Old Westbury, C.W. Post, Farmingdale State College, and Nassau Community College.

Nassau County officials had to make similar cuts, affecting dozens of medical-related social service organizations, in order to prevent a property tax hike, said Brian Nevin, a spokesperson for County Executive Edward Mangano.

“It would be a complete travesty and disservice not only to the college community but the community at large if they could not continue their important mission,” said Dr. Debra Kaplan, a psychology professor at the SUNY campus who has worked closely with LIMAC.

Also at risk are programs providing prevention education in minority communities in Nassau and Suffolk, counseling for homeless people, and syringe access for drug users.

“I had to lay off our health educator because of the cutback,” said Aziz, whose group has one other full-time employee and one part-timer. “We have the largest population of HIV-positive people in suburban America and actually more people than some states,” Aziz said, citing state health department data.

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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Putting Gay Black Men on Safer Path Is Their Cause

Q Spot is a Broad Street Ministry-hosted resource for Philadelphia’s young black men who have sex with men (MSM). The event is held at the ministry on two Saturdays a month, from 8 p.m. to 1 a.m., offering HIV prevention and treatment resources to at-risk youths.

Noel Ramirez, 25, a social worker at St. Christopher’s Hospital, and Quincy Greene, 32, a program manager at Brothers United, a CDC-supported HIV prevention project, connect the MSM to services ranging from academic tutoring to free and confidential HIV testing. The aim of the outreach is to meet minority MSM on their own turf, said Ramirez.

Reaching this population is “like trying to catch water,” Ramirez said. “They slip through your fingertips.” MSM often are stigmatized by family, he said, and many have been led to believe that being gay means being promiscuous.

Ramirez recalled that when he came out to his mother in high school, she warned him, “You’d better not get HIV. And don’t trust anyone, because they’ll drug you and rape you.” “Talking to young people like that, sexualizing them, assuming that their identity is clustered around that disease - it creates shame and guilt, social isolation, and unhealthy relationships,” said Ramirez, though he added that his mother meant well.

Greene, whose parents are from Guyana, said his evangelist mother could not accept that he was gay. “She told me, ‘Reject this. It’s not real. It’s the devil,’” he said.

Q Spot gives MSM the chance “to meet other HIV-positive men and talk about what we’re going through,” Ramirez said. “You need people you can relate to.”

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 Drugs Can Cause Premature Aging: Study

A class of AIDS drugs has been linked with mitochondrial DNA mutations, which could help explain the premature aging and age-related illnesses seen in some HIV patients, British researchers say in a new study. The implicated class, nucleoside analog reverse-transcriptase inhibitors (NRTIs), represented a great advance in treatment in the late 1980s.

In the study, researchers analyzed muscle cells from HIV-positive adults, including some previously treated with NRTIs. Patients who had taken NRTIs, even those who took them as long as 10 years ago, had damaged mitochondrial DNA much like that of a healthy older person.

“It takes time for these side effects to become apparent, so there is a question mark about the future and whether or not the newer drugs will cause this problem,” said study leader Patrick Chinnery of the Institute of Genetic Medicine at Newcastle University. “They are probably less likely to, but we don’t know because we haven’t had time to see.”

NRTIs became less frequently used among patients in wealthier countries due to toxicity concerns. However, generic NRTIs still are commonly dispensed to patients in developing countries who may have little access to newer drugs.

“These drugs may not be perfect, but we must remember that when they were introduced they gave people an extra 10 or 20 years when they would otherwise have died,” said study co-author Brendan Payne of the Royal Victoria Infirmary in Newcastle. “In Africa, where the HIV epidemic has hit hardest and where more expensive medications are not an option, they are an absolute necessity.”

The researchers are exploring ways to repair the damage or curb mitochondrial disease, and they believe exercise is a promising area on which to focus.

The full report, “Mitochondrial Aging Is Accelerated by Antiretroviral Therapy Through the Clonal Expansion of mtDNA Mutations,” was published online ahead of the print edition of Nature Genetics (2011;doi:10.1038/ng.863).

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 Phone Call Could Provide HIV/AIDS Treatment

Civil society in Kenya is considering various ways of sustaining and expanding antiretroviral treatment (ART) programs, including a tax on cellphone users.

Currently, donors provide more than 90 percent of the funds used to supply ART to Kenyans. The Japanese government, a major donor to the Global Fund to Fight AIDS, TB and Malaria, announced two months ago it intends to scale back its contribution following the recent earthquake and tsunami. Pediatric HIV treatment and efforts to prevent mother-to-child transmission are funded solely by the US President’s Emergency Plan for AIDS Relief.

James Kamau of the nongovernmental group Kenya Treatment Access Movement said cellphone taxes are being considered because nearly all other sectors are overtaxed. “What we are asking for is a 10 Kenyan-cent (US $0.001) levy for every phone call made from the country,” he said.

“If the proposal finds favor among the lawmakers, then the funds raised from such levies will go a long way to scale up the number of Kenyans living with HIV/AIDS who need to be enrolled [in ART], and sustain treatment in case the donors pull out or reduce funding,” explained Kamau.

In Kenya, an estimated 1.4 million people are living with HIV and of these, 760,000 have fully developed AIDS. Just 343,000 Kenyans with HIV/AIDS can currently access ART.

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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Cutting AIDS Funding to China a Big Mistake: UNAIDS

The executive director of UNAIDS warned Monday that critics who say China is too wealthy to be receiving donations for fighting HIV are off the mark.

“I think it’ll be a big mistake for a donor and particularly, for anyone who’s invested in China today, to withdraw, for the simple reason that this funding is a catalytic fund,” Michel Sidibe said in Beijing at a meeting of health ministers from Brazil, Russia, India, China, and South Africa.

By creating linkages among government, civil society, and nongovernmental organizations (NGOs), the Global Fund to Fight AIDS, TB and Malaria is making progress in China, Sidibe said. The fund has approved $947 million to China, of which $369 million goes toward HIV/AIDS.

China has cracked down on AIDS activists and NGOs working there, yet it also has launched programs to provide universal access to antiretroviral treatment and introduced policies to curb disease-related discrimination. In June, officials released Hu Jia, a longtime advocate for rural HIV/AIDS patients, after he served three-and-a-half years in jail on subversion charges. Sidibe said Vice Premier Li Keqiang told him Monday that involving community-based organizations in the fight against AIDS “was an important transformation that China wants to see.”

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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Wait Grows for HIV/AIDS Help

More than 1,600 Georgians are on the waiting list for help from the state’s AIDS Drug Assistance Program (ADAP). Among the 13 states with such a list, Georgia’s list is second in length only to Florida’s.

Georgia’s ADAP is a nearly $46.3 million program. While the federal government’s contribution remained steady last year, the state cut its allocation from $12.5 million in fiscal 2010 to $11.1 million this year. The Legislature also cut $100,000 from ADAP for fiscal 2012.

Advocates say that while most of the wait-listed low-income HIV patients are accessing their medications through other means, that process is often difficult. Drugmakers’ charity programs help, but patients typically take medicines from several manufacturers, meaning they must complete multiple separate applications.

Enrolling all the patients currently on the list would take an additional $17 million. Lacking those funds, Georgia is launching a pilot program to transition patients to the federal government’s program, created as part of the health insurance overhaul, to help persons with pre-existing conditions buy insurance.

However, that program’s yearly cap for out-of-pocket expenses is almost $6,000, an excessive amount for someone living at or below the poverty level, said Jeff Graham, executive director of Georgia Equality. Dr. Anil Mangla, director of infectious disease and immunization at the state Division of Public Health, said Georgia will pay premiums and deductibles under the pilot program. Other efforts include using drug-assistance funds to assist Medicare Part D clients with out-of-pocket costs, and using generic drugs.

Robert MacLean was enrolled in South Carolina’s ADAP but had to start from scratch when he moved to Georgia, traveling to various offices to secure the required documentation. He has applied to ADAP but has not been informed whether he is officially on the waiting list. Meanwhile, he has been off his medications since April. “My body’s breaking down now,” he 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.


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Forum Focuses on Reducing Stigma of HIV/AIDS

A forum dedicated to reducing the stigma of homosexuality and HIV/AIDS, sponsored by the Black Leadership Commission on AIDS of Buffalo (BLCAB), drew about 40 people to the Buffalo Museum of Science on June 28.

“Hopefully, we’ll come out of here with some sure-fire action steps,” said Donna Chapman, affiliate services coordinator for the National Black Leadership Commission on AIDS. “There’s no sense of talking just to talk, because we’ve been talking about HIV [for] 30 years. We’ve had 30 years of inaction, 30 years of misaction.” Shame and denial, she said, are to blame for missed prevention opportunities in Buffalo’s black community, which is seeing a growing rate of HIV/AIDS.

A three-member panel - comprising L. Nathan Hare, president and CEO of Community Action Organization of Erie County; the Rev. T. Gerard Williams, pastor of Unity Fellowship of Christ Church; and Stephaun Wallace, director of Men of Color Health Awareness - addressed the impact of issues including poverty, education, health care access, unemployment, religion, and views on masculinity.

“One of the shifts that’s going to have to happen is the schism between our spirituality and our physicality, oftentimes perpetuated by the black church,” Williams said.

Barbara Jemmott, chair of BLCAB’s legislative and public policy committee, hosted the meeting; the panel’s moderator was the Rev. Matthew Brown, a member of the group’s ecumenical committee.

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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Understanding Disparities in HIV Infection Between Black and White MSM in the United States

The investigators sought to evaluate several hypotheses for HIV infection disparities between white and black men who have sex with men, including incarceration, partner HIV status, circumcision, sexual networks, and duration of infectiousness. The study design incorporated the 2008 National HIV Behavioral Surveillance System, a cross-sectional survey performed in 21 US cities.

MSM were interviewed and tested for HIV. For previously undiagnosed MSM, logistic regression was used to test associations between newly diagnosed HIV and incarceration history, partner HIV status, circumcision status, and sexual networks (oldest partners, concurrency and partner risk behaviors). For HIV-positive MSM, factors related to duration of infectiousness were assessed.

Among 5,183 previously undiagnosed MSM, incarceration history, circumcision status, and sexual networks were not independently associated with HIV infection. Infection was associated with having HIV-positive partners (adjusted odds ratio=1.9, 95 percent confidence interval=1.2-3.0) or partners of unknown status (AOR=1.4, CI=1.1-1.7). “Of these two factors, only one was more common among black MSM - having partners of unknown HIV status. Among previously diagnosed HIV-positive MSM, black MSM were less likely to be on antiretroviral therapy (ART),” the authors wrote.

HIV infection differences between black and white MSM may partly be explained by less knowledge of partner HIV status and lower ART use among black MSM, the investigators concluded. “Efforts to encourage discussions about HIV status between MSM and their partners and decrease barriers to ART provision among black MSM may decrease transmission,” they 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.


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India Prime Minister Hails Success in Battle Against HIV

New HIV infections in India have plummeted over the past decade, falling to about 120,000 annually from 270,000 in 2000, officials announced on July 4. But an estimated 2.4 million people in India have HIV, new Ministry of Health data show, so “there should be no room for complacency,” Prime Minister Manmohan Singh told a conference in New Delhi.

“India’s testing and treatment for HIV/AIDS have increased their reach,” Singh said. AIDS mortality rates have fallen over the years, and cutting mother-to-child infections further is now a “priority area” for the nation, he said.

“Our HIV/AIDS program can justifiably claim a measure of success,” Singh reflected.

First-line antiretroviral drugs have been widely available for free through India’s public health system since 2004. Second-line ARVs, though also free, are accessible only at a limited number of centers. Generic ARVs from Indian firms are critical to driving down treatment costs for India and other developing countries.

A key part of India’s strategy has been its increasing prevention focus among high-risk groups, said Singh. The prime minister condemned stigma faced by people affected by HIV/AIDS in India, pointing out the many reports of schools denying admission to children with HIV. “We must see that there is no social ostracization,” he said.

Outside the ministry where Singh was speaking, about 100 protesters denounced the government’s HIV/AIDS efforts as inadequate.

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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Gilead Kickstarts Patent Pool for AIDS Drugs

In a move that may signal a change in how the developing world accesses treatment, Gilead Sciences - the leading maker of HIV drugs - has announced it will share its intellectual property rights with the new Medicines Patent Pool. Gilead is the first drugmaker to sign on with MPP, an initiative of the UNITAID health financing system that is funded by a tax on airline tickets. MPP’s aim is to create a patent pool that licenses technologies to generic drugmakers to make medicines more widely available to poor patients worldwide.

Gilead will allow for generic copies of the HIV drugs tenofovir, emtricitabine, cobicistat, and elvitegravir, in addition to a combination of these drugs in a single pill known as “Quad.” Cobicistat, Quad, and elvitegravir are still in clinical development, and their inclusion should significantly speed the flow of new treatments to the poor.

“Through systematic licensing of intellectual property related to HIV products, people in developing countries will have access to low-cost versions of those products almost at the same time that people in rich countries do,” said MPP Executive Director Ellen ‘t Hoen.

Gilead will receive a 3 percent royalty on generic sales of tenofovir, which is also used to treat hepatitis B, and 5 percent on the other drugs.

‘t Hoen expects other pharmaceutical firms will follow Gilead’s lead. She is negotiating terms for similar deals with Bristol-Myers Squibb, Roche, Boehringer Ingelheim, Sequoia Pharmaceuticals, and ViiV Healthcare, a GlaxoSmithKline and Pfizer joint venture. “The whole field is changing ... there will be more to follow,” she said.

Drugmakers, who previously negotiated voluntary licensing deals on a case-by-case basis, have had difficulty accepting the concept of a “one-stop” pooling system. The US National Institutes of Health was the first organization to join MPP last September.

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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Appeals Court: US Can't Force Anti-Sex-Work Pledge

The federal government cannot compel AIDS organizations to publicly denounce sex work and human trafficking as a condition of receiving federal money for work abroad, the US 2nd Circuit Court of Appeals in Manhattan ruled on July 6. Two organizations filed suit in 2005, after having complied with the mandate in order to maintain project funding. Alliance for Open Society International Inc. and Pathfinder International argued their Constitutional rights were being violated by the 2003 congressional requirement.

“Compelling speech as a condition of receiving a government benefit cannot be squared with the First Amendment,” the majority wrote in the court’s 2-1 decision, which noted Pathfinder’s wish to remain neutral on the issue of prostitution. “The right to communicate freely on such matters of public concern lies at the heart of the First Amendment.”

The majority noted as motive in creating the mandate a concern about social, cultural, and behavioral factors intersecting with HIV/AIDS. However, the requirement went beyond a mandate to refrain from certain conduct and compelled partners “to espouse the government’s viewpoint,” the majority wrote, citing two historic First Amendment-related cases.

However, in a long dissent to the circuit’s ruling, Judge Chester J. Straub advocated seeking final adjudication by the Supreme Court to “set us straight” on the matter. He cited a 2007 decision by a District of Columbia federal appeals court that upheld the mandate, and he opined that the law would ensure no federal funds were used to promote sex work and that only organizations that shared the government’s disapproval of such work could be grant partners.

The circuit’s decision upholds a lower court ruling in favor of the plaintiffs. The latest ruling means an injunction will continue to block the law’s enforcement for now, said Rebekah Diller, counsel for plaintiffs. A government spokesperson had no immediate comment on the ruling.

The case docket number is 08-4917-cv.

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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Merck to Partner on HIV Projects

Merck & Co. is joining HIV research projects led by two major US universities, a top official with the pharmaceutical firm has announced. “Collaboration has been the hallmark of much of the progress made against HIV since the virus was first identified 30 years ago,” said Daria Hazuda, Merck’s research laboratories vice president.

Merck will become the only pharmaceutical partner in a new project steered by the University of North Carolina-Chapel Hill. A team including 19 investigators from UNC and eight other universities will look for ways to purge persistent HIV infection from the body.

Concurrently, Merck will work with researchers at the University of California-San Francisco on a five-year effort to define and better understand HIV’s reservoirs and test potential treatments.

The National Institute of Allergy and Infectious Diseases is the primary funder for both research initiatives. Merck will not receive any funding for its participation.

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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Clinics Boost Number Tested for HIV/AIDS: Authorities Credit Fast Exam, Marketing Campaigns

National HIV Testing Day was June 27, capping off an effort by health officials in Colorado to boost screenings there.

The Colorado AIDS Project (CAP) has stepped up its outreach, and its free testing center has served twice as many people during the past year, said Marketing Director Tim Schuetz. “If more people knew it only took 20-30 minutes, more people would come,” he said of rapid HIV testing.

Schuetz said CAP’s center now offers free testing every weekday by appointment and walk-in testing every Saturday, possibly another factor contributing to the increase in testing numbers this year.

Planned Parenthood of the Rocky Mountains also has boosted its education and awareness efforts, said spokesperson Monica McCafferty. It tested 13,000 people in 2010, up from 8,000 in 2007.

Health departments across Colorado have eliminated or significantly reduced funding for HIV tests in recent years, said Ralph Wilmoth of the state health department’s STI/HIV section. El Paso County had to shutter an STD clinic, he noted. Since 2008, the number of people tested at state sites has declined by roughly 1,800, he 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.


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India Says EU Deal Won't Hit AIDS Drugs Supply - UN

At a July 5 meeting, Indian Commerce Minister Anand Sharma reassured UNAIDS Executive Director Michel Sidibe that ongoing trade talks between India and the European Union will not impede the supply of generic HIV/AIDS drugs.

“The government of India reaffirms its full commitment to ensure that quality generic medicines, including antiretroviral [ARV] drugs, are seamlessly available, and to make them available to all countries,” said Sharma. “India will also use the flexibilities allowed under [the copyright pact] TRIPS, including the use of compulsory licensing, to ensure that people living with HIV have access to all lifesaving medicines.”

Worldwide, millions of people who rely on ARVs would die if the proposed trade deal blocked India from producing generic medicines, said Sidibe. India supplies about 86 percent of first-line, generic HIV/AIDS drugs.

The EU is India’s biggest trading partner, and the talks have hit snags over topics such as market access, child labor, and climate change. Discussions about immigration have been complicated as well, particularly for Britain. The current proposal could delay or restrict competition from generic drugs by extending patent terms.

Sidibe said he welcomed Sharma’s pledge. “India, together with Brazil, South Africa, China, and Russia, must forge an alliance with other high-income countries to ensure that no single person in the world dies because they could not afford to buy lifesaving medicines or health care,” Sidibe said in a statement.

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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