The Friends of AIDS Foundation Community Journal: November 2012

Thursday, November 29, 2012

AIDS Activists Arrested after Disrobing in House Speaker Boehner's Office Lobby

Declaring that they wanted to emphasize the “naked truth” about potential spending cuts in HIV programs, three women AIDS activists took their clothes off in House Speaker John Boehner’s office lobby on November 27 and were arrested shortly thereafter. The women had painted the words “AIDS cuts kill” on their bodies and had linked arms with four men who likewise undressed as part of the protest.

The Capitol police arrested the women after they had put their clothes back on, charging the women with “lewd and indecent acts” under the District of Columbia’s disorderly conduct law. The naked male protesters had seemingly left the group at that point. Many other clothed demonstrators were present at the protest and chanted slogans.

A coalition of AIDS activist groups organized the protest outside of Boehner’s office in advance of Washington’s observance of World AIDS Day on Saturday, December 1. The protest happened as congressional leaders and President Obama seek a deal to prevent automatic spending cuts and tax increases in January.

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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Fair to Fight HIV/AIDS in BR

Health officials from the Louisiana State University (LSU) Mid City Clinic will hold a health fair Friday, November 30, one day prior to World AIDS Day on December 1, in hopes that this awareness event will help people know their status by getting tested.

AIDS is a huge problem in the Baton Rouge area, as the city’s metro area ranked first in the nation in 2010 in the rate of AIDS cases per 100,000 of population. There were 1,300 new HIV cases and 795 new AIDS cases diagnosed in Louisiana in 2011, according to the state’s Department of Health and Hospitals (DHH) data. According to the same DHH data, there were 319 new HIV cases (or 25 percent) and 227 new AIDS cases (or 29 percent), diagnosed in Louisiana that were from the Baton Rouge metro area. On the whole, there are 4,888 people currently living with HIV/AIDS in metro Baton Rouge, DHH says.

The November 30 health fair—which runs from 10 a.m. to 2 p.m.—features more than 30 health-care providers, community and government agencies, and local businesses. The fair will provide free HIV testing as well as free syphilis, glucose level, blood pressure, and cholesterol testing. The event will include a raffle for a 40-inch high-definition television set, as well as gift card raffles. The theme for the health fair is “Zero Takes a Community,” which signifies zero discrimination for people with HIV/AIDS, zero new HIV infections, and zero AIDS-related deaths.

Fair officials will dedicate a live oak tree near the clinic in recognition of World AIDS Day, during a ceremony at 10 a.m. on November 30. Dr. Tatiana Saavedra, one of five LSU Mid City Clinic physicians who work at LSU’s Early Intervention Clinic, explains that the oak tree is symbolic, and declared “The tree, which is beautiful, is strong and firm and represents LSU’s years-long fight to prevent HIV/AIDS.”

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Grants Help Those with HIV/AIDS

Mohave County in Arizona is currently in its sixth year of providing funding for housing and medical assistance to individuals with HIV or AIDS through grant money. According to Housing and Community Revitalization Manager Dave Wolf, the U.S. Department of Housing and Urban Development assists the program for Mohave County through a voucher program. He noted that since the county began overseeing the Housing Opportunities for Persons with AIDS (HOPWA) program in 2007, the program has received a total of $384,998.

Beginning in 2007 with 15 families, HOPWA has since assisted 87 families and 160 individuals. During that same time period, the Mohave County Department of Health has also received $123,741 in funds from the Ryan White Program. The Health Department’s Nursing Services Manager, Christine Bronston, says that the goal of the Ryan White Program is to ensure that patients are on medications and that they see their healthcare providers, which is often difficult due to their life situations.

For more information on HIV/AIDS, testing, or the Ryan White Program, contact Mohave County Ryan White Case Manager Marlo Kunze at (928)753-0714, ext. 4282. For more information on Mohave County’s voucher programs, call Dave Wolf at (928)753-0723, ext.4395.

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HIV Testing Goes Mobile

YoungAfricaLive (YAL), a free mobile social network, will provide information on HIV testing sites in South Africa beginning on World AIDS Day, December 1. YAL was launched in South Africa on December 1, 2009, as an entertainment-oriented, fun, and interactive space for young South Africans to communicate about hot topics that affect their daily lives such as love, sex, relationships, gender and cultural issues, as well as HIV/AIDS. The YAL mobile social network has grown to almost 1.3 million users, making it South Africa’s largest mobile social network on sexual and reproductive health.

The info4africa database (formerly HIVAN/HIV-911), the most complete database of HIV Counseling and Testing sites in South Africa, has now been integrated into YAL, giving users the ability to search for and find the nearest HIV counseling and testing site anywhere in South Africa.

Users will find a link to the new feature on the homepage of YAL SA on Vodafone Live and can then query the info4africa HIV data by means of a series of drop-down menus to find a clinic in a specific province, city, or suburb in South Africa. Once the user has chosen the clinic, the information provided includes the name of the clinic, its address, a click-to-call phone number, and the type of services available.

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Jamaica Slashes HIV/AIDS Deaths

According to Jamaica’s Health Minister Dr. Fenton Ferguson, while the Caribbean region has achieved a 42 percent reduction in AIDS deaths between 2005 and 2011, Jamaica has seen an even greater reduction of up to 50 percent in the number of individuals who have died from HIV/AIDS since the beginning of public access to antiretroviral drugs (ARVs) in 2004.

In his address November 25 during the World AIDS Day service at St. Matthew’s Anglican Church in Allman Town, Kingston, Ferguson noted “333 deaths (197 males and 136 females) were reported in 2010 compared with 665 in 2004. This represents a 50 percent decrease in AIDS deaths since the inception of universal access to ARVs in 2004 and a 46 percent decrease when compared to 2000 (617).”

The church service marks the official beginning of Jamaica’s observance of World AIDS Day, which will also include an event in National Heroes’ Park in Kingston on November 30 that will feature HIV and syphilis testing.

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Man Hides HIV Status to Obtain Surgery

An HIV-infected man from Tianjin, China, concealed his condition from doctors, because several other hospitals had refused to treat him, to obtain surgery for treatment of his lung cancer.

The regional director of the China Alliance of People Living with HIV/AIDS, Li Hu, stated on the Weibo social network website that the man successfully received surgery by hiding his condition. Hu added that the man will sue the hospitals who refused to treat him.

Shortly after the information was posted on Weibo, thousands of people responded to the website, making it a debate battleground over the patient’s controversial act. Many denounced the man’s act and called it reckless; they pointed out that it put the medical staff at risk. Others, distraught with the hospitals’ refusal to treat HIV/AIDS patients, thought that these hospitals should be sued for discrimination.

According to China’s Regulation on the Prevention and Treatment of HIV/AIDS, a patient must disclose his or her virus status to doctors, and doctors must not refuse treatment based on a patient’s status. However, the organization is also aware of some hospitals being unwilling to treat infected patients.

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Heroin Use Linked to Hepatitis C Increase

The increase in the number of persons infected with the hepatitis C virus (HCV) in central Wisconsin is attributed to the growing popularity of the drug heroin. In the year 2000, when the state began tracking HCV infections, there were 24 cases of HCV infection in Langlade, Oneida, and Lincoln counties. At present, there are 50 confirmed cases in two counties—Marathon and Portage. A 2011 study by CDC and the Wisconsin Division of Public Health, with assistance from local county health departments, indicated that the primary cause of hepatitis C infection was sharing needles to inject heroin.

Jim Cramm, a Marshfield police department detective who investigates drug crime in Wisconsin, stated that heroin has become more common, as it is cheaper than prescription opioid drugs. Cramm also said that after drugs in the opioid oxycodone family were reformulated in 2010 to prevent abuse, users turned to heroin, which has similar effects. He explained how it is brought through Chicago into Wisconsin’s smaller communities.

Melanie Baehr, Portage County’s Health Department nursing supervisor, stated that the problem of HCV is further complicated by the fact that that approximately 75 percent of persons with HCV infection are unaware of it, as there usually are no symptoms in the early stages of the disease. She suggests that preventing transmission of hepatitis C involves counseling those who are infected about risks and prevention methods.

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Paper Test Could Make Drug Treatment Safer

Researchers from the Beth Israel Deaconess Medical Center in Boston, Mass., have developed a paper-based test for drug-induced liver toxicity. Liver tests are important for patients being treated for TB as the anti-tuberculosis drugs rifampicin and pyrazinamide can cause liver damage, especially in people co-infected with hepatitis B or hepatitis C. Also, people with HIV can develop liver damage when treated with nevirapine-based drugs. US doctors normally check blood to determine if patients are developing serious liver damage and adjust medications to suit, but in developing countries, clinicians may not have easy access to laboratory facilities to test for drug-induced liver injury, particularly clinicians in rural areas.

The new test uses a postage stamp-sized paper device with channels and wells that mix, split, and filter blood from a finger prick to detect chemical markers. In the trial, researchers used existing blood samples to compare the device to established tests. The overall accuracy of the new test was 90 percent compared with the gold standard of 100 percent. In 15 minutes, the test indicated normal, moderate, or high levels of liver markers based on color changes. It also includes a control that confirms the test was accurate. The estimated cost of the test is 10 US cents.

According to Jason Rolland, senior director of research at Diagnostics For All, which developed the technology, the test is cheap, easy to use, and portable, without need of electricity or instruments. Nira Pollock, assistant professor of medicine at Harvard Medical School, coordinated the trial and is liaising with the National Hospital for Tropical Disease in Vietnam to conduct field trials with HIV patients. If the test works as well in the field trials, the researchers are hoping to have a commercial product by 2014. At present, Diagnostics For All can manufacture 500 to 1,000 tests per day.

The study, “A Paper-Based Multiplexed Transaminase Test for Low-Cost, Point-of-Care Liver Function Testing,” was published in the journal Science Translational Medicine 2012 (Sep 19;4(152):152ra129).

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Inuit Health Group is Giving Voice and Vocabulary to Sex Terms in Inuktitut

Pauktuutit Inuit Women of Canada, a nonprofit organization that addresses social health issues in aboriginal communities, has released a 25-page glossary of terms relating to sexual health vocabulary for persons who speak Inuktitut. Among the 53 Inuit communities in Canada, more than 35,000 people speak Inuktitut as a first language, but the language lacked specific terms and phrases relating to sexually transmitted infections (STIs) like HIV/AIDS. This was seen as a barrier to public health. Geri Bailey, Pauktuutit’s manager of health policy and programs, explained that there were no consistent definitions. She stated that the lack of terms to describe the illness accurately leaves patients at risk of not understanding clearly. Bailey added that cancer and HIV translated the same way in some dialects to mean that you have a terminal illness and you are going to die. Also, many anatomical references were unspecific and confusing.

Pauktuutit held a summit for Inuktitut language experts, elders, community workers, and health providers. They defined 56 terms clearly relating to STIs, HIV/AIDS, and the specifics of human anatomy in four major dialects of Inuktitut. The result is the booklet, “Tukisiviit—Do You Understand Sexual Health?” which is now available to the public after 18 months of work and a Canadian federal government grant of $269,000. Copies have been distributed to schools, social service centers, clinics, and hospitals across Nunavut, the Northwest Territories, northern Quebec, and Labrador.

Tracy O’Hearn, Pauktuutit’s executive director, noted that Inuit communities have some of the highest rates of STIs in Canada. According to a government report on STIs, in Nunavut, where more than two thirds o f Canada’s Inuktitut-speaking people live, the rate of chlamydia infection in 2008 was more than 15 times that of the national average and the rate of gonorrhea was more than 30 times the national average.

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Stigmatization Slows Kenya's Efforts to Avert Mother-to-Child HIV Transmission

Pregnant women in Kenya are giving birth to HIV-infected babies either because they do not know their HIV status or they are avoiding the hospitals. Stigma and discrimination are driving their behaviors. At a recent forum in Nairobi, on mother-to-child HIV transmission, Dr. William Maina, head of Kenya’s National AIDS/STD Control Program (Nascop), said that in spite of the country’s great improvements in the fight against HIV, stigmatization is still a challenge. People with the disease are frowned upon, and, as a result, the fear keeps women away from the hospital.

An estimated 13,000 women give birth to HIV positive babies annually, a decrease from approximately 23,000 in 2007. The reduction is due to the government’s efforts to strengthen prevention of mother-to-child transmission (PMTCT) services offered in the country. PMTCT services are available at approximately 5,000 private and public health facilities and are free at public hospitals. Also, pregnant women who go to the hospital for delivery or attend a prenatal clinic are given the HIV test. If the result is positive, they are counseled and encouraged to attend clinics. Maina noted that only about 67 percent of pregnant women who know their status fully attend prenatal clinics. Many women avoid the clinics and hospital and resort to traditional birth attendants or deliver in poorly equipped health centers. Without treatment or proper counseling, mothers may transmit the disease to the infant in the womb, during the birth process, or when breastfeeding.

Mercy Achieng, an HIV positive woman who mentors HIV-positive pregnant women, explained that stigmatization is a major hindrance to the country’s goal to eliminate perinatal transmission of HIV. She noted that the discrimination is worse for pregnant women, and it begins with the family. Also, at the hospital, some nurses stigmatize patients, abuse them, and make negative comments. As a result, the women may choose not return to the hospital or clinic. In addition, violence against women and poverty contribute to mother-to-child HIV infections. Women are unable to negotiate condom use with their husbands or make them go for an HIV test, and many men who know their status do not inform their wives. Some women breastfeed their infants because they cannot afford to buy formula, and thus may pass the disease to a baby that was born healthy.

Kenya aims to eliminate perinatal HIV transmission by 2015. Toward this end, the country recently launched a program called Elimination of Mother-to-Child Transmission of HIV.

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MTV Special Profiles Young People with HIV

MTV will present a special on December 1 at 7:00 p.m., Eastern Time, which profiles three young people who are HIV-infected. MTV hopes that the special, “I’m Positive,” will become a regular series. In the 30 years that HIV has existed, the virus that causes AIDS has gone from a death sentence to a chronic condition that can be controlled with early detection and a drug regimen; however, many are worried that some people are not taking the condition seriously enough. According to Drew Pinsky, one of the producers of the show, even if HIV does not develop into full-blown AIDS, there are still questions about the long-term health implications of living with HIV and the drugs that are taken to control it.

The three profiles presented in the program reveal a generational divide. One of the three subjects is a California girl who feels in control of the situation in spite of her infection, while another subject’s mother is distraught and thinks her daughter is dying because her single, Southern daughter became infected through one instance of unprotected sex. The third profile subject, a male, has a difficult time telling his family that he is HIV-infected, since he had only revealed to them that he was gay one year ago.

MTV has successfully used documentary-style programming to effectively reach its young viewers with a message; its programming on teenage pregnancy is a prime example. Pinsky declares that young people can relate to peers who are struggling with the HIV problem. MTV originated its “safe sex” campaigns in 1985, and has been working with the Kaiser Family Foundation since 1997 to encourage youth to get tested for HIV. Two in five people infected with HIV each year in the United States are between the ages of 13 and 29—MTV’s target audience. More than 1.1 million Americans are living with HIV infection, according to the CDC.

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Survival Gene May be Key to Controlling HIV and Hepatitis

Dr. Marc Pellegrini and Dr. Greg Ebert of the Infection and Immunity Division of the Walter and Eliza Hall Institute of Medical Research, Parkville, Australia, and colleagues from the University of Toronto conducted research that discovered a gene called Arih2 that is important to the function of the immune system. The gene is essential for embryo survival and could be key to treating chronic infections such as HIV, hepatitis, and TB.

Dr. Pellegrini described Arih2, which is found in dendritic cells, as the sentinels of the immune system that play an essential role in the body’s response to the presence of foreign invaders. He stated that Arih2 is responsible for the decision that the immune system makes as to whether the immune response should be initiated and progressed or whether it should be switched off to avoid development of chronic inflammation or autoimmunity. He explained that the immune system works well against many infections, but some organisms have developed ways of exhausting the immune system so that the system switches off. He listed HIV, hepatitis B, and TB as examples of organisms that counter the immune response—exhausting T cells “which are stimulated over and over again by the infection” and then become exhausted or paralyzed. He said that with this discovery, researchers should be able to reinvigorate the immune response temporarily to boost the immune system and help clear these infections.

Dr. Ebert stated that the research team was examining the effect on the immune response of switching off Arih2 for short periods of time during chronic infections and looking at how manipulating Arih2 and associated pathways promote immunity in chronic infections. He noted that Arih2 showed promise as a drug target. The researchers state that it would take many years for the discovery to be translated into a drug that can be used by humans, but that the discovery has significant implications for manipulating the immune response to infections and suppressing chronic inflammation or autoimmunity, as researchers can target this agent to try to push immune responses in different directions, either promoting or suppressing it.

The study, “ARIH2 Is Essential for Embryogenesis, and Its Hematopoietic Deficiency Causes Lethal Activation of the Immune System,” was published ahead of print in the journal Nature Immunology 2012 (doi:10.1038/ni.2478).

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Cellphones Reshape Prostitution in India, Complicate Efforts to Prevent AIDS

Cellphone use by prostitutes in India has freed them from the brothels and the control of madams, but it may also cost them dearly. Sex workers are using inexpensive mobile phones to lure customers elsewhere, but this independence makes it difficult for the government and safe-sex counselors to find them. Formerly government workers and other safe sex workers could use the brothels as important prevention points to offer free advice and condoms. Without the advice and free condom distribution, counselors fear that sex workers and their customers are returning to dangerous unprotected sex.

Studies show that sex workers who rely on cellphones are more susceptible to HIV as they are less likely to require their clients to use condoms, compared to those in the brothels. When interviewed, sex workers stated that they had given up control in the bedroom in exchange for more control over their money. India has about 1.5 million AIDS cases, less than the predicted 25 million. Reasons for the success in preventing HIV include the fact that women in India have fewer sex partners than in many other developing countries, as well as the way that the government targeted red light districts with safe sex messages and free condom distributions and trained dozens of sex workers to counsel their peers in safe-sex practices. Also, the World Bank and the Bill and Melinda Gates Foundation underwrote an intensive effort to target such high-risk groups as sex workers, gay men, and intravenous drug users.

When the sex workers move from brothels, the targeted interventions are threatened. Also, because of the use of cellphones, more women are drawn to becoming sex workers, and more men who may not have gone to a brothel are using cellphone-accessible sex workers because of the convenience and privacy that this affords. Ashok Alexander, former director in India of the Gates Foundation, noted that the mobility of sex workers is huge and contacting them is very difficult. He noted that it is a totally different challenge, and the strategies will have to change The Gates Foundation is lending its oversight and support for AIDS prevention in India.

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More than Half of HIV-Infected Young People Unaware of Their Status

Young people between the ages of 13 and 24 represent more than a quarter of new HIV infections each year (26 percent) and most of these youth living with HIV (60 percent) are unaware they are infected, according to a Vital Signs report from the Centers for Disease Control and Prevention. The most-affected young people are young gay and bisexual men and African–Americans, the report says.

The analysis looks at the latest data on HIV infections, testing, and risk behaviors among young people and was published in advance of World AIDS Day, Dec. 1.

Despite recommendations from CDC and the American Academy of Pediatrics that call for routine HIV testing of youth in medical settings, the analysis shows that 35 percent of 18-24 year olds have been tested for HIV, while only 13 percent of high school students (and 22 percent of sexually experienced students) have ever been tested.

Additionally, an analysis of data on risk behaviors among high school students in 12 states and nine large urban school districts found that young men who have sex with men reported engaging in substantially higher levels of risk behavior than their heterosexual male peers.

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Tuesday, November 20, 2012

People with HIV/AIDS in T&T Battle Against Discrimination

Speaking at a fundraising dinner held November 16 at the House of Angostura in Laventille, Dale Enoch, chairman of the Caribbean Action Resource (Care) declared that while there had been some progress in treatment and access to medication for those with HIV/AIDS living in Trinidad and Tobago, the battle against discrimination continues.

Enoch went on to say that for the past 23 years Care has excelled in the areas of community outreach and nationwide education about safer sex, stigma, and discrimination against those who live with HIV/AIDS. T

he gathering included the Minister of State Rodger Samuel, and Enoch chastised Samuel for what Care views as the state’s lethargic approach to initiatives such as the National HIV/AIDS Strategic Plan and the National Workplace Policy, which Care has contributed to.

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388,864 Nigerians Infected with HIV in One Year

According to Nigeria’s Lagos State Government, at least 388,864 Nigerians were infected with HIV in 2011. On November 15, Dr. Dolapo Badru, Special Advisor to the Governor on Youth and Social Development, spoke at a HIV Prevention and HTC Workshop organized in conjunction with the Lagos State AIDS Control Agency.

Badru announced that between 1986 and 2011, 3,459,363 Nigerians now have HIV and 1,449,166 require antiretroviral medications. He also stated, “As of today, 5.4 million young people out of the global population of 1.7 billion are living with HIV and 40 percent of new HIV infections occur among young people; they have the highest rates of sexually transmitted infections (STIs).” He went on to say that 55 percent of AIDS deaths in Nigeria are currently occurring among women and girls.

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Ocean County Board of Health Gets $92K State Grant to Prevent HIV/AIDS

The state government of New Jersey recently awarded $92,000 to the Ocean County Board of Health for HIV/AIDS prevention in fiscal year 2013. According to Leslie D. Terjesen, the county’s Board of Health spokesperson, the funds will be used for the counseling and testing program, as the HIV/AIDS clinic is funded through the Ryan White Program. Terjesen stated that the counseling and testing clinic tested 784 persons in 2011 and 578 persons as of late October of this year.

The Ocean County Health Department provides free and confidential HIV counseling and testing and maintains a full service clinic for HIV/AIDS patients who have no medical insurance. Testing is done on Tuesday and Wednesday evenings of each week at its main headquarters. A limited number of daytime appointments can be made, and bilingual counseling is available.

The state’s Department of Health estimates that more than 36,000 people in New Jersey are living with HIV. Approximately 7,000 state residents with HIV/AIDS receive drugs through the health department’s AIDS drug distribution program. Testing sites located in all 21 counties include community organizations, hospitals, health departments, community health centers, and other health care facilities. Funding was distributed for specific purposes: some agencies, such as the Ocean County Board of Health, received grants in one category, and other organizations received funding for care, treatment, and behavioral services.

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Nonprofit Educates About HIV, Teen Pregnancy Risks

The Red Ribbon Project, a nonprofit organization of Colorado’s Eagle County, empowers the community to reduce HIV/AIDS, teen pregnancy, and sexually transmitted infections. Red Ribbon has built meaningful relationships with health agencies, youth-serving organizations, and the school district. The organization team is made up of community members and is known as “a small nonprofit that does big things.”

When the Red Ribbon Projects began in 1996, the group offered HIV 101 to middle- and high-school youth. The course has evolved into the Youth Skills Building Program, which is a comprehensive life skills curriculum encouraging youth to make informed and positive decisions. The program offers culturally and age-appropriate HIV/AIDS education to students in grades 6 through 12. The Youth Skills Building program provides 14 classes at Eagle County middle and high schools, from which the students can pick to enroll.

The Red Ribbon Project has also begun a teen pregnancy prevention program, called Cuidate!, which means “take care of yourself.” This program is aimed at Latino youth and designed to reduce HIV sexual risks by emphasizing risk reduction strategies that support safe decision making. The Red Ribbon project’s testing program specifically serves high school youth and a Latino transient population living in Eagle County, as the county’s resort economy relies on tourism and recreation.

On average, 17 babies were born to teens in Colorado every day—about one baby born every 84 minutes. Nearly three in 10 girls in the United States get pregnant at least once before the age of 20, and 18 percent of Americans with HIV do not know they are infected. These statistics make it clear that education about reproductive health should be provided. The Red Ribbon Project educates youth about the consequences of sex, and presents them with comprehensive education that includes information about safe sex and abstinence.

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Texas Biomed Files for Novel HIV Vaccine

The Texas Biomedical Research Institute (Texas Biomed) has applied for a patent for a genetically-engineered vaccine for HIV prevention. The vaccine is designed to be administered in a single dose that will last the patient a lifetime. It targets the outer layers of the body structures that first come into contact with the virus. Officials at Texas Biomed believe that the vaccine could be adapted for use against other infections.

Marie-Claire Gauduin, PhD., of Texas Biomed’s Department of Virology and Immunology is co-inventor on the patent with Philippe Blancou, PhD., a visiting scientist from the University of Nice-Sophia Antipolis in France. Gauduin stated that the development of an effective AIDS vaccine that restricts viral replication at the mucosal level of entry may be the best hope of controlling HIV. She added that only life-long stimulation of the immune system by the vaccine will be sufficient to achieve long-term protection.

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U.S. Panel Advises HIV Tests for Everyone Ages 15 to 64

The US Preventive Services Task Force, an independent group that operates under the sponsorship of the US Department of Health and Human Services to advise the US government and physicians on the medical evidence for preventive health measures, has recommended HIV tests for everyone aged 15 to 64.

The guidelines also recommend that doctors offer HIV testing to people under 15 or over 64 if they are at high risk for contracting HIV and that they offer HIV testing to all pregnant women. On November 19, the task force posted its recommended guidelines to its website for a four-week period of public comment.

The task force conducted two reviews of the science done by independent groups of scientists: one focused on pregnant women and one focused on HIV screening for the population at large. Annals of Internal Medicine published the two reviews on November 19.

The recommendations would apply to all but very-low-risk populations. In their 2005 guidelines, the task force suggested routine HIV screening only for adolescents and adults at increased risk. Since then, however, studies have been published that offer sound evidence that HIV-infected individuals, as well as their intimate partners and the public, are better served by near-universal screening.

Dr. Bernard M. Branson, an epidemiologist at the Centers for Disease Control and Prevention (CDC) and a co-writer of the CDC’s 2006 guidelines, states that every HIV infection that is prevented saves $367,000 in lifetime medical costs. CDC’s guidelines are mainly in agreement with the task force’s current ones, differing only in that CDC recommends that testing begin at age 13 instead of 15. Other groups such as the American Congress of Obstetricians and Gynecologists, the American College of Physicians, and the American Academy of Pediatrics also recommend widespread HIV testing, with slight differences. Dr. Jeffrey D. Klausner, a professor of medicine and infectious diseases at UCLA, notes that regardless of the increasing endorsements, surveys show that many doctors are not performing the tests routinely.

The panel listed its recommendations as Grade A, meaning that there is high certainty of substantial benefit. If the panel ultimately adopts those recommendations, Medicare and most private health insurers would be required to pay for the tests.

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Openly Gay CDC Director Leaving after 7 Years at Helm of HIV/AIDS Division

Dr. Kevin Fenton announced in a letter to colleagues on November 16 that he is leaving his position as the Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) at the Centers for Disease Control and Prevention (CDC).

Dr. Fenton states in his letter, “During my tenure as Director of NCHHSTP, it has been my honor and privilege to take part in the process through which voices of the community and the country’s top professionals at all levels inform CDC’s programmatic decisions.” He wrote, “We have worked together on disease-specific initiatives while moving forward more holistic and integrated approaches to address the overlapping epidemics of HIV, STD, hepatitis, and TB.”

Dr. Fenton will leave CDC by the end of 2012 and return to his home country, the United Kingdom, to take a position with Public Health England (PHE) as Director for Health Improvement and Population Health, beginning in April 2013. Dr. Fenton has served seven years as the Director of NCHHSTP.

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Inaugural World AIDS Day Concert in Downtown Los Angeles Hosted by AIDS Research Alliance, Presented by Kaiser Permanente

The AIDS Research Alliance (ARA) will host its inaugural World AIDS Day concert at 7:30 p.m. on Friday, November 30, in Zipper Hall at the Colburn School in downtown Los Angeles.

Master of Ceremonies LeVar Burton, Emmy Award winner, will speak about the historic significance of World AIDS Day. Keynote speaker Dr. David Hardy, director of the Division of Infectious Diseases at Cedars-Sinai Medical Center and professor of Medicine at the David Geffen School of Medicine at UCLA, will address the impact of HIV/AIDS in Los Angeles and more globally.

Musical performances by the award-winning Calidore String Quartet and the Colburn Woodwind Ensemble will begin at 8:00 p.m. The community event is free and open to all.

Registration for the concert is required prior to the event via this link: http://bit.ly/QRsaJY. For further information, please contact development@aidsresearch.org.

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HIV/AIDS Group Petitioning for "Stop Runaway Drug Pricing" Ballot Measure

The Los Angeles-based AIDS Healthcare Foundation, an organization of HIV/AIDS patient advocates, announced on November 15 that it intends to put a measure on San Francisco’s 2013 ballot, encouraging the city to negotiate for the lowest possible cost for the prescription drugs that it purchases. San Francisco residents need to collect 9,703 valid signatures on a petition for the measure, “Stop Runaway Drug Pricing,” to be placed on the city’s ballot in November 2013. AIDS Healthcare Foundation officials stated that signature gathering would begin the weekend of November 17, with organizers having until mid-May 2013 to compile enough signatures.

San Francisco law presently authorizes the city’s Public Health Department to use outside companies to negotiate prices for prescription drugs. This new measure would change that city’s policy by allowing San Francisco to directly negotiate with drug manufacturers. AIDS Healthcare Foundation spokesman Ged Kenslea declared that governments are the largest purchaser of pharmaceutical products and have the ability to say no to companies that are charging for drugs to treat AIDS, cancer, and other illnesses, but they have not done that. Dr. Lisha Wilson, Bay Area Clinical Medical Director at the AIDS Healthcare Foundation, cites the drug Stribild, a four-in-one AIDS treatment combination drug produced by Gilead Sciences, Inc., as an example of a drug that is extremely high-priced; it costs $28,500 annually. That is more than most AIDS patients earn in a year, according to Wilson. Officials at Gilead were not immediately available for comment. One community activist, who has lived with HIV/AIDS for more than 19 years, worries about being priced out of the market for the medicine he needs, saying that one day, he may not be able to afford it.

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TB No Barrier to Anti-TNF Treatment

The cytokine tumor necrosis factor (TNF) is important in protecting against TB infection; however TNF suppression is necessary for treating certain diseases. After the use of TNF inhibitors began, it was found that the suppression activated latent TB infection. The instructions for resuming TNF suppression in TB patients for treatment of other diseases—including arthritis—have not been very clear. The 2012 recommendations from the American College of Rheumatology announce that biologic therapy may be resumed after TB treatment. The guidelines from the British Society for Rheumatology hold that patients may continue on biologics if necessary during TB treatment, and the Spanish Society of Rheumatology states that there is no evidence of the optimal time for resumption.

Researchers led by Maria Victoria Hernández, MD, of the Hospital Clinic of Barcelona, and colleagues conducted a retrospective study to determine the effects of timing in restarting biologic therapy for persons receiving TNF treatment. Data were taken from the Spanish Biologic Therapy Registry, which covered 6,479 patients. By November 2011, there were 52 cases of active TB. In all cases, biologic treatment was stopped, and in 27, anti-TNF therapy was resumed before TB treatment was completed. The 27 patients were classified as Group 1, and those who completed TB treatment before resuming biologic therapy were labeled Group 2. The median time for resumption of treatment was two months in Group 1 and 12 months in Group 2. There were 15 women in group 1; the mean age of the group was 57 years, and the mean disease duration was 19 years. Of the 27 patients, the underlying diagnosis was rheumatoid arthritis in 14, ankylosing spondylitis in 6, psoriatic arthritis in 3, juvenile idiopathic arthritis in 2, Behçet’s disease in 1, and undifferentiated spondyloarthropathy in 1. Of these patients, 20 were taking infliximab, 3 etanercept, and 4 adalimumab. The median time to resumption of TNF treatment was 2 months in group 1 and 12 months in group 2.

In all but two patients, good control was achieved after resuming anti-TNF therapy, and patients remained on treatment. There was no evidence of relapse in the 27 patients during the four-year follow up. The researchers conclude that resumption of biologic therapy may not always need to be deferred; patients being treated with TNF inhibitors who develop TB may safely reinstitute TNF treatment before they complete TB treatment.

The study, "When Can Biological Therapy Be Resumed in Patients with Rheumatic Conditions Who Develop Tuberculosis Infection During Tumor Necrosis Factor Antagonist Therapy?" was presented at the 76th annual meeting of the American College of Rheumatology, November 9–14, 2012, Washington D.C., and was published in the American College of Rheumatology Abstract Supplement (2012; 64(10 supp.):(S701–S702).

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Disease Control Dept to Encourage Teens to Carry Condoms

Dr. Pornthep Siriwanarangsan, director of the Department of Disease Control, Thailand, has stated that parents should allow their daughters of high school age to carry two condoms to prevent sexually transmitted diseases (STDs) and teenage pregnancy. Dr. Siriwanarangsan cited results of a study showing that 20 percent of Mathayom 2 students (approximately aged 13 years) and 40 percent of Mathayom 5 students (approximately aged 15 years), and 50–60 percent of vocational students (aged 15 to 17 years) are sexually active. He added that 42 percent of persons with STDs were under age 20 years, and these diseases are caused by unprotected sex. Also, 80 percent of youth in this age group become pregnant. He suggested that parents provide their adolescents with two condoms a day. The parents can buy the condoms or acquire them from health offices, as the health department had procured 60 million condoms a year for distribution.

The Thai Red Cross Society’s Secretary General Phaen Wannamethee urged people to get tested for HIV, as Thailand now has 12,000 new HIV infections per year. Wannamethee announced that to mark World AIDS Day on December 1, free blood tests would be available at five malls in Bangkok on November 30 and December 1. Results will be available in one hour. He advised listeners that early detection resulted in early treatment to keep the virus count low and improve longevity.

Pradit Sinthawanarong, public health minister, noted that Thailand had 500,000 HIV-infected persons, but approximately 200,000 persons did not receive treatment because they were not aware of their diagnosis and did not take care of their health until they became ill. He reminded universal healthcare subscribers that they were allowed to take two blood tests a year.

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Ruling Soon on Isolation of Inmates with HIV

Federal judge Myron H. Thompson, of the Middle District of Alabama, plans to rule before Thanksgiving on the legality of isolating HIV-positive inmates from other prisoners. In September, the judge held a trial in a class action suit brought by the American Civil Liberties Union (ACLU) against the Alabama Corrections Department on behalf of the HIV-positive inmates. The Alabama Corrections Department believes that separating HIV-positive inmates will prevent HIV transmission among inmates, and reduce medical costs. The department is concerned that the virus will spread through consensual sex, rape, or blood, such as when inmates give each other tattoos. Alabama and South Carolina are the only two states that still separate inmates with HIV.

Inmates are tested when they enter Alabama prisons. Of 26,400 inmates, approximately 270 have tested positive. Inmates who test positive are placed in special dormitories in two prisons: men are sent to the Limestone Correctional Facility and women to the Julia Tutwiler Prison for Women. There, inmates have air conditioned dormitories and private cells, but they are subject to the following restrictions: they eat alone and not in the cafeteria, they wear white plastic armbands identifying them as HIV positive, they are not allowed to work in jobs around food, they cannot live in dormitories for elderly or religious inmates, they cannot transfer to prisons closer to their families, and until three years ago, they could not attend prison-wide church services.

The state claims that by confining HIV-positive patients to two prisons, they are able to provide good care as fewer doctors are needed and the prisons can become centers for excellence, attracting HIV specialists. Both sides agree that the state provides high-quality care. The state claims that they could not provide the current level of care if inmates were spread across the state, but medical experts note that isolation is not necessary, as other states provide treatment to HIV-positive inmates at all facilities.

HIV positive inmates testified at the trial that prison workers bullied and ridiculed them, and they were subjected to embarrassment and abuse. In addition, Margaret Winter, associate director of the ACLU’s National Prison Project, commented that being within visiting distance of family and having real work experience are two of the most important factors for successful reentry, but the HIV-positive inmates are being denied those opportunities.

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Countywide AIDS Support Campaign Starts Nov. 23

BizAid for AIDS, a county-wide AIDS support program in Santa Cruz, Calif., provides a way for businesses to support people with HIV/AIDS. Scott Roseman, co-owner of the Santa Cruz AIDS Project (SCAP) and the New Leaf Community Markets, developed BizAid 22 years ago so that businesses could commit either a percentage of sales or a specific amount to SCAP during the 10 days following Thanksgiving. The BizAid campaign runs from November 23 through December 2 and leads up to a gathering for World AIDS Day on December 1. World AIDS Day will be observed at the Pacific Cultural Center at 1307 Seabright Ave., Santa Cruz, Calif., starting at 6 p.m.

Roseman declares that “BizAid for AIDs is a great way for our business community to come together to support a most worthy cause, and have a dramatic impact on what Santa Cruz AIDS Project can do to support those affected by HIV.” SCAP representatives will be at New Leaf stores at various times during the campaign to talk about the ongoing need for support for people with HIV/AIDS. The list of New Leaf and additional participating businesses can be found at: www.scapsite.org/node/14.

Since July 2012, SCAP has been a part of the Santa Cruz Community Counseling Center and provides free support to people with HIV/AIDS, including access to counseling, medical care, and financial support. SCAP manages outreach prevention programs to high-risk populations to prevent the spread of HIV, STDs, and hepatitis. The two organizations collaborate to focus on direct services.

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Poverello "Turkey Hunt" Provides Turkeys for People with HIV

Each year, the Poverello Center in Wilton Manors, Fla., organizes a “Turkey Hunt” fundraiser intended to provide Thanksgiving dinners to the families of HIV/AIDS patients. The center supports these same families throughout the year with the proceeds from sales through their thrift stores. According to Fundraising Director Jim O’Hay, the center assists between 2,000 and 3,000 families per month.

A donation of $14.57 will fund a complete Thanksgiving dinner of a 10-lb. turkey with all of the trimmings and traditional side dishes for a family of four to six individuals. A donation of $29.14 will provide two dinners, and $43.71 will provide three dinners.

Credit card donations can be made by visiting Poverello.org or by calling (954) 561-3663. Donations can also be made by a check payable to The Poverello Center Inc., which can be mailed or hand-delivered to the center’s thrift store at 2056 N. Dixie Highway, Wilton Manors, Fla., 33305.

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Great American Smokeout: An Opportunity for Smokers Living with HIV to Improve their Health

Ronald Valdiserri, deputy assistant secretary for Health, Infectious Diseases and director, Office of HIV/AIDS and Infectious Disease Policy at the US Department of Health and Human Services, writes about the 37th Great American Smokeout organized by the American Cancer Society. The purpose of the smokeout is to encourage smokers to use the date to make a plan to quit or to quit on that day. He states that smokers, including those with HIV, will be making an important step toward a healthier life and reducing many health risks.

Valdiserri discusses why smoking is even more harmful for persons living with HIV/AIDS (PLWHA) than the general population. He uses the HRSA Guide for HIV/AIDS Clinical Care, and research to provide evidence that PLWHA should not smoke and should take advantage of the Great American Smokeout to quit. He lists the smoking-related problems in PLWHA, including the normal tobacco-related conditions such as lung cancer and other cancers, as well problems that are specific to PLWHA, such as decreased immunologic and virologic response to antiretroviral therapy, nonadherence to treatment, and a greater chance of being diagnosed with an AIDS-defining condition—or dying of the disease.

Valdiserri emphasizes the role of health care providers in encouraging and supporting PLWHA to quit smoking and references studies that document the importance of clinicians and other HIV service providers’ roles in encouraging smoking cessation and promoting health. To prepare to help patients who are trying to quit smoking, he suggests that HIV providers review the chapter on Smoking Cessation in the Guide for HIV/AIDS Clinical Care (2011), which contains information on behavioral and pharmacological interventions that may be useful. Valdiserri also provides a list of resources for persons who plan to quit smoking or are supporting others to do so.

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Thursday, November 15, 2012

Alcohol and Drug Abuse Initiative Educates Students on Responsibility Behind Drinking, Safe Sex

On November 14, the Sam Houston State University (SHSU) Alcohol and Drug Abuse Initiative (ADAI) sponsored a discussion titled, “Playing with the Wrong Odds,” at which students and faculty discussed responsibility while drinking alcohol and practicing safe sex. The ADAI, Alpha Delta Phi, and the Dean of Students Office hosted the event, which drew approximately 80 students.

ADAI Coordinator Eddie Gisemba emphasized the social roles that alcohol and sex play in students’ lives and the consequences of each. He demonstrated a spinning wheel game depicting how peer pressure greatly influences a person’s choice to consume more alcohol or engage in sex. “Socially, alcohol plays a huge role. We often connect it to the meals we eat and how we socialize,” declared Gisemba. He added that ADAI had hosted similar discussions for students in the past, but this one approached the topic differently, focusing on responsibility rather than prevention. “Oftentimes, telling students ‘don’t do it’ is not effective because it’s not realistic. So what I try to do is focus more on the responsibility and health and legal consequences of these actions,” explained Gisemba.

The students viewed the presentation as a learning experience. One student lamented that a lot of people get caught up in drinking and sex because these are the “cool” things to do. However, another student acknowledged that the discussion convinced her not to participate in drinking, as it affects both students and the people around them.

For more information, visit the ADAI program on the SHSU website at http://shsu.edu/dept/adai/programs/.

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Condoms Treated with Silver Nanoparticles Could 'Completely Inactivate' HIV, Other STDs

Condoms have a 15 percent failure rate. Also, they do not completely protect against sexually transmitted diseases (STDs). However, when researchers at the University of Manitoba soaked condoms in a solution of microscopic silver nanoparticles, the condoms seemed to kill all HIV and herpes viruses in lab experiments.

Silver has been known to have disinfectant powers, but its effectiveness was not reliable. According to Dr. Xiaojian Yao, lead author of the study, when silver was used in a nanoparticle form, it seemed to become more effective at fighting off bacteria and viruses. The small size of the nanoparticles also enabled the researchers to place them on a polyurethane condom without changing its size or shape. The researchers do not know exactly how the silver nanoparticles neutralize HIV and other viruses.

Dr. Yao added that the silver nanoparticles do not cause inflammation. Currently, there are condoms treated with the antimicrobial called Nonoxynol-9, but these can cause inflammation and genital ulcers, which may make infection more likely. Also Dr. Yao noted that the treated condoms are quickly discarded, so that the potentially toxic metal does not remain in users’ bodies. Another consideration is that discarded nanosilver-treated condoms could prevent infecting anyone who finds and touches them.

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Health Parties for Latinas Tackle Important Women's Issues

Home health parties have become a very successful method of educating Latinas in Wisconsin about sexual health. The parties, which are based on the home party plan used to sell jewelry and other goods, were developed by Planned Parenthood of Wisconsin (PPWI) specifically for Latinas. Maria Barker, PPWI’s multicultural program manager and a Latina, began them in 2006 in response to the high rates of teen pregnancy and sexually transmitted diseases (STDs) among Latinos. Data from the Wisconsin Department of Heath Services show teen birth rates among the Latino population to be 3.5 times higher and STD rates 1.6 times higher than those of Caucasians. Also, there is little communication about sex in the Latino community. Barker describes the goal as providing a comfortable, nonjudgmental place to educate families with fact-based, medically accurate, and age-appropriate information.

The home health party usually consists of a small group of participants—about 10 family members and friends of the volunteer host—and is led by a trained “promotore de salud” health educator. The educator presents a two-hour interactive presentation and discussion on one of seven topics: cultural values in sexuality, anatomy, puberty, adult/child communication, birth control, STDs, and breast and cervical cancer. PPWI provides childcare if needed and a stipend to buy snacks so that hosting would not create a financial burden. When designing the model, Barker realized the curriculum had to be culturally relevant and geared to the whole family, not only to women. She also took into account the religious aspect of the culture.

In the first year of operation, PPWI reached 800 Latinos with one health educator. In 2011, it reached more than 5,000 Latinas through hundreds of parties in Madison and Milwaukee with 10 health educators. The program has been so successful that it has received the support of a pro-life Milwaukee priest who became educated as a health promoter to help PPWI with topics related to sexuality and faith. PPWI has a two-year planning grant to evaluate how to expand the party outreach model and has implemented a version of the program in schools and churches. Barker was also invited to speak on a panel at the White House on how to implement the party model on a national scale. She views the key to success of the home health parties as keeping them small and local. In addition to the health aspects, the parties have provided many Latinas with social circles in the community.

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HIV/AIDS Forum Set for Thursday

On November 15, the city of West Hollywood will host a discussion forum called “HIV Game Change 2012—The State of HIV/AIDS in West Hollywood,” featuring educators, doctors, and others who will discuss the changing culture of HIV/AIDS and its potential effects on gay males in West Hollywood and neighboring cities.

City Councilman John D’Amico, who has HIV, declared that West Hollywood (Weho) has a responsibility to discuss HIV/AIDS because of the great number of Weho residents with the disease. “I think it’s important for our city, which is the epicenter of HIV and AIDS in LA County, to step up and talk about a changing epidemic,” explained D’Amico. Forty percent of the current Weho population is gay, and 25 percent of the gay population is living with HIV—meaning that approximately 10 percent of Weho residents have the disease. D’Amico stated that a major point of the forum will deal with what is true for the sex lives of gay men, those with HIV, and those that do not have the disease.

Alex Garner, editor-at-large for PositiveFrontiers.com, will speak at the discussion forum. Garner has had HIV for the past 17 years, even though doctors only gave him 10 to 15 years to live when he was first diagnosed. He has lived a healthy and fulfilling life due to the advancements in HIV/AIDS treatment. Garner emphasized that the discussion forum’s focus on November 15 will be education about advancements that continue to be made.

Other speakers include Eric Gutierrez, Health Policy Director for the L.A. Gay & Lesbian Center, and Christopher Brown, Director of Health and Mental Health Services with the L.A. Gay & Lesbian Center. “HIV Game Change 2012—The State of HIV/AIDS in West Hollywood” will begin at 7:30 p.m., November 15, in the Community Room at the West Hollywood Library, located at 625 N. San Vicente Boulevard.

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