The Friends of AIDS Foundation Community Journal: December 2012

Saturday, December 29, 2012

Indian Doctors Force Headbands onto HIV Patients

AIDS patients at Jamnagar's general hospital are made to wear headbands which proclaim their HIV positive status. The Gujarat high court (HC) on Thursday issued notices to concerned authorities after this issue was brought to its notice in a public interest litigation (PIL).

The PIL was filed by advocate Vijay Nangesh highlighting the "improper" practice in G G Hospital in Jamnagar. The lawyer submitted that the patients infected with HIV are given a band to be tied on their heads so that others could identify them and keep distance from them. He also produced photographs of patients carrying tags of HIV on their heads.

The petition claims that such a branding of HIV infected people is inhuman treatment to them, for this marking leads to isolation of these patients as other patients and their relatives maintain a "safe distance" from them. The petitioner also pointed out that this inhuman practice also causes panic among other patients who are in the hospital.

The PIL cited a guideline given by the Supreme Court saying that the identity of such people must not be disclosed. The lawyer also cited rules framed by the Medical Council of India in this regard. The PIL has demanded immediate restriction on this practice of disclosing AIDS patients' identity. It has also sought action against responsible officials. After hearing the case, a bench of Chief Justice Bhaskar Bhattacharya and Justice J B Pardiwala sought reply from the state health department secretary, Jamnagar collector and the medical superintendent of the GG Hospital. Further hearing on this issue is kept next week.

Meanwhile, other PILs are also being heard by the HC on the issue of HIV infected people. The high court has ordered CBI probe in the incident of HIV infection among thallassemic kids in Junagadh.

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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CDC Updates Estimates of HIV Incidence in the United States, 2007-2010

Recently the Centers for Disease Control and Prevention (CDC) released estimates of HIV incidence among adults and adolescents in the United States for the years 2007-2010. These estimates, published in the online HIV Surveillance Supplemental Report, show that while the epidemic has been relatively stable overall at 50,000, per year, there are noteworthy findings among some hard-hit populations.

Comparing 2008 to 2010, new infections among African-American women has declined by 21 percent, giving us cautious optimism. This is the first CDC incidence report to show statistically significant declines among black women. However more time is needed to see if these trends will persist.

Yet, disparities still persist and the burden is too high. Overall men who have sex with men (MSM) of all races and African American and Latino men and women are most affected. We continue to see troubling increases among young MSM. New infections have risen sharply in this group, the only group to experience statistically significant increases. CDC estimates that incidence in MSM aged 13 to 24 has increased 22 percent, comparing 2008 to 2010. Young black MSM continue to bear the heaviest burden, and now account for more new infections than any other subgroup.

To have the greatest effect possible on HIV prevention and care, the CDC is working through a High Impact Prevention approach that directs every prevention dollar where it will have the greatest impact. CDC continues to fund and provide technical assistance to support state, local and community efforts, and expand HIV testing to the hardest hit populations. In addition, they are focusing on researching and engaging the community to better understand how to overcome the social, economic and cultural barriers that contribute to increase risk; and launching innovative communication campaigns.

Additional information on the new HIV incidence estimates can be found online at: http://www.cdc.gov/hiv/surveillance/resources/reports/2010supp_vol17no4/index.htm

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Sunday, December 23, 2012

Penn State Alumnus Wins $5M Grant to Develop HIV Vaccine

Penn State Hazelton alumnus Dr. Gary R. Matyas has won the 2012 Avant-Garde Award for Medications Development, a $5 million award, from the National Institute on Drug Abuse. The award will fund his research to develop a vaccine against HIV that also prevents heroin addiction.

Matyas works with the U.S. Military HIV Research Program at the Walter Reed Army Institute of Research in Silver Spring, Md., where research has already produced the anti-heroin component of the vaccine called haptens. The anti-heroin haptens is now ready for a more advanced, pre-clinical testing phase.

Through the award, Matyas will receive $1 million per year for the next five years in support of this next phase of research and development. According to Matyas, “there is a strong correlation between heroin abuse and HIV infection, especially in developing countries.” He goes on to note that work to create a combination heroin/HIV vaccine provides a unique opportunity to treat heroin abuse as well as to develop an effective preventive HIV vaccine.

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Greenwood Schools Not Teaching Contraception

The three Greenwood, Miss.-area school districts opted for an abstinence-plus sex education curriculum, but according to Jennifer Wilson, the Greenwood Public Schools interim school superintendent, only two of the three schools in the school districts—The Carroll and Leflore County schools—are teaching curricula that include discussion of contraception. The Greenwood Public Schools do not include contraception in their abstinence-plus program. Wilson explained that abstinence-plus was adopted to enable the district to teach about STDs, not contraceptives.

Shalonda Matthews, division director for HIV, STD and Teen Pregnancy Prevention for the Mississippi Department of Education, stated that an abstinence-plus curriculum must include some discussion of contraception. She said that school districts have been instructed on what was supposed to be included in the curriculum.

Greenwood Public Schools implemented an abstinence-plus policy called “Choosing the Best.” The “Choosing the Best” website states that numerous contraceptive methods are discussed with complete information about the effectiveness and limitations of each with respect to pregnancy and STDs.

The crux of the problem seems to be whether a curriculum that does not include a discussion of contraceptives is really abstinence-plus, and this seems to be contingent on the interpretation of the law passed in 2011. The law requires all Mississippi school districts to offer some kind of sex education beginning with the current academic year. It lists seven components and states that an abstinence-only curriculum may include whatever components of the list are deemed appropriate to the school district, and an abstinence-plus program must include all components of the list. In the list, the two references to contraceptives are “The teaching of abstinence as the only way to avoid pregnancy, STDs, and related health problems. The instruction may include a discussion of condoms or contraceptives, but only if that discussion includes a factual presentation of: the risks and failures of those contraceptives; the teaching of state law related to sexual conduct; the teaching that a mutually faithful monogamous relationship in context of marriage is the healthiest option.”

Wilson argues that because the law specifies that the instruction “may” include a discussion of contraceptives, that component is not necessary for a curriculum to be considered abstinence-plus; it is optional. Matthews disagrees with this view and maintains that abstinence-plus includes contraceptives.

Personnel in the other two districts where they teach contraception agreed with Matthews. Cassandra Taylor, Leflore County Schools nurse responsible for implementing the abstinence-plus program for that district, reasoned that the goal of the program is to protect students by offering as much education as possible about sex. She felt it was important for the children to know how to protect themselves because they are having sex. Taylor maintained that abstinence will be taught as the primary mode of preventing pregnancy, HIV, and other STDs, but that teaching only abstinence is a disservice to the children. Billy Joe Ferguson, superintendent of the Carroll County Schools, added that his district was already teaching an abstinence-plus program that included contraceptives. He said that they try to be realistic and that he saw part of his role as having kids really be prepared to face the real world.

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Low Awareness, Unsafe Sex Fuel Papuan HIV/AIDS Rise

The Papua Health Office reported that over 13,000 people in the Indonesian province of Papua are HIV-infected. More than 150 of the HIV-infected individuals are younger than five years of age and contracted the virus from their parents. The head of the Papua Health Office, Josef Rinta, reported that 80 percent of the HIV-infected Papuans are between the ages of 15 and 40. Rinta attributed “ninety-eight percent” of HIV infections to unprotected sex and multiple sexual partners.

Health officials face geographic challenges in promoting HIV awareness campaigns in remote areas of Papua. Australia and Indonesia have completed four years of a six-year partnership—Rapidly Expanding Access to Care for HIV (REACH)—to build access to HIV services and care in Papua and West Papua. The Indonesian government and the United Nations are also working together to prevent mother-to-child transmission of HIV in Papua.

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HIV/AIDS Talks Highlight Annual NAACP Religious Summit

At its 14th annual National Religious Leaders Summit held December 10–12 in Atlanta, the National Association for the Advancement of Colored People focused on moving the faith community back to a leadership role in matters of social justice. Faith leaders committed to working with the NAACP on HIV/AIDS and other issues. At the three-day meeting, faith and lay leaders created a post-election agenda for communities of faith, and Roslyn M. Brock, NAACP board of directors chairperson, led a dialogue session with mainline protestant denominations to discuss the NAACP’s five strategic “Game Changer” areas.

In response to the dialogue, faith leaders made a national commitment to address HIV/AIDS in the black community after hearing NAACP’s report, “The Black Church and HIV: The Social Justice Imperative.” Church leaders agreed to work with the NAACP to expand HIV testing opportunities and to offer faith-based training and prevention education in churches, seminaries, historically black colleges and universities, and organizational national conventions.

The Summit presented a national training session on HIV/AIDS awareness and prevention that was attended by 100 pastors, faith leaders, and members of local NAACP units and state conferences, including representatives from cities with some of the highest rates of HIV prevalence. Brock commented that the commitment by the highest offices of these denominations to engage in this work, has solidified the Black Church’s concern and commitment to reverse the HIV/AIDS epidemic.

The churches represented at the NAACP meeting included AME Zion, Christian Methodist Episcopal, Black Methodist for Church Renewal, National Baptist Convention-USA, National Baptist Convention of America, Progressive National Baptist, and Primitive National Baptist.

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Recreational Use of HIV Drugs Leading to Pre-Treatment Resistance in South Africa

According to the NPR “Shots” blog, two primary HIV drugs are now being used in South Africa as recreational drugs. According to the blog, individuals with HIV who smoke what is called “whoonga,” a mixture of an AIDS medication and a street drug like marijuana or heroin, may develop a mutant strain of the virus that is resistant to the medication.

Another possibility is that individuals may become infected with a strain of HIV that came from someone who used “whoonga.” The blog noted that according to Harvard School of Public Health researcher Dr. David Grelotti, a large study demonstrated that 3 to 5 percent of individuals with HIV were “coming in with pre-treatment resistance to antiretroviral drugs used to treat HIV.”

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HIV & AIDS Impacting Indian Country

Native American populations are seeing an increase in HIV and AIDS, as many Native groups lack disease prevention information. To reverse that trend, Arizona authorities are urging Navajo residents to get tested and become educated about the spread of HIV. Dr. Paul Bloomquist of the Indian Health Services declares that, “One in five people don't know they have HIV infection, and the only way that they can prevent transmission to others and get well or prevent themselves from getting sick is to get tested and know their status.”

Obstacles, such as traditional taboos in speaking of death or sex, are prevalent. To overcome those challenges, Indian officials are incorporating traditional medicine in the treatment of HIV and AIDS. In the Four Corners region, one medical center is reducing Navaho HIV transmissions and offering culturally competent care and treatment. Medicine men at the Indian Medical Center in Gallup, New Mexico, visit hospital rooms offering ancient prayers, healing herbs for drinking, and blessings. The Indian Health Service encourages dual treatment—modern medicine and traditional Navajo healing—so that patients are more receptive of treatment and continue to receive care.

The following organizations offer information on HIV/AIDS: National Native American AIDS Prevention Center: 1-720-382-2244; AIDS Treatment Data Network: 1-800-734-7104; HIV Health InfoLine: 1-866-HIV-INFO; National AIDS Hotline: 1-800-CDC-INFO; National Association of People with AIDS Hotline: 1-240-247-0880; and the National Prevention Information Network: 1-800-458-5231.

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Smoking Deadlier for HIV Patients Than Virus Itself

A study by Dr. Marie Helleberg of Copenhagen University Hospital and colleagues showed that individuals with HIV infection who received proper care, but who were smokers, lose more years of life to smoking than to HIV. The researchers examined records of approximately 3,000 individuals with HIV who were treated in Denmark from 1995 to 2010. The patients had received good care and free access to antiretroviral therapy.

Results show that more than 60 percent of the patients’ deaths were associated with smoking, rather than HIV. Also, there were significant differences in life expectancy between individuals with HIV who were smokers and those who were nonsmokers. For example, a 35-year-old smoker had a life expectancy of about 63 years, while a nonsmoker of the same age had a life expectancy of more than 78 years. The loss of years of life associated with smoking was double that associated with HIV, and the increased risk of death among persons with HIV who smoked was three times higher than that of persons who did not have HIV.

The researchers note that findings emphasize the importance of counseling persons with HIV about smoking cessation as smoking may have a greater impact on their life expectancy than the HIV infection.

The study, “Mortality Attributable to Smoking Among HIV-1–Infected Individuals: A Nationwide, Population-Based Cohort Study,” was published online in the journal Clinical Infectious Diseases (2012; doi: 10.1093/cid/cis933).

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HIV Cases Decline for Black Women, Increase for Gay Men

CDC reported that the number of new cases of HIV among black women declined 21 percent between 2008 and 2010, while the incidence of HIV among young gay and bisexual men rose by 22 percent in the same time frame. The rate of HIV infections among black women remains 20 times higher than the number of new cases in white women, and HIV-infected black women account for 70 percent of HIV incidence among all women. Men who have sex with men comprised almost two-thirds of all new HIV infections in 2010.

Joseph Prejean, chief of the Behavioral and Clinical Surveillance Branch in CDC’s Division of HIV/AIDS Prevention, attributed the decline in new HIV cases among black women to HIV testing and the success of HIV awareness campaigns. “Treatment advances” for AIDS may have caused young men to underestimate their risk and the health threat posed by HIV, said Prejean. Although anti-retroviral treatment prolongs life, HIV-infected individuals can expect to take medicine for the rest of their lives, at an estimated lifetime cost of $400,000.

Young black men who have sex with men have the highest HIV incidence of any population group within the United States. An earlier CDC report stated that 26 percent of new HIV cases occurred among young people age 13 to 24. Half of HIV-infected young people do not know their HIV status, reported CDC Director Thomas Frieden, MD.

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An App to Fight AIDS

To raise awareness and money for the fight against AIDS, the Coca-Cola Company and the RED charity have introduced THRED, which is a free mobile game available at the Apple App Store. In THRED, players are able to donate money, if they choose, to RED, at low-cost and high-cost ends.

According to Lee Perry, president and designer at BitMonster, who developed the game, a donation of $209 may seem large, but he emphasizes that players of other games do make similar expensive microtransactions such as this.

Perry declares that this donation can “literally save a life,” or pay for an expectant mother’s antiviral medication in Africa. He explained that BitMonster created the game by focusing on the “spiritual realm” of games, rather than using an epidemic simulator.

Anne Carelli, senior manager of global sports and entertainment marketing at Coca-Cola, emphasized that the free app design of THRED, with the possibility of garnering potential in-app microtransactions, was a good fit, rather than offering the game for purchase at the outset.

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Health Crisis of Bronx Re-Entry Populations

The study, “Health Gaps Survey of Bronx Re-entry Populations,” indicates that more than 40 percent of parolees and released prisoners sent to the Bronx from the state prisons have two or more major chronic conditions. The study also found that levels of hepatitis C testing and treatment in those released individuals are very low, even though hepatitis C is a major problem in prison populations. Only 36 percent of the released persons who were interviewed reported having been tested for hepatitis C.

The study interviewed 181 Bronx releasees. Among these, 68 percent reported substance abuse problems, 22 percent reported mental health problems, and 40 percent reported being in treatment for HIV/AIDS. Chris Norwood, executive director of Health People and lead author of the study, stated that the numbers underscore a crisis in health for parolees, which has to be addressed. He explained that it was not a random survey, but was focused on the poorest parolees with many staying in homeless shelters.

The study will be released at a public briefing at Health People Community Preventive Health Institute in the Bronx. Also, at the briefing the challenges the Bronx faces and the progress being made with its re-entry population will be discussed, including a discussion by the Bronx Borough Presidents’ Office on the work of the new Bronx Re-Entry task force, community efforts by the Bronx Re-Entry working group to increase support services for returning prisoners, and early results of outcomes from a study of Health Seeking behavior among Bronx Re-Entry populations. Norwood stated that the Bronx is making great efforts to ensure health services and social support for parolees; but with the increase in numbers and the serious health issues of parolees, help is needed. The study was sponsored by the Elton John AIDS Foundation. The full study results are available by emailing ChrisNorwood@HealthPeople.org.

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Half-Hour HIV Test to Reduce Infection Risk

A new HIV test that provides results in 30 minutes while the patient waits has been approved for marketing in Australia, according to Health Minister Tanya Plibersek.

The new test, requiring only a finger prick of blood, is a preliminary screening only. Positive results will still require the confirmation of a laboratory test. However, Plibersek said that she hoped the convenience of the new test developed by Alere would encourage those at risk for HIV infection to be tested more regularly. This would ensure that those newly infected would have quick access to treatment and therefore have a lower risk of passing on the virus.

Rob Lake, executive director of the Australian Federation of AIDS Organizations, welcomed approval of the test and echoed Plibersek’s sentiments, saying the test would increase the level of testing and enable earlier diagnoses. An estimated 24,731 individuals were living with HIV in Australia at the end of 2011.

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Groups to Assess Birmingham's Untreated HIV-Positive Population

AIDS United has given $750,000 to three Birmingham organizations to ascertain the number of HIV-positive persons in the Birmingham region who are not receiving treatment. With this grant, the University of Alabama at Birmingham’s 1917 Clinic and the organization Birmingham AIDS Outreach (BAO) will hire two social workers and a project director to gather data on the HIV-positive residents, according to BAO executive director Karen Musgrove. Aletheia House, a substance abuse treatment and prevention service organization, will use $2,000 to provide office space for the social workers at its facility.

Musgrove describes the steps that they will use in working with an HIV-positive person without medical care. They will ask the person why they are not in medical care and determine the barriers that the person has experienced and how these barriers can be broken; they will get the person back into medical care; and they will evaluate the person to figure out ways to keep the individual in care. The Alabama Department of Public Health estimates that there are approximately 6,000 HIV-positive persons in Alabama who have not accessed health care in the last year. Musgrove cites possible reasons, such as lack of transportation, being fearful and not wanting to go to a physician, having mental health issues and substance abuse problems, and being afraid to divulge their HIV status. James Raper, the 1917 Clinic’s director, declares that being on HIV medication lowers the chance of passing on HIV to someone else and lowers the viral load to “undetectable” levels. He explains that, “Treatment is prevention. When we treat people, and they’re undetectable, the chance of them passing on the virus to someone else is negligible.”

The project will run for three years, with the projected start date being January 1, 2013. During the first year, the project is expected to reach 200 to 250 people who are not receiving medical care.

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Long Beach Gay Friendly Church Makes Sure HIV-AIDS Patients Can Eat

The AIDS Food Store at Christ Chapel of Long Beach, Calif., has operated a free weekly or bimonthly food distribution program for 27 years to help persons with HIV/AIDS. Participants do not have to be church members to receive help. The store started in 1985 at the beginning of the AIDS epidemic. Members at Christ Chapel befriended and assisted persons with HIV/AIDS at a time when they were being shunned and ostracized by churches and the general public. Neighbors in the area even protested against the food store, but the church stood its ground.

The store began when food baskets were distributed to seven church members with AIDS who were too sick to work and could not support themselves. At first, the church started a weekly food distribution serving about 125 persons a week. People, including non-church goers, donated food and the congregation stocked the shelves. The demand was so great that the food store received its 501 C-3 nonprofit status in 1992. About six years ago, the food store, serving about 80 people, became bimonthly. According to Greg Thompson, head pastor, although the demand has dropped, the food store will continue. He vowed that as long as people are living with HIV and AIDS in their community, the church will maintain the food store.

Margo Martinez, a 75-year-old who began as a volunteer and is now the interim director, stated that they were “given a gift” to help individuals with HIV/AIDS. She noted that people needed help, and the members were not afraid. No one was turned away. She explained how much worse the disease got and that many people died. Martinez described how she first attended the church when it was located in a converted garage at the pastor’s home, how friendly and welcoming people were, and how she became a member. She added that the church works primarily with the lesbian, gay, bisexual, and transgender community, who many times feel alienated or isolated from church because of people’s attitudes toward them.

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Potent Antibodies Neutralize HIV and Could Offer New Therapy, Study Finds

Researchers at Rockefeller University, New York, appear to have found another approach to treating HIV infection. They have shown that it is possible to harness proteins from the human immune system to suppress the virus in mice without the need for daily application as is done with current antiretroviral drugs. Using a combination of five different antibodies, Florian Klein and colleagues at Michel Nussenzweig’s Laboratory of Molecular Immunology were able to effectively suppress HIV-1 replication and prevent the virus for 60 days after termination of therapy. They used “humanized mice” as normal mice do not have the receptors to be infected with HIV-1.

HIV-1 evades the human immune system’s attacks by mutating; but with the combination of the new antibodies, mutation did not work. The antibodies target HIV-1’s surface protein, gp160, a molecule that forms a spike that attaches to host cells. Five antibodies in unison were required to stop gp160. The five antibodies were too complicated for gp160 to mutate in time to avoid them. The antibodies, called broadly neutralizing antibodies, were recently discovered. They were identified and cloned from HIV-infected patients whose immune systems had an unusually high ability to neutralize HIV. These antibodies have been able to prevent HIV from infecting non-human primates, which leads to a possibility of a vaccine for humans. However, it was felt that they would have little or no effect on established infections.

Klein stated that the results are encouraging enough to prompt an investigation of these antibodies in clinical trials. He surmised that a combination of antibodies and antiretroviral therapy may lead to a treatment for humans that will not require daily medication.

The study, “HIV Therapy by a Combination of Broadly Neutralizing Antibodies in Humanized Mice,” was published in the journal Nature (2012; 492 (7427):118 DOI: 10.1038/nature11604).

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Agriculture and Healthcare Come Together to Fight HIV/AIDS

Olam International, a London-based global agribusiness, partnered with nongovernmental organizations on World AIDS Day to offer HIV testing, a new element of Olam’s ongoing HIV/AIDS prevention efforts in Africa.

Olam has a presence in 28 African countries, where the company works with small-scale farmers and operates food processing units in rural areas. Using its extensive network of farmers and employees, Olam and its NGO partners reached 234,000 people in Africa with HIV/AIDS awareness messages this year. In addition, Olam collaborated with USAIDS, the German NGO GIZ, and other NGOs in 2012 to offer HIV screening to people in the Olam network.

Chris Brett, senior vice-president of Olam International, stated that the company will “go forward” with counseling and supplying anti-retroviral drugs as people learn their status. The Olam interventions align with the World AIDS Day strategy of “getting to zero” new HIV infections, AIDS deaths, and discrimination against HIV-infected persons. Through Olam’s initiatives, healthcare and agriculture are linked in preventing HIV and helping HIV-infected persons, said Brett.

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Tuesday, December 18, 2012

Guinea-Bassau: HIV/AIDS Fight Hit by Global Fund Cuts

At the end of 2011, the Global Fund to Fight AIDS, Tuberculosis and Malaria stopped the majority of its funding to the Secretriado National de Luta Contra le Sida (SNLS), the government structure in charge of coordinating HIV prevention and treatment activities in Guinea-Bassau, because of poor management and a lack of transparent financial control.

The Fund’s decision was strengthened in April 2012 following a coup d’etat after which the body charged with program verification could not perform its function due to security concerns. Although the Fund has continued to supply basic medicines and testing through their Voluntary Pooled Procurement facility, the SNLS, which is responsible for overseeing the transport of medicines to clinics and hospitals across the country and for medicine storage, has no funds for staff salaries, transport, or even electricity.

According to Alison Jenkins, HIV/AIDS specialist at the UN Children’s Fund in Guinea-Bassau, only 16 percent of HIV-positive children and 39 percent of HIV-positive men who were eligible were receiving antiretroviral treatment at the end of March 2012. Of the adults aged 15–49, 5.3 percent are estimated to have HIV/AIDS in Guinea-Bassau, with women being three times more likely to be infected than men, according to a 2010 study.

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New Office in U.S. to Fight AIDS

The head of the Obama administration’s global AIDS organization, the President’s Emergency Plan for AIDS Relief (PEPFAR), Ambassador Eric Goosby, has been named to lead a new Office of Global Health Diplomacy.

According to the State Department, the announcement was made on December 14. The ambassador’s new role was welcomed by some advocacy groups and U.N.AIDS. Policy chief for AmFAR, Chris Collins, commented that high-level diplomacy was instrumental for getting countries to invest more on their epidemics and for encouraging them to stop ignoring politically unpopular victims like gay men, drug users, and prostitutes.

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New Guidelines to Better Prevent HIV in Sex Workers

The World Health Organization (WHO), the United Nations Population Fund (UNFPA), UNAIDS, and the Global Network of Sex Work Projects have developed a set of technical recommendations for effective programs to prevent and treat HIV/AIDS and other STDs among sex workers.

The complete report, “Prevention and Treatment of HIV and Other Sexually Transmitted Infections for Sex Workers in Low- and Middle-income Countries,” was published by the WHO Department of HIV/AIDS in December 2012 at URL: http://www.who.int/hiv/pub/guidelines/sex_worker/en/index.html.

The guidelines advise that nations should decriminalize sex work and increase the access of sex workers to health services. Regular, voluntary screening and treatment for sex workers and empowerment regarding condom negotiation were other key elements of the guidelines.

Factors that increase the risk of HIV and other STDs for sex workers include a larger number of sexual partners and social marginalization. Because their work is against the law, sex workers face barriers to condom negotiation. Violence and alcohol and drug use may also contribute to higher risk for sex workers.

The guidelines provide direction for national public health officials, health workers, HIV/AIDS program managers, and community organizations that serve sex workers. Brazil, India, Kenya, and Thailand have successfully implemented similar steps to improve the health of sex workers and control the epidemic of HIV and STDs among the wider population.

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Friday, December 14, 2012

Pilot Project at Vancouver Hospitals Finds 30 HIV Patients Upon Admission

Under a pilot project launched in October 2011, four area hospitals in Vancouver began offering HIV testing to patients when other blood tests were ordered upon admission.

More than 30 individuals were diagnosed with HIV in the program’s first year. Before the project began, only those who were believed to be at high risk for HIV were offered the test.

According to Dr. Patricia Daly, chief medical health officer for the Vancouver Coastal Health Authority, the individuals diagnosed are men and women from a range of backgrounds, reinforcing the point that all adults should be tested for HIV as part of their routine health care. The provincial government recently announced that it will expand the program to the rest of the province in the next year as part of a plan called STOP HIV/AIDS.

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Syphilis and HIV: A Dangerous Duo Affecting Gay and Bisexual Men

A blog by Gail Bolan, M.D., Director of the Division of STD Prevention, Centers for Disease Control and Prevention (CDC), discusses surveillance data released in CDC’s 2011 STD Surveillance Report. Bolan draws attention to the increase in primary and secondary syphilis rates among gay and bisexual men—who account for more than 70 percent of all infections—and what can be done to reverse the high rates of infection among this sector of society. She notes that a large number of these infections are among young men who have sex with men (MSM), with the highest rates among 20–29 year olds.

Annual surveillance data in the report emphasize the disproportionate burden of disease among gay and bisexual men. Bolan explains that the genital sores caused by syphilis make sexual transmission and acquisition of HIV even easier. Hence, there is an estimated two-to-fivefold increased risk of HIV if persons with syphilis are exposed to the virus. Also, studies show that syphilis increases the viral load of persons with HIV infection. These facts increase Bolan’s concern, since data show that four of every 10 MSM with syphilis is co-infected with HIV. Bolan argues that the stakes are too high to ignore these health disparities and emphasizes the importance of promptly diagnosing and treating syphilis infections among MSM to decrease their chances for HIV infection.

Bolan stated that to fight the root causes of health disparities among gay and bisexual men involves confronting the underlying conditions that place the group at greater risk of STDs. She contends that risk behavior alone does not explain the disproportionate STD burden of MSM, but that complex issues such as homophobia and stigma are responsible to some extent for these infections. She discusses how CDC is working with program partners to take action to confront the underlying causes of STD disparities and provides the example of the more comprehensive holistic sexual healthcare through CDC’s program collaboration and service integration. Also, action plans guided by the best available science and input from partners are being implemented to help individuals and communities overcome environmental forces that increase the risk of acquiring an STD.

Bolan is aware that government cannot do it alone and that more broad-based action is needed by all involved. She envisages that working together, government and individuals can face sexual health issues. The blog concludes with Bolan’ suggestions for what health care providers, individuals, and community leaders should do to create greater awareness and openness about sexual health issues, to help end the disparity, and to ensure good health for gay and bisexual men who are disproportionately impacted by STDs and HIV.

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Thursday, December 13, 2012

Teaneck Group Raises Awareness of HIV and AIDS

The Bergen/Passaic Chapter of the National Coalition of 100 Black Women partnered with Teaneck High School’s FORUM to sponsor an HIV/AIDS awareness event, the Red Ribbon Forum, timed to coincide with World AIDS Day. The occasion, which drew 45 adolescent participants, consisted of a presentation by an HIV-infected individual, a performance by a teen theater group, and a question-and-answer session with the health committee of the local chapter of 100 Black Women. Key messages emphasized the importance of early detection in HIV prevention and advances in effective treatment for HIV-infected persons.

Keynote speaker Lolisa Gibson contracted HIV/AIDS from her mother, and was diagnosed at 17 with HIV. The treatment that she receives for HIV has prevented her 3-year-old son and her fiancée from becoming infected with HIV, declared Gibson. Sponsors of the event cited fear as a factor that deters individuals from having HIV testing and learning their status.

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Researchers Find Clue to How Hepatitis C Virus Harms Liver

Researchers at the University of Southern California (USC) found a trigger that is used by the hepatitis C virus (HCV) to enter liver cells. They discovered that in the early stages of HCV infection, the virus binds to receptors on the surface of liver cells and activates PI3K and AKT, proteins that control cell growth and metabolism, and which allow HCV to enter the cells. According to James Ou, professor of molecular microbiology and immunology at USC’s Keck School of Medicine, when the two protein factors are activated, they initiate a group of reactions that alter the physiology of infected cells. Later, by continuing to disturb this pathway, HCV may sensitize the liver cells to become cancerous.

Ou has been studying HCV for 20 years and the hepatitis B virus for 30 years. He explained that the next step is to understand how activation of the PI3K-AKT pathway allows HCV to enter the cell. Ou also noted that the research has led to the identification of a novel target for developing new drugs to treat HCV in the form of compounds that disrupt the PI3K-AKT pathway. These anti-hepatitis drugs would be expected to prevent the virus from entering, and thus, cause the virus to disappear.

The study, “Transient Activation of the PI3K-AKT Pathway by Hepatitis C Virus to Enhance Viral Entry,” was published in the Journal of Biological Chemistry (2012;287(50): 41922–41930).

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FAMU Professor Receives Patent for Highly Effective Anti-HIV Compounds

Kinfe Ken Redda, interim vice president of research at Florida A&M University (FAMU), and his research team have received a patent for the development of therapeutic agents suitable for treating humans who are infected with HIV. They were awarded US Patent #8,314,143 titled, “Synthetic Flavonoids and Pharmaceutical Compositions and Therapeutic Methods of Treatment of HIV Infection and other Pathologies.” Redda was principal investigator and co-inventor.

The patent includes a group of compounds called flavonoids. Flavonoids are present in vascular plants and are known for their range of biological activities. Redda’s team has developed compounds that are synthetic flavonoid derivatives designed to target a specific enzyme, HIV integrase. Redda stated that the compounds showed superior inhibitory activities compared to zidovudine (AZT), a drug used for HIV treatment. He admits that there is a long way to go before the right remedy for treating HIV is developed, but Redda believes that they have taken the first step, and sees great potential for the compounds to become an effective HIV/AIDS treatment.

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Wednesday, December 12, 2012

STD Numbers Increase in Brown County

According to the South Dakota Department of Health, chlamydia cases in Brown County have been climbing in step with the rest of the state. Brown County’s numbers—655 cases of chlamydia from 2006 through 2011—account for 3.7 percent of the state’s chlamydia cases. Lon Kightlinger, state epidemiologist, declared that chlamydia is the most commonly reported STD throughout South Dakota and the United States. Brown County reported the following numbers of chlamydia cases per year: 97 cases reported to date for 2012; 128 in 2011; 159 in 2010; 88 in 2009; 84 in 2008; 85 in 2007; and 111 in 2006. Surrounding counties reported considerably fewer cases of chlamydia since 2006.

Although gonorrhea rates saw a growth in numbers throughout South Dakota in 2012, rates for the region were relatively low. Only 39 cases of gonorrhea have been reported in Brown County since 2006, with Walworth County reporting 23 total cases for the same time period, and other counties reporting seven or fewer. According to health department data, the state as a whole reported 558 cases. There were no cases of syphilis reported in the area, as most of the syphilis cases are near Sioux Falls, according to Kightlinger. South Dakota has reported 17 cases of syphilis since 2006. Brown County reported 12 cases of HIV from 1985 to 2011. South Dakota has a low rate of the HIV virus and is one of the four lowest states for HIV rates in the country, with a rate of 2.9 cases per 100,000 people during the last five years.

Kightlinger warned people all over the state to be cautious and vigilant. Kightlinger cautioned, “The interpretation could be that STDs are common in South Dakota, and there’s no region of the state that does not have STDs.”

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40 CEOs Call on Countries to Lift HIV Travel Bans

Chief Executive Officers (CEOs) from 40 companies are asking countries to eliminate laws that restrict the travel of individuals with HIV, because such laws are discriminatory and detrimental to the global economy, in which companies have to be free to send employees around the world. Business leaders who agreed with the change in policy include the CEOs of Coca-Cola, Aetna, Viacom, Pfizer, the National Basketball Association, Johnson & Johnson, and Gap.

According to UNAIDS, 45 countries have laws or policies that deport, detain, or deny entry to persons with HIV. Five countries in the Middle East refuse entry to people with HIV, and another five—including Singapore, Egypt, and the Turks and Caicos—require anyone who plans to remain in the country longer than five days to provide evidence that they are not infected with the HIV virus. The United States regulations barring HIV-infected foreign nationals from receiving a visa to enter the country were lifted in January 2010. The restrictions were introduced in 1987, when HIV was added to the list of diseases of public health significance. Foreign nationals requesting a visa to enter the United States were tested for HIV during medical screening by US immigration.

Many of these laws and policies were made in the 1980s when HIV was first publicly known and resulted from a combination of transmission myths, fears that it could not be treated, and the lack of a reliable test to diagnose it. All these factors have now changed. Bertil Lindblad, of UNAIDS in New York, stated that many of the reactions arose from fear about HIV, stigma, and discrimination. However, in some countries, the disease is considered a social evil, and in places, it is part of a larger human rights issue, the illegality of homosexuality.

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Tuesday, December 11, 2012

HIV Health Series Open for Teens

Educating Teens about HIV/AIDS Inc., is set to continue its “Live Life Without the Disease Series for Parents and Teens” beginning January 12.

The program is interested in finding individuals aged 13 to 19 years old and their parents or guardians to participate. The series intends to assist teens with understanding how the decisions they make on a daily basis affect their health and well-being. There are 10 sessions, each of which includes a healthy meal.

The series, supported by Highmark Foundation, was first developed in 2008 after the youth asked Educating Teens to involve their parents in their HIV/AIDS education.

Teens or parents who are interested in registering for the series may call (412) 973-9524 or visit http://www.educatingteens.org.

TOGETHER WE REMAIN STRONG!

Study Shows Soaring STD Rates in Many Areas of New York City

A 2010 study of 181 ZIP codes in New York City examined the rates of HIV/AIDS, chlamydia, gonorrhea, syphilis, and hepatitis B, which are sexually transmitted, and two infections—hepatitis C and TB—that are not sexually transmitted. The New York City Department of Health and Mental Hygiene reported that concurrent infections of STDs, hepatitis C, and TB plague many areas of the city.

ZIP codes in the Bronx comprised 68 percent of the areas with the highest concentration of multiple STDs. Results of the study placed ZIP code 10474—Hunts Point, in the Bronx—in the top 20 percent for hepatitis C, chlamydia, gonorrhea, and HIV/AIDS infections. The Tremont section of the Bronx, ZIP code 10475, was in the top 20 percent for all seven diseases. Almost half of the residents in Tremont are below the federal poverty line. Nineteen other ZIP codes in the South Bronx, North Manhattan, and north-central Brooklyn had high rates of poverty and ranked in the top 20 percent for HIV/AIDS, chlamydia, and gonorrhea.

Thirteen Manhattan ZIP codes reported HIV/AIDS rates in the top 20 percent: Chelsea-Hell’s Kitchen, Central Harlem-Morningside Heights, East Harlem, Washington Heights-Inwood, and Greenwich Village-SoHo. The top 20 percent rates of HIV/AIDS and hepatitis C occurred in 23 ZIP codes in South Bronx, north central Brooklyn, northern Manhattan, Chelsea-Hell’s Kitchen, and the Rockaways in Queens.

The areas of New York City that were hit hardest by hepatitis B and TB were characterized by large foreign-born populations. These include Flushing Clearview, West Queens, Bayside-Little Neck, Ridgewood-Forest Hills, Sunset Park, Bensonhurst-Bay Ridge, and Borough Park in Brooklyn.

Staten Island was the only area of New York City with no ZIP codes in the top 20 percent for concurrent infection with STDs.

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Drexel University Contributes to AIDS Awareness

In recognition of HIV/AIDS Awareness Month, researchers from the Drexel University College of Medicine’s Division of Infectious Disease and HIV Medicine outlined their HIV/AIDS research and prevention activities. Three HIV research approaches exist: kill HIV-infected cells, “re-educate the immune system,” or make cells resist HIV, according to university researchers. The primary research emphasis of the Drexel team is to re-educate the immune system and find a “functional cure,” similar to the way the human immune system controls the chicken pox virus, explained Jeffrey M. Jacobson, MD. To accomplish this “definitive solution,” the team is attempting to keep infection from entering cells using antibodies against HIV. The outcome of the research would be vaccines or immune-based therapies that assist the immune system in controlling HIV infections.

The Drexel team is also working with the University of Pennsylvania on research to make cells resistant to HIV infection. This study focuses on helping HIV-infected patients by loading their lymphocytes with genes that help the cells resist the virus.

The prevention aspects of the Drexel team’s efforts include working in the community to identify HIV-infected individuals and connect them to care or return them to care. Stopping the spread of HIV/AIDS also focuses on helping individuals with drug and alcohol problems, which interfere with HIV/AIDS treatment. Jacobson recommended routine HIV/AIDS testing for people ages 18 to 65. The Drexel HIV/AIDS care program is the largest in Philadelphia. Funded by the National Institutes of Health, the program includes a team of clinicians, social workers, psychiatrists, pharmacists, nutritionists, and other disciplines.

Other HIV/AIDS researchers take a third approach that is based on interrupting HIV’s replicating cycle by identifying the cells that contain a latent HIV infection in memory-retaining T cells.

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More Stepping Forward for Anonymous HIV Testing

The advocacy group Action for AIDS (AfA) in Singapore reports that more individuals are taking anonymous HIV tests. So far, 1,368 persons have been tested for HIV at AfA’s mobile van in the past 11 months. Of this number, seven persons tested positive. The van started testing in December 2011. Another site, the Anonymous Test Site, which works at a clinic operated by the Department of Sexually Transmitted Infections Control, tested 540 individuals during one month of this year. This clinic conducts more comprehensive blood tests. A total of 5, 521 persons in Singapore have been diagnosed with HIV.

Dr. Amy Khor, minister of state for health, said that stigma and discrimination create an unnecessary barrier to early detection and treatment of at-risk persons. She stated that individuals may be shunned by their family, rejected by friends, or lose their jobs if it were known that they tested positive. As a result, they are afraid of taking the test to the detriment of their health and the increased possibility of exposing their sexual partners to the risk of HIV infection.

To fight the fear and stigma, Tan Tock Seng Hospital became the first public hospital to launch an HIV stigma and discrimination campaign called the Power to Change is Within You. Banners, posters, and stickers will be displayed around the hospital, the Communicable Disease Centre, and clinics. Also, stories and positive experiences of HIV patients and healthcare workers who have treated such patients will be highlighted. The aim is to help persons with HIV think more positively and to demonstrate to the public that persons with HIV can continue to live normal lives.

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HIV/AIDS Comprehensive Care Clinics Celebrate 25th Anniversary

Patients with HIV/AIDS in Vermont have received state-of-the-art care through the Comprehensive Care Clinics (CCC) for 25 years under the leadership of Christopher Grace, MD., professor of medicine and director of infectious diseases at the University of Vermont/Fletcher Allen Health Care, and Deborah Kutzko, nurse practitioner and leader of the clinic program. The clinic also employs a team of providers, nurses, social workers, and a dietitian and psychiatrist. The HIV/AIDS comprehensive care clinics were established in 1987. According to Melissa Farr, Vermont Cares Services program director, at that time, the establishment of a long-term clinical program to treat HIV was a heroic act, but because of the strong network of HIV care and treatment that distinguishes CCC, persons with HIV/AIDS in Vermont are living longer, healthier lives.

The program now includes four clinics across the state. They are supported by Ryan White CARE Act funding and other federal grants. At present, there are approximately 500 persons with HIV in Vermont, and according to Dr. Grace, the number of clinic patients increases each year by about 35 to 50. In 2011, the clinics provided health care for approximately 440 patients. Each clinic has a physician, nurse, social worker, dietitian, and psychiatric clinician. The model on which the clinics are based specifies an onsite nurse, onsite social worker, phone access to an infectious disease specialist, and visits once a month by a dietitian, and psychiatric nurse practitioner. Also once every month, a professor of medicine, an associate professor of medicine, and Dr. Grace visit different clinics. The group also has associates in northern counties of Vermont and upstate New York who assist with patient management.

One of the clinics, the Burlington clinic, cares for approximately 300 patients and is staffed by four physicians, in addition to Dr. Grace, and two other doctors who visit once per month. The Rutland clinic has 50 patients, the Brattleboro clinic, approximately 60 to 70, and St. Johnsbury, 20 patients. The collaborative relationship between Vermont CARES and the CCC facilitates patients’ entry to medical case management and medical care. Patients are able to work with a team that is focused on supporting their overall wellbeing, including stable housing, good nutrition, growing social networks, and mental health support.

TOGETHER WE REMAIN STRONG!

Monday, December 10, 2012

HIV/AIDS Clinic Opens in Arusha

In collaboration with the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR), the US Centers for Disease Control and Prevention (CDC) has built a new HIV care and treatment clinic (CTC) at St. Elizabeth Hospital in Arusha, Tanzania.

Speaking at the facility’s inauguration, CDC representative Gloria Munthali said the clinic is set to benefit thousands who are receiving antiretroviral drugs at the St. Elizabeth hospital CTC. EGPAF Regional Program Manager Dr. Andrew Gwaja states that as of September of this year 4,657 HIV patients were enrolled in the program, with 502 being under the age of 14.

According to Munthali, with the assistance of PEPFAR and organizations such as EGPAF, over 160 CTCs have been opened across Tanzania.

TOGETHER WE REMAIN STRONG!

Panel Seeks to Educate Students on HIV/AIDS

Eastern Michigan University’s (EMU) Black Student Union and the organization, You Beautiful Black Woman, sponsored a community panel discussion called “See No Evil, Hear No Evil, Speak No Evil: AIDS in Our Community,” on December 6. The discussion was held in the middle of AIDS week at the campus, as EMU accounts for more than 30 percent of all sexually transmitted infections in Washtenaw County, Michigan. Panelists included Sheyonna Watson, HIV/AIDS Resource Center (HARC) case manager; Myka Herron, president of EMU’s Black Student Union; Reverend Horace Sheffield III, a Detroit pastor; and a client from HARC, whose identity was not revealed for confidentiality reasons.

The panel discussed the fear of being tested because people are afraid of receiving positive results that could change their lives forever. The panel emphasized, however, the importance of getting tested for HIV when a person becomes sexually active, as well as making sure that the person’s sexual partner is tested. The panel noted that a girl in a heterosexual relationship needs to have her own protection and not rely solely on the male to provide protection.

Another problem the panel addressed was that so much unprotected sex takes place. The panel declared that naïveté is one of the reasons, as many people do not realize they are at risk and feel burdened and awkward asking someone else to use a condom. Also people often have unprotected sex when they are under the influence of illegal substances that can impair judgment. The panel spoke about HIV being so prevalent in African-Americans and explained that African-Americans often have high rates of many other health conditions as well, such as diabetes and heart disease, and they often do not have adequate health care benefits.

The panelists urged newly HIV-diagnosed persons not to become isolated, advising them to join support groups, talk to others, and be open with their physicians about their lifestyles and behavior.

EMU’s Snow Health Center provides free HIV testing every Thursday between 10 a.m. and 4 p.m. The panelists recommended all sexually active or previously sexually active students get tested.

TOGETHER WE REMAIN STRONG!

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