Many Pregnant Women May Not Get STD Tests

Many pregnant women are not following recommendations that they undergo testing for certain STDs, according to a new study.

CDC and the American College of Obstetricians and Gynecologists (ACOG) say all pregnant women should be tested for chlamydia at their first prenatal visit. CDC and other groups also recommend gonorrhea screening for pregnant women at increased risk, including those younger than 25 and residents of areas of the country where the STD is common.

The new study showed that of almost 1.3 million US women who had blood tests done during pregnancy, only 59 percent were tested for chlamydia. Fifty-seven percent were screened for gonorrhea.

Because not all pregnant women are counseled to be tested for gonorrhea, it is difficult to determine whether the 57 percent rate is appropriate, according to Dr. Jay M. Lieberman, who worked on the study. Lieberman is infectious-diseases medical director at Quest Diagnostics Inc., which financed the research. But he noted the results found that some women for whom guidelines indicated screening did not get tested: Of pregnant women ages 16-24, only 69 percent were tested for gonorrhea. Left untreated, both STDs can endanger the health of a mother and her baby.

One limitation of the study is that it is based on tests conducted between 2005 and 2008, when screening guidelines were in transition. ACOG issued its guidelines in 2007.

Despite acknowledging that the situation is evolving, Lieberman said, “there’s also no evidence that screening rates have improved.” In 2009, a CDC study found that only a minority of all US women for whom chlamydia screening was indicated had undergone the test.

Lieberman said the current study’s data do not indicate why women were not taking the recommended tests. While access to care is a challenge for some, all the participants were receiving prenatal care. Pregnant women should consult their doctors if they have not been tested for STDs or do not know if they have been tested.

[PNU editor’s note: The study, “Chlamydial and Gonococcal Testing During Pregnancy in the United States,” was published in the American Journal of Obstetrics & Gynecology (2012;doi:10.1016/j.ajog.2012.04.027).

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

TOGETHER WE REMAIN STRONG!

Maternal Deaths Plunged over 2 Decades, to About 287,000 in 2010, UN Reports

Increases in contraceptive use, health care provider-assisted births, and treatment for HIV-positive mothers have helped cut the maternal death rate by 47 percent since 1990, according to UN agencies.

In 2010, maternal deaths declined to roughly 287,000, from the UN’s estimate of 543,000 in 1990. Deaths are falling rapidly in East Asia but slowly in Africa, according to the report compiled by the World Health Organization (WHO), UNICEF, the UN Population Fund, the UN Population Division, the World Bank, and a team from the University of California-Berkeley. Countries in southern Africa are witnessing the start of a reversal as more HIV-positive women there receive antiretroviral treatment.

UN maternal death estimates have been challenged in the past. Two years ago, the Institute for Health Metrics and Evaluation, which was created by the Bill & Melinda Gates Foundation as a way to validate WHO figures, disputed the UN’s 2008 tally using three times as much data. In response, the UN “revised and improved” its count for that year. The institute estimated maternal deaths at 274,000 in 2011, meaning the new UN number is within the same statistical boundaries, said Dr. Rafael Lozano, epidemiologist for IHME.

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

TOGETHER WE REMAIN STRONG!

House Panel Approves Anti-Cancer Bill

The Ohio House Ways and Means Committee recently approved a bill that would create an option to allow income tax filers to donate money to a state fund that supports cervical and breast cancer testing and treatment. The bill is expected to advance to the full House soon.

The state Department of Health’s Ohio Breast and Cervical Cancer Project provided services to 73,547 women between March 1994 and May last year. Women age 40 or older who earn less than twice the federal poverty limit are eligible for the program, and those needing treatment are eligible to apply for Medicaid coverage, said Sarah Gudz, OBCCP’s director.

OBCCP received about $4.2 million in the past year, much of it from CDC. The program also received a one-time $1.3 million payment from tobacco settlement funds and $832,000 from Ohio’s general-revenue fund.

“There’s never a guarantee when it comes to funding,” said Gudz. The additional resources help OBCCP serve more women, she added.

Many state lawmakers know women who have had breast or cervical cancer, said Peter Beck (R-Mason), chair of the House Ways and Means Committee. “It’s important to protect those women,” he said.

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

TOGETHER WE REMAIN STRONG!

AIDS Fight Enters New Phase with Prevention Pill

With a Food and Drug Administration (FDA) panel’s endorsement of the use of the drug Truvada to prevent HIV infection, the 30-year battle against the AIDS epidemic is advancing to a new phase, advocates say.

“With this recommendation, we’re nearing a watershed moment in our fight against HIV,” said James Loduca, a spokesperson for the San Francisco AIDS Foundation. “We know this isn’t a magic bullet, and it’s not going to be the right prevention strategy for everyone, but it could save thousands of lives in the United States and potentially millions around the world.”

Truvada has been on the US market as an HIV treatment since 2004. It is already being prescribed off-label by some doctors for preventing HIV infection in certain patients who are healthy but at risk. If FDA expands approval to formally sanction this use, insurance companies could likely cover the cost. And widening the market could prompt Truvada’s maker, Gilead Sciences Inc., to lower its price - currently around $11,000 to $14,000 a year.

Truvada is available in poor countries for as little as $9 per month, said a Gilead spokesperson, but generic versions will not be available in the United States until after the US patent expires in 2021.

Truvada can cause kidney and liver problems. But for some people, the risk of kidney problems “10 years down the line may be less than the risk for acquiring HIV, which is significantly more problematic and can be fatal,” said Jim Pickett, prevention advocacy director at AIDS Foundation of Chicago.

FDA’s decision is expected by June 15.

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

TOGETHER WE REMAIN STRONG!

Low Rates of Hepatitis Screening and Vaccination of HIV-Infected MSM in HIV Clinics

Due to similar behavioral risk factors for the two infections, HIV-positive men who have sex with men are at increased risk of viral hepatitis. The authors of the current study set out to assess adherence to HIV management guidelines that recommend hepatitis A, B, and C testing for HIV-positive patients, and vaccination against hepatitis A and B for those susceptible.

The researchers evaluated the hepatitis prevention services received by a random sample of HIV-positive MSM at eight HIV clinics in six US cities. To estimate rates of hepatitis screening and vaccination both overall and by clinic site, the team abstracted the medical records of all clinic visits by these patients from 2004 to 2007.

The records of 1,329 patients making a total of 14,831 clinic visits from 2004 to 2006 were abstracted, indicating screening rates of 47 percent for hepatitis A, 52 percent for hepatitis B, and 54 percent for hepatitis C. Among screened patients found to be susceptible, 29 percent were vaccinated for hepatitis A, and 25 percent were vaccinated for hepatitis B. Significant variations in screening and vaccination rates by clinic were noted.

“Awareness of hepatitis susceptibility and hepatitis co-infection status in HIV-infected patients is essential for optimal clinical management,” the researchers concluded. “Despite recommendations for hepatitis screening and vaccination of HIV-infected MSM, rates were suboptimal at all clinic sites. These low rates highlight the importance of routine review of adherence to recommended clinical services. Such reviews can prompt the development and implementation of simple and sustainable interventions to improve the quality of care.”

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

TOGETHER WE REMAIN STRONG!

Exploring the Role of Mobile Technology as a Health Care Helper

In rural areas of the developing world, mobile telephones are helping people connect with health care providers in major cities. For instance, today a woman in Uganda having a difficult childbirth can get help from a physician in Kampala, contact a community health worker, or even secure transportation to a hospital.

“Now, a phone call can compress the time that it would have taken before to come to that decision point and get the woman care more often and quickly,” said Dr. Alain Labrique, a professor of international health and epidemiology at Johns Hopkins University (JHU).

JHU’s Global mHealth Initiative is evaluating the role of mobile technology for care in 51 projects involving 120 students and more than 60 faculty members. Next March, JHU’s Bloomberg School of Public Health will start two courses on using these technologies in the field.

“There’s a lot of excitement among faculty, but there’s 10 times as much excitement coming from students,” Labrique said. “What mobile technologies are doing is changing the way that we see global health in terms of our ability to impact populations, to collect data in real time, to develop real strategies, to impact public health that we hadn’t thought of before.”

JHU’s Dr. Larry Chang, who studied HIV/AIDS and technology in Uganda, and Labrique both agree on the need to rigorously evaluate the potential of such tools. In addition, greater patient access to care would require a larger capacity to absorb the extra workload, such as more health workers, Labrique said.

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

TOGETHER WE REMAIN STRONG!

HIV May Afflict Almost Half Asia-Pacific Transgenders: UN

Stigma, poor health care access, and high-risk sex are pushing up HIV infection rates among Asia-Pacific transgender women, the UN Development Program said Thursday. Some 9 million to 9.5 million transgender people live in the region, and they are “bearing the brunt of the HIV epidemic,” a new UNDP report says. “Scattered and often small-scale research” suggests that 49 percent of transgender women there could have HIV.

Disapproval at home and school leads many transgender youths to leave both, and scant economic opportunities mean many turn to sex work and have unprotected sex, according to the report. “Social exclusion, poverty, and HIV infection contribute to what we call a ‘stigma sickness slope’ - a downward spiral that is difficult to reverse,” said report author Sam Winter of Hong Kong University.

In positive developments, the report notes the emergence of a confident transgender identity and a greater willingness by transgenders to access mainstream services and engage in policy discussions.

[PNU editor’s note: For more information about the report, visit: http://www.undp.org/content/undp/en/home/presscenter/pressreleases/2012/05/17/transgender-persons-are-lost-in-transition-on-human-rights-and-hiv-responses-says-new-asia-pacific-report/.]

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

TOGETHER WE REMAIN STRONG!