Category Archives: News

By MARK MCDONALD

HONG KONG — China has just issued a new “action plan” to combat the rising spread of H.I.V. and AIDS, and this seems to be the takeaway: Condoms or condom vending machines should be available in 95 percent of the country’s hotels by 2015.

The plan by the State Council, according to the official Chinese news agency Xinhua, “urged comprehensive intervention to prevent H.I.V./AIDS infection through sexual intercourse, as intercourse has become the most common transmission channel in China.”

China’s “overall burden” from H.I.V. and AIDS cases is low, according to the World Health Organization office in Beijing. But the numbers of reported cases in China are rising as heterosexual transmission surpasses injection drug use as the No. 1 cause of infection.

“There is still time for China to slow the spread of HIV and to prevent a wider epidemic,” a W.H.O. bulletin said. “Concerted, scaled-up prevention efforts are needed to ensure universal access to condoms, clean needles and other protective measures.”

Government figures say the country has about 780,000 people living with H.I.V./AIDS, including 154,000 AIDS patients.
Michel Sidibé, executive director of the United Nations’ AIDS prevention agency, has lobbied China, South Africa, India and Russia to energize (or in some cases reverse) their approaches to the epidemic, as my colleague Donald G. McNeil Jr. reported in a recent profile of Mr. Sidibé.The government wants AIDS deaths to decrease 30 percent by 2015, with new infections dropping 25 percent and total infections maxxing out at 1.2 million by 2015.

“He pressed China to admit that H.I.V. was spreading rapidly among gay men and drug users,” Donald wrote, “and that the 500,000 Chinese working in Africa and 40 million migrant laborers, many of whom visit prostitutes, were potential risk pools.”

 

By BERTRAND AUDOIN and CHRIS BEYRER

Published: March 2, 2012

It is common knowledge that illicit drug use in the Russian Federation has reached critical proportions. It is also common knowledge that people who use drugs are among those most at-risk of infection with H.I.V. And it is common knowledge that since the beginning of the H.I.V./AIDS epidemic three decades ago simple tools such as Medication Assisted Therapy (methadone, buprenorphine) and clean needle-exchange services have proven very effective in decreasing drug abuse and reducing risk of infection with H.I.V., Hepatitis C and other diseases.

So why has this evidence had so little impact on the policies and programs of the Russian Federation?

Russia has one of the world’s highest levels of injecting drug use. The estimated number of injecting drug users is 1.8 million, and the estimated number of opiate users exceeds 1.6 million. A decade ago 100,000 people were H.I.V. positive in Russia. Today there are over 1 million, and injecting drug users represent some 78 percent of all H.I.V. cases in the country. This means that more than one third of all injecting drugs users are H.I.V.-positive — with peaks at three-quarters in some cities — and three-quarters of them are also living with the Hepatitis C virus. The human cost is devastating, and the social fallout is appalling: Russia now accounts for two thirds of the Eastern Europe and Central Asian H.I.V. epidemic, the fastest growing in the world.

Confronted with such a huge political and social issue, the Russian authorities have come up with answers of their own. For example, the recently adopted “State Anti-Drug Policy Strategy of the Russian Federation” reinforces the government’s opposition to the use of Medication Assisted Therapy, or MAT, for opioid dependence with essential drugs such as methadone and buprenorphine. Both of these agents are on the World Health Organization’s essential drug list but remain banned in Russia in a holdover from Soviet times.

Russia also restricts such measures as needle and syringe exchange programs. The new National Drug Strategy proclaims a “zero-tolerance” approach to drug use in a country that already incarcerates enormous numbers of young people for substance use — and does so without drug treatment for those who need it.

These policies fuel poor treatment, discrimination and vulnerability to disease among drug users. They are contrary to WHO and U.N. recommendations, and go against the “E.U.-Russia Roadmap on the Common Space of Freedom, Security and Justice,” which emphasizes the principles of nondiscrimination and respect for human rights. They also contradict the 2001 Declaration of Commitment on H.I.V./AIDS and the 2006 Political Declaration on H.I.V./AIDS, both of which have been signed by the Russian Federation.

President Obama Announces Grant Colfax as New Director of the Office of National AIDS Policy

WASHINGTON, DC – Today, President Obama announced the appointment of one of the nation’s leading public health policy experts as the Director of the Office of National AIDS Policy (ONAP). Grant Colfax, MD, Director of the HIV Prevention Section in the San Francisco Department of Public Health will coordinate the continuing efforts of the government to reduce the number of HIV infections across the United States. A component of the White House Domestic Policy Council, ONAP emphasizes prevention through wide-ranging education initiatives and helps to coordinate the care and treatment of citizens with HIV/AIDS.

“Grant Colfax will lead my Administration’s continued progress in providing care and treatment to people living with HIV/AIDS,” said President Obama. “Grant’s expertise will be key as we continue to face serious challenges and take bold steps to meet them.  I look forward to his leadership in the months and years to come.”

ONAP coordinates with the National Security Council and the Office of the Global AIDS Coordinator, and works with international bodies to ensure that America’s response to the global pandemic is fully integrated with other prevention, care, and treatment efforts around the world. Through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) initiative, the U.S. has made enormous progress in responding to the global HIV/AIDS pandemic, working with countries heavily impacted by HIV/AIDS to help expand access to treatment, care, and prevention.

Grant Colfax, MD, was most recently Director of the HIV Prevention Section in the San Francisco Department of Public Health (http://sfhiv.org/profiles/grant_colfax.php).   Dr. Colfax is a graduate of Harvard Medical School and completed his medical residency at the University of California, San Francisco. His work focuses on collaborating with community stakeholders to implement sustainable, evidence-based HIV prevention and treatment interventions and policies in public health settings and measuring their effectiveness. Under his leadership, San Francisco greatly expanded HIV testing and treatment support efforts. Until assuming his ONAP role, Dr. Colfax was also an NIH- and CDC supported scientist studying HIV testing strategies, clinical trials of medications to treat substance dependence, and biomedical HIV prevention interventions. Dr. Colfax was a practicing clinician at the Positive Health Program, San Francisco’s premier public HIV clinic.

 

 

The Food and Drug Administration (FDA) announces the upcoming meeting of its Antiviral Drugs Advisory Committee on May 10, 2012, from 8 a.m. to 5:30 p.m.  The committee will discuss an efficacy supplement for TRUVADA (emtricitabine/tenofovir disoproxil fumarate) Tablet, submitted by Gilead Sciences, Inc.  The supplemental application proposes an indication for Pre-Exposure Prophylaxis (PrEP) to reduce the risk of sexually acquired HIV–1 infection.

The meeting will be held at the FDA White Oak Campus, 10903 New Hampshire Ave., Building 31 Conference Center, the Great Room (rm. 1503), Silver Spring, MD 20993.  Information regarding special accommodations for a disability, visitor parking, transportation, and lodging may be accessed at: http://www.fda.gov/AdvisoryCommittees/default.htm; under the heading ‘‘Resources for You,’’ click on ‘‘Public Meetings at the FDA White Oak Campus.’’  Please note that visitors to the White Oak Campus must enter through Building 1.

The meeting is open to the public.  No registration is required.  Free parking will be available.

Interested persons may present data, information, or views, orally at the meeting, or in writing, on issues pending before the committee. Oral presentations from the public will be scheduled between approximately 2 p.m. and 3 p.m. Those individuals interested in making formal oral presentations should notify Yvette Waples, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 31, rm. 2417, Silver Spring, MD 20993–0002, 301.796.9001, FAX: 301.847.8533, or email: AVAC@fda.hhs.gov, and submit a brief statement of the general nature of the evidence or arguments they wish to present, the names and addresses of proposed participants, and an indication of the approximate time requested to make their presentation on or before April 18, 2012. Time allotted for each presentation may be limited. If the number of registrants requesting to speak is greater than can be reasonably accommodated during the scheduled open public hearing session, FDA may conduct a lottery to determine the speakers for the scheduled open public hearing session. Interested persons will be notified regarding their request to speak by April 19, 2012.

Click here for more information about public participation in the upcoming meeting and how to obtain additional information as it becomes available.  

 

Fairfax, Va.—A new study by researchers at George Mason University and Indiana University provides a large-scale assessment of condom use during the most recent anal intercourse among gay, bisexual, and other men who have sex with men (MSM) in the United States. Findings from this study highlight diversity in condom use behaviors and demonstrate varying degrees of potential risk for HIV and other STIs, regardless of sexual orientation.

The study, published online ahead of print in the Journal of Sexual Medicine, tapped the largest sample of its kind in the United States to examine condom use among MSM.  In collaboration with the OLB Research Institute at Online Buddies, Inc., researchers were able to include data from nearly 15,000 men.

According to the study’s findings, one in three acts of anal intercourse between men are condom protected in the U.S.

From a public health standpoint, say the researchers, this study demonstrates that condom use between men involves multiple factors and is influenced by a variety of contextual components including: the nature of the sexual partner, location of sexual encounter, prior intercourse with the partner, and knowledge of partner’s sexual history with others.

“While gay and bisexual men have been the focus of many public health campaigns given the disproportionate impact of HIV and AIDS in their communities, there remains a need to understand how these men live their sexual lives and the manner in which the specific characteristics of their sexual activities influence condom use,” said co-author Michael Reece, director of IU’s Center for Sexual Health Promotion.   “A one size-fits-all approach to increasing condom use does not work better among these communities than we would expect it to for their heterosexual counterparts.”

Lead author Joshua G. Rosenberger, professor in the Department of Global and Community Health in the College of Health and Human Services at George Mason University, said the study is the one of the first to explore condom use at the event level among a national sample of MSM.

“As such, this study was focused primarily on a single sexual event — the most recent — and therefore these data are able to provide a level of detail about MSM condom use that has not previously been documented,” he said.

A major strength of this study was the inclusion of unique data points designed to capture information regarding men’s ejaculatory behaviors. In total, only 2.5% of the entire sample reported that ejaculation occurred in either their own or their sexual partner’s anus without a condom during most recent anal intercourse.

“While MSM have been traditionally categorized as ‘high risk,’ these data suggest that our current framing of risk based solely on gendered sexual behavior may be shortsighted,” said Rosenberger, “Rather, in order to appropriately identify men who are at increased risk for disease acquisition, clinicians must inquire more thoroughly about potential modes of disease transmission.”

Additional key findings include:

• Rates of condom use were highest among men ages 18–24.
• Men who identified as black, Hispanic/Latino, and Asian were all significantly more likely than those who identified as white to report a condom being used during their most recent anal intercourse with another man.
• Men who indicated that they were not in a romantic relationship with their most recent male sexual partner were significantly more likely to report a condom being used during intercourse.
• Men were more likely to have used a condom when intercourse occurred in their sexual partner’s home or a hotel/motel, compared with other locations including in a car/truck/van.

Study authors include Joshua G. Rosenberger from GMU’s Department of Global and Community Health; Michael Reece, Vanessa Schick and Debby Herbenick , Center for Sexual Health Promotion, IU School of Health, Physical Education and Recreation; Barbara Van Der Pol, Department of Kinesiology, IU School of HPER; J. Dennis Fortenberry, IU School of Medicine; and David S. Novak from Online Buddies Inc.  Online Buddies is one of the world’s largest operators of Internet websites for men who seek social or sexual interactions with other men.

 

Click HERE to read about the study on the George Mason University Website

Mission Statement

National Native HIV/AIDS Awareness Day (NNHAAD) is a nationwide effort designed to promote HIV testing in Native communities through educational materials and use of marketing strategies.

Goals and Objectives

1. Encourage Native people to get educated and to learn more about HIV/AIDS and it’s impact in their community;
2. Work together to encourage testing options and HIV counseling in Native communities;
3. Help decrease the stigma associated with HIV/AIDS.

 

•  Visit CDC’s website for more information about National Native HIV/AIDS Awareness Day and the impact of HIV/AIDS on American Indians (AIs), Alaska Natives (ANs) and Native Hawaiians (NHs).

• Download and print NNHAAD posters and materials to promote the observance or an event in their community, or publish and online banner by clicking HERE

 Global Health Awareness Week (GHAW) 2012 starts tomorrow with a community service event serving food at Midnight Mission on Skid Row! GHAW Continues with lunch lectures everyday next week, a documentary screening with former ER and Law & Oder: SVU producer Dr. Neal Baer, and a faculty & student dinner and roundtable discussion with a very special keynote speaker.

GHAW is also hosting a book drive with WorldwideBooks.org. Bring your new and used books, textbooks, and cookbooks to CHS 13-154 or to any GHAW event to donate.

RSVP at http://ghaw.org/ucla by this Friday!

Results from a small study suggest that in some individuals with well-controlled HIV infection, replacing antiretroviral therapy with interferon treatment may help the immune system control HIV. The findings also suggest that interferon treatment may lower HIV levels in ‘reservoirs’ where it hides from antiretroviral drugs.

Interferon is a protein produced by immune cells that stimulates immune function. An artificial form of interferon is a common line of treatment for hepatitis C infection and some types of cancers.

“Our data shows that our human immune response can be made to control HIV in persons who have otherwise lost that ability,” said Dr. Luis Montaner, Director of the HIV-1 Immunopathogenesis Laboratory at the Wistar Institute in Philadelphia, and senior author of the study, in a recent press release.

“And while we still have much to pursue with this early clinical finding, I firmly believe this gives us hope that one day we can control – and eventually eradicate – HIV in absence of antiretroviral therapy,” he added.

Dr. Montaner noted that HIV usually impairs interferon-producing immune cells after infection. “But in our study, conducted at a later stage of chronic infection in an individual, we saw that adding interferon to a recovered immune system can have a dramatic effect in directing responses against HIV to both control and reduce its detection within places we know it can hide,” he said.

“While our data may not immediately change clinical practice, it identifies the first strategy that shows a clinical response where both viral replication and HIV reservoir indicators are observed to be reduced in the absence of current [antiretroviral therapy],” said Dr. Montaner. “This is the type of response HIV cure research aims to achieve.”

Results from this study were presented last week at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

 

Click HERE to read the rest of the article about this study at aidsbeacon.com

 

 

 

Snigdha Vallabhaneni, X Li, E Vittinghoff, D Donnell, C Pilcher, and S Buchbinder, Univ of California, San Francisco, US; Fred Hutchinson Cancer Res Ctr, Seattle, WA, US; and San Francisco Dept of Publ Hlth, CA, US

 

 

Background:  Although efficacy is unknown, some men who have sex with men (MSM) attempt to reduce their HIV risk by adapting their sexual practices to the perceived HIV serostatus of their partners. We used data from several cohorts to assess the association of seroadaptive practices with HIV seroconversion.

Conclusions:  All seroadaptive practices considered in this study appear to be protective when compared to receptive anal sex with an HIV⁺ or unknown serostatus partner. MSM reporting monogamy and being top-only have the lowest risk of seroconversion, while those who practice seropositioning have a similar risk to those reporting no UAS. The increased risk associated with serosorting, compared to no UAS, likely results from mistaken perceptions of partner serostatus.

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An meta-analysis of HIV-negative gay men’s sexual behaviour and HIV incidence rate in four HIV prevention studies, presented aerlier this month at the 19^th Conference on Retroviruses and Opportunistic Infections (CROI) has found that attempting to ‘serosort’ by restricting unprotected sex to partners known to be HIV-negative does have efficacy as an HIV prevention strategy when compared with having none at all.

Serosorting is, however, considerably less effective in reducing the chances of having HIV compared to other strategies such as monogamy, only having insertive sex, or ‘seropositioning’ (only taking the bottom role with partners known not to have HIV and being top with partners of positive or unknown status). ‘Seroadaptive’ behaviours include any method of attempting to reduce the risk of HIV acquisition or transmission by altering one’s sexual behaviour according to the HIV status of partners. The term ‘serosorting’ has been used in various different ways. Most commonly it means restricting unprotected anal sex to partners known to have the same HIV status as yourself. When unprotected sex between HIV-negative men is confined to a primary relationship, with condoms use in all other encounters, this has been called ‘negotiated safety’.

While some studies have found serosorting in HIV-negative men to be effective, others have not. Attempted serosorting by HIV-negative people has an inherent drawback that serosorting by HIV-positive people lacks: people can only be certain of their status up to the first time they risk exposure to HIV after their last negative HIV test. Research indicates that a large minority of people in high-risk communities who assume they are HIV-negative in fact have HIV, and that a large proportion of men who ‘know’ their partner’s HIV status have in fact tried to guess it.

Click HERE to read the full article about this study on www.aidsmap.com

The Center for HIV Identification, Prevention and Treatment Services (CHIPTS) at the University of California, Los Angeles and the Center for Strengthening Youth Prevention Paradigms (SYPP Center) of Children’s Hospital Los Angeles announce the release of a new resource titled The Role of Social Determinants of Health & HIV.  This is the first publication in a series called HIV Prevention at the Structural Level.

Understanding social determinants of health is critical for effective implementation of the National HIV/AIDS Strategy for the United States.  This resource provides a framework for HIV service providers and community planners to better articulate the many factors that impact HIV risk beyond the individual level.

Download the PDF here: [Download not found]