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12 JUNE 2015 VOLUME 16 ISSUE 24

Media Coverage

  • Trials from the UK, US, France and Thailand show that PrEP (pre-exposure prophylaxis) dramatically reduces HIV infection in high-risk categories....Although widely available as a preventative measure in the US, it is not licensed for the prevention of HIV transmission in Europe. But if it is introduced here, it won’t be without controversy. Who should have it? Who will pay for it? And is there a risk that it could actually increase sexually risky behaviour?

    June 11, 2015
    Irish Times
  • In the wake of the innovations of the early AIDS era, new-drug approvals by the FDA have become the fastest in the world, and the agency has introduced new mechanisms such as fast-track and breakthrough drug designations that are increasingly being used to speed lifesaving new treatments to market. But the 21st Century Cures Act could substantially lower the standards for approval of many medical products, potentially placing patients at unnecessary risk of injury or death.

    June 11, 2015
    NY Times
  • US Ambassador Patrick Gaspard said while the world’s largest economy and South Africa’s biggest donor in fighting HIV/AIDS is slowly ­reducing their financial aid, the US intends maintaining a technical presence, staying ­involved at grassroots level and youth ­development. Speaking at the side of the South African Aids conference in Durban, Gaspard said he was confident that South Africa would ­continue to roll out the world’s most successful HIV/AIDS programme.

    June 11, 2015
    News24
  • The New Zealand AIDS Foundation has been given the go-ahead from Pharmac and the Ministry of Health to trial PrEP in New Zealand.

    June 11, 2015
    Gay NZ
  • HIV activists warned that the era of AIDS denialism was returning in response to the AIDS Healthcare Foundation's opposition to PrEP at the recent SA AIDS Conference in Durban and elsewhere. Activists argue "the Foundation has consistently opposed Truvada using faulty science and fear mongering".

    June 11, 2015
    Times Live
  • South Africa’s first national HIV stigma index has found that seven percent of HIV-positive women surveyed reported being sterilised against their will and about 40 percent reported contraception was a pre-requisite of accessing antiretrovirals (ARVs)....Commissioned by the South African National AIDS Council (SANAC), the [stigma] report also showed that 14 percent of surveyed women living with the virus reported not receiving ARVs during pregnancy despite national policies.

    June 10, 2015
    Health-e News
  • A third of South Africans living with HIV say they have experienced stigma and a tenth have contemplated suicide, according to SA’s first Stigma Index, released Tuesday at the 7th South African AIDS Conference in Durban....The Index was conducted by the Human Sciences Research Council and surveyed 10,473 people living with HIV in all nine provinces....The index, conducted in 50 countries throughout the world, found much higher stigma and discrimination levels in other African countries.

    June 10, 2015
    Business Day Live
  • With new research showing that one third of people living with HIV suffered stigma, Deputy President Cyril Ramaphosa urged South Africans to speak out against discrimination....Before the conference, Ramaphosa visited Gugu Dlamini Memorial Park, named after the KwaMashu woman stoned to death in 1998 after publicly disclosing her HIV positive status....Mandisa Dlamini, 13 when her mother was murdered,...has gone on to establish the Gugu Dlamini Foundation, helping young women living in KwaMashu to make informed life choices.

    June 10, 2015
    IOL News
  • Benny Malakoane, Member of the Executive Council (MEC) for Health in the Free State, came under fire while sitting in the audience at the opening of the 7th South African AIDS Conference in Durban on Tuesday evening....The Treatment Action Campaign (TAC) has been campaigning for Malakoane to be fired because of a range of problems in the Free State health system. The MEC is also facing charges of fraud and corruption.

    June 10, 2015
    All Africa
  • An international team of researchers from Europe and the US looked at HIV-related service use, need and behaviours among 175,000 gay or bisexual men living in 38 European countries with differing levels of national homophobia. They found that men in homophobic countries had fewer sexual partners and were less likely to be diagnosed with HIV. However, they also found those men knew less about HIV, were less likely to use condoms and are at greater potential risk of getting HIV when they do have sex.

    June 10, 2015
    Science Daily
  • The AIDS Healthcare Foundation (AHF)...is having a very bad week. AHF's various PrEP positions collided online, as Facebook users noticed their new PrEP-promotion posters in San Francisco, at the same time they continued their anti-PrEP campaign in Africa....AIDS activists won't be caught off guard this time....During yesterday's opening session of the 7th South African AIDS Conference, the president of the International AIDS Society, Dr. Chris Beyrer, slammed AHF's "PrEP Denialism".

    June 10, 2015
    POZ Blogs
  • A single dose of the human papillomavirus vaccine Cervarix may offer a similar level of protection against HPV-16/18 infections...as current two- and three-dose schedules, according to new research combining data from two large phase 3 trials. "Our findings... suggest a one-dose schedule should be further evaluated....This is especially important in less developed regions of the world where more than 80% of cervical cancer cases occur," says author Aimée Kreimer, National Cancer Institute.

    June 9, 2015
    Science Daily
  • A new CDC study that combines 3 years of data to produce nationally representative estimates characterizing HIV-infected adults receiving care in the U.S. shows that those who identify as transgender women are significantly less likely to adhere to anti-HIV medication regimens and to achieve viral suppression. In addition, they have higher unmet needs for basic services such as food and housing than non-transgender men.

    June 9, 2015
    Medical News Today
  • HIV was once a virus that flourished in cities, but it has been moving to rural areas. The small town of Austin, Indiana, is the site of one outbreak....Since December, 150 people have been diagnosed with HIV, raising concerns of public health officials and the state government. Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, talks with Here & Now’s Jeremy Hobson about what can be done to prevent rural HIV outbreaks like the one in Austin, Indiana.

    June 9, 2015
    New Hampshire Public Radio
  • Specialised groups, be they economists or sports organisations, develop their own special vocabularies when discussing their work....The problem is that when discussing matters with the general public these words and phrases, which are not in the general vocabulary, only confuse. When it comes to health matters, such confusion can have deadly consequences. This gets in the way of understanding....For instance, what does this mean: “multiple concurrent partners”?

    June 9, 2015
    Swazi Observer
  • Los Angeles County supervisors voted Tuesday to develop a plan to distribute a controversial HIV-prevention drug to county residents at high risk of contracting the virus....The prevention method is known as pre-exposure prophylaxis, or PrEP. Supervisor Sheila Kuehl, who proposed the plan, said that "together with other HIV prevention tools, it’ll make it possible for us to dramatically reduce new HIV infections." The supervisors directed the public health department to come back in 30 days with a plan to reach out to high-risk populations and disseminate the drug.

    June 9, 2015
    LA Times
  • The regional framework for action on HIV and AIDS beyond 2015 was endorsed at a recent session of the UN Economic and Social Commission for Asia and the Pacific or ESCAP. The plan involves addressing legal and policy barriers around HIV prevention and care, ensuring access to affordable medicine and the sustainable financing of the AIDS response.

    June 8, 2015
    Radio New Zealand
  • According to new analysis from the Global Burden of Disease Study 2013, worldwide the proportion of lost years of healthy life due to illness rose from around a fifth in 1990 to almost a third in 2013....The main drivers of increases in the number of years lived with disability were musculoskeletal, mental, neurological, and substance abuse disorders, and chronic respiratory conditions. HIV/AIDS was a key driver of rising numbers of years lived with disability in sub-Saharan Africa.

    June 8, 2015
    Science Daily
  • As officials in Indiana scramble to contain a fast-spreading HIV outbreak, TIME has learned that in May 2013, federal regulators from the Food and Drug Administration told Endo Pharmaceuticals, maker of the widely used prescription pain pill Opana, that the newest version of the drug could be driving behavior that is contributing to the crisis, driving abusers to inject the drug intravenously instead of snorting it.

    June 8, 2015
    TIME
  • India's Cipla recently got FDA approval for a pediatric formulation of the combo drug lopinavir/ritonavir to treat HIV/AIDS in the developing world, but not in the US, where market exclusivity rules apply. The oral pellets can be sprinkled on sweetened porridge for administration to infants, who often have difficulty swallowing tablets and spit out bad-tasting liquid formulations. The pellets received expedited approval under the President's Emergency Plan for AIDS Relief.

    June 8, 2015
    Fierce Drug Delivery
  • Over the past year, public health agencies across the U.S....have started distributing a groundbreaking drug — widely known as PrEP but marketed as Truvada. But three years after [it] was approved by federal regulators, a public health program for the medication has yet to be launched in the nation’s second-largest epicenter of people living with HIV/AIDS: Los Angeles County....County officials...and PrEP proponents blame most of the delay on one man: Michael Weinstein.

    June 8, 2015
    BuzzFeed
  • How most babies are protected from acquiring HIV from their infected mothers has been a matter of scientific controversy. Now researchers at Duke Medicine provide new data identifying an antibody response long discounted as inadequate to confer protection...."We hope this will be a major clue to making a vaccine to effectively prevent all mother-to-child HIV transmission, since these antibodies are the type that our current experimental HIV vaccines can boost," said M. Anthony Moody, Duke Human Vaccine Institute.

    June 8, 2015
    Science Daily
  • The CDC announced today that it has updated national guidelines to inform health care providers on strategies to prevent, diagnose and treat sexually transmitted diseases. Kimberly Workowski, professor of medicine at Emory University, said updates to the CDC's Sexually Transmitted Diseases Treatment Guidelines are critical, as chlamydia and gonorrhea continue to be number one and number two, respectively, in terms of reportable infections, and as syphilis cases continue to rise.

    June 4, 2015
    Healio
  • In a scientific discovery that has significant implications for preventing HIV infections, researchers at Sanford-Burnham Medical Research Institute have identified a protein that could improve the body's immune response to HIV vaccines and prevent transmission of the virus....The research, which identified PQBP1 as a target for improving HIV vaccines, was published June 4 online ahead of print in the journal Cell.

    June 4, 2015
    Science Daily
  • New technology developed by Howard Hughes Medical Institute researchers makes it possible to test for current and past infections with any known human virus by analyzing a single drop of a person's blood. The method, called VirScan, is an efficient alternative to existing diagnostics that test for specific viruses one at a time.

    June 4, 2015
    Science Daily
  • Yesterday, Wednesday, June 3, the Sexual Offences Bill, sponsored by Senator Christiana Anyanwu, was passed into law by the Nigerian Senate.The new law contains a number of problematic provisions relating to “HIV or any other life threatening sexually transmitted disease(s)” that were added between the 2012 draft and the 2013 draft that became law yesterday.

    June 4, 2015
    HIV Justice Network
  • The company selling a costly breakthrough to millions of hepatitis C sufferers thinks price is the wrong thing to talk about.

    June 3, 2015
    Bloomberg Business

Published Research

  • Development of long-acting ARVs can present novel regulatory challenges:..determining the appropriate dosing regimen, need for an oral lead-in, and whether existing data with an approved oral agent...can be leveraged for a treatment or prevention indication. For PrEP, additional nonclinical studies and evaluation of tissue concentrations in multiple compartments may be necessary....Study design and choice of controls for registrational trials...might also prove challenging following availability of an oral PrEP drug.

    July 1, 2015
    Current Opinion in HIV and AIDS
  • Over the past year, advances continued to be made in the development of vaginal rings to deliver antiviral agents for prevention of HIV. An array of antiviral agents and vaginal ring designs to deliver these products are at various stages in the product pipeline process. Results from the first efficacy trials of an antiretroviral-containing vaginal ring are expected soon and will inform the continued development of this important product class.

    July 1, 2015
    Current Opinion in HIV and AIDS
  • The contraceptive agent DMPA faced a long regulatory journey in the USA, with a lag of 25 years from initial application (1967) to approval (1992)....Lessons learned include that extensive acceptability work is needed in parallel to product development. Also, low continuation rates,...timing of initiation, and difficulty ensuring access...have limited DMPA’s impact. Those involved in long-acting injectable PrEP development and implementation must consider these lessons and solutions to ensure a successful future for this new HIV prevention modality.

    July 1, 2015
    Current Opinion in HIV and AIDS
  • Table of Contents for special issue on this topic.

    July 1, 2015
    Current Opinion in HIV and AIDS
  • New genetic studies that compare different HIV isolates with each other are allowing researchers to create sophisticated maps of transmission networks. These phylogenetic transmission maps, in turn, are pinpointing where prevention efforts can get the most bang for their buck.

    June 12, 2015
    Science
  • A Western import. Unnatural. Contagious. Un-African. All of these arguments and more have been invoked to support the numerous laws criminalizing homosexuality in Africa. But now African academics have used scientific evidence to argue against such laws and to urge African nations to abandon them. In a report published on 10 June by the Academy of Science of South Africa, the academics...make the case that laws criminalizing homosexuality have no basis in science....

    June 11, 2015
    Nature
  • The Academy of Science of South Africa has published a comprehensive study on the science of human sexuality and the implications for policy. The report demolishes the political lie that anti-gay laws are supported by scientific evidence. And it shows that, contrary to the public-health claims of politicians who want to criminalize homosexuality, such laws hamper efforts to combat the spread of HIV and other sexually transmitted infections.

    June 11, 2015
    Nature
  • ASPIRE is a phase III trial testing the safety and effectiveness of a vaginal ring containing... dapivirine for prevention of HIV-1 infection. 2629 HIV-1 seronegative women between 18–45 years of age were enrolled from 15 research sites in Malawi, South Africa, Uganda, and Zimbabwe. Nearly 100% of participants reported having a primary sex partner in the prior 3 months but 43% did not know the [primary partner's] HIV-1 status; 17% reported additional concurrent partners [and] 64% reported having disclosed to primary partners about planned vaginal ring use in the trial.

    June 10, 2015
    PLOS One
  • Our findings indicate that modest increases in risky sexual behavior could occur with PrEP. Although responses from the majority of participants suggest they would not be more likely to engage in risky sexual behavior if they took PrEP, a substantial proportion might. Programs rolling out PrEP should be prepared to assist similar women in making informed choices about reducing their risk of HIV and about their sexual health beyond HIV prevention.

    June 9, 2015
    PLOS One
  • We show here in a SIV-rhesus macaque model of HIV-1 transmission to women, that glycerol monolaurate microbicide (GML) used daily and before vaginal challenge, protects against repeat high doses of SIV by criteria that include virological and immunological assays to detect occult infection....Developing a sustained formulation for GML delivery could contribute an independent, complementary protective component to an ARV-containing microbicide.

    June 9, 2015
    PLOS One
  • From 2004 to 2013, PEPFAR programmes provided support for a cumulative number of 24,565,127 adults and children on ART, 4,154,878 medical male circumcisions, and ART for PMTCT among 4,154,478 pregnant women in 16 PEPFAR countries. Based on findings from the model, these efforts have helped avert 2.9 million HIV infections in the same period....Our estimates do not account for the impact of the PEPFAR-funded non-biomedical interventions.

    June 8, 2015
    Sexually Transmitted Infections
  • In vitro evaluation of the immuno-inflammatory potential of microbicides using the pro-inflammatory compounds (PIC)-associated genes defined in this study could help in the initial screening of candidates prior to entering clinical trials. Additional characterization of these genes can provide further insight into the cervicovaginal immuno-inflammatory and mucosal-altering processes that facilitate or limit HIV transmission with implications for the design of prevention strategies.

    June 8, 2015
    PLOS One
  • So where do the findings presented at CROI 2015 leave the field?...For MSM, the CROI 2015 findings suggest that access to oral PrEP needs to be scaled up....For young African women,...the findings presented at CROI 2015 suggest that longer duration methods of HIV prevention that do not require daily pills or gel applicators could offer culturally congruent approaches....One challenge for future studies is that...it will become increasingly difficult to do placebo-controlled studies among high risk populations.

    June 6, 2015
    The Lancet
  • Girls' and women's health is in transition....Population ageing and transformations in the social determinants of health have increased the coexistence of disease burdens related to reproductive health, nutrition, and infections, and the emerging epidemic of chronic and non-communicable diseases. Simultaneously, worldwide priorities...have themselves been changing...to the broader framework of sexual and reproductive health and [an] encompassing concept of women's health founded on a life-course approach.

    June 4, 2015
    The Lancet
  • We compared HIV clinical outcomes and stigma before and after implementation of the Same-Sex Marriage Prohibition Act. Reported history of fear of seeking health care was significantly higher in postlaw visits than in prelaw visits, as was avoidance of health care. The negative effects of HIV treatment and care in MSM reinforce the unintended consequences of such legislation on global goals of HIV eradication. Strategies to reach MSM in highly stigmatised environments are needed.

    June 2, 2015
    The Lancet
  • [S]eminal fluid is a complex and dynamic medium containing high concentrations of factors that play key roles in modulating the local immune response in the female reproductive tract during fertilization and embryogenesis....To understand how these factors affect male-to-female HIV-1 transmission, multiple studies have comparatively profiled the contents of seminal fluid collected from uninfected and HIV-1–infected men. This review provides an overview of these studies [and] a discussion of the potential impact of semen on HIV-1 transmission.

    June 1, 2015
    JAIDS
  • Most participants were linked to/retrained in care and initiated onto ART, but ART discontinuation and irregular adherence were frequent....The odds of ART interruption were 3.24 times higher among women who experienced FSW-related discrimination, 2.41 times higher among women who used any drug, and 2.35 times higher among women who worked in an FSW establishment. Internalized stigma related to FSW was associated with higher odds of interruption and positive perceptions of HIV providers were protective.

    June 1, 2015
    General
    JAIDS
  • Through pill count, 82% of participants were adherent at 1 month and 83.3% at 1 year. Mental health was the only psychosocial variable associated with adherence, although regional differences emerged. Although adherence was high among individuals in stable relationships taking ART for prevention, mental health and adherence covaried....Adherence and couples' counseling, feedback about viral suppression, and/or altruism may also help explain the magnitude of adherence observed.

    June 1, 2015
    JAIDS
  • The analysis included 557 married adults, 264 of whom were diagnosed with HIV before ART was available (2000–2004), and 293 diagnosed after ART was introduced (2005–2008).Treatment availability and use, especially ART initiation, was associated with increased self-disclosure of HIV diagnosis to partners. ART access may facilitate the prevention of transmission to uninfected partners and linkage to treatment for infected couples.

    June 1, 2015
    General
    JAIDS
  • Six different service delivery models were implemented sequentially to provide ART in pregnancy, including integration of ART into antenatal care (ANC), point-of-care CD4 cell count testing, and universal ART initiation for all HIV-infected pregnant women. The strategy of universal ART led to the highest levels of ART initiation (with 92% of women starting before delivery) and the shortest delays, with 82% of women starting ART on the day of the first ANC visit.

    June 1, 2015
    JAIDS
  • Recent findings on the initial steps in viral entry and establishment of a productive local infectious nidus in the vaginal epithelium has provided important clues for HIV prevention in the female genital tract....Nonhuman primate studies demonstrate that broadly neutralizing HIV mAbs can protect rhesus macaques from...SHIV infection....If potent broadly neutralizing mAbs are effective in preventing HIV infection in women, this outcome could fill an important gap in HIV prevention technologies for young women, especially in Africa.

    May 31, 2015
    Current Opinions in HIV and AIDS
  • Table of Contents for special issue on this topic.

    May 31, 2015
    Current Opinion in HIV and AIDS

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