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15 September 2017 VOLUME 18 ISSUE 37

Media Coverage

  • As this article is being written..., Republicans in Congress are engaged in a frenzied effort to repeal and replace the Affordable Care Act....[Proposed] cuts...threaten to affect women more than men—whether by removing basic health coverage, cutting maternity care or sharply limiting reproductive rights. It's time to take a stand against this war on women's health,...just the latest insult in a long history of male-centric medicine, often driven not by politicians but by scientists and physicians.

    September 14, 2017
    Scientific American
  • Women should be offered the choice to avoid treatment with tenofovir and emtricitabine during pregnancy according to new recommendations published this week in the British Medical Journal. The authors – a panel of experts in maternal and child health, and of women living with HIV - say that women's strong preferences to avoid early infant death and have a healthy infant are not given sufficient weight in other recommendations, and that in order to reduce this risk, antiretroviral treatment during pregnancy should be based on zidovudine and lamivudine.

    September 13, 2017
    AIDSmap
  • State lawmakers on Monday gave final legislative approval to a bill that would reduce from a felony to a misdemeanor the crime of knowingly exposing a sexual partner to HIV without disclosing the infection....The same reduction in crime level would apply to people who donate blood or semen without disclosing that they have tested positive for HIV or AIDS.

    September 13, 2017
    LA TImes
  • In recent years, researchers have firmly established that people living with HIV can best protect their health by starting ARV medications as early as possible....From then on out, it’s important to adhere well to the daily drug regimen indefinitely....So why are the investigators behind so many studies in the HIV research field these days experimenting with taking people off their ARVs for periods of time? They do it in the name of finding a cure.

    September 13, 2017
    POZ
  • More than 60 percent of the world's nations are expected to meet some of their health targets in the United Nations Sustainable Development Goals by 2030....The news comes in a report published Wednesday by the British journal The Lancet that analyzed health-related Sustainable Development Goals in 188 countries....On the downside, only seven percent of countries were projected to meet the HIV/AIDS target, and no country was projected to reach the target on tuberculosis.

    September 13, 2017
    VOA
  • Bill and Melinda Gates have released their first-annual "Goalkeepers" report, a celebration of key milestones in public health and a look at which issues are still most pressing....One of the biggest concerns for Gates moving forward is HIV...[He] expressed concern that a swelling African population could cause the number of new cases to skyrocket in coming years. "Without R&D investments, we won't have the new discoveries that will make it easier to prevent the transmission of HIV."

    September 13, 2017
    Business Insider
  • Melinda Gates is calling on world leaders to step up global aid funding, saying “a loss of U.S. leadership” is resulting in “confusion and chaos” in some most vulnerable corners of the planet....The Trump administration has recommended that the United States...reduce its support in almost all areas of public health....Although lawmakers have said they would reject some cuts,...this “mood of retrenchment” has the potential to undo...significant progress over the past few decades.

    September 13, 2017
    Washington Post
  • The model finds that the two most significant factors in whether PrEP saves money or not are population HIV prevalence, and adherence. PrEP saves money when background HIV prevalence is high because it prevents more of the infections that would otherwise have occurred. As a result, the authors say, PrEP could be cost-effective with modest price reductions in US states like Georgia but would need to be discounted substantially, or only taken by a targeted few, to be cost-effective in low-prevalence states like Montana.

    September 12, 2017
    AIDSmap
  • After running the CDC for eight years under President Obama, Dr. Thomas Frieden is starting a global health initiative that will focus on two big areas: heart health and epidemic preparedness. Called Resolve, it is funded with $225 million over five years by Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill and Melinda Gates Foundation, [and] will be based at Vital Strategies, a public health nonprofit in New York.

    September 12, 2017
    NY Times
  • Speaking at the RAPS Regulatory Convergence conference yesterday, new FDA Commissioner Gottlieb focused much of his speech on driving efficiencies into the biomedical R&D model and thinking about the traditional three phases of trials....He said one way of cutting down on costs and time is the use of combined-phase studies, or what’s referred to as seamless trials, increasingly being used in cancer tests.

    September 12, 2017
    Fierce Biotech
  • As Dr. David Williams of Harvard University, the keynote speaker at the opening plenary of the 2017 U.S. Conference on AIDS (USCA), illustrated with diverse statistics -- the overlap between structural racism that people of color, particularly Black people, face every day, and significantly lower health outcomes, is impossible to ignore.

    September 11, 2017
    BodyPRO
  • The readability of science has steadily decreased since 1881, researchers at the Karolinska Institutet in Sweden conclude in a new study in eLIFE. Examining 709,577 abstracts published between 1881 and 2015 in 123 scientific journals, including Nature, Science, the Lancet and JAMA, the researchers conclude that use of scientific jargon is on the rise—to the detriment of a reader’s understanding. The authors say their results should concern scientists and the wider public.

    September 11, 2017
    Global Health Now
  • In March, when President Trump released the first draft of his budget proposal for the coming fiscal year, he asked lawmakers for deep cuts to one of their favorite institutions, the National Institutes of Health — part of a broad reordering of priorities...toward defense and border security. Six months later, Congress has not only rejected the president’s NIH proposal; lawmakers from both parties have joined forces to increase spending on biomedical research — and have bragged about it.

    September 9, 2017
    NY TImes
  • This week, a study finds that increased muscle area after starting HIV treatment may be due to fat accumulation within the muscle rather than new muscle formation. Another study finds that greater social network clustering among people who inject drugs in the Philippines may contribute to the higher rates of HIV transmission. And partners of people newly diagnosed with HIV were more likely to get tested after receiving assisted partner notifications compared to passive testing referrals.

    September 8, 2017
    BodyPRO
  • Gay men in England who have recently become HIV positive describe a complex web of factors [at individual, community, and structural levels] which may have contributed to their infection, according to a qualitative study recently published in BMJ Open....The relative importance of factors at each level varied for each person.

    September 8, 2017
    AIDSmap
  • The clinical trial for a herpes vaccine flouted just about every norm in the book: American patients were flown in to the Caribbean island of St. Kitts for experimental injections. Local authorities didn’t give permission. Nor did the FDA. Nor did a safety panel. That’s why the trial — run by a startup that has since received funding from billionaire investor Peter Thiel — prompted widespread alarm and censure when it was reported last week by Kaiser Health News.

    September 8, 2017
    STAT News

Published Research

  • Substance use has rarely been the primary focus of studies in African MSM. In general, measurement of substance use was suboptimal....No interventions were found addressing substance use among African MSM....Assessment of substance use practices in this population has to be improved. The available information suggests, though, that there is an urgent need for interventions addressing substance use tailored to the needs of this critical population.

    October 1, 2017
    JAIDS
  • In a cohort of serodiscordant cohabiting couples in Zambia from 1995 to 2012 (n = 3049),...there were 100 unlinked infections in couples....Predictors...were alcohol use, genital inflammation, and ulceration. Causes of genital inflammation and ulceration should be screened for and treated in HIV-negative individuals and counseling on risk of alcohol use and sex with outside partners discussed with couples where 1 or both are HIV-negative, including counseling on use of pre-exposure prophylaxis when feasible.

    October 1, 2017
    JAIDS
  • Results: Pregnancy incidence did not differ by study arm for any of the hormonal contraceptive methods. Conclusions: Use of the dapivirine ring does not reduce the effectiveness of hormonal contraceptives for pregnancy prevention. Oral contraceptive pill use was associated with high pregnancy incidence, potentially because of poor pill adherence. Injectable and implantable methods were highly effective in preventing pregnancy.

    October 1, 2017
    JAIDS
  • The authors...analyze current private sector spending in global R&D and calculate how much pharmaceutical firms, venture capital funds, and impact investors invest in: 1) overall R&D focused on drugs, vaccines, and therapeutics in the developed and developing world; 2) global health R&D that emphasizes medical treatments in the developing world; and 3) neglected disease R&D...focused on drugs, vaccines, and therapeutics for illnesses that primarily impact populations in very poor nations.

    September 12, 2017
    Brookings
  • We enrolled participants aged 18 years or older with HIV-1 RNA of 1000 or more copies per mL and no previous antiretroviral treatment at 139 sites worldwide. Findings: A once daily raltegravir 1200 mg regimen was non-inferior compared with raltegravir 400 mg twice daily for initial treatment of HIV-1 infection. Interpretation: These results support the use of raltegravir 1200 mg once daily for first-line therapy.

    September 11, 2017
    Lancet
  • The study was conducted from July 2013 to July 2015, targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Of 2,009 participants, 46% were MSM, a third from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63%; 72% among MSM; and 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants, 45% for people from sub-Saharan Africa.

    September 10, 2017
    AIDS
  • The primary objective of this study was to characterize the pharmacokinetics of etonogestrel (ENG) released from a contraceptive implant in Ugandan women living with HIV who were receiving efavirenz (EFV) or nevirapine (NVP)-based ART, compared with ART-naive women over 24 weeks. Conclusion: After 24 weeks of combined use, ENG exposure was 82% lower in women using EFV-based ART compared with ART-naive women. In contrast, NVP did not significantly impact ENG exposure. These results raise concerns about reduced effectiveness of implantable contraception for women taking EFV-based ART.

    September 10, 2017
    AIDS
  • HIV is an important cofactor in Kaposi sarcoma pathogenesis, and widespread use of ART has reduced Kaposi sarcoma incidence. However, it remains the second most frequent tumor arising in HIV-infected patients in the United States and is particularly common in sub-Saharan Africa. Kaposi-associated herpesvirus (KSHV) prevalence varies substantially in different populations....Although there have been advances in the treatment of Kaposi sarcoma..., improved therapies are needed, especially those appropriate for resource-poor regions.

    September 10, 2017
    AIDS
  • The [new] WHO framework introduces six guiding principles that should be used to design new, or to improve existing, programmes and research.operationalising sexual health and its linkages to reproductive health,...[and] provides a roadmap for SDG 3.7 by illustrating the expectations of quality and comprehensive interventions that address the sexual and reproductive health needs of all populations.

    September 9, 2017
    Lancet
  • Between Sept 26, 2007, and Dec 18, 2009, we recruited and randomly assigned 14,215 participants to receive 9vHPV or qHPV vaccine. Results: The 9vHPV vaccine could potentially provide broader coverage and prevent 90% of cervical cancer cases worldwide.

    September 5, 2017
    Lancet
  • A new study in The Lancet Global Health...found that overall prevalence of smoking among men with HIV was more than 24 percent; among women with HIV just more than 1 percent [possibly underestimated]. Because of treatment options, HIV patients may only lose about five years of life because of the infection; however, smokers with HIV may lose up to 12 years of life. Therefore, the researchers noted, tobacco use is more than twice as likely to cause death in people with HIV as the infection itself.

    September 1, 2017
    Nation's Health
  • Writing in the middle of the northern hemisphere's summer holidays, the lull in journal submissions and acceptance that peer-review probably won't happen for a few weeks gives time to pause and reflect on the broader picture in HIV/AIDS in 2017. Just a few weeks after the International AIDS Society Conference on HIV Science and the launch of UNAIDS updated statistics on the global HIV epidemic, now is a good time to take stock.

    September 1, 2017
    Lancet HIV
  • The number of states providing Medicaid reimbursement for the female condom increased 33% (from 25 to 36) since 2007. 29 states provided data showing low numbers of claims for female condoms but high rates of reimbursement. This period of heightened access demands that the public health community seize the moment....The pending repeal of the ACA may thwart important gains in access; policies promoting women's reproductive health must be implemented immediately.

    August 7, 2017
    AJPH
  • We estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario....All countries will need to strengthen investments in health systems to expand service provision in order to reach SDG 3 health targets, but even the poorest can reach some level of universality.

    July 17, 2017
    Lancet

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