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19 August 2017 VOLUME 17 ISSUE 33

Media Coverage

  • Tuberculosis is a leading killer of people with HIV, and providing therapy for both illnesses simultaneously saves lives, according to new guidelines...developed jointly by the American Thoracic Society, Centers for Disease Control and Prevention and Infectious Diseases Society of America, [and] published in the journal Clinical Infectious Diseases.

    August 19, 2016
    Science Daily
  • An expensive breakthrough drug that prevents people from getting HIV won't be funded by taxpayers in Australia this year, the nation's drug funding panel has ruled.

    August 19, 2016
    Sydney Morning Herald
  • The Delhi Commission for Women received a representation from 15 former outreach workers who are HIV positive, regarding the fact that they had been arbitrarily removed from their jobs....In order to effectively carry-out their roles as outreach workers [for NACO], these individuals had self identified to the community and their families as HIV positive, risking social marginalisation.

    August 17, 2016
    India Today
  • At the 21st International AIDS conference in Durban, South Africa, Nobel laureates met alongside transgender sex workers, activist grandmothers alongside gay men—over 18,000 delegates with over 18,000 stories of a virus that continues to elude us. Natasha Mitchell shares 10 things she learned from her days observing the action.

    August 16, 2016
    Radio National (Australia)
  • The project, a five-year, multisite clinical trial, will adapt and test MyPEEPS, an evidence driven intervention using mobile phone technology to deliver HIV prevention information to diverse, high risk, adolescent MSM. The randomized controlled trial will be conducted across four geographically diverse sites: Birmingham; Chicago; New York City; and Seattle.

    August 16, 2016
    Hispanic Outlook
  • While earlier and more widespread use of effective antiretroviral therapy for HIV in this millennium has likely contributed to the dramatic decline in the incidence of HIV-associated Kaposi's sarcoma and non-Hodgkin lymphoma, therapy may also have contributed to changes in the presenting characteristics of these cancers in HIV patients, according to a cohort study spanning 15 years.

    August 16, 2016
    MedPage Today
  • In the majority of countries around the world nurses provide most of the HIV services, as well as much of the primary care. Yet research funding, participation in meetings, and professional support do not reflect this fact. While nurses "will jump in to do the work," they need the resources to do so....A global call to action to help people in this profession obtain the necessary resources and support...has been endorsed by...UNAIDS and IAS.

    August 15, 2016
    BodyPro
  • Oral PrEP works. So there was limited new scientific data with the overwhelming majority of studies relating to implementation issues. A few of the studies with new scientific data are summarised [hereinafter]below....The poster with early data supporting a potential role for EFdA as PrEP is perhaps a highlight from the conference.

    August 15, 2016
    BodyPro
  • The Treasury said that whilst Britain remains part of the EU, organisations bidding directly to the European Commission for EU funded projects will have their funding underwritten, even when projects continue beyond the UK’s departure from the EU....These include universities participating in Horizon 2020, the EU’s research and innovation programme that is making nearly €80bn of funding available over seven years to 2020.

    August 15, 2016
    The Engineer
  • So what's going on with this AIDS thing anyway? If you interview a cab driver -- a time-honored resort for the harried journalist -- you get the impression that it's all pretty much over. I asked a couple about HIV while I was Durban, South Africa for the International AIDS Conference....And in the developed world, HIV/AIDS has been off the radar for a while.

    August 14, 2016
    MedPage Today
  • NHS England has today launched a 45-day public consultation on a proposed clinical commissioning policy on Pre-Exposure Prophylaxis for HIV....The draft commissioning policy has been published for consultation pending a ruling from the Court of Appeal, so that a system can be put in place as quickly as possible once a final decision is reached.

    August 13, 2016
    EATG
  • Women who took part in two clinical trials on the efficacy of a vaginal ring as an HIV prevention tool in Uganda, South Africa, Malawi and Zimbabwe, will now be enrolled in an open label extension study.....“In this follow-up study, we shall largely be gathering data on adherence and acceptability of the ring,” said Dr. Flavia Matovu, a researcher on the Aspire study at the Uganda site.

    August 13, 2016
    East African
  • Approximately 85% of people switched to protease inhibitor-based second-line ART in sub-Saharan Africa achieve and maintain an undetectable viral load..., according to research in Clinical Infectious Diseases online....Write the authors, “These findings indicate that future treatment of individuals with failure of second-line ART requires third-line drug options,…which are currently unavailable and/or unaffordable in the public sector in sub-Saharan Africa.”

    August 12, 2016
    aidsmap
  • Demetre Daskalakis, MD, is the first public health official in the United States to sign a consensus statement concluding that there is “negligible risk” of HIV transmission when a person living with the virus is taking HIV meds and has maintained a consistently undetectable viral load for at least six months.

    August 12, 2016
    POZ
  • It is 1979....It will be years before HIV is pinned down as the cause of what...now is called AIDS. And it will be years more before effective treatment is available....That period of confusion, fear, and slowly advancing knowledge is the setting for Sensing Light, a novel by Mark Jacobson, MD, an eminent HIV clinician at the University of California San Francisco. The work of fiction follows three physicians as they grapple with the growing epidemic.

    August 12, 2016
    MedPage Today
  • Gilead has struck a deal to access bispecific antibody technology from Genmab. The agreement gives Gilead an exclusive license to use the Danish drugmaker’s bispecific platform to create an HIV therapeutic, plus an option to take up another exclusive license on the technology.

    August 11, 2016
    Fierce BioTech
  • When Bill Clinton wasn’t retelling how he courted his wife,...he applauded her work on HIV/AIDS. "She tripled the number of people with AIDS whose lives are being saved with your tax dollars,...and it did not cost you any more money...". His staff told us Clinton was talking about...PEPFAR. We took his essential claim to be that thanks to his wife, treatment tripled and costs held steady. That’s not perfectly accurate, but it's close.

    August 10, 2016
    Politifact
  • Scientists from the Medical Research Council Laboratory of Molecular Biology in Cambridge and University College London have discovered an essential feature of HIV that the virus uses to infect cells whilst avoiding detection by the immune system. This discovery presents a new drug target and the opportunity to re-evaluate existing treatments for HIV to improve their efficacy.

    August 10, 2016
    Science Daily
  • While the human immunodeficiency virus pandemic fuels tuberculosis outbreaks, it does not drive the development and transmission of multidrug-resistance in TB patients as previously suspected, according to findings...from a collaboration between Norwegian, British and Argentinian scientists that also show that TB drug resistance is not more likely to evolve in HIV-positive patients compared to HIV-negative patients.

    August 9, 2016
    Science Daily

Published Research

  • 711 participants provided sufficient responses to be included in the analysis. 67% were women....Willingness to participate in trials increased from 59.0% in phase 1 to 68.5% in phase 2, and 81.2% in phase 3 trials, and 40% reported willingness to participate even in the absence of immediate, personal benefits. Mean perceived severity of receiving genital HSV-2 diagnosis was 4.2 on a scale of 1 to 5.

    September 1, 2016
    Sex Transm Dis
  • Self-regulation adherence counseling demonstrated significant improvements in achieving 90% ART adherence relative to the control group over the first 6 months of follow-up,...although these benefits were not evidenced in all patients or in the long-term. Advancing adherence interventions along with an effective means for sustaining gains in adherence remain priorities if ART is to achieve its potential clinical and public health benefits.

    September 1, 2016
    JAIDS
  • This study shows the reversal of HIV/AIDS, non-communicable disease, and injury mortality trends in South Africa during the study period. Mortality differentials show the importance of social determinants, raise concerns about quality of health services, and provide relevant information to policy makers for addressing inequalities. Differences between GBD estimates for South Africa and this study emphasise the need for more careful calibration of global models with local data.

    September 1, 2016
    Lancet Global Health
  • Stagnating incidence and growing epidemics in key populations saw the optimism of other recent conferences give way to an embattled air in Durban....Not for the first time, the conference was alive with talk of cuts to funding in the global fight against HIV/AIDS....And during protests calling for ongoing funding support, banners called on countries to “Brexit on the Global Fund”, showing how...Britain's vote to leave the EU has quickly become synonymous with reneging on commitment.

    September 1, 2016
    Lancet
  • Most sexually transmitted infections (STIs) have been...paid little attention and accorded only peripheral interest....However, this lack of focus...is leading the health-care community perilously close to disaster.....To contribute to filling the gaps with regard to STI strategies, The Lancet Infectious Diseases will be publishing a Commission on this topic in 2017....to explore the challenges faced by this field and highlight ways ahead.

    September 1, 2016
    Lancet
  • I feel as though I live in two worlds. One is populated by scientists working on advanced tools... The other is populated by public health professionals working on the demanding challenges of combating infectious diseases, empowering women and girls, and ensuring that more children survive and thrive. If we want to achieve the ambitions set out by the United Nations...by 2030, we need to bring these two worlds closer together through a new concept—precision public health.

    August 19, 2016
    Science
  • In The Lancet HIV, Lara Coelho and colleagues report findings from their observational cohort study of 2224 HIV-infected individuals [in Brazil]....After excluding individuals who reported injection drug use or heavy cocaine use, MSM were 2·24 times more likely to die from AIDS-related causes than were women,...younger, more likely to be white, had more years of education at enrolment, and had slightly more compromised immune status in the follow-up period.

    August 17, 2016
    Lancet
  • We used data from the Bangladesh Demographic and Health Survey survey conducted in 2011. In total 12,512 women ageing between 15 and 49 ever-hearing about HIV regardless of HIV status were selected for this study. Little over half the respondents had good knowledge regarding HIV transmission risks. Educational level of women and sex of household head were found to be significantly associated with the level of HIV knowledge.

    August 17, 2016
    BMC Public Health
  • The following themes were identified at 4 levels including 1) exosystem (community); 2) mesosystem (network); 3) microsystem (dyadic); and 4) individual: HIV/STI awareness, risk taking, and substance use. A strong theme emerged with over 80% of responses linked to the fundamental role of financial insecurity underlying risk-taking behavioral pathways.

    August 17, 2016
    BMC Public Health
  • For lessons, the universal health coverage (UHC) movement should look to the global HIV response, which has confronted many of the same barriers to access in weak health systems. Considerable success on HIV has resulted from innovative approaches that UHC efforts can build upon, in areas including governance, financing, service delivery, political mobilization, accountability, and human rights.

    August 16, 2016
    PLoS Med
  • In spite of intensive scale-up of HIV counselling and testing (HCT) in SSA, few well-designed studies have assessed the prevention impacts of HCT. The limited body of evidence suggests that individual HCT does not have a consistent impact on HIV acquisition, and that couple HCT (cHCT) is more protective than individual HCT.

    August 16, 2016
    Sex Transm Infect
  • The study involved 6,395 teenagers aged 15–18 years where 2,532 declined HIV testing, 44 tested positive and 3,806 tested negative. HIV prevalence...in females was 1.6 % whereas in males it was 0.58 %. Prevalence of HIV was twice as high among the urban than the rural teenagers, and being divorced or widowed was associated with higher risk of HIV regardless of residence. Risk of HIV was lower among students or those in school compared to those who were unemployed and not in school.

    August 15, 2016
    BMC Public Health
  • The landmark decision by the UK High Court on Aug 2 concerning NHS England and funding of HIV pre-exposure prophylaxis is still resonating. Unless NHS England successfully appeals against the judgment, responsibility for funding an estimated £10–20 million a year HIV prevention programme will land squarely in its court.

    August 13, 2016
    Lancet
  • Trichomonas vaginalis is the world's most common curable STI and has implications for reproductive health in women....In this peripartum cohort....after adjustment for socio-economic factors, male partner circumcision status, pregnancy status and other STIs,...women with circumcised male partners had a 58% lower risk of incident T. vaginalis compared with women with uncircumcised partners. Male circumcision may confer benefits in preventing T. vaginalis.

    August 12, 2016
    Sex Transm Infect
  • This large, mixed-methods study found high overall prevalence of CSA among MSM (22.4%), with substantially higher prevalence among MSM residing in the South and among more feminine sexual identities. Qualitative findings highlighted boys’ vulnerabilities to CSA,...and CSA’s role in further sexual encounters, including sex work. Additionally, CSA was associated with an elevated rate of recent, and an even higher rate of lifetime HIV-related risk factors.

    August 12, 2016
    BMC Public Health
  • In our cohort of HIV-infected adults depressive symptoms were common. Important disparities in the prevalence of depressive symptoms and receipt of antidepressant treatment existed by gender and race/ethnicity.

    August 11, 2016
    PLoS ONE
  • The 2016 AIDS Conference was...not a celebratory affair,...but [its] over-riding air was not of defeat or despair....The importance of committed activism has been hammered home by recent ongoing discussions around pre-exposure prophylaxis (PrEP) in the UK [where] activist groups are facing a backlash from commentators who argue that PrEP should not be publicly funded....For the fourth time in this journal's first 2 years, we call for NHS England to do the right thing, make the responsible decision: fund PrEP.

    August 11, 2016
    Lancet
  • Some HIV-infected individuals produce broadly neutralizing antibodies that can target multiple HIV strains. Moody et al. found that broadly neutralizing antibody production is associated with a higher frequency of autoantibodies, fewer regulatory T cells, and more circulating memory T follicular helper cells. Vaccine protocols that can mimic these immune perturbations may therefore promote better immune responses to HIV.

    August 5, 2016
    Science
  • In multivariate analysis, providers who had ever prescribed antiretrovirals to prevent HIV had greater odds of high PrEP knowledge. Despite concerns about medication side effects and prescribing PrEP without clear evidence, 64% of participants indicated PrEP should be offered in the Military Health System and 68% disagreed with the statement that their patient population was not at risk for HIV infection.

    August 1, 2016
    Medicine
  • This community-based testing campaign identified an adolescent and youth population with an HIV prevalence six times higher than the estimated national adolescent HIV prevalence in Haiti, including perinatally infected adolescents. This type of community-based campaign for HIV testing within a package of services can serve as a model for other resource-poor settings.

    August 1, 2016
    AIDS Patient Care and STDs
  • This article provides a framework for the development of appropriate interventions and guidelines for use in clinical and community-based settings....A comprehensive approach is suggested that addresses not only medical needs but also emphasizes ways to mitigate the impact of social and economic factors on the health and well-being of these young parents and their children.

    July 31, 2016
    AIDS Patient Care and STDs
  • Primary studies of direct prevention mechanisms showed strong evidence for the efficacy of PrEP and voluntary medical male circumcision. Evidence suggests that interventions to increase supply of prevention methods such as condoms or clean needles can be effective; evidence from demand-side interventions and interventions to promote use of or adherence to prevention tools was less clear.

    July 31, 2016
    Lancet
  • In 2014 UNAIDS reaffirmed its 2011 commitment to end the scourge of AIDS by 2030. Recent articulations of this commitment are outlined in the UNAIDS Fast-Track Strategy and the UNAIDS 90-90-90 Strategy. If, indeed, targets are to be met, a long overdue rethink is needed about what works in HIV prevention.

    July 11, 2016
    Afr J AIDS Research
  • The HIV prevention field has been criticised for the tendency to adopt a narrow focus. The [UNAIDS] Fast-Track Strategy offers a unique opportunity for the HIV prevention field to broaden its gaze....We discuss the intersecting pathways between HIV prevention and unintended pregnancy prevention and build a case for contraception to be placed at the centre of the HIV prevention agenda.

    July 11, 2016
    Afr J AIDS Research
  • Given that a single HIV prevention intervention is unlikely to be able to alter the epidemic trajectory as HIV epidemics in communities are complex and comprise a mosaic of different risk factors and different routes of transmission, there is need to provide combination prevention....This paper reviews the available HIV prevention strategies for young women and discusses new HIV prevention approaches in development.

    July 11, 2016
    Afr J AIDS Research
  • This study will...explore potential users' preferences regarding HIV prevention products, quantify importance of product attributes, and predict uptake of products to inform estimates of potential impact on the HIV epidemic in South Africa. We consider oral pre-exposure prophylaxis; a vaginal microbicide gel; a long-acting vaginal ring; a SILCS diaphragm used in concert with gel; and a long-acting ARV-based injectable.

    June 27, 2016
    BMJ

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