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8 January 2016 VOLUME 17 ISSUE 1

Media Coverage

  • But a survey of 600 doctors found that more than one-third don't actually recommend it, according to the Associated Press. The reason? They don't want to talk about sex.

    January 8, 2016
    Mic
  • The pill that prevents HIV is not widely available in Europe. If it were, it would probably drop infections considerably, researchers say.

    January 7, 2016
    BuzzFeed
  • How far the field of microbicides has progressed...is a pipeline half-full, half-empty situation....Only one trial of a topical vaginal microbicide to date showed any efficacy and follow-up studies have failed to confirm the candidate's protective effect....Yet the microbicide pipeline remains quite robust with attention now focused on new formulations that are less user-dependent.

    January 7, 2016
    IAVI Report
  • Achieving a widespread and appropriate use of pre-exposure prophylaxis (PrEP) will take several years and will require considerable attention to the shape and quality of health services, according to researchers who have looked at the way in which contraceptive methods have been introduced.

    January 6, 2016
    aidsmap
  • Gilead Sciences said its once-daily experimental hepatitis B drug was found to be as effective as its approved drug, Viread, in two late-stage studies. The drug, tenofovir alafenamide, or TAF, also showed improved renal and bone safety compared with Viread. Gilead plans to submit regulatory applications for TAF in the United States and the European Union in the first quarter of 2016.

    January 6, 2016
    Reuters
  • In times of competing demands on diminishing dollars, two recently released modelling exercises look beyond that goal, to quantify specifically the public health and economic returns of investments in saving lives.

    January 6, 2016
    Science Speaks
  • New infections in the country have skyrocketed...but HIV prevention is a difficult undertaking in Cebu City, which has plenty of places to go shoot up on Nubain or “milkshake” (an injectable combination of Nubain and crack cocaine) but few places to access a clean needle....The city’s drug problem is creating a sort of ripple effect, increasing the risk of infection for non-IV-drug users as well.

    January 5, 2016
    The Atlantic
  • What do you do when the people responsible for implementing PrEP education programs don't trust the science?...These are people in prime positions to provide PrEP education to key populations, but suggesting that otherwise healthy clients start a daily medication for prevention is a tough pill for some front-line staff to swallow.

    January 5, 2016
    The Body
  • The state of the epidemic is improving. It is not really one epidemic, however, but a loose collection of smaller epidemics among various risk groups, including MSM and in particular black MSM, injection drug users (IDUs), and women of color.

    January 5, 2016
    POZ
  • Many pediatricians and family doctors are not strongly recommending the cancer-preventing HPV vaccine to preteens and their parents, contributing to low vaccination rates, a survey [by University of Colorado researchers] of nearly 600 doctors suggests....Their study was published online Monday in Pediatrics.

    January 4, 2016
    AP
  • Nucleoside reverse transcriptase inhibitors can be safely omitted from HIV salvage therapy, investigators from the United States report in the Annals of Internal Medicine. The findings come from a randomised study conducted between 2008 and 2011....The study may not be applicable to resource-limited settings because of the high cost of resistance and tropism testing.

    January 4, 2016
    aidsmap
  • A Science feature this week describes the concerted effort underway to more aggressively develop many vaccines that wind up sitting in laboratory freezers because of a lack of marketplace. [Following] is an expanded table of the survey of vaccine experts noted in the feature.

    December 31, 2015
    Science
  • A pivotal clinical trial of a novel HIV vaccine regimen is expected to get underway in South Africa during 2016. Some 252 HIV-free South Africans between ages 18 and 40 are to get the HVTN 100 experimental regimen....Pre-clinical trials suggest that it may confer at least 50% protection against the acquisition of HIV. The...findings generated from the trial will help determine whether this vaccine regimen will be tested in a larger study.

    December 31, 2015
    LA Times
  • At the end of 2015, Science looked back at some of the biggest science stories of the year. Now we’re looking forward, pondering which research trends and ideas are poised to create buzz in 2016 [Ending AIDS]...and which ones are losing some steam [Treatment upon immune damage].

    December 30, 2015
    Science
  • The Texas state health department has elected not to renew a nearly 30-year contract providing HIV prevention funds to Planned Parenthood Gulf Coast....The contract — which totaled $618,227 in 2015 — is provided by the CDC to the state health department.....Since Planned Parenthood Gulf Coast’s HIV program was established in 1988, it has conducted 138,000 HIV tests and identified 1,182 people with infection in several affected counties.

    December 30, 2015
    Healio
  • An HIV pre-exposure prophylaxis (PrEP) program piloted at a pharmacy in Seattle shows promising results for patients.

    December 30, 2015
    Pharmacy Times
  • Margaret Thatcher attempted to block explicit, public health warnings about AIDS because she feared the proposed descriptions of “risky sex” would do immense harm to young teenagers. Objections raised by the prime minister and older cabinet colleagues in the 1980s may appear inappropriate now but reflect public reluctance at the time to acknowledge that the UK was facing a major epidemic.

    December 29, 2015
    Guardian
  • ...does a disservice to Africans and others around the world defending human rights, including those of lesbian, gay, bisexual, transgender and intersex persons.... And these local efforts have often been successful.

    December 29, 2015
    NY Times
  • 1. The fight against HIV and AIDS took a huge step forward in 2015 when researchers at the Scripps Research Institute developed a vaccine that was incredibly effective against HIV-1, HIV-2 and simian immunodeficiency virus. The key difference here is the new HIV vaccine actually alters DNA to fight off the virus....The research is still in early stages, but results thus far are extremely promising.

    December 29, 2015
    Paste Magazine
  • Results of HIV vaccine trial conducted in 2007 and 2009 by the Muhimbili National Hospital on police officers may not be out soon, thanks to elusive nature of human immunodeficiency virus (HIV).

    December 29, 2015
    IPPMedia
  • The Chief Medical Officer of England has warned of an antibiotic resistant strain of gonorrhea reemerging in the industrial city of Leeds...Other cases of the superbug have cropped up internationally, with Australia, Japan, and Canada all reporting cases within the last three years....Peter Leone, an epidemiology professor at the University of North Carolina in Chapel Hill,...dismisses the more apocalyptic assessments.

    December 28, 2015
    Inverse
  • And, although the crucial discoveries were made earlier, it was only in the last year that a new approach to fighting the AIDS epidemic in the United States began to take hold.... Although a viable HIV vaccine is still far off, using one of those methods is just as effective as any vaccine could be.

    December 28, 2015
    NY Times
  • Targeted, multilevel strategies are needed to reduce risk behaviors among young MSM living with HIV, particularly among those with a detectable viral load, according to a study in JAMA Pediatrics.

    December 27, 2015
    Healio
  • Congress has finally started to boost federal funding for biomedical research. The omnibus spending bill just signed by the president will provide a vital increase for the National Institutes of Health — its budget will go up 6.6 percent, or $2 billion from the current $30.1 billion. This is the largest single increase in more than a decade and signals a much-needed change of direction.

    December 25, 2015
    Washington Post
  • Immunogeneticists specializing in immunoglobulin GM genes monitored for immune responses that could limit the effectiveness of the broadly neutralizing antibody VRC01 in HIV-infected individuals in a phase 1 trial of that antibody in HIV-infected individuals led by a team at the National Institute of Allergy and Infectious Diseases....The trial...showed that a single infusion of the VRC01 antibody could suppress the blood plasma level of HIV in infected individuals not taking antiretroviral therapy.

    December 23, 2015
    Science Daily
  • Results of a randomized, controlled clinical trial in two Chinese provinces show that providing [systematic] sexually transmitted infection training and education for physicians resulted in significantly reduced infection risk among their patients.

    December 23, 2015
    Science Daily
  • In one of the most tightly controlled trials ever conducted of drugs used to treat sexually transmitted infections, University of Alabama researchers...compared the two most commonly used medications for urogenital chlamydia -- a single dose of azithromycin versus doxycycline twice daily for seven days.....[The] study confirmed that azithromycin should be considered a front-line therapy, especially when drug adherence is a factor.

    December 23, 2015
    Science Daily
  • Using innovative technology, scientists have filmed in vivo the process by which an AIDS vaccine candidate triggers the immune response. This previously unseen footage clearly shows how the vaccine recruits the immune cells needed to destroy infected cells. These results shed new light on the mode of action and potential of this vaccine.

    December 22, 2015
    Science Daily
  • As the...UN Millennium Development Goals...[are] replaced by the Sustainable Development Goals, deeper analysis...is necessary....The case of South Africa...suggests that success is partly determined by how the goal was formulated. In South Africa, under-five mortality was already low in 1990, but increased as the HIV epidemic emerged. Thus, despite considerable mortality reduction in the last 10 years, South Africa saw no appreciable change between 2015 and the beginning of the MDG period.

    December 22, 2015
    Science Daily
  • A recent study shows that a specific human antibody labelled with the alpha emitter bismuth-213 can penetrate the blood brain barrier and selectively target and destroy HIV-infected cells while sparing non-infected healthy cells. These findings may open new options for the treatment of HIV associated neurocognitive disorders.

    December 21, 2015
    Science Daily
  • Some AIDS organizations don’t promote use of the drug, partly out of concern it could encourage more risky sexual behavior. “We are having an explosion of other sexually transmitted diseases impacting the gay community and PrEP offers no protection whatsoever for any other disease,” said Ged Kenslea, communications director for AIDS Healthcare Foundation, a Los Angeles-based global AIDS organization.

    December 21, 2015
    WSJ

Published Research

  • The Science feature “What does a disease deserve?” asserts that “AIDS death rates began dropping dramatically” about 2 decades ago.” This is only part of the truth....Many of us seem to have forgotten that...HIV is an infectious disease that can be controlled by reducing transmission....To [end the epidemic in the United States],,...the Office of AIDS Research and NIH must make a major investment in implementation science (with participation of social, political, and economics experts) and coordinate these initiatives with the CDC.

    January 8, 2016
    Science Mag
  • The US Department of Health and Human Services (HHS) released their annual report—Advancing LGBT Health & Well-being—which highlights substantial advances in health initiatives for LGBTQ people and their families, as well as outlining HHS objectives in LGBTQ health care for 2016.

    January 8, 2016
    Lancet
  • Having both Black and non-Black sexual partners was the only sexual network factor associated with prevalent STIs. Age and the number and racial composition of sexual partners were associated with prevalent STIs among Black MSM, while other sexual network factors were not. Further studies are needed to inform combination interventions to reduce STIs among these men.

    January 7, 2016
    PLoS
  • Scientifically feasible vaccines against major diseases are stalled for lack of funds. Science names 10 top candidates that need a boost.

    January 7, 2016
    Science Mag
  • Ratmann et al. were able to reconstruct ~600 past transmission events among men having sex with men in the Netherlands....They found the large majority of new infections neither attributable to ineffective ART nor inadequate retention in care. Rather, many of these cases could have been averted with more comprehensive HIV testing and broader use of ART that includes provision to uninfected men as well as starting ART as soon as possible among newly diagnosed men.

    January 6, 2016
    Science Translational Medicine
  • Cross-continent collaboration in the sciences has become the norm. We must ensure that disadvantaged regions are not left out....There must also be broader awareness that, just as there is more to research than papers, there is more provided to a partnership than conventional resources such as cash and equipment.

    January 6, 2016
    Nature
  • There was higher prevalence of SRBs among circumcised men in both surveys, but the only significant change from 2004 to 2011 was a lower prevalence of condom use among the circumcised. Nevertheless, HIV prevalence was lower among circumcised men. Targeted messages for circumcised men and their sexual partners to continue using condoms even after circumcision should be enhanced to avoid risk compensation.

    January 5, 2016
    BMC Public Health
  • The Investment Framework Enhanced (IFE) proposed in 2013 by UNAIDS explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs).

    January 5, 2016
    PLoS
  • Two studies have unveiled widespread flaws in the reporting of animal experiments — the latest in a series of papers to criticize shoddy biomedical research.

    January 5, 2016
    Nature
  • Increased anal and penile high-risk HPV (hrHPV) incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal high-risk HPV infections.

    January 2, 2016
    AIDS
  • Despite freely available PEP for Nairobi-based FSWs, women at highest risk were less likely to have heard of PEP, access PEP, or complete the full course of therapy once initiated. Program delivery needs to be improved to ensure that FSW most at risk are able to benefit from this resource.

    January 2, 2016
    AIDS
  • The Lancet (Oct 10) stated that the new WHO antiretroviral therapy guidelines are based on trials that “showed promising, but modest, benefits for affected individuals, and for reducing HIV transmission following early treatment initiation”. The benefits are not modest....The Lancet also labelled the guidelines “ambitious” and questioned whether ART as a prevention means can be done at scale....The accompanying editorial in The Lancet HIV similarly missed the potential benefits and listed the challenges instead.

    January 2, 2016
    Lancet
  • Overall, 557 participants initiated PrEP, and 437 of these (78.5%) were retained through 48 weeks....The incidence of HIV acquisition was extremely low despite a high incidence of STIs in [this] large US PrEP demonstration project. Adherence was higher among those participants who reported more risk behaviors. Interventions that address racial and geographic disparities and housing instability may increase the impact of PrEP.

    January 1, 2016
    JAMA Intern Med
  • We examined outcomes of ART patients decentralized to community-based adherence clubs (CACs) in Cape Town, South Africa and compared these to patients managed in the community health center. CAC participation was associated with a 67% reduction in the risk of LTFU compared with community health centre, and this association persisted when stratified by patient demographic and clinic characteristics. Community-based models represent an important development to facilitate ART delivery and possibly improve patient outcomes.

    January 1, 2016
    JAIDS
  • Use of a rapid HIV testing algorithm (RTA) in which all tests are conducted within one client appointment was implemented in 9 sites in Los Angeles and San Francisco....The RTA increased the PPV of rapid testing to 100%, giving providers, clients, and HIV counselors timely information about a client's HIV-positive serostatus. Use of RTA could reduce loss to follow-up between testing positive and confirmation and increase the proportion of HIV-infected persons receiving HIV care.

    January 1, 2016
    JAIDS
  • The HVTN 907 study identified a high-risk cohort of women with excellent retention for all 3 sites, despite major challenges, especially in Haiti. These results show that a bridging study of a vaccine shown to be efficacious in other clade settings would be possible among FSWs in the region, particularly in Haiti.

    January 1, 2016
    JAIDS
  • Among HIV-infected US adults in routine HIV care, durability of the first and second combination antiretroviral therapy (cART) regimens and the likelihood of prompt virological suppression increased during 1996–2011, coincident with the availability of more tolerable, less complex cART options.

    January 1, 2016
    JAIDS
  • A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for young adults living with HIV (YLWH) was more effective in achieving and sustaining remission from depression than treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics to successfully treat YLWH, who are at particular risk for depression.

    January 1, 2016
    JAIDS
  • Success with maintaining virologic control declined postpartum among HIV-infected women who remained in care and on antiretroviral therapy, and CD4 T-cell count decline and drug resistance were common.

    January 1, 2016
    JAIDS
  • Most respondents were nurses and female, from public clinics, and had received formal STI training. Most correctly identified all common STI syndromes....However, almost none correctly identified the most common etiologies for all 3 of these syndromes...and very few correctly answered the 14 basic STI knowledge questions. Providers reporting formal STI training were more likely to...answer correctly... compared with those not reporting STI training. Several providers reported negative attitudes about patients with STI.

    January 1, 2016
    Sex Transm Dis
  • Tim Farley's letter precisely illustrates our argument, that unless a high level of adherence can be assured, a randomised controlled trial is the wrong design from which to assess efficacy of a treatment. His inference that these trials cast doubt on the efficacy of the product is flawed. True, as he notes, some useful information on adherence can be gleaned from the two so-called replication trials of the tenofovir gel, but no useful information can be gleaned about efficacy.

    January 1, 2016
    Lancet HIV
  • Although I share the impatience of Kuhn and colleagues to accelerate implementation of new HIV prevention methods, particularly for young women,...their criticism of the importance of replicating results from randomised controlled trials is misplaced. Their argument concerns studies of tenofovir gel....Rather than considering these trials as “disastrous, because their results now cast inappropriate doubt on the preventive effects of tenofovir”,...we have learnt a great deal....There are grave dangers in using a product of uncertain efficacy to prevent HIV infection.

    January 1, 2016
    Lancet HIV
  • Each year, World AIDS Day on December 1 provides an opportunity to assess progress in the global fight against HIV....This year, the exercise has an added importance as UNAIDS launches a fast-track strategy to double the number of people on life-saving treatment in 2020, which must be reconciled with the shift in the global health agenda from the millennium development goals (MDGs) to the sustainable development goals (SDGs)....

    January 1, 2016
    Lancet HIV
  • In the wake of reports of an HIV cure for Timothy Brown (the Berlin patient) after two haemopoietic stem cell transplantations from a donor homozygous for the CCR5Δ32 mutation, at least four other individuals have had antiretroviral therapy (ART) stopped as analytical treatment interruptions after similar procedures....The clinical outcome after each of these interruptions has been disappointing, with pronounced viral rebound and associated morbidity.

    January 1, 2016
    Lancet HIV
  • The inflammasome is activated in response to a variety of pathogens and has an important role in shaping adaptive immunity, yet the orchestration of inflammasome activation in vivo and the mechanisms by which it promotes an effective immune response are not fully understood. Using an in vivo reporter..., we establish the distribution, kinetics and propagation of the inflammasome response to a local viral infection....,identifying an important aspect of inflammasome-driven vaccination strategies.

    January 1, 2016
    Nature
  • Tenofovir disoproxil fumarate [TDF] is generally well tolerated clinically but is associated with effects on the kidney and bone. Tenofovir alafenamide [TAF] more efficiently delivers tenofovir to target cells resulting in lower plasma and kidney exposures. Clinical studies have shown tenofovir alafenamide has reduced impact on markers of renal function and bone mineralization.

    January 1, 2016
    Science Direct
  • This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

    December 31, 2015
    PLoS One
  • We tested participants’ oral fluid for HIV using OraQuick monthly and blood using a nucleic-acid amplification test (NAAT) every 3 months. The oral fluid HIV test performed well at screening, suggesting it can be used when rapid results and non-invasive tools are preferred. However, participants receiving tenofovir took longer to develop a reactive oral fluid test result than those receiving placebo. Thus, among people using pre-exposure prophylaxis, a blood-based HIV test may be an appropriate choice.

    December 30, 2015
    PLoS ONE
  • For its 2015 end-of-year editorial, PLOS Medicine asked 11 researchers and clinicians spanning a range of specialties to comment on the state of their field and what they expect or hope to see next year....Nicola Low, University of Bern,...[responded]:..."Those in the field of 'other sexually transmitted infections urgently need to quantify accurately the years of life lost to STI to show the gains of investing in prevention and control....The major challenge must be to determine whether enough people in the most heavily affected countries can be encouraged to find out their HIV status before embarking on testing and treating our way out of the HIV epidemic."

    December 29, 2015
    PLoS Med
  • For media members and public communicators of many kinds it is imperative to do more than just read study abstracts; understanding the methods and concepts that underpin academic studies is essential to being able to judge the merits of a particular piece of research...Knowing the basic language can help in formulating better, more critical questions for experts, and foster deeper thinking, and skepticism, about findings.

    December 29, 2015
    Journalist's Resource
  • HIV infection was the hottest topic in 2015, garnering 6 of our top 10 stories. The START study was by far the number one story....The other HIV/AIDS selections addressed a variety of clinical issues, including the importance of retention in care for curbing transmission, recognition of primary HIV, outbreak of HIV among persons who inject prescription drugs in rural Indiana, effectiveness of pre-exposure prophylaxis (PrEP), and treatment of hepatitis C virus among HIV-infected persons.

    December 28, 2015
    JWatch
  • Many HIV patients on cART exhibit HIV-associated neurocognitive disorders because the brain becomes a viral reservoir. There is a need for therapeutics that can enter the CNS and eradicate the virus....We demonstrated that [radiolabeled human] Bi-2556 mAb crossed an in vitro human BBB [blood brain barrier] and specifically killed transmigrated HIV-infected PBMCs and monocytes without overt damage to the barrier.

    November 20, 2015
    AIDS
  • They note that diseases imposing a relatively small burden on US society, such as AIDS, can get a larger share of NIH funding than those that cause greater harm, such as heart disease. Recently, while responding to pointed questions from a member of Congress about the issue, NIH Director Francis Collins said the agency is ready to abandon the 10% set-aside.

    November 20, 2015
    Science

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