CDC HIV/Hepatitis/STD/TB Prevention News Update
For Friday, March 19, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• CALIFORNIA: TB Cases Fall in All but One Valley County
• UNITED STATES: Johnson Urges More Hepatitis Funding

INTERNATIONAL NEWS

• GLOBAL: Multidrug-Resistant TB a Serious Global Threat: WHO
• UNITED KINGDOM: UK Tuberculosis Cases Rise by 5.5 Percent
• CANADA: British Columbia Officials Seek to Boost HPV Vaccinations in Girls

MEDICAL NEWS

• SOUTHEAST ASIA: An Algorithm for Tuberculosis Screening and Diagnosis in People with HIV

NEWS BRIEFS

• HAWAII: Homeless TB Patient Being Treated in Honolulu
• SINGAPORE: Singapore's Tuberculosis Cases Lower in 2009
• INDONESIA: Tuberculosis Kills over 100,000 People Annually in Indonesia

   NATIONAL NEWS CALIFORNIA: TB Cases Fall in All but One Valley County

Barbara Anderson

Fresno Bee (03.18.10) - Friday, March 19, 2010 On Thursday, the California Department of Public Health (CDPH) released new data showing the state recorded 2,472 active TB cases in 2009, down from 2,695 cases in 2008. State health officials said the TB rate went from 7 cases per 100,000 residents in 2008 to 6.4 last year, the lowest on record.
"We have come a long way in our struggle to eliminate TB, and we can be proud of our aggressive efforts to control the disease," said CDPH's Dr. Mark Horton.
According to officials, three-quarters of TB cases statewide were among foreign-born individuals. Yet even in this population, officials noted a significant decline in cases, from 279 in 2008 to 176 in 2009, among persons who had been in the United States for less than one year.
Dr. Kenneth Bird, TB control officer for Fresno County, said the drop in TB statewide could be due to lower immigration rates. Better health screenings of immigrants prior to their arrival in the United States also have contributed to the decline, he said.
In the central San Joaquin Valley region, all but one county, Merced, posted a decline in TB cases last year. Merced County logged 11 active cases in 2009, up from five in 2008.
"When the numbers are relatively small, any increase or decrease is more pronounced," said Richard Rios, public information officer for Merced County's Department of Public Health. "It's important to recognize prevention measures are an ongoing necessity. And we feel this increase is not due to any lull in our prevention and control measures."
UNITED STATES: Johnson Urges More Hepatitis Funding

Bob Keefe

Atlanta Journal-Constitution (03.17.10) - Friday, March 19, 2010 A bipartisan bill introduced by US Rep. Mike Honda (D-Calif.) and co-sponsored by Rep. Hank Johnson (D-Ga.) and more than 30 others seeks to boost federal funding for hepatitis research and awareness efforts from roughly $21 million to $90 million.
The National Viral Hepatitis Roundtable (NVHR) estimates 5 million Americans are infected with hepatitis B or C. Blacks and Asian Americans are most affected, and the disease is particularly prevalent in the South. The virus is most commonly spread today via intravenous drug use, though it can also be transmitted from mother to child and contact with infected blood. Hepatitis is known as a "silent killer" since many who are infected are unaware they have the virus.
While hepatitis prevalence is growing, federal funding for CDC's hepatitis programs has declined over the past decade, said Lorren Sandt of NVHR. "It [CDC's hepatitis division] is so grossly under-funded that people are dying needlessly every year," Sandt said.
In December, Johnson announced his battle with hepatitis C. "Who knows how I contracted it?" the Georgia congressman said Tuesday at a news conference. "You can put your hand up and swear on the Bible that you've never used intravenous drugs or got a blood transfusion and people will still think, 'OK, he's not being truthful.' The fact is, it could've happened anywhere."
Johnson was declared virus-free in January 2009 after months of aggressive treatment. However, he is still recovering from the disease and the side effects of treatment.
The bill faces an uphill battle, given Congress' focus on other issues and federal and state funding shortfalls. The measure is currently stalled in committee. Sandt said passing it should be a priority, noting the cost of hepatitis treatment could more than triple to $85 billion by 2024.
   INTERNATIONAL NEWS GLOBAL: Multidrug-Resistant TB a Serious Global Threat: WHO Agence France Presse (03.18.10) - Friday, March 19, 2010 The World Health Organization's latest report on multidrug-resistant tuberculosis (MDR TB) documents the highest proportion of such cases ever, at about 5 percent. Roughly 440,000 people worldwide had MDR TB in 2008 and a third of them died, out of the 9.4 million new TB infections annually, WHO said.
"We confirm in that report that MDR TB is really a serious threat to global health. We estimated approximately half a million cases every year. And only a small proportion of them, 7 percent, get a diagnosis and treatment," co-author Matteo Zignol said Thursday.
Nearly half the MDR TB cases are estimated to have occurred in China and India, WHO said. In northwestern Russia, one-quarter of all TB cases were found to be drug resistant, a proportion never seen before, the report found.
Fifty-eight countries have reported the deadliest form of the disease - extensively drug-resistant TB (XDR TB). "XDR TB is virtually untreatable. In the best hands, the cure rate is above 60 percent. In the vast majority of cases, there is nothing to offer," co-author Ernesto Jaramillo told journalists.
Drug resistance is fueled by stopping treatment before a course of antibiotics has been completed and by poor- quality medicines, the report said.
The authors said there is an urgent need to improve diagnostic capabilities. In Africa, just two laboratories are certified to diagnose XDR TB, the report noted. "Still in many, many countries, there is not yet capacity for diagnosing and treating [MDR TB]," said Zignol. "So these people continue to spread the infection before they die. That's why the response to MDR TB has to be prioritized - because it's not enough to do good basic control."
UNITED KINGDOM: UK Tuberculosis Cases Rise by 5.5 Percent

Beverley Rouse, Press Association

The Independent (London) (03.16.10) - Friday, March 19, 2010 On Tuesday, the Health Protection Agency announced that TB cases in the United Kingdom rose by 5.5 percent in 2009, according to preliminary data. That is the largest increase in cases since the 9.4 percent jump in 2005, said Ibrahim Abubakar, a TB expert at HPA.
"This increase shows that we must remain vigilant in our fight against TB," Abubakar said. "This is an entirely preventable and curable infection, but it can be fatal if prompt diagnosis and treatment are not given."
More than a third of the 9,153 cases were in London (3,476), and the West Midlands had 1,035. Case numbers did not change significantly from 2008 in either region.
The largest increases were in Wales, rising 31.7 percent in one year to 220 cases, and in the South West, where cases rose 25.8 percent to 337. Increases topped 10 percent in the East Midlands, North West and South East. However, cases declined by 28.8 percent to 42 in Northern Ireland last year.
"Although some progress is being made, the consistent increase in the number of cases of TB in the UK means our efforts to control the disease must be strengthened," said Maria Zambon, director of HPA's center for infections. "Both health professionals and the general public alike must remain vigilant if we are to eradicate this major global killer infection."
In May, HPA will launch a nationwide TB strain-typing service to help understand how the disease is spreading. The data will be used to identify those at risk, determine the allocation of public health resources, and improve diagnosis and treatment.
CANADA: British Columbia Officials Seek to Boost HPV Vaccinations in Girls

Pamela Fayerman

Vancouver Sun (03.17.10) - Friday, March 19, 2010 More than two years after its launch, British Columbia's human papillomavirus (HPV) vaccination program has achieved 62 percent uptake among grade-six and -nine girls. That is second only to Quebec, where uptake is 80 percent - a goal B.C. officials are hoping to achieve with a ramped-up campaign.
French-language media in Quebec did not carry as many anti-vaccine stories or focus on controversies, peers there told Dr. Gina Ogilvie, B.C. Center for Disease Control (BCCDC)'s associate director of STD prevention and control. As a result, many parents in Quebec were not persuaded to refuse the vaccine for their child.
To increase uptake, BCCDC plans to boost HPV vaccine awareness among health professionals so they can share information about the three-shot series with parents. According to a survey conducted for the agency, some parents were concerned that they lacked enough information about the vaccine, worried about its safety, and wished to wait until their daughters were older.
"The vaccine has, in my mind, an excellent safety profile with a 0.01 percent adverse-event rate," Ogilvie said. Only one girl had an adverse reaction, an allergic response, and she was briefly hospitalized for observation.
About 50,000 girls have received the vaccine in the province, with more than 120,000 doses administered; some girls have not yet had all three shots. The province pays for the vaccine, which prevents four types of HPV that are responsible for about 70 percent of cervical cancer cases and 90 percent of genital warts.
   MEDICAL NEWS SOUTHEAST ASIA: An Algorithm for Tuberculosis Screening and Diagnosis in People with HIV

Kevin P. Cain, MD; Kimberly D. McCarthy, MM; Charles M. Heilig, PhD; Patama Monkongdee, MSc; Theerawit Tasaneeyapan, MSc; Nong Kanara, MD; Michael E. Kimerling, MD, MPH; Phalkun Chheng, MD, MPH; Sopheak Thai, MD; Borann Sar, MD, PhD; Praphan Phanuphak, MD, PhD; Nipat Teeratakulpisarn, MD; Nittaya Phanuphak, MD; Nguyen Huy Dung, MD; Hoang Thi Quy, MD; Le Hung Thai, MD; Jay K. Varma, MD

New England Journal of Medicine Vol. 362; No. 8: P. 707-716 (02.25.10) - Friday, March 19, 2010 Tuberculosis is a leading cause of death among adults with HIV. In some countries, up to 50 percent of these patients die during TB treatment, usually within two months of the TB diagnosis. Delayed diagnosis is probably a significant contributor to high mortality, an international team of researchers noted in this collaborative study.
While TB screening is recommended for those with HIV to facilitate antiretroviral and isoniazid preventive therapy, there are no internationally accepted, evidence-based guidelines for optimal screening. Nonetheless, screening for chronic cough is common.
In the current study, researchers consecutively enrolled 1,748 HIV patients from eight outpatient clinics in Cambodia, Thailand, and Vietnam, irrespective of evidence or absence of TB symptoms. Median CD4+ T-lymphocyte count was 242 per cubic millimeter; interquartile range 82-396. Three samples of sputum and one each of urine, stool, blood, and lymph-node aspirate (for those with lymphadenopathy) were obtained for mycobacterial culture. The team compared the characteristics of patients diagnosed with TB (on the basis of one or more culture-positive specimens) with TB-free patients to derive an algorithm for screening and diagnosis.
TB was diagnosed in 267 (15 percent) patients. Cough of two to three weeks duration in the preceding four weeks had a sensitivity of 22-33 percent for detecting TB. Cough of any duration, fever of any duration, or night sweats lasting three or more weeks in the preceding four weeks was 93 percent sensitive and 36 percent specific for TB. TB diagnosis was ruled out for the 1,199 patients with any symptoms with the help of a combination of two sputum-negative smears, normal chest radiograph, and CD4+ cell count of 350 or more per cubic millimeter. A positive diagnosis could be made for only 113 patients (9 percent) who had one or more positive sputum smears; mycobacterial culture was required for most other patients.
"In persons with HIV infection, screening for tuberculosis should include asking questions about a combination of symptoms rather than only about chronic cough," the authors concluded. "It is likely that antiretroviral therapy and isoniazid preventive therapy can be started safely in people whose screening for all three symptoms is negative, whereas diagnosis in most others will require mycobacterial culture."
   NEWS BRIEFS HAWAII: Homeless TB Patient Being Treated in Honolulu Associated Press (03.18.10) - Friday, March 19, 2010 On Wednesday, the state Attorney General's Office filed paperwork in Circuit Court seeking authority to quarantine a homeless man diagnosed with a highly contagious form of TB. In a declaration, the state Department of Health's Dr. Glenn Wasserman said the man was treated in February at The Queen's Medical Center before being transferred to Leahi Hospital in Honolulu. Against medical advice, the patient left the hospital on March 9 but later returned. To prevent the man from flying to the Big Island, the department contacted CDC, which activated its federal "Do Not Board" authority in coordination with the Department of Homeland Security. The patient continues to receive treatment in isolation at Leahi.
SINGAPORE: Singapore's Tuberculosis Cases Lower in 2009 Xinhua News Agency (03.19.10) - Friday, March 19, 2010 Singapore's Health Ministry on Friday reported that the city-state recorded 1,442 TB cases last year, down 0.6 percent from the 1,451 cases logged in 2008. According to local radio 938 Live, the ministry said Singapore's emphasis on treatment compliance through the national TB control program contributes to a low incidence of TB. Older persons and men continue to account for a significant portion of new cases.
INDONESIA: Tuberculosis Kills over 100,000 People Annually in Indonesia Xinhua News Agency (03.19.10) - Friday, March 19, 2010 Indonesia sees more than 500,000 new TB cases annually, and the disease kills 100,000 people a year, the Health Ministry reported Friday. "Tuberculosis is still a deadly disease in Indonesia," said Iwan Muljono, a ministry director, according to the Antara news agency. Poverty and a lack of resources to tackle the disease are among reasons it continues to spread, he said.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

AIDS care rebounding in Haiti, though many lack shelter

Miami Herald - March 19, 2010
Michael Vasquez and Carol Rosenberg

http://www.aegis.org/news/mh/2010/MH100301.html

Jean Rejane Geralda's main problem isn't receiving her AIDS medications -- she hasn't missed a dose -- it's putting some sort of roof over the head of her daughter, Shara.

Geralda, like hundreds of thousands across post-earthquake Haiti, has been unable to obtain even a basic tent or tarpaulin from relief agencies. As the rainy season approaches, Geralda sleeps on an uncovered mattress with her newborn child in the back yard of her quake-damaged home.

"My bed is right on the ground," Geralda said, a situation in stark contrast to her AIDS-related medical care, where "I am able to get everything I need."

Geralda's situation highlights the fact that AIDS care in Haiti, by some measure, has rebounded faster from the Jan. 12 earthquake than the country as a whole. But the post-quake conditions still present prevention challenges -- threatening what had been steady progress for a nation that accounts for half of all AIDS cases in the Caribbean.

QUIET SUCCESS

In recent years, Haiti's battle to reduce that number was a quiet success story. U.S.-backed AIDS programs brought the incidence of the disease down from 10 percent to 2.2 percent at the time of the Jan. 12 earthquake. Though restoring these programs has proved easier than providing shelter to the 1.3 million people left homeless by the quake, international health organizations still worry that the disaster has dealt a severe blow to AIDS treatment and prevention efforts.

Prevention is a challenge in the tent cities. At the city's largest encampment, where an estimated 45,000 crowd the site of an old military airport, the occasional free condom distribution is not enough, said Dr. Kobel Dubique, who coordinates a clinic there.

A three-pack of condoms in Haiti costs about 15 gourdes -- less than one dollar -- but that's still more than many quake-battered Haitians can afford. "We need to be distributing more condoms," Dubique said. "And free. Free, free, free."

Dubique said security in the tent cities must also be strengthened, as there have been at least four confirmed rapes at the camp where he works. One woman was raped twice. Camp dwellers themselves have organized into security details to reduce crime, but these security "patrols" are unarmed.

Refugee International's Emilie Parry, back from a recent visit to Haiti, warns that the impromptu settlements around the city present great risks.

"There's no lighting," she said. "Women are being attacked sexually and otherwise ... they feel very vulnerable."

On a positive note, doctors and administrators boast that they were able to restore services to nearly all HIV/AIDS patients receiving antiretroviral treatments within days of the quake. At the GHESKIO clinic, Dr. Serena Koenig reports that all but 5 percent of the 14,000 patients on antiretroviral drugs before the quake were continuously being treated.

Of the rest, she said, the Haiti Ministry of Health and doctors at the clinic believe some died and the others are in the countryside, where they are eligible to continue their drug therapies.

SUPPLY IN PLACE

HIV/AIDS treatment avoided interruption because, according to the U.S. Centers for Disease Control's Dr. Steven Harris, there was already a three-month supply on the island. Moreover, the U.S. program had sponsored an electronic database of AIDS patients -- a rarity in Haiti's Ministry of Health -- which allowed for greater ease in tracking the patients after the disaster.

Clinics that were destroyed or damaged shifted to tents or other temporary quarters. At the General Hospital in Port-au-Prince, where Geralda receives care for both herself and her newborn, blue and white tents service about 50 HIV/AIDS patients per day.

That's down from the pre-quake norm of 80 per day, but the number of returning patients is continually growing. By next week, the hospital plans to have its in-house computer-tracking system up and running again and should be able to better pinpoint those patients that have gone missing.

Meantime, Geralda receives free medicine at the CDC-sponsored facility. Giralda hadn't planned on getting pregnant -- she says she was practicing safe sex -- but with the help of AIDS medications that she took during pregnancy and now administers to her newborn, there's a good chance that the child can avoid contracting the disease.

"I get very good care here," she said.

mrvasquez@MiamiHerald.com

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Copyright © 2010 - Miami Herald. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Miami Herald, Permissions, One Herald Plaza, Miami, FL 33132-1693 TEL: (305) 376-3719.  http://www.herald.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

WHO: Not sure if drug-resistant TB is worsening

Associated Press - March 18, 2010
Maria Cheng, AP Medical Writer

http://www.aegis.org/news/ap/2010/AP100319.html 

LONDON, United Kingdom (AP) -- The World Health Organization says it doesn't have enough information to know if it is winning the fight against drug-resistant tuberculosis.

In a new report on the global status of drug-resistant TB based on data from 2008, the agency says almost half of all people with the disease are in China and India, with both countries reporting about 100,000 new cases each.

High rates of drug-resistant TB strains were also seen in eastern Europe and central Asia, with up to 60 percent of people who already had TB in some parts of Tajikistan and Uzbekistan developing drug-resistant versions.

About 4 percent of all TB cases worldwide are thought to be non-responsive to the usual TB drugs. The agency estimated there were between 390,000 and 510,000 cases of drug-resistant TB in 2008, including about 150,000 people who were killed by the disease. But those numbers are based on modeling and come with a big margin of error.

The report is based on information from 35 countries worldwide, leaving a huge gap in the global TB picture.

"The country data reported to WHO make it impossible at this time to conclude whether the (drug-resistant TB) epidemic worldwide is growing or shrinking," the agency wrote in its report.

In the United States, the proportion of TB cases that are resistant to at least two first-line antibiotics remained stable in 2008, at less than 1 percent. And there were no cases that year of extensively drug-resistant TB, which is resistant to most available treatments, according to the U.S. Centers for Disease Control and Prevention.

The CDC does not yet have data on drug-resistant TB for last year. But other, preliminary data indicate a historic drop in new tuberculosis cases of all kinds in 2009 - the largest single-year decrease in more than 50 years of federal record keeping.

TB rates fell more than 11 percent in 2009, to 3.8 cases per 100,000 people. Generally, the annual decline is about 4 percent. CDC officials are investigating, but say it could be related to fewer cases coming in to the country through immigration.

Drug-resistant tuberculosis usually arises when people are poorly treated or take substandard medicines. It takes longer to treat than regular TB and requires more expensive drugs, which also cause bad side effects like liver damage.

In recent years, WHO and other health authorities have warned the collision of TB with the AIDS virus could fuel simultaneous epidemics - and asked for more money to fight both. In its latest report, however, the agency acknowledged there is little proof of that.

Again citing missing data, the agency says "it has not been possible to conclude whether an overall association between (drug-resistant) TB and HIV epidemics exists."

In Estonia, Latvia and Moldova, WHO said people infected with both HIV and TB were more likely to develop drug-resistant TB. But there is no information from many countries across Africa where the most people with HIV live.

Some health experts wondered why WHO's report failed to mention in detail one of the main drivers of drug resistance: bad medicines.

"Many substandard drugs are fakes, but we are also concerned about legitimately manufactured copies - mainly from India and China - which are not made to exacting high standards," said Philip Stevens, a health policy expert at the London think-tank International Policy Network.

Stevens said the lack of global TB data was troubling. "WHO doesn't really have a clue as to the true extent of the problem," he said. "It's difficult then, to start promoting targets and goals when you don't know what baseline you are starting from."

WHO reported rates of drug-resistant TB were dropping in some parts of Russia with previously large outbreaks.

"It's good news that it can be controlled even in those difficult regions," said Ruth McNerney, a TB expert at London's School of Hygiene and Tropical Medicine, who was not connected to the report.

McNerney said that though progress was being made, authorities need more money to fight it, and more information about where the disease is striking. "We've got to find out where there are very serious problems, otherwise we won't know about it until it's too late."

--- AP Medical Writer Mike Stobbe in Atlanta contributed to this report.

--- On the Net: www.who.int

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Copyright © 2010 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

With Ban on H.I.V. Immigrants Now History, Relief and Revision

The New York Times - March 18, 2010

By SCOTT JAMES

John Newman fondly recalled the eight years he taught first and second grades in Vallejo public schools - he felt appreciated, and was once named "Teacher of the Year." It was the 1990s, before he got sick and was told to leave the United States.

To read the full article, please go to: http://www.nytimes.com/2010/03/19/us/19sfmetro.html?scp=2&sq=hiv&st=cse  

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980,2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Advisory panel would consider increasing regulation of California's porn industry

Los Angeles Times - March 18, 2010
Molly Hennessy-Fiske, molly.hennessy-fiske@latimes.com  

http://www.aegis.org/news/lt/2010/LT100305.html

After hearing from industry workers, a board of the Division of Occupational Safety and Health votes to form an advisory group. Increased regulation would include mandating the use of condoms.

State regulators voted unanimously Thursday to create an advisory committee to consider increasing regulation of California's porn industry, including mandating the use of condoms and testing for sexually transmitted diseases.

Guy Prescott, director of safety for Operating Engineers Local Union #3 and one of six members of the California Division of Occupational Safety and Health's standards board, said he had planned to vote against the measure but changed his mind after hearing from performers and others in the porn industry.

Fellow board member Jonathan Frisch, principal risk manager at PG&E Corp., said that despite some people's distaste for the industry it was important to treat it as an employer. He said it was "extremely interesting to hear from members of the industry."

"It's going to be very, very important that we do have them at the table," Frisch said. Former porn actor Darren James, who tested HIV-positive during a 2004 outbreak in the San Fernando Valley's porn community, told the board that current testing in the industry is a false "security blanket."

"You think you're safe, but you're not. In between scenes, you don't know what other actors are doing," James told the board before turning to the crowd of about 40.

"I'm living your nightmare every day," he said.

But porn actress Angelina Armani told the board that during the last two years, she has appeared in many adult films, been tested regularly and never contracted a disease.

"My industry has protected my safety and continues to protect the safety of other performers," Armani said.

Dr. Robert Kim-Farley, director of communicable disease control and prevention for the Los Angeles County Department of Public Health, recommended Thursday that the board mandate condom use and require the adult film industry to pay for testing. Infection rates for chlamydia and gonorrhea, he told the board, are seven times higher in the porn industry than in the general population, and as many as a quarter of porn performers are diagnosed with a sexually transmitted disease in any given year.

The vote Thursday was in response to a petition filed in December by the AIDS Healthcare Foundation, an advocacy group that has been pushing for increased regulation in the porn industry since the 2004 outbreak. Michael Weinstein, president of the foundation, called the board's vote a "big step forward" and said he believed it signaled an openness to increased regulation by the state.

Diane Duke, executive director of the Free Speech Coalition, a Canoga Park-based porn trade association, said her group backed the board's vote as long as the committee includes adult-film workers, producers or other industry representatives.

After the vote, James said he wished more hard-core porn actors had come forward to tell their stories, and that the board -- which will take a least a month to form an advisory group -- had acted sooner.

"They need to do more," he said. "They should have done this years ago."

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Copyright © 2010 - Los Angeles Times. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Los Angeles Times, Permissions, Times Mirror Square, Los Angeles, CA 90053.  http://www.latimes.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

WHO report highlights growing numbers of drug-resistant tuberculosis

UNAIDS - 19 March 2010

http://www.aegis.org/news/unaids/2010/UN100325.html

Up to a quarter of people with tuberculosis in some regions can no longer be treated with standard drug regimens. This is the stark finding of a new World Health Organization report which estimates that 440,000 people had multidrug-resistant TB (MDR-TB) in 2008, a third of whom died.

Multidrug and Extensively Drug-Resistant Tuberculosis (M/XDR-TB): 2010 Global Report on Surveillance and Response presents data from 114 countries. It underlines that almost half of all cases of MDR-TB are estimated to occur in China and India. In Africa an estimated 69,000 cases emerged.

The report also explores the relationship between HIV and MDR-TB and notes that drug resistant TB among people living with HIV has been widely documented in certain settings, such as hospitals. It further states that TB patients co-infected with HIV in three Eastern European countries, Estonia, Latvia, and the Republic of Moldova, were found to be at greater risk of having multidrug-resistant tuberculosis compared to TB patients without HIV infection. Studies in Lithuania, Ukraine and Mozambique show similar results. More research is required to ascertain whether these findings would be replicated worldwide and the report notes that no data have been received from countries with the highest HIV prevalence.

According to UNAIDS, HIV-positive people are especially vulnerable to the impact of TB and MDR-TB. They are at increased risk of contracting the disease and experiencing serious side effects and are more likely to die if infected. HIV and TB are seen as so closely connected that they are often referred to as 'co-epidemics'. To appropriately respond to both epidemics and avoid more widespread drug resistance, fully integrated TB/HIV services should be priority concern of all TB and HIV programmes.

Preventing people living with HIV dying from tuberculosis is one of the nine priority areas in the UNAIDS Outcome Framework 2009-11.

For the first time, the WHO global report includes an assessment of progress countries are making in the diagnosis and treatment of multidrug-resistant TB. Six countries are the subject of special focus. Bangladesh is one of the few developing nations carrying out continuous surveillance among TB cases which were previously treated in selected areas. China has reported results from its first ever drug resistance survey; Ethiopia was among the first countries to introduce rapid molecular laboratory tests. Nepal and Romania both have successful treatment programmes for MDR-TB and South Africa has introduced policy changes for improving management and care for those living with the disease.

Although there has been notable success in some countries, world-wide progress in controlling multidrug-resistant TB remains slow. According to the WHO report only an estimated 7% of all MDR-TB patients are diagnosed.

Of major concern is the very high cost of treating this form of the disease. The price of drugs alone is 50 to 200 times higher than treating a drug-susceptible TB patient. However, WHO maintains that treatment of MDR-TB has been shown to be cost-effective.

According to the report, there is an urgent need for drug regimens which are shorter than the current two year span, improvements in laboratory facilities and access to rapid diagnosis and treatment. WHO is undertaking a five-year project aimed at strengthening TB laboratories with rapid tests in some 30 countries. It is also working closely with a number of organisations to increase access to treatment so that more lives can be saved.

Note: Multi-drug resistant TB (MDR-TB) is tuberculosis that is resistant to at least Rifampicin and Isoniazid, the two most powerful anti-tuberculosis drugs. Extensively drug- resistant TB (XDR-TB) is MDR-TB that is also resistant to at least two out of the three classes of second line TB medicines.

Resources:

Policy and guidance:

Tuberculosis and HIV - technical policies of the UNAIDS Programm - http://www.unaids.org/en/PolicyAndPractice/HIVTreatment/Coinfection/TB/technical_policies.asp

Related information:

Tuberculosis and HIV - http://www.unaids.org/en/PolicyAndPractice/HIVTreatment/Coinfection/TB/default.asp

Coinfection - http://www.unaids.org/en/PolicyAndPractice/HIVTreatment/Coinfection/default.asp

Cosponsors:

World Health Organization - http://www.who.int/en/index.html  

Partners:

Stop TB Partnership - http://www.who.int/tb/publications/global_report/en/index.html  

Feature stories:

Call for global action on the threat of drug-resistant tuberculosis (03 April 2009) - http://www.aegis.org/news/unaids/2009/UN090404.html  

Call for fully funded Global Fund to fight AIDS, Tuberculosis and Malaria (31 March 2009) - http://www.aegis.org/news/unaids/2009/UN090335.html  

UNAIDS Executive Director meets with TB Programme Managers, TB civil society (26 March 2009) - http://www.aegis.org/news/unaids/2009/UN090332.html  

Need for scale up in integrated TB and HIV screening to address linked epidemics (24 March 2009) - http://www.aegis.org/news/unaids/2009/UN090326.html  

TB deaths rise in people living with HIV (17 March 2008) - http://www.aegis.org/news/unaids/2008/UN080307.html  

MDR-TB more common in people living with HIV (28 February 2008) - http://www.aegis.org/news/unaids/2008/UN080219.html  

Publications:

Multidrug and Extensively Drug-Resistant Tuberculosis (M/XDR-TB): 2010 Global Report on Surveillance and Response (pdf, 850 Kb) - http://whqlibdoc.who.int/publications/2010/9789241599191_eng.pdf  
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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

      Friday, March 19, 2010
Treatment for HIV found in bananas (No, really)

"A chemical in bananas has been found to inhibit HIV, according to research findings from a University of Michigan Medical School published in the March 19 issue of the Journal of Biological Chemistry. According to the study authors, this may lead to the development of inexpensive microbicides to prevent HIV transmission and, quite possibly, novel compounds to treat the disease."   Read more.   Circumcision may not prevent male-to-male HIV transmission
  "While studies in Africa have shown that circumcised heterosexual men are as much as 60 percent less likely than their uncircumcised peers to contract HIV from female partners, a new three-year study from the Centers for Disease Control and Prevention finds that circumcision does not necessarily prevent transmission among men who have sex with men in Western countries, Reuters reports."   Read more.   For some, twice daily anti-HIV treatment may be better than once daily
  "Even though people living with HIV may be more likely to adhere to a Kaletra (lopinavir/ritonavir)-based treatment regimen taken once a day compared with twice a day, those with high pre-treatment viral loads may experience virologic failure faster using Kaletra's once-daily dosing option, according to a study published in the April 1 issue of Clinical Infectious Diseases."   Read more.   Gential ulcers often associated with HIV shedding in men
  "HIV was detected in the lesions of almost 50% of HIV-positive men with genital ulcer disease, investigators report in the April 1st edition of Clinical Infectious Diseases.

A higher viral load, larger lesions, multiple ulcers, and weeping ulcers were all associated with an increased risk of HIV being shed by the ulcers."   Read more.   ICAAC registration
  General registration opens Monday, March 29 for the 2010 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). This year's ICAAC, the 50th, is set for Sept. 12-15 in Boston.     The RITA! Weekly Newsletter is a compilation of research, treatment, and advocacy news from a variety of trustworthy sources. The Center for AIDS Information & Advocacy (The CFA) is not responsible for the accuracy of the information provided by these sources. The views or opinions reflected in this newsletter do not necessarily reflect the views or opinions of The CFA. You can support our work with a donation using an online form. It's fast and secure. Address postal inquiries to: The Center for AIDS Information & Advocacy 1407 Hawthorne Houston, TX 77006

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine,and donations from users like you.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980,2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

CDC HIV/Hepatitis/STD/TB Prevention News Update
For Thursday, March 18, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• SOUTH CAROLINA: Hundreds Protest HIV Funding Cuts

INTERNATIONAL NEWS

• CANADA: Free Needles, Crack Pipes Considered at Victoria Clinic
• CANADA: City Can't Wait Any Longer for Needle-Exchange Site, Victoria Councilor Says
• AUSTRALIA: Spike in Sexual Infection Cases in Newcastle

MEDICAL NEWS

• SWEDEN: Sexual Risk-Taking in the General Population of Sweden (1989-2007)

LOCAL AND COMMUNITY NEWS

• NEW JERSEY: Symposium Infects HIV Awareness Within University
• ARIZONA: Kyrene School District Parents Review Lesson Plans for Sex Education Program

NEWS BRIEFS

• UNITED STATES: New Price for AIDS Drug: $30,600 a Year
• UNITED STATES: Social Networking for the HIV+
• CALIFORNIA: Marin AIDS Project Offers Home- Based Health Care

   NATIONAL NEWS SOUTH CAROLINA: Hundreds Protest HIV Funding Cuts

Gina Smith

The State (Columbia, S.C.) (03.18.10) - Thursday, March 18, 2010 South Carolina's dwindling revenues are wreaking havoc on its budget, prompting cuts to many state agencies and programs. On Wednesday, hundreds of advocates rallied at the Capitol to protest a spending plan that would eliminate all state funds for HIV/AIDS. South Carolina is believed to be the first state in the nation to consider such a move.
The current version of the state budget for the 2010-11 fiscal year starting July 1 cuts out all funding for the AIDS Drug Assistance Program (ADAP) as well as for statewide HIV prevention efforts. And without state money, matching prevention funds from the federal government would also be in jeopardy.
"These are difficult [budget] times. But even in the midst of that, we have to find the resources to battle this disease," said Rep. Joe Neal (D-Richland), adding that a growing body of research indicates the South is where most new HIV/AIDS cases are occurring.
South Carolina ranks eighth among states in its rate of new AIDS cases annually, Kaiser Family Foundation data show. Columbia's AIDS rate places it ninth among US cities.
The cut would affect 2,055 low-income patients who rely on ADAP for life-saving medicines. Neal has proposed a budget amendment that would restore $2.2 million in state funds for the $5.9 million ADAP program.
But a partial restoration of ADAP is not enough, advocates maintain. Without the full $5.9 million, some clients will be dropped and will go without their medicines, and newly eligible patients will be placed on a waiting list.
"The waiting list means people will be delayed in treatment," said Johanna Hayes, director of an HIV/AIDS advocacy group. "Delayed treatment means they get sicker and end up in the hospital," eventually costing taxpayers more.
   INTERNATIONAL NEWS CANADA: Free Needles, Crack Pipes Considered at Victoria Clinic

Richard Watts, Times Colonist

Vancouver Sun (03.17.10) - Thursday, March 18, 2010 The Vancouver Island Health Authority (VIHA) is considering about 60 potential sites across the island from which to provide sterile needles and other supplies for drug users. A final decision could be made by late June or early July.
One proposed site, the Addiction Outpatient Treatment office in downtown Victoria, would place addiction treatment and harm-reduction services under one roof.
"I can't imagine anybody would have such poor insight as to think that's a reasonable thing to do," said Neal Berger, executive director of the Cedars addiction recovery center in Cobble Hills. "Just the sight of a needle, just the thought of it. [Addiction] is a brain disease and the brain starts playing tricks on people."
There is a process in place for excluding the outpatient office from the final list of sites if the two functions are irreconcilable, said Suzanne Germain, VIHA's spokesperson.
The fixed-site needle exchange in Victoria closed in 2008 after neighbors complained about public disturbances and dangers. Since then, public anger has prevented the establishment of another fixed-site needle exchange in the city.
CANADA: City Can't Wait Any Longer for Needle-Exchange Site, Victoria Councilor Says

Bill Cleverley, Times Colonist

Vancouver Sun (03.17.10) - Thursday, March 18, 2010 Victoria needs a fixed-site needle exchange and cannot wait on regional health plans that would help establish a Vancouver Island-wide system, City Councilor Philippe Lucas says. The city has not had a fixed-site exchange for two years.
"There's absolutely no reason and no excuse for us to wait for an island-wide model to be put in place before this municipality takes action in trying to reduce the spread of disease and improve the public health of our region," Lucas said.
The council approved Lucas' proposal that city staff members compile a history of harm-reduction initiatives and solicit stakeholders' advice in devising a report on possible courses of action and costs. Lucas also supports one or more supervised consumption facilities in the Capital Region.
"We hear from tourists and businesses alike that the visible drug use is a concern for our community and the best way to deal with that is to actually give people a place to go and a safe place to use the substances that they are addicted to," Lucas said.
AUSTRALIA: Spike in Sexual Infection Cases in Newcastle

Danny Rose

Australian Associated Press (03.15.10) - Thursday, March 18, 2010 Officials in the New South Wales city of Newcastle are concerned about a recent spike in gonorrhea cases. So far this year, Newcastle-based sexual health services have recorded 41 cases of the STD, more than four times the nine cases logged during the same timeframe last year. The port city registered 29 cases for the same period in 2008 and 13 in 2007.
Cases are increasingly being seen in teenagers and people in their 20s, said Dr. Treeny Ooi, director of sexual health at Hunter New England Health.
"Men who have sex with men have been identified as a group particularly at risk," said Ooi. "However, heterosexual people have also been infected."
"Gonorrhea often causes no symptoms and people may not be aware that they are infected," Ooi said. "Too many people are unwittingly infecting their partners, and the only way to ensure that you do not have an [STD] such as gonorrhea is to have a sexual health check at your doctor."
"Untreated, gonorrhea can cause serious and permanent health problems in men and women," said Ooi. "It can cause painful infection in the testicles or fallopian tubes that connect the womb to the ovaries and may result in infertility."
Fortunately, testing for gonorrhea is easy and can be arranged through a general practitioner or sexual health clinic, Ooi said. "There is a high awareness about the benefits of condom use, but it can be a very different story when it comes time to put that knowledge into practice," she said.
   MEDICAL NEWS SWEDEN: Sexual Risk-Taking in the General Population of Sweden (1989-2007)

Claes Herlitz

Sexual Health (11.09) Vol. 6; No. 4: P. 272-280 (11..09) - Thursday, March 18, 2010 The current study aimed to examine changes in sexual behaviors and attitudes related to HIV and sexually transmitted infections (STI) during "a long period of intensive efforts by the Swedish authorities to curb the spread of HIV."
In 1989, 1994, 1997, 2000, 2003, and 2007, a total of 16,773 surveys were mailed to random samples of the general Swedish population. Each sample included 4,000 to 6,000 persons ages 16 to 44, stratified by age: 16-17, 18-19, 20-24, 25-34, and 35-44. Participation rates were 53.5 percent for men and 69.9 percent for women, for an overall participation rate of 61.6 percent.
During 1989-1994, the proportion of respondents holding a restrictive view on sexual intercourse outside a stable relationship decreased significantly. The surveys since 1994 show no change in that respect. Throughout the period, the prevalence of casual sexual partners increased significantly. Casual sexual intercourse without a condom increased significantly from 1989 to 2003, then decreased slightly from 2003 to 2007 - a behavior change that was more common among women than men. Compared to older age cohorts, prevalence of several sexual partners and casual intercourse without a condom was significantly higher among younger cohorts.
"This study demonstrates the need for a continuous preventive campaign against HIV/STI in the general population in Sweden, particularly among young people," the author concluded.
   LOCAL AND COMMUNITY NEWS NEW JERSEY: Symposium Infects HIV Awareness Within University

Henna Kathiya

Daily Targum (Rutgers University-New Brunswick) (03.15.10) - Thursday, March 18, 2010 Rutgers Health Services' Health Outreach, Promotion and Education on HIV/AIDS (HOPE) hosted a March 10 symposium to raise students' awareness about the disease. The event was held on National Women and Girls HIV/AIDS Awareness Day.
At the HIV/AIDS Interactive Symposium, students could walk around to different stations and learn about topics like safe-sex practices and drug and alcohol use. One station run by HOPE's Wellness Learning Community invited students to send inspirational postcards to friends and family.
The event also featured a photo exhibit titled "Faces of Awareness." The images of people affected by HIV/AIDS are part of a traveling exhibit originally started on the Douglass campus.
For some students, the information provided served either to refresh their memories or boost their knowledge of HIV/AIDS. "I feel like I already knew a lot of this stuff, but it reinforced what I knew. This event served as a reminder for me," said Hieu Phung, a senior. "If everybody here at least learns about how to use a condom and what types of contraceptives there are, I think it would help and maybe lower birth rates and help protect against diseases," said sophomore Sofya Andemicael.
ARIZONA: Kyrene School District Parents Review Lesson Plans for Sex Education Program

Kerry Fehr-Snyder

Arizona Republic (Phoenix) (03.12.10) - Thursday, March 18, 2010 Lesson plans for Kyrene School District's sex education curriculum, among other topics, are now being reviewed by parents, administrators, and community members. The KSD board adopted the human growth, development, and sex education curriculum last year. Lesson plans will also be reviewed by the district's health steering committee, which may make recommendations to the board by mid-April.
About seven parents have visited KSD offices to peruse three 15- to 18-minute sex education videos, which deal with puberty; HIV/AIDS; and physical, emotional, and sexual abuse. Course materials are available for review on Tuesday and Wednesday evenings through March 26.
The curriculum will include lessons for fourth-graders about learning to recognize and report sexual abuse. Fifth-graders will learn about HIV/AIDS in video presentations. Seventh- and eighth-graders will be taught about reducing the risk of pregnancy and STDs through PowerPoint presentations. The latter two grades will also learn about condoms.
"We expect seventh- and eighth-graders to be abstinent," said Sue Yost, KSD's health curriculum coordinator. "Condoms are not going to be handed out, there's not going to be a demonstration."
Still, students who are not abstinent should be prepared with information, Yost said. "We don't want our kids having sex, obviously," she said. "We don't think it's appropriate for kids that age."
Because studies show rates of pregnancy and STDs jump between middle and high school, Yost said initiating sex education in high school would be too late.
   NEWS BRIEFS UNITED STATES: New Price for AIDS Drug: $30,600 a Year News and Observer (Raleigh NC) (03.17.10) - Thursday, March 18, 2010 In a filing this week with the Securities and Exchange Commission, Durham-based Trimeris disclosed that the price of its AIDS drug Fuzeon has been increased by 3 percent, to $30,600 for a one-year supply. The new price is 50 percent higher than the drug cost when it was rolled out in 2003. Fuzeon's sales have been hurt by its high price, side effects, and the availability of newer medicines. Trimeris said the responsibility of setting the product's price is solely that of Swiss drug maker Roche, which markets it.
UNITED STATES: Social Networking for the HIV+

Deaidre Newby

Q Notes (Charlotte) (03.15.10) - Thursday, March 18, 2010 Thanks to online social networks, people with HIV are finding it easier to access support services and make new friends. In 2007, Robert Breining launched POZIAM, a site where HIV-positive people can link up to share their experiences and resources. It also offers a weekly online radio broadcast hosted by Breining, Jeromy Dunn of Charlotte, and "Project Runway" star Jack Mackenroth. Visit www.community.poziam.com. Similar services are offered by www.beonecity.com.
CALIFORNIA: Marin AIDS Project Offers Home-Based Health Care

Cynthia Laird

Bay Area Reporter (San Francisco) (03.11.10) - Thursday, March 18, 2010 Home-based health care has been added to the Marin AIDS Project's slate of comprehensive services. To help clients transition from hospital to home, MAP offers nursing care, attendant care, and medical case management. It also assists seriously ill AIDS patients so they can be cared for at home instead of at a skilled nursing facility. Patients are referred by their physician; qualification is determined by health status. MAP's services are free to low-income Marin County residents. For more information, telephone 415-457-2487.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Russia - 1 in 4 with TB develop resistance

Health-e News - March 18, 2010

http://www.aegis.org/news/healthe/2010/HE100314.html

In some areas of the world, one in four people with tuberculosis (TB) becomes ill with a resistant form of the disease that can no longer be treated with standard drug regimens, a World Health Organization (WHO) report says.

The report reveals that in one region of north-western Russia 28% of all people newly diagnosed with TB had the multidrug-resistant form of the disease (MDR-TB) in 2008. This is the highest level ever reported. Previously, the highest recorded level was 22% in Baku City, Azerbaijan, in 2007.

The WHO report Multidrug and Extensively Drug-Resistant Tuberculosis: 2010 Global Report on Surveillance and Response, estimates that 440 000 people had MDR-TB worldwide in 2008 and that a third of them died.

In sheer numbers, Asia bears the brunt of the epidemic. Almost 50% of MDR-TB cases worldwide are estimated to occur in China and India. In Africa, estimates show 69 000 cases emerged, the vast majority of which went undiagnosed.

Tuberculosis programmes face tremendous challenges in reducing MDR-TB rates. But there are encouraging signs that even in the presence of severe epidemics, governments and partners can turn around MDR-TB by strengthening efforts to control the disease and implementing WHO recommendations.

Two regions in the Russian Federation - Orel and Tomsk - have achieved a remarkable decline in MDR-TB in about five years. These regions join two countries - Estonia and Latvia - which have reversed rising high rates of MDR-TB, ultimately achieving a decline. The United States of America and China, Hong Kong Special Administrative Region (SAR), have achieved sustained successes in controlling MDR-TB.

Progress remains slow in most other countries. Worldwide, of those patients receiving treatment, 60% were reported as cured. However, only an estimated 7% of all MDR-TB patients are diagnosed. "This points to the urgent need for improvements in laboratory facilities, access to rapid diagnosis and treatment with more effective drugs and regimens shorter than the current two years," a WHO statement said.

WHO is engaged in a five year project to strengthen TB laboratories with rapid tests in nearly 30 countries. This will ensure more people benefit early from life-saving treatments. It is also working closely with the Global Fund to fight AIDS, Tuberculosis and Malaria and the international community on increasing access to treatment.

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Copyright © 2010 - Health-e is a news service reporting on public health issues. They are therefore only able to respond to e-mails concerning specific stories or radio programmes that they have published or broadcast. Related comments or suggestions can be addressed to the editor or the relevant journalists. They are unable to respond to e-mails of a medical nature or other queries unrelated to our specific work. For more information, please Contact Health-e. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through Health-e News Service.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

SA launches massive HIV testing campaign

Health-e News - March 18, 2010
Kerry Cullinan and Khopotso Bodibe

http://www.aegis.org/news/healthe/2010/HE100313.html

From April 15, everyone attending a clinic or hospital will be offered an HIV test, regardless of whether they have symptoms of the disease or not.

Dubbed the HIV Counselling and Testing campaign, or HCT, this is the most ambitious HIV testing campaign in the world, according to SA National AIDS Council (SANAC) co-chairperson Mark Heywood.

The HCT's target is to have 15 million South Africans tested for HIV by June next year at any of the country's 4 300 health facilities.

HCT's launch was scheduled to be announced at a press conference this week but it was delayed until March 25 to allow the Health Minister time to canvas support for the campaign from a wide range of organisations and ensure that South Africa's health facilities will be ready to provide HIV testing services when the campaign kicks off.

"This is a special campaign of SANAC and the government, so we will be raising funds from our development partners for testing kits. Health facilities won't be expected to provide those," Health Minister Dr Aaron Motsoaledi told a gathering of the SANAC leadership forum in Durban yesterday (17 March).

But he stressed that he expected very health facility to be in a position to test people by mid-April and to use their own staff and facilities to do so.

All health workers have already received a letter from the Health Minister explaining the campaign.

It has four objectives: to increase health-seeking behaviour; to encourage South Africans to know their HIV status; to equip those who test HIV-negative with ways of ensuring that they don't get HIV; and to create a quick and easy entry point to accessing wellness and treatment services for those who test HIV-positive

"The mainstay of the fight against any disease is to prevent it from happening," said Motsoaledi. " You don't have to be a scientist to know that. We grew up knowing that 'prevention is better than cure' at all times. But if you have failed to prevent it and it has happened, you have to treat it. We do accept that the fact that we have got so many people on treatment, might be the failure of prevention."

The HCT campaign will run until the end 2011, which is when the current National Strategic Plan on HIV and AIDS is due to end.

The campaign was first mentioned on World AIDS Day 2009 when President Jacob Zuma announced new protocols for the prevention of mother-to-child HIV transmission and the treatment of HIV, effective as of April 01.

"I don't have a feeling that South Africans understand that the biggest weapon [against HIV] must be prevention," said the Minister.

"In the budget read by Minister Pravin Gordhan, the HIV/AIDS budget increased by 33% over the previous year. If you look at the budgetary items which the government has done, whether it's education, housing, water, electricity, 33% is the highest increment of any of the other budgetary items," said Dr Motsoaledi.

"We can't keep on increasing by 33%. We have got to cut the rate of infection. That's where the issue of prevention comes in. If we keep on increasing that by 33% we will reach a situation in South Africa where the whole budget must go to treatment of HIV/AIDS, and I don't think any country can afford that. So, our war of prevention is extraordinarily important.

The HCT be based on a routine HIV test offered to all patients who will have the option to refuse it. Until now, only pregnant women and people showing HIV symptoms have been offered HIV tests. However, Motsoaledi stressed that, while in the past people we asked to volunteer for an HIV test while during the campaign people would be encouraged to test, "no one can force any human being to test."

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Copyright © 2010 - Health-e is a news service reporting on public health issues. They are therefore only able to respond to e-mails concerning specific stories or radio programmes that they have published or broadcast. Related comments or suggestions can be addressed to the editor or the relevant journalists. They are unable to respond to e-mails of a medical nature or other queries unrelated to our specific work. For more information, please Contact Health-e. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through Health-e News Service.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Disproportionate impact of HIV on men who have sex with men in US underlines need for better outreach

UNAIDS - 18 March 2010

http://www.aegis.org/news/unaids/2010/UN100324.html

New data analysis released on 10 March by the United States Centers for Disease Control and Prevention (CDC) highlights that HIV and syphilis disproportionately impact men who have sex with men in the United States (U.S.).

The data, presented at CDC's 2010 National STD Prevention Conference, found that the rate of new HIV diagnoses among men who have sex with men (MSM) in the U.S. is more than 44 times that of other men and more than 40 times that of women.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said Kevin Fenton, M.D., Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

According to CDC many aspects contribute to the high rates of HIV and syphilis among gay and bisexual men in this country. Homophobia and stigma can prevent MSM from seeking prevention, HIV testing and counselling, and treatment services. Other causes include limited access to prevention services, unsafe sex practices and complacency about HIV risk due to existence of treatment, particularly among young gay and bisexual men. Also, the risk of HIV transmission through anal sex is much greater than the risk of transmission via other sexual activities.

"It seems like we have come full circle in the United States," said UNAIDS Executive Director Michel Sidibe. "Efforts must be redoubled to include gay and bisexual men in AIDS programming and reach out to and address the HIV prevention needs of all men who have sex with men."

Prevention programmes

According to UNAIDS, HIV prevention measures for men who have sex with men should include consistent and proper use of condoms, and access to water-based lubricants. High quality HIV-related services, like voluntary counseling and testing in a non-discriminatory environment,, should be made available as well as specific and targeted information on prevention and risk reduction strategies designed to appeal to and meet the needs of men who have sex with men. Further quality treatment for sexually transmitted infections with referral for HIV services must be made available.

The U.S. Department of Health and Human Services notes that in the United States men as a whole, are less likely to use the health care system than women. Men often seek care when they are experiencing critical health problems. Men who have sex with men who do not access health care may not know they are infected with HIV or an STD, thus compromising their own health status. The persistence of stigma and homophobia compounds the situation still further.

CDC officials noted that the new analysis underscores the importance of the HIV and STD prevention efforts to reach gay and bisexual men recently announced as part of the U.S. President's fiscal year 2011 national budget proposal.

The new analysis is the first step in more fully assessing the extent of HIV among MSM and other populations in the United States. The CDC is developing more detailed estimates of infection rates among MSM by race and age, as well as among injection drug users. Ultimately, these data can be used to better inform national and local approaches to HIV and STD prevention to ensure that efforts are reaching the populations in greatest need.

Resources:

Policy and guidance:

Men who have sex with men - Technical policies of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance/Techpolicies/men_men_sex_technical_policies.asp  

Men who have sex with men: Key operational guidelines of the UNAIDS Programme - http://www.unaids.org/en/KnowledgeCentre/Resources/PolicyGuidance/OperationGuidelines/men_men_sex_operational_guidelines.asp  

Sexual Minorities - UNAIDS Guidance for Applicants to the Global fund to Fight AIDS, TB and Malaria Round 8 Call for proposals (pdf,127 Kb.) - http://data.unaids.org/pub/BaseDocument/2008/20080228_Rd8_SexualMinorities_en.pdf

Related information:

Men who have sex with men - http://www.unaids.org/en/PolicyAndPractice/KeyPopulations/MenSexMen/default.asp

Speeches:

Speech by UNAIDS Executive Director ôUniversal access for men who have sex with men: winds of change; signs of hopeö (pdf,34.8 Kb.) - http://data.unaids.org/pub/SpeechEXD/2009/20090916_sp_ms_msmwashingtondc_en.pdf

Feature stories:

Universal access in the Caribbean must include men who have sex with men (16 March 2010) - http://www.aegis.org/news/unaids/2010/UN100323.html  

External links:

Centers for Disease Control and Prevention - http://www.cdc.gov/hiv/  

Publications:

UNAIDS Action Framework: Universal Access for Men who have Sex with Men (pdf, 324 Kb) - http://data.unaids.org/pub/Report/2009/jc1720_action_framework_msm_en.pdf

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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

South Africa: HIV testing and mental illness

Integrated Regional Information Networks - March 17, 2010

http://www.aegis.org/news/irin/2010/IR100318.html

JOHANNESBURG, 17 March 2010 (PlusNews) - As more HIV-positive people access treatment and live longer, the number of people suffering from HIV-related mental disorders is growing, but mental health remains an ethical, legal and clinical minefield, where many doctors and nurses fear to tread - and fear to test.

"We're moving away from seeing patients on their death beds towards patients who are living longer, and are being affected by mental disorders that have real impacts on their life and work," said Dr Greg Jonsson, a psychiatrist at the Luthando Psychiatric HIV Clinic at the Chris Hani Baragwanath Hospital, in Johannesburg.

Various studies have shown a higher than average prevalence of mental illness among people living with HIV. A 2005 study by South Africa's Human Sciences Research Council found that about 44 percent of the 900 HIV-positive individuals surveyed suffered from a mental disorder.

The links between HIV and mental illness are complex, but factors include the effects of the virus on the central nervous system, as well as difficulties in dealing with HIV-related stigma and discrimination.

South Africa has the world's largest ARV programme to counter an HIV prevalence rate of about 18 percent, according to UNAIDS, and about 920,000 people are on ARV treatment.

No easy choices

Doctors and nurses in clinics often find it daunting to test mental health patients for HIV. "People who are not trained in psychiatric disorders are scared of getting consent from patients with mental disorders," Jonsson told IRIN/PlusNews. "People should not assume that mentally ill or even psychotic patients are incapable of understanding [testing] and consenting."

But Jonsson added that there would be times where doctors would need to make tough calls about testing severely mentally ill patients who could not consent to HIV testing and whose families may not be approachable to consent on their behalf.

"If you can't obtain informed consent, you need to weigh up the potential harm and benefit to the patient - ask yourself whether this test is going to change your diagnoses or your treatment," he suggested to health workers at an annual symposium held by the Aurum Institute, a non-profit medical research organization.

"I think if the answer is 'yes' to either, then go for it. It is really the right of the patient to be offered effective HIV treatment," said Jonsson, who pointed out that doctors should be aware of possible interactions between mental health medications and antiretroviral (ARV) drugs.

He advised doctors to document the process and counsel patients throughout, especially about how to reduce risk, given the prevalence of substance abuse among mental health as well as HIV patients.

"Psych is hard because the 'three ticks equal this' approach doesn't really work, and that's why people are so scared of it," Jonsson told IRIN/PlusNews.

No right answers

Once a mental health patient started taking ARVs, healthcare providers would have to evaluate whether mandating a "treatment supporter" - a friend or family member to help the patient adhere to treatment - would be appropriate. Again, there may not be a right answer.

"We need to draw up protocols and put them in primary healthcare, but the problem with protocol-based system is that people don't think outside the box - with mental health patients it really is on a case-by-case basis," Jonsson told the symposium audience.

"I tell most of my patients, 'If you can get treatment support, go for it', but I don't insist on it - disclosing to a patient's family is difficult and ... at my clinic, our patients on treatment are already so stigmatized and victimized."

The Luthando Psychiatric HIV Clinic has a treatment default rate - patients who discontinue ARVs - that is the same as institutions in Johannesburg that mandate treatment supporters, Jonsson added.

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Africa: Mapping truckers' route to the health centre

Integrated Regional Information Networks - March 16, 2010

http://www.aegis.org/news/irin/2010/IR100316.html

NAIROBI/DAR ES SALAAM, 16 March 2010 (PlusNews) - New maps pin-pointing the exact location of "wellness centres" in sub-Saharan Africa are improving truck drivers' access to treatment and care for HIV and other sexually transmitted infections (STIs).

Oil giant Shell, with risk specialist Maplecroft and the North Star Alliance, which builds roadside clinics at truck stops, have developed and printed 20,000 maps for distribution to truck drivers in Kenya, South Africa, Cote d'Ivoire, Burkina Faso, Togo, Tanzania, Uganda, Botswana, Guinea, Mali and Namibia. The maps show the locations of more than 160 clinics.

"Many of us want treatment but at times you might not know where to get it when you are on the road but these maps can help us now," Eliud Musili told IRIN/PlusNews at Mlolongo, a truck stop in the Kenyan capital, Nairobi. "Now you can even advise other drivers where to get [health services]."

In East and Central Africa, the maps are being distributed to truckers at "SafeTStops" where wellness centres provide a range of services, including screening of STIs, HIV testing and counselling and tuberculosis screening, for truck drivers and communities with whom they interact.

"The wellness centres have been put up in areas where these high-risk groups converge to provide information about HIV and other STIs, prevention methods like condoms, diagnosis of STIs and testing and counselling," says Dorothy Muroki, project director for the Regional Outreach Addressing AIDS through Development Strategies II, a project of the NGO, Family Health International (FHI). "For high-risk groups, information is critical."

FHI runs sites in Uganda, Tanzania and Rwanda in partnership with North Star Alliance, the Solidarity Centre and local transport unions; so far, the map distribution has not been rolled out at these sites.

Living dangerously

For more than six years now, Julius Mwapele*, 35, a father of five, has worked as a loader at Dar es Salaam port; three months ago, he visited a clinic to treat a persistent rash on his penis.

"At first I wanted to [ignore] it but when it continued, I decided to go to a clinic here at the port," he told IRIN/PlusNews. "At the clinic, they told me I had gonorrhoea; I was afraid but they told me it can be treated."

While his job is not particularly well paid, compared with many of the residents around the port, Mwapele is well-to-do. He suspects that he contracted the STI from a local woman.

"I have three mistresses here - I buy food from them," he said. "I get into sexual relationships with them so that at times I can get free food when I don't have money but when I get money, it is my turn to give them a treat."

Sex stops

Sex work is widespread at truck stops along sub-Saharan Africa's transport corridors; a 2006 University of Manitoba study found an estimated 8,000 female sex workers on the trans-Africa highway from Kenya's coastal city of Mombasa to the Ugandan capital, Kampala. It also reported that truckers and their assistants had high rates of reported STIs and many exhibited high-risk sexual behaviour.

The SafeTStops aim to provide truck drivers and sex workers with information and other services in a non-judgmental way. "Women do not get into commercial sex work for fun but due to economic needs, just like truck drivers seek sexual services from commercial sex workers because they are rarely with their spouses," said FHI's Muroki.

The centres are also a source of entertainment. "We provide facilities like pool and offer reading material and TV so when one walks in, nobody knows for sure what has brought them except the clinic personnel," said Victoria Jonathan, head of the wellness centre in the port of Dar es Salaam. "This gives a sense of privacy; the uptake of the services is very impressive.

Alcohol a factor

"The centres are alcohol-free to send the message that alcohol abuse is one of the key drivers for risky sexual behaviour," she added.

Ben Manyala, an HIV-positive trucker in Dar es Salaam, agreed that alcohol was an important factor in HIV transmission among truck drivers.

"Alcohol is contributing [to the spread of HIV]; we have a joke that after five bottles of beer, every woman is beautiful," he said.

* Not his real name

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

New Research by VGTI Florida Science Director Demonstrates How HIV Disables the Immune System

Business Wire - March 16, 2010

http://www.aegis.org/news/bw/2010/BW100315.html

Research Helps Focus Future Studies to Specifically Target the Series of Cellular Interactions That Cause the Body to Drop Its Guard

PORT ST. LUCIE, Fla. - New research conducted by the scientific director for VGTI Florida and his colleagues at the University of Montreal, in collaboration with scientists from the NIH and the McGill University Hospital center, may soon lead to an expansion of the drug arsenal used to fight HIV. The research sheds new light on how HIV gradually weakens the body's immune system and highlights the need for new research into therapies that will target the chain of events that cause the progression of the disease.

The study, published in the journal Nature Medicine, describes the pivotal role of two molecules, PD-1 and IL-10, in impairing the function of disease-fighting T-cells known as CD4 T-cells û a phenomenon that weakens the body's immune system.

Specifically, the researchers found that when HIV invades the body, bacterial products are released from the gut and white blood cells respond by releasing a protein on the surface of the cell called PD-1. Heightened levels of PD-1 lead to the activation of a gene that produces another protein called IL-10. Both of these proteins (PD-1 and IL-10) are known to appear at increased levels during HIV infection.

"We are the first to show that these two molecules work together to shut down the function of CD4 T-cells in HIV patients. This in turn, may lead to paralysis of the immune system and an accelerated disease progression," said Dr. Rafick-Pierre Sekaly, scientific director of VGTI Florida, a professor at the University of Montreal and researcher at the Research Center of the University of Montreal Hospital Center.

"Our results suggest that it is important to block both IL-10 and PD-1 interactions to restore the immune response during HIV infection," said Dr. Sekaly. "We believe that immunotherapies that target PD-1 and IL-10 should be part of the arsenal used to restore immune function in HIV-infected subjects."

About the study:

The article "PD-1 Induced IL-10 Production by Monocytes Impairs CD4 T-Cell Activation during HIV Infection," published in Nature, was authored by Elias A. Said, Franck P. Dupuy, Lydie Trautmann, Yuwei Zhang, Yu Shi, Mohamed El-Far, Brenna J. Hill, Alessandra Noto, Petronela Ancuta, Yoav Peretz, Simone G. Fonseca, Julien Van Grevenynghe, Mohamed R. Boulassel, Julie Bruneau, Naglaa H. Shoukry, Jean-Pierre Routy, Daniel C. Douek, Elias K. Haddad, and Rafick P. Sekaly.

About VGTI Florida:

VGTI Florida is the Florida-funded expansion of Oregon Health & Science University's highly successful Vaccine and Gene Therapy Institute. Research at the facility will focus on vaccine development with a special focus on vaccines and therapeutics that protect the aging population, which is the most vulnerable to disease.

Contacts

For VGTI Florida

Ryan Banfill, 850-222-1996

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Copyright © 2010 - Business Wire. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Business Wire, Permissions Desk, Business Wire, 1185 Avenue of the Americas, 3rd Floor, New York, NY 10036; Tel: (212) 575-8822; FAX: (212) 575-1854. http://www.businesswire.com.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Bananas against AIDS?

afrol News - March 15, 2010

http://www.aegis.org/news/afrol/2010/AO100302.html

Scientists have found a special protein in the banana that could help women prevent being infected by HIV during sexual intercourse. They hope this may open the door to new and cheaper treatments to prevent the spread of AIDS.

The researchers, from the US University of Michigan Medical School, have an emerging interest in lectins, a type of proteins naturally occurring chemicals in plants, because of their ability to halt the chain of reaction that leads to a variety of infections.

"In laboratory tests, BanLec, the lectin found in bananas, was as potent as two current anti-HIV drugs," according to the study. Based on the findings published this month in the scientific 'Journal of Biological Chemistry,' "BanLec may become a less expensive new component of applied vaginal microbicides," researchers say.

Although condom use is quite effective, condoms are most successful in preventing infection if used consistently and correctly, which is often not the case.

"That is particularly true in developing countries where women have little control over sexual encounters so development of a long-lasting, self-applied microbicide is very attractive," says study senior author David Marvovitz.

Some of the most promising compounds for inhibiting vaginal and rectal HIV transmission are agents that block HIV prior to integration into its target cell, according to the study.

The new research describes the complex actions of lectins and their ability to outsmart HIV. Lectins are sugar-binding proteins. They can identify foreign invaders, like a virus, and attach themselves to the pathogen.

The researcher team discovered BanLec, the lectin in bananas, can inhibit HIV infection by binding to the sugar-rich HIV-1 envelope protein, gp120, and blocking its entry to the body.

"Therapies using BanLec could be cheaper to create than current anti-retroviral medications which use synthetically produced components, plus BanLec may provide a wider range of protection," the US researchers say.

"The problem with some HIV drugs is that the virus can mutate and become resistant, but that is much harder to do in the presence of lectins," says lead author Michael Swanson.

By staff writer

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Copyright © 2010 - afrol News. All rights reserved. Reproducing or buying afrol News' articles. Reproduction of this article (other than one copy for personal reference) must be cleared through afrol News.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

California Embarks on Setting 'Condoms in Porn' Health Regulations

Business Wire - March 17, 2010

http://www.aegis.org/news/bw/2010/BW100319.html

Former Adult Film Actors, Public Health Advocates to Testify at March 18th Cal/OSHA Standards Board Meeting in Costa Mesa; Board to Consider Creating Advisory Panel to Revisit Adult Film Worker Safety

In December, AHF Filed Petition Seeking Amendment to State's "Bloodborne Pathogens" Regulation to Better Encompass Adult Film Industry, Expressly Requiring Condoms to Protect Performers

LOS ANGELES - California's Department of Occupational Safety and Health (Cal/OSHA) will explore strengthening adult film worker safety regulations in California during its next regularly scheduled Standards Board meeting (Item # IV "B") on Thursday, March 18th in Costa Mesa. The action comes in response to a petition filed in December by AIDS Healthcare Foundation (AHF) seeking an amendment to broaden the Cal/OSHA's "bloodborne pathogens" workplace safety regulations to better encompass adult film industry worksites.

"I was a porn star living the glamorous life. Drug overdoses, herpes, suicide attempts and abuse at the hands of the porn industry"

At Thursday's meeting, state officials will consider Cal/OSHA's own staff's recommendation to create an advisory panel to determine whether--and how--to amend state health statutes to better protect adult film workers. Several former adult entertainment actresses, a current producer/director/performer as well as several public health advocates will testify at the meeting in support of Cal/OSHA's creation of an advisory panel as well as ultimately changing state health regulations.

WHAT:

PUBLIC HEARING & TESTIMONY--10am (Item #IV "B")

Cal/OSHA to consider creating advisory panel on adult film worker safety

WHEN:

THURSDAY, March 18th 2010---10:00 AM Pacific

WHERE: Meeting: Costa Mesa City Council Chambers, 77 Fair Drive, Costa Mesa, CA 92626

WHO:

Shelley Lubben, former adult entertainment actress and founder of Pink Cross Foundation

Jan (Meza) Merritt, former adult entertainment actress and member of Pink Cross Foundation

Madelyne Hernandez, former adult entertainment actress and member of Pink Cross Foundation

Dave Pounder, Producer/Director/Performer, President, Dave Pounder Productions

Tim Tritch, Former Laboratory Representative/Account Manager; clients includes AIM Clinic

Robert Kim-Farley, MD, MPH, Director, Communicable Disease Control and Prevention Program, Los Angeles County Department of Public Health

Mark McGrath, Adult Film Industry Subcommittee, Reproductive Health Interest Group, UCLA School of Public Health, UC Berkeley Research Fellow

Michael Weinstein, AIDS Healthcare Foundation, President

Brian Chase, Assistant General Counsel, AIDS Healthcare Foundation

CONTACT:

Ged Kenslea, AHF Dir. of Communications (323) 791-5526 cell (323) 308-1833 office

Also:

WHAT:

POST Cal/OSHA HEARING TELECONFERENCEû12:30 PM Pacific

Advocates respond after Cal/OSHA hearing on adult film health and safety

WHEN:

THURSDAY, March 18th 2010---12:30 PM Pacific

Teleconference Dial in information: +1.877.411.9748 participant code #7931503

WHERE: Hilton Hotel Orange County/Costa Mesa, 3050 Bristol Street, Costa Mesa, CA 92626

Late last week, Cal/OSHA officials released its staff evaluation of AHF's petition as well as a proposed decision that the Cal/OSHA's Standards Board is expected to evaluate and act on during Thursday's meeting. In its proposed decision (http://www.dir.ca.gov/oshsb/petition513.html), Cal/OSHA officials wrote:

"In light of the evaluations, it is apparent to the Board that serious consideration should be given to the possible amendment of Section 5193 in order to give greater protection to employees in the adult film industry."(Emphasis added)

"This is a huge step in the right direction toward protecting the health and safety of adult film workers here in California, and I want to thank Cal/OSHA officials for their work on this and urge its Standards Board members to vote in favor of convening an advisory panel on this issue," said Michael Weinstein, President of AIDS Healthcare Foundation. "Although workers in adult films should enjoy protections under the current phrasing of Cal/OSHA's regulations, the adult film industry has steadfastly refused to take any steps to protect its workers from diseases spread by bloodborne pathogens, resulting in thousands of employees becoming infected with sexually transmitted diseases. AHF filed this petition because adult film industry producers were unwilling or unable to comply with current Cal/OSHA regulations and to take steps necessary to protect performers by providing and enforcing the use of condoms during filming."

"I was a porn star living the glamorous life. Drug overdoses, herpes, suicide attempts and abuse at the hands of the porn industry," said Shelley Lubben, former porn actress and founder of the Pink Cross Foundation, an IRS approved 501(c)(3) public charity dedicated to offering adult industry workers emotional, financial and transitional support for those who want out of the adult industry. "In my time in the industry, I did some very hardcore movies, and only drugs and alcohol could get me through them. I played a crazy game of Russian roulette with my life. The industry did not and still does NOT enforce condom usage, so STDs and HIV were--and still are--a high risk among porn actors and actresses. While my own life has taken an entirely new and profoundly fulfilling direction and I now work to help performers leave the industry altogether, I wholeheartedly support the call to amend Cal/OSHA regulations to better protect those still involved in the ongoing production of adult films in California."

"It breaks my heart to acknowledge that during my time as a porn star, I've done a scene with 25 men and even though I was assured that all of the STD testing had been taken care of by the producers, in my heart I realize now that this was probably a lie because I never saw the tests for myself," said Jan (Meza) Merritt, former porn actress and member of the Pink Cross Foundation. "There are thousands of porn stars actively working in the adult industry. How much higher is the risk of getting HIV and other STDs in an industry where you have not only one sexual partner per day, but several or more and condoms are looked at as an unnecessary, negative component of this industry? I urge Cal/OSHA to convene an advisory panel to thoroughly consider amending California safety and health regulations covering the industry."

Background on AHF's Petition to Cal/OSHA

AHF filed its petition at the final 2009 meeting of the California Occupational Safety and Health Standards Board (Cal/OSHA) in mid-December in Sacramento. The petition sought an amendment to California Code of Regulations, Title 8, Section 5193 "Bloodborne Pathogens" and asked Cal/OSHA to clarify protections for workers in the adult film industry and to explicitly include a condom requirement. As reported by the Associated Press at the time, ("AIDS group wants rule requiring condoms in porn" AP, 12/16/09) AHF said, "regulations to prevent the spread of bloodborne diseases in hospitals should extend to adult film sets. The current regulations aren't clear enough."

Cal/OSHA's proposed decision also noted:

"In view of the fact that the Petitioner does not represent all stakeholders and in view of the complexity of the issues, the possibly differing approaches to potential rulemaking and possible issues regarding federal equivalence, the Board concludes that an advisory committee would be of great benefit in determining the manner (if any) in which Section 5193 should be amended. Labor Code Section 147.1(c) provides, in effect, that the Division is to take the lead in developing and presenting proposed health standards to the Board, in which case, it is appropriate that the Division take the lead with respect to the advisory committee discussed herein." (Emphasis added)

"In view of the foregoing, the Board grants the Petition that is the subject of Petition File No. 513 to the extent that the Division is requested to convene an advisory committee representing stakeholders in order to consider possible amendments of California Code of Regulations, Title 8, Section 5193 as it pertains to employees in the adult film industry. If determined necessary, regulatory language or amendments should be developed for the Board's consideration at a future public hearing."

Background on STDs--including HIV--in the Adult film Industry and AHF's Ongoing Advocacy

AHF's action was prompted by the ongoing epidemic of sexually transmitted diseases (STDs) in California's adult film industry. According to the Los Angeles County Department of Public Health (LADPH), workers in the adult film industry are ten times more likely to be infected with a sexually transmitted disease than members of the population at large. LADPH documented 2,013 individual cases of chlamydia and 965 cases of gonorrhea among workers between the years 2003 and 2007. LADPH has observed that many workers suffer multiple infections, with some performers having four or more separate infections over the course of a year. In addition, LADPH has stated that as many as 25 industry-related cases of HIV have been reported since 2004. Included in the presentation will be two PowerPoint slideshows created by Peter R. Kerndt, MD, MPH, Director, Sexually Transmitted Disease Program for LADPH detailing the rampant epidemic of STDs in Los Angeles' adult film industry and the need for condoms to prevent disease transmission.

This past August, AHF filed sixteen worker-safety complaints with Cal/OSHA over the lack of condom use in adult films made in California. AHF supported its complaints with the submission of nearly 60 adult DVDs filmed in California and in which the performers do not wear condoms. The complaints asserted that the films demonstrated unsafe--potentially life-threatening--behavior in a California workplace, as the sexual acts filmed without participating performers using condoms depict the unprotected exchange of bodily fluids.

AIDS Healthcare Foundation (AHF) is the largest global AIDS organization. AHF currently provides medical care and/or services to more than 130,000 individuals in 22 countries worldwide in the US, Africa, Latin America/Caribbean and the Asia Pacific Region. www.aidshealth.org  

The Pink Cross Foundation is an IRS approved 501(c)(3) public charity dedicated to offering adult industry workers emotional, financial and transitional support for those who want out of the adult industry. www.thepinkcross.org and www.shelleylubben.com  

Contacts

AHF Dir. of Communications

Ged Kenslea

Telephone: 323-308-1833, Mobile: 323-791-5526

gedk@aidshealth.org

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AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Universal access in the Caribbean must include men who have sex with men

UNAIDS - 16 March 2010

http://www.aegis.org/news/unaids/2010/UN100323.html

Although the Caribbean as a region has the second highest HIV prevalence after sub-Saharan Africa, most countries have concentrated epidemics which disproportionately affect certain groups including gay men and other men who have sex with men (MSM). In many countries men who have sex with men experience considerable social stigma and are not reached with vital HIV prevention, treatment, care and support services. Not only are men afraid of disclosing their sexual activity, they are also deterred from finding out what they need to know to reduce their risk or to buy condoms.

An environment of homophobia is often reinforced by anti-sodomy legislation which exists in 11 of 16 Caribbean countries*. This can contribute to an intolerant cultural and social environment which risks keeping men who have sex with men away from accessing HIV testing and counselling and education services that would reduce the vulnerability to HIV infection.

In Jamaica--a country with anti-sodomy laws--there is 32% HIV prevalence among MSM, versus 1.6% in the general population. In Trinidad & Tobago and Guyana, countries which also criminalize sex between men, the HIV prevalence ranges from 20% to 32%. While in Cuba, Suriname, the Bahamas, Dominican Republic, countries without such legislation, the HIV prevalence in MSM ranges from 1% to 8%.

According to 2007 UNGASS Country Progress reports less than 40% of MSM in the Caribbean are reached by prevention programmes. Local groups in many countries in the Caribbean have been urging civil society and government programmes to include MSM issues and organizations within the AIDS response. These efforts have been supported by regional networks including PANCAP.

UNAIDS Executive Director Michel Sidibe has called for an end to punitive laws which hamper the AIDS response in this region.

"In most of the countries in the Caribbean that don't have repressive laws, HIV prevalence is between 1% and 8% among men who have sex with men," said UNAIDS Executive Director Michel Sidibe. "This contrasts sharply with a range of between 20% and 32% in countries which outlaw sex between men."

"Reducing homophobia and removing punitive laws that criminalize sex between men creates the right conditions for achieving universal access," Mr Sidibe continued.

A collaborative effort is underway between UNAIDS, UNDP and PAHO/WHO to develop strategies for Latin America and the Caribbean on human rights and improvement of access to health services for MSM and other sexual minorities.

UNAIDS will lead a regional effort in the Caribbean to strengthen HIV prevention programmes among these groups, to bring together the human rights and service provision components for their improved health, human rights and well-being.

* Countries in the Caribbean with laws that criminalize men who have sex with men: Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago. Countries in the Caribbean with no laws criminalizing men who have sex with men: Bahamas, Cuba, Dominican Republic, Haiti, Suriname. According to ILGA web site accessed 16 March 2010

Resources:

Related information:

Caribbean - http://www.unaids.org/en/CountryResponses/Regions/Caribbean.asp  

Feature stories:

Fiji first Pacific Island nation with colonial-era sodomy laws to formally to decriminalize homosexuality (04 March 2010) - http://www.aegis.org/news/unaids/2010/UN100306.html  

Publications:

Keeping Score II (pdf, 2.87 Mb) - http://data.unaids.org/pub/Report/2008/20081206_keepingscoreii_en.pdf  

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Copyright © 2010 - Joint United Nations Programme on HIV/AIDS (UNAIDS). All rights reserved. UNAIDS articles, which are not formal publications of UNAIDS, may be freely reviewed, quoted, reproduced or translated, in part or in full, provided the source is acknowledged. The documents may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre).

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Mississippi Stops Segregating Prisoners With HIV: Alabama and South Carolina Last States to Maintain Discriminatory Policy

Human Rights Watch - March 17, 2010

http://www.aegis.org/news/hrw/2010/HRW100301.html

(Jackson) - The Mississippi Department of Corrections (MDOC) has agreed to end the segregation of prisoners with HIV, Human Rights Watch and the American Civil Liberties Union (ACLU) said today. This longstanding discriminatory policy, reversed after two decades of advocacy by the ACLU, Human Rights Watch, and others, prevented prisoners from accessing key resources that facilitate their successful transition back into the community.

The decision by Mississippi's corrections commissioner Christopher Epps, prompted by recent advocacy by the ACLU and Human Rights Watch, leaves Alabama and South Carolina as the only states in the nation that segregate prisoners based on their HIV status. Epps made the decision ahead of a forthcoming report by the ACLU and Human Rights Watch analyzing the harmful impact segregation policies have had in the three states.

"Commissioner Epps deserves a tremendous amount of credit for making this courageous decision to replace a policy based on irrational HIV prejudice with a policy based on science, sound correctional practice, and respect for human rights," said Margaret Winter, associate director of the ACLU National Prison Project. "The remaining segregation policies in South Carolina and Alabama are a remnant of the early days of the HIV epidemic and continue to stigmatize prisoners and inflict them and their families with a tremendous amount of needless suffering."

Public and correctional health experts agree that there is no medical basis for segregating HIV-positive prisoners within correctional facilities or for limiting access to jobs, vocational training and educational programs available to others. Since 1987, however, MDOC has performed mandatory HIV tests on all prisoners entering the state prison system, and has permanently housed all male prisoners who test positive in a segregated unit at the Mississippi State Penitentiary, the state's highest security prison. As a result, prisoners with HIV have been faced with unjustified isolation, exclusion, and marginalization, and low-custody prisoners have been forced unnecessarily to serve their sentences in more violent, more expensive prisons.

The change in policy will enable prisoners with HIV to participate in jobs, training programs, and other services to which they were previously denied access because of their HIV status and which are designed to prepare prisoners for a productive return to society. Prisoners with HIV will now be able to participate in kitchen work, for example, which can be beneficial to them in many ways. Many prisoners worked in kitchens, cafes, or restaurants prior to their incarceration, and continued employment in that area can help them upon re-entry. According to the US Centers for Disease Control, there is no medical basis for preventing persons with HIV from working in kitchens or other food service employment.

Additionally, prisoners with HIV will no longer be assigned to a segregated HIV unit, which resulted in the public disclosure of their HIV status and left them at risk of being ostracized and subjected to hostility and violence at the hands of other prisoners. Epps said he will phase in the new desegregation policy gradually for prisoners currently housed in the HIV unit, and will form a committee to make individualized placement decisions for these prisoners. Starting immediately, incoming prisoners will be housed using only criteria set out in the state classification plan such as criminal history, length of sentence and other factors unrelated to their HIV status.

"Prisoners with HIV were often forced to live in cruel, inhuman, and degrading conditions, and we're delighted that Mississippi has changed its policy," said Megan McLemore, health researcher at Human Rights Watch. "Integrating prisoners with HIV is the norm across the United States and MDOC deserves significant credit for making this decision."

Mississippi's decision to change its segregation policy to comply with civil and human rights standards is the latest in a series of reforms prompted by ongoing dialogue between the ACLU, Human Rights Watch, and MDOC officials. In 2001, based on the recommendations of a task force convened by the MDOC commissioner and comprised of MDOC security staff, public health officials, ACLU staff, and other HIV advocates, MDOC ended its policy of excluding prisoners with HIV from in-prison vocational, educational and religious programs. And in 2004, as a result of a class action lawsuit filed by the ACLU on behalf of all Mississippi prisoners with HIV, MDOC ended its policy of excluding prisoners with HIV from the state's work release and community corrections programs.

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Copyright © 2010 - Human Rights Watch. Reproduction of this article (other than one copy for personal reference) must be cleared through the Human Rights Watch - Contact Us.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

CDC HIV/Hepatitis/STD/TB Prevention News Update
For Wednesday, March 17, 2010 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2010, Information Inc., Bethesda, MD. NATIONAL NEWS

• RHODE ISLAND: Money Woes Curtail Free Cancer Tests

INTERNATIONAL NEWS

• AFRICA: New Maps Guide African Truckers to AIDS Clinics
• AUSTRALIA: High Time to Clean Up Prisoner Drug Use: Anex

MEDICAL NEWS

• NETHERLANDS: Home 'Cervical Cancer' Test Hope

LOCAL AND COMMUNITY NEWS

• ILLINOIS: 'Sexpert' Lauds Benefits of Updated Female Condom
• ARIZONA: HIV Clinic Augments Cardiology Practice

NEWS BRIEFS

• UNITED STATES: Former Surgeon General Koop Honored for AIDS Work
• GEORGIA: Nearly 360 Students, Staff to Get TB Test Friday in Gwinnett School
• CANADA: Blood Tests Urged for Tattoo Clients

   NATIONAL NEWS RHODE ISLAND: Money Woes Curtail Free Cancer Tests

Felice J. Freyer

Providence Journal (03.12.10) - Wednesday, March 17, 2010 A Rhode Island cancer screening program that helps uninsured low-income women access Pap smears, mammograms, office visits and follow-up testing will be suspended from March 15 through June. The CDC-funded Women's Cancer Screening Program (WCSP) is operated by the state Department of Health and has a $1.5 million annual budget. Though flat-funded, the program has seen its number of clients grow by more than 50 percent this fiscal year, as more women who lost health insurance in the economic downturn sought its free services.
A 16-week testing delay would not usually make much of a difference, but nearly one in five WCSP patients have abnormal results requiring follow-up. Women needing biopsies, which should not be delayed, will have to apply to Medicaid or make arrangements with their physician. Either way, federal rules require that the women receive timely follow-up, said Nikki Hayes, assistant branch chief in CDC's division of cancer prevention and control.
Most of the 115 contracting service providers - medical practices, hospitals, labs, health and imaging centers - were surprised by the March 1 announcement of WCSP's suspension.
WCSP ran through 90 percent of its budget halfway through the current fiscal year, or by Dec. 31, said Annemarie Beardsworth, a Department of Health spokesperson. The department had no reason to alert providers earlier because there was nothing WCSP contractors could do to cut costs, she said. In January, the program lowered reimbursements. When WCSP services resume on July 1, patients will be screened every other year instead of annually, in line with recommendations by the US Preventive Services Task Force.
Rhode Island will seek an additional $300,000 for WCSP next fiscal year.
   INTERNATIONAL NEWS AFRICA: New Maps Guide African Truckers to AIDS Clinics Agence France Presse (03.10.10) - Wednesday, March 17, 2010 Approximately 20,000 maps detailing HIV/AIDS clinic locations are being distributed to truck drivers across Africa, thanks to a new initiative.
African trucking routes have long served to spread the virus across borders. The maps - in English for east and southern Africa, and in English and French for west Africa - pinpoint 160 clinics run by more than 40 governments and charities that provide free AIDS services.
"For the first time, truckers can see where they can access health services along major trucking corridors and transport hubs on the subcontinent," said Paul Matthew, Africa director for North Star Alliance, which sets up clinics on highways and at border posts. NSA is a partnership started by the courier company TNT and the UN World Food Program.
NSA's foundation initiated the project, working with risk-mapping firm Maplecroft and petroleum giant Royal Dutch Shell. "Our research showed categorically that the spread of HIV moved down transportation routes," said Maplecroft spokesperson Jason McGeown. Shell, which funded the project, said truck drivers' health directly impacts their business in Africa. Organizers hope to distribute the maps to truckers across the continent.
AUSTRALIA: High Time to Clean Up Prisoner Drug Use: Anex

Danny Rose

Australian Associated Press (03.16.10) - Wednesday, March 17, 2010 Australia should allow controlled needle and syringe programs (NSPs) in prisons to prevent hepatitis C and HIV transmission among incarcerated needle-sharing injection drug users, a harm-reduction group says. Such an NSP would require prisoners to store a used syringe inside a protective container before swapping it for a clean one in a container, said the Association for Prevention and Harm Reduction Programs Australia (Anex).
Australian researchers have found that almost 40 percent of inmates report injection drug use (IDU) while imprisoned, and about 70 percent of them shared needles. Some prisoners reported a needle being reused by as many as 100 inmates, with needles being re-sharpened by grinding them on cell walls. Two-thirds of corrections officers reported finding contraband needles, which is a potential risk during cell and prisoner searches. About 35 percent of inmates are infected with hepatitis C virus, and 0.5 percent have HIV.
"It is irrefutable that prison authorities owe a duty of care to prisoners, to protect them from foreseeable harm while they are in custody," said John Ryan, executive director of Anex. Such programs "have been operating for up to 10 years in Switzerland, Germany, Luxembourg, Spain, Moldova, Kyrgyzstan, and Belarus."
"The introduction of prison-regulated and controlled NSPs in these countries has not resulted in instances of syringes being used as weapons," Ryan said. "In fact, international experience shows that prison-regulated and controlled NSPs actually can increase institutional safety."
   MEDICAL NEWS NETHERLANDS: Home 'Cervical Cancer' Test Hope BBC (03.12.10) - Wednesday, March 17, 2010 A new study suggests that home-testing kits for human papillomavirus (HPV) could lead to the earlier detection of more cases of cervical cancer.
"While it's important for women to attend cervical screening appointments, some find it difficult to do so for cultural or other reasons," said Professor Stephen Duffy of Cancer Research UK.
The subjects of the research were 28,073 Dutch women who had not responded to two invitations to come in for regular cervical screening. Most (27,792) were then invited to collect a specimen sample and mail it in for evaluation; 281 were sent a third reminder to present for screening.
Adjusted rates of compliance were significantly higher among women in the self-sampling group (27.5 percent) versus the control group (16.6 percent). Among self-sampling responders, the 43 percent who had missed the previous round of screening had a higher risk of abnormal changes in the cervix than the 57 percent who had participated in the previous round.
"Offering self-sampling by sending a device for collecting cervicovaginal specimens for high-risk HPV testing to women who did not attend regular screening is a feasible and effective method of increasing coverage in a screening program," the authors concluded. "The response rate and the yield of high-grade lesions support implementation of this method for such women."
The report, "HPV Testing on Self-Collected Cervicovaginal Lavage Specimens as Screening Method for Women Who Do Not Attend Cervical Screening: Cohort Study," was published in the British Medical Journal (2010;340:c1040).
   LOCAL AND COMMUNITY NEWS ILLINOIS: 'Sexpert' Lauds Benefits of Updated Female Condom Chicago Tribune (03.15.10) - Wednesday, March 17, 2010 Last week, a coalition of organizations including Chicago Women's AIDS Project (CWAP) and AIDS Foundation of Chicago launched "Put a Ring On It," a campaign aimed at boosting awareness of the new female condom.
The Food and Drug Administration approved FC2, the second-generation female condom, in March 2009. FC2 uses a softer material than the original female condom, which came out 15 years ago, allowing it to feel more natural and cost less. Zoe Lehman, support services coordinator at CWAP and a self-described "sexpert," said a main reason the first female condom was not successful was that women did not know how to use it. FC2 has instructions on the package, unlike the old one, which had a large, unwieldy user guide packaged inside.
FC2 can be inserted up to 45 minutes before sex. It has a solid inner ring that sits around the cervix and anchors the condom behind the pubic bone, and an outer ring that "blossoms outside the vagina," Lehman said.
A key element of the campaign is peer-to-peer training. "One of the most exciting things about this campaign is that we, along with groups such as the Illinois Caucus on Adolescent Health, have spent the last two years training over a thousand people in the Chicago area who will train others on how to use it," said Lehman.
"We've been letting everyone know how easy [the female condom] is to use," said Lehman. "It's just as effective as the male condom, really pleasurable and empowers a woman because she doesn't have to request that the male partner wears the condom."
FC2 is not yet widely available in drug stores but can be picked up at Chicago Public Health Department clinics across the city. For more information, visit www.ringonit.org.
ARIZONA: HIV Clinic Augments Cardiology Practice

Angelique Soenarie

Arizona Republic (Phoenix) (03.06.10) - Wednesday, March 17, 2010 Low-income HIV patients in the Southeast Valley can now access primary care services at the Advanced Cardiac Specialists (ACS) clinic at Greenfield and Baseline roads. The practice recently became a care provider through the federal Ryan White HIV/AIDS program, which gives grants to community-based health care organizations.
The new clinic will serve east Mesa, Apache Junction, Queen Creek, Gold Canyon, and Florence. Mark Kezios, chair of the Ryan White council for Maricopa County, said an additional clinic was needed since the county is geographically one of the largest in the nation.
About 80 patients living in rural areas of Maricopa and Pinal counties drive up to three hours to Phoenix for care, said Kezios - too far for patients requiring frequent treatment.
ACS applied for the grant since several of its staff are HIV treatment experts, Kezios noted. "It's just wonderful that we have a provider that is experienced in treating HIV. So opening up in the East Valley is making the quality for people's lives much easier," he said.
The Ryan White program serves 836 HIV patients in Maricopa County, with the per-patient annual cost averaging $2,343. Sun Life Family Health Center in Casa Grande has also joined the program as a network provider.
   NEWS BRIEFS UNITED STATES: Former Surgeon General Koop Honored for AIDS Work Associated Press (03.17.10) - Wednesday, March 17, 2010 Dr. C. Everett Koop on Wednesday will receive the 2010 Ryan White Distinguished Leadership Award from Indiana University's Rural Center for AIDS/STD Prevention. Jeanne White Ginder, whose son Ryan's battle with HIV made him a national symbol in the fight against AIDS, will present the award to Koop at Dartmouth Medical School in Hanover, N.H. While serving as US surgeon general in the 1980s, Koop took important steps to fight the epidemic, including commissioning a special report and mailing a brochure about AIDS to every US household.
GEORGIA: Nearly 360 Students, Staff to Get TB Test Friday in Gwinnett School

D. Aileen Dodd

Atlanta Journal-Constitution (03.16.10) - Wednesday, March 17, 2010 On Friday at Lilburn Middle School, the Gwinnett County health department will offer TB testing to 313 students and 45 staff members in response to two students testing positive for the disease. This, the second round of testing at the school, is seen as a precaution. Previous testing in February found a student who tested positive and was treated. A second student also tested positive, though non-infectious. "There is no way of telling whether or not they are related," Suleima Salgado, spokesperson for the East Metro Health District, said of the cases. "Since this is the second case at this school at that grade level, we are erring on the side of caution and we are going to test the remaining sixth-graders who weren't tested in the first round." A letter sent Monday from Principal Gene Taylor asked the students' parents to give their consent for the testing. For more information, visit www.eastmetrohealth.com.
CANADA: Blood Tests Urged for Tattoo Clients

Paul Forsyth

Niagara This Week (Thorold, Ontario) (03.12.10) - Wednesday, March 17, 2010 Niagara Region Public Health is urging anyone who underwent tattooing or piercing at Needlez Tattoo, located at 16 Thorold Rd. East, Welland, to contact the department. The establishment, which opened in December, was ordered closed on March 5 after inspectors, responding to a complaint, found it to have improperly sterilized equipment. There is currently no evidence of infectious disease transmission as a result, said Dave Carey, a manager of environmental health for NRPH; however, the operator was unable to provide a complete, detailed client list. Anyone who received a tattoo or piercing at Needlez should visit a doctor or clinic to be tested for HIV and hepatitis B and C, said Dr. Robin Williams, NRPH's chief medical officer of health. The department also advises clients of the shop to exercise caution until they are tested to avoid possible transmission to others. For more information, telephone 888-505-6074, 905-688-8248 ext. 7330, or after hours 905-984-3690.

Copyright © 2010 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.

Kenya: The downside of door-to-door testing

Integrated Regional Information Networks - March 17, 2010

http://www.aegis.org/news/irin/2010/IR100317.html

TESO, 17 March 2010 (PlusNews) - While the public response to Kenya's national HIV testing drive has been enormous, many women are not keen to be tested, knowing that a positive result could mean the breakdown of their marriages, loss of home and more.

Isabella Omoto, who lives in western Kenya's Teso district, was recently forced by her husband of seven years to go for an HIV test; the result was positive.

"I revealed it to my husband and he just started beating me; he said I had been sleeping with other men," she told IRIN/PlusNews at her mother's home, where she now lives. "He threw my things out and told me to go back to my mother with all our children.

"He won't take me back because to him I am a prostitute," she added. "Today he has another wife and he has inherited another - I don't want to interfere with them."

According to Teso District AIDS and sexually transmitted diseases coordinator Nelson Andanje, men in the area - too afraid to go for HIV tests themselves - have been forcing their wives to get tested, believing their status will reflect their own.

"Here, like in many areas, it is women who come for HIV tests and you will see very few men," he said. "The man believes that if his wife is positive or negative then the same results apply to him."

Rights issues

In December 2009, Human Rights Watch warned of the possibility of human rights violations during the mass testing drive.

"It a gross violation of a woman's human rights to force her to go for HIV tests and then use the same tests to decide whether she should continue to live with you or not when, ridiculously, you don't even know your own status," Andanje said.

Statistics from the district AIDS coordinator's office show that over the past year, 10,838 women were tested; only 183 were accompanied by their husbands. According to the Kenya AIDS Indicator Survey, an estimated 45 percent of women have been tested for HIV, against just 25 percent of men.

"The high number of women who test more than men could be attributed to antenatal testing, but even in this you never see their husbands accompanying them, which should ideally be the case," he noted.

Teso district's HIV prevalence is 24 percent; health authorities have identified high levels of polygamy and wife inheritance, aided by strong cultural beliefs, as some of the key drivers of HIV transmission.

"Strong cultural beliefs make men believe it is beneath them to go for voluntary counselling and testing and women are solely responsible for HIV transmission," Andanje said.

Discordance

"Many people still do not know about discordance," he added.

An estimated 6 percent of Kenyan couples - about 344,000 - are HIV discordant, while just 22 percent of couples know the HIV status of their sexual partners.

According to the Kenya National Strategic Plan for HIV/AIDS, "social norms regarding relationships, gender roles/imbalances, stigma and discrimination, fear and risk-perception, and fertility intentions present difficult prevention challenges".

Andanje says the district authorities are trying to sensitise the community about discordance and to encourage women to speak out if they are being forced to take a test.

"We are using the local administration to reach out to men and let them know the benefits of individually going for an HIV test; we want them to know that they may be in a discordant union," he said. "When a woman comes alone or a man comes alone, it is difficult to know whether they are in a discordant union and you can't therefore give them services adequately.

"Men must be made to know that there is nothing feminine or masculine in testing for HIV. It is purely a health issue," he added.

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Copyright © 2010 - Integrated Regional Information Networks (IRIN). Reproduction of this article (other than one copy for personal reference) must be cleared through the Integrated Regional Information Network. .

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2010. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2010. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.