Texas judge OKs ban on Planned Parenthood funding

AUSTIN, Texas (AP) - Texas can cut off funding to Planned Parenthood's family planning programs for poor women, a state judge ruled Monday, requiring thousands to find new state-approved doctors for their annual exams, cancer screenings and birth control.

Judge Gary Harger said that Texas may exclude otherwise qualified doctors and clinics from receiving state funding if they advocate for abortion rights.

Texas has long banned the use of state funds for abortion, but had continued to reimburse Planned Parenthood clinics for providing basic health care to poor women through the state's Women's Health Program. The program provides preventive care to 110,000 poor women a year, and Planned Parenthood clinics were treating 48,000 of them.

Planned Parenthood's lawsuit to stop the rule will still go forward, but the judge decided Monday that the ban may go into effect for now. In seeking a temporary restraining order, Planned Parenthood wanted its patients to be able to see their current doctors until a final decision was made.

'We are pleased the court rejected Planned Parenthood's latest attempt to skirt state law,' attorney general spokeswoman Lauren Bean said. 'The Texas Attorney General's office will continue to defend the Texas Legislature's decision to prohibit abortion providers and their affiliates from receiving taxpayer dollars through the Women's Health Program.'

Ken Lambrecht, president and CEO of Planned Parenthood of Greater Texas, said he brought the lawsuit on behalf of poor women who depend on its clinics.

'It is shocking that once again Texas officials are letting politics jeopardize health care access for women,' Lambrecht said. 'Our doors remain open today and always to Texas women in need. We only wish Texas politicians shared this commitment to Texas women, their health, and their well-being.'

Planned Parenthood has brought three lawsuits over Texas' so-called 'affiliate rule,' claiming it violates the constitutional rights of doctors and patients while also contradicting existing state law.

Republican lawmakers who passed the affiliate rule last year have argued that Texas is an anti-abortion state, and therefore should cut off funds to groups that support abortion rights. Gov. Rick Perry, who vehemently opposes abortion, has pledged to do everything legally possible to shut down Planned Parenthood in Texas and welcomed the court's ruling.

'Today's ruling finally clears the way for thousands of low-income Texas women to access much-needed care, while at the same time respecting the values and laws of our state,' Perry said. 'I applaud all those who stand ready to help these women live healthy lives without sending taxpayer money to abortion providers and their affiliates.'

The Texas Health and Human Services Commission has spent the last nine months preparing to implement the affiliate rule. But federal officials warned it violated the Social Security Act and cut off federal funds for the Women's Health Program, prompting the commission to start a new program using only state money.

State officials have also scrambled to sign up new doctors and clinics to replace Planned Parenthood. Women who previously went to Planned Parenthood clinics will now have to use the agency's web site to find a new state-approved doctor. HHSC officials acknowledged Monday they are unsure whether the new doctors can pick up Planned Parenthood's caseload in all parts of the state.

Any capacity issues will become clear in the next few weeks as women try to make appointments with new clinics and doctors, with problems anticipated in South Texas and other impoverished areas. Texas already suffers from a shortage of primary care physicians willing to take on new patients who rely on state-funded health care.

Linda Edwards Gockel, a spokesman for the Texas Health and Human Services Commission, said Monday that the new state program will launch as planned on Tuesday.

'We have more than 3,500 doctors, clinics and other providers in the program and will be able to continue to provide women with family planning services while fully complying with state law,' she said. 'We welcome Planned Parenthood's help in referring patients to providers in the new program.'

Democratic lawmakers continued to question whether women will have to wait longer for appointments and services.

'I vehemently disagree with the state's efforts to blacklist a qualified provider and, thereby, interfere with a woman's right to choose her own provider,' said state Rep. Donna Howard, D-Austin. 'I will be submitting a letter to the Texas Health and Human Services Commission, requesting a list of approved providers to gauge the outreach of the new program, and ensure that all qualified women throughout the state have access to its services.'

Another hearing is scheduled with a different judge for Jan. 11, where Planned Parenthood will again ask for an injunction to receive state funding.



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FDA approves Salix's diarrhea drug for HIV/AIDS patients

(Reuters) - U.S. health regulators approved Salix Pharmaceuticals Ltd's drug to treat diarrhea in HIV/AIDS patients on antiretroviral therapy, a combination of medicines used to treat HIV infection.

Diarrhea is a common reason why HIV/AIDS patients discontinue or switch their antiretroviral therapies.

The drug, called Fulyzaq, is intended to be used in HIV/AIDS patients whose diarrhea is not caused by an infection from a virus, bacteria, or parasite.

Until now, there have been no therapies for HIV-associated diarrhea approved by the U.S. Food and Drug Administration.

(Reporting By Debra Sherman; Editing by David Gregorio)



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Employer wins relief from U.S. contraceptives mandate

(Reuters) - A divided federal appeals court has temporarily barred the U.S. government from requiring an Illinois company to obtain insurance coverage for contraceptives, as required under the 2010 healthcare overhaul, after the owners objected on religious grounds.

More than 40 lawsuits are challenging a requirement in the Patient Protection and Affordable Care Act that requires most for-profit companies to offer workers insurance coverage for contraceptive drugs and devices and other birth control methods.

Friday's 2-1 order by a panel of the 7th U.S. Circuit Court of Appeals in Chicago in favor of Cyril and Jane Korte was the first by a federal appeals court to temporarily halt enforcement against people who said it violated their faith, said Edward White, a lawyer for the Roman Catholic couple.

It came two days after U.S. Supreme Court Justice Sonia Sotomayor declined to block the provision's enforcement against companies controlled by the family of Oklahoma City billionaire David Green.

The U.S. Department of Justice, which had defended the contraceptives provision, did not immediately respond on Saturday to a request for comment.

The Kortes, who own the construction firm Korte & Luitjohan Contractors, had sought to drop a health insurance plan for 20 non-unionized workers that included coverage for contraception, and substitute a different plan consistent with their faith.

But the Obama administration's healthcare law did not allow the change, and the Kortes said that violated the First Amendment to the U.S. Constitution and the federal Religious Freedom Restoration Act, or RFRA.

In issuing an injunction, the 7th Circuit majority said the Kortes had established a reasonable likelihood of success on the merits of their RFRA claim, and that the government had not yet justified the apparent 'substantial burden' on their religious exercise.

The court also said the couple had established irreparable harm, because absent an injunction they would have to choose between maintaining insurance coverage they considered inappropriate or facing substantial financial penalties.

'Business owners who are objecting to the mandate are not objecting to people using contraceptives, but that they have to arrange for and pay for it,' White, a lawyer with the American Center for Law and Justice, said in a phone interview. 'The federal government shouldn't tell business owners they have to contract to buy what they see as immoral services and goods.'

Judges Joel Flaum and Diane Sykes comprised the 7th Circuit majority.

Judge Ilana Rovner dissented. She said the Kortes were 'multiple steps' removed from the contraceptives services because it was their company paying for the coverage, and because it would be a worker, her doctor and the insurer involved in the decisions about the services and their funding.

The Kortes' case is expected to continue in the 7th Circuit.

Neither the 7th Circuit nor Sotomayor ruled on the merits of their respective cases. The legal standard for obtaining an injunction from the Supreme Court is much higher.

The case is Korte et al v. Sebelius, 7th U.S. Circuit Court of Appeals, No. 12-3841.

(Reporting by Jonathan Stempel in New York; Editing by Peter Cooney)



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Poor reading skills tied to risk of teen pregnancy

NEW YORK (Reuters Health) - Seventh grade girls who have trouble reading are more likely to get pregnant in high school than average or above-average readers, according to a new study from Philadelphia.

Researchers found that pattern stuck even after they took into account the girls' race and poverty in their neighborhoods - both of which are tied to teen pregnancy rates.

'We certainly know that social disadvantages definitely play a part in teen pregnancy risk, and certainly poor educational achievement is one of those factors,' said Dr. Krishna Upadhya, a reproductive health and teen pregnancy researcher from Johns Hopkins Children's Center in Baltimore.

Poor academic skills may play into how teens see their future economic opportunities and influence the risks they take - even if those aren't conscious decisions, explained Upadhya, who wasn't involved in the new research.

Dr. Ian Bennett from the University of Pennsylvania and his colleagues looked up standardized test reading scores for 12,339 seventh grade girls from 92 different Philadelphia public schools and tracked them over the next six years.

During that period, 1,616 of the teenagers had a baby, including 201 that gave birth two or three times.

Hispanic and African American girls were more likely than white girls to get pregnant. But education appeared to play a role, as well.

Among girls who scored below average on their reading tests, 21 percent went on to have a baby as a teenager. That compared to 12 percent who had average scores and five percent of girls who scored above average on the standardized tests.

Once race and poverty were taken into consideration, girls with below-average reading skills were two and a half times more likely to have a baby than average-scoring girls, according to findings published in the journal Contraception.

Birth rates among girls ages 15 through 19 were at a record low in the U.S. in 2011 at 31 births for every 1,000 girls, according to the Centers for Disease Control and Prevention. But that rate is still much higher in minority and poorer girls than in white, well-off ones, researchers noted.

And in general, it's significantly higher than teen birth rates in other wealthy nations.

Teen pregnancies are a concern because young moms and their babies have more health problems and pregnancy-related complications, and girls who get pregnant are at higher risk of dropping out of school.

Upadhya said the answer to preventing teen pregnancy in less-educated girls isn't simply to add more sex ed to the curriculum.

'This is really about adolescent health and development more broadly, so it's really important for us to make sure that kids are in schools and in quality educational programs and that they have opportunities to grow and develop academically and vocationally,' she told Reuters Health.

'That is just as important in preventing teen pregnancy as making sure they know where to get condoms.'

SOURCE: http://bit.ly/TcHB0s Contraception, online December 13, 2012.



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Condom Dispensers in Philly Schools

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Federal judge blocks Missouri law to deny birth control coverage

(Reuters) - A federal judge on Friday blocked a new Missouri law that requires health insurers to offer plans that exclude contraception coverage if employers or individuals object to birth control on moral or religious grounds.

U.S. District Judge Audrey Fleissig granted a temporary restraining order preventing the enforcement of the law, writing that it appears to conflict with the new federal health care law.

Republican lawmakers in Missouri drafted the law in response to President Barack Obama's policy of requiring insurers to cover birth control for free as part of the new federal health care law, even if they work for a church or other employer that has a moral objection.

State lawmakers in September overrode a veto by Democratic Governor Jay Nixon to enact the law.

The Missouri Insurance Coalition, a nonprofit whose members include health insurers that do business in the state, asked the judge to block the state law, arguing that it conflicts with federal law and is therefore invalid.

Fleissig wrote that the coalition is likely to succeed on that claim 'given what appears to be an irreconcilable conflict' between the federal and state laws.

At a hearing, the judge wrote, the Missouri Department of Insurance 'could offer no response to how there would not be a direct conflict' between the federal and state laws if an insurer offered a health insurance plan 'that acquiesced to an employer's decision not to offer contraceptive coverage.'

She is expected to schedule a hearing on a preliminary injunction.

(Reporting By Corrie MacLaggan; editing by Todd Eastham)



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Judge stops Ala. policy of segregating HIV inmates

MONTGOMERY, Ala. (AP) - A judge struck down Alabama's decades-old policy of segregating prison inmates with HIV, ruling Friday that it violates federal disabilities law.

U.S. District Judge Myron Thompson ruled in favor of inmates who sued to end the longstanding practice and said he would give the state and inmate attorneys time to propose a way to bring state prisons into compliance with his order.

The American Civil Liberties Union, which filed the lawsuit on behalf of seven HIV-positive inmates, called the decision 'historic.'

Prisons Commissioner Kim Thomas issued a statement saying corrections officials were still studying the ruling and had not decided 'our next course of action.

But he said the department 'is very disappointed with the conclusions and characterizations reached by the Court.'

'The men and women of the ADOC are not prejudiced against HIV-positive inmates, and have worked hard over the years to improve their health care, living conditions, and their activities,' Thomas said. 'The ADOC remains committed to providing appropriate housing for all of its inmates, including the HIV-positive population, ensuring that these inmates receive a constitutional level of medical care and that the correctional system in Alabama does not further contribute to the current HIV epidemic in our State.'

Alabama and South Carolina are the only states that segregate HIV-positive prisoners. The class-action lawsuit accused the state of violating the Americans with Disabilities Act.

'It spells an end to a segregation policy that has inflicted needless misery on Alabama prisoners with HIV and their families,' said ACLU attorney Margaret Winter, who was lead counsel for the plaintiffs during a monthlong trial.

Neither the lawsuit or the judge's ruling mentions South Carolina, but Winter said she hoped it helped end that state's practice.

'A judge considering a similar case in South Carolina would almost certainly give this ruling significant weight, but would not be required to follow it. We hope this opinion will influence South Carolina to abandon its policy,' Winter said.

In his opinion, the judge recounted the history of the AIDS scare in the 1980s and noted the extreme rarity of HIV being transmitted by any means other than the sharing of bodily fluids, particularly during unprotected sex between males or between a man and a woman.

'It is not transmitted through casual contact or through the food supply,' he wrote. 'A person would have to drink a 55-gallon drum of saliva in order for it to potentially result in a transmission. There is no documented case of HIV being sexually transmitted between women.'

The prison system had asked Thompson to dismiss the plaintiff's claims, saying the issue had been decided in an earlier lawsuit. But Thompson wrote that circumstances have changed since that ruling and HIV 'is no longer inevitably fatal.'

Alabama's policy resulted from a 'panic' over AIDS in prisons, Thompson wrote. While other states have ended similar practices, Alabama hasn't because of 'outdated and unsupported assumptions about HIV and the prison system's ability to deal with HIV-positive prisoners.'

Bias from agency leaders is at the heart of the plan to segregate infected inmates, the judge said. He still must decide a part of the suit involving work-release inmates.

___

Associated Press Writer Jay Reeves in Birmingham contributed to this report.



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Judge orders end to HIV prison segregation in Alabama

BIRMINGHAM, Alabama (Reuters) - A U.S. federal judge ruled on Friday to end the segregation of prisoners with HIV in Alabama, agreeing that it violates the Americans with Disabilities Act (ADA).

'It is evident that, while the ... segregation policy has been an unnecessary tool for preventing the transmission of HIV, it has been an effective one for humiliating and isolating prisoners living with the disease,' U. S. District Judge Myron Thompson wrote in his ruling.

South Carolina now remains the only state segregating HIV inmates from the general population. Mississippi ceased a similar practice in March 2010.

The ruling came in response to a lawsuit by the American Civil Liberties Union (ACLU) over what the group contended was a discriminatory practice that prevented most HIV-positive inmates from participating in rehabilitation and retraining programs, including mental health and substance abuse programs, important for their success after prison.

'We won on all counts. It is a total victory and a glorious day for everyone with HIV,' said Margaret Winter, associate director of the ACLU National Prison Project and lead counsel for the plaintiffs.

Proponents of ending the policy sited an out-dated view of HIV/AIDS, which has become increasingly controllable. In the case of a virus transmitted by behavior, and not environment, preventing its spread is easier through proper medical treatment, rather than radical segregation of HIV positive inmates, according to Nancy Mahon, who chairs the Presidential Advisory Council on HIV/AIDS (PACHA).

'We now have ability to suppress the virus and reduce the possibility of transmission to four percent. Alabama and South Carolina have been in the dark ages about this public health sorrow,' said Mahon, who also directs the MAC AIDS Fund, which is financing the ACLU challenges in both states.

'The last thing we want to do is send them back into the community without treatment,' she added.

Two of Alabama's 29 prisons have dormitories specifically housing prisoners with HIV. A handful of prisoners had been allowed to live and work in non-segregated settings in work-release programs, Winter said.

Currently, the inmates with HIV live, eat and exercise apart from the general population, according to court documents filed by the ACLU. Male inmates in the HIV dormitories were given white armbands that signal their medical status.

'First, we are isolated ... like we are contagious animals,' Dana Harley, another prisoner who was a plaintiff in the case, said in a letter included in the court file. 'It is like punishment three times over.'

Approximately 270 inmates out of the 26,400 in the state prison system have tested positive for the virus and none have developed AIDS, according to Alabama Department of Corrections spokesman Brian Corbett, who did not respond to inquiries about the ruling.

The judge plans to rule separately on the medical criteria for work release for HIV prisoners, according to his ruling.

(Editing by David Adams and Andrew Hay)



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Judge blocks Ala policy of segregating HIV inmates

MONTGOMERY, Ala. (AP) - A judge struck down Alabama's decades-old policy of segregating prison inmates with HIV, ruling Friday that it violates federal law.

U.S. District Judge Myron Thompson ruled in favor of inmates who filed suit to end the longstanding practice. Thompson says the state's policy violates federal disabilities law.

Thompson said the state and inmate attorneys will have time to propose a way to bring state prisons into compliance with his order.

The American Civil Liberties Union, which filed the lawsuit on behalf of seven HIV-positive inmates, called the decision 'historic.' State officials did not immediately respond to requests for comment.

Alabama and South Carolina are the only states that segregate HIV-positive prisoners. The class-action lawsuit accused the state of violating the Americans with Disabilities Act.

ACLU attorney Margaret Winter, who was lead counsel for the plaintiffs during a month-long trial, called the decision historic.

'It spells an end to a segregation policy that has inflicted needless misery on Alabama prisoners with HIV and their families,' Winter said.

In his 153-page opinion, Thompson recounted the history of the AIDS scare in the 1980s and noted the extreme rarity of HIV being transmitted by any means other than the sharing of bodily fluids, particularly during unprotected sex between males or between a man and a woman.

'It is not transmitted through casual contact or through the food supply,' he wrote. 'A person would have to drink a 55-gallon drum of saliva in order for it to potentially result in a transmission. There is no documented case of HIV being sexually transmitted between women.'

Alabama's policy resulted from a 'panic' over AIDS in prisons, Thompson wrote. While other states have ended similar practices, he said, Alabama hasn't because of 'outdated and unsupported assumptions about HIV and the prison system's ability to deal with HIV-positive prisoners.'

Bias from agency leaders is at the heart of the plan to segregate infected inmates, Thomas said.

Olivia Turner, executive director of the ACLU of Alabama, said Thompson's ruling will end a policy 'that treated human beings like cattle to be tagged and herded. 'She called the ruling 'a tremendous victory for human rights.'

Thompson says he still must decide a part of the suit involving work-release inmates.

____

Associated Press correspondent Jay Reeves contributed to this report.



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Hobby Lobby Request to Block Health Law Denied

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On The Fly: Pre-market Movers

HIGHER AFTER EARNINGS: Red Hat (RHT), up 5.4%... Nike (NKE), up 3%... ALSO HIGHER: Chembio Diagnostics (CEMI), up 20.7% after receiving FDA approval for its rapid HIV test... Halozyme (HALO), up 17.4% after entering a development collaboration with Pfizer (PFE)... Ameristar Casinos (ASCA), up 17% after agreeing to be acquired by Pinnacle Entertainment (PNK) for $26.50 per share... LOWER AFTER EARNINGS: Research in Motion (RIMM), down 16.3%... Walgreen (WAG), down 1.7%... ALSO LOWER: Transcept (TSPT), down 14.7% after Phase 2 trial of OCD drug misses primary endpoint.



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Alliance Health Networks Brings Prominent HCV Clinical Trials Leader, Dr. Peter Ruane, to Hepatitis Connect Social Network

SALT LAKE CITY--(BUSINESS WIRE)--

Alliance Health Networks, the leading social networking company serving consumers and the healthcare industry, today announced the addition of Dr. Peter Ruane, prominent HIV and HCV clinical trials doctor and founder of Lightsource Medical, as a new community advocate on the Hepatitis Connect social network.

Hepatitis Connect is part of Alliance Health's growing portfolio of social networks currently serving more than 1.5 million registered users across some 50 condition-specific sites. Hepatitis Connect aims to empower people infected with HCV to more actively manage their health through personal connections, powerful tools, and quality resources. Community and patient advocates offer network members deep insights and experience dealing with a particular disease or condition.

"From the beginning, our top priority at Alliance Health has been to create an online community that provides actionable information with a personal touch, and one of the ways we accomplish that is through our patient advocates," said Dan Hickey, senior vice president of product at Alliance Health Networks. "What is so fascinating in the case of Dr. Ruane is that he was a physician in the clinical trial that led to a successful outcome for John Lavitt, our patient advocate at Hepatitis Connect. It adds a new dimension by demonstrating that a clinical trial can have a meaningful impact on a person's life today, not just down the road."

A specialist in infectious diseases and HIV medicine, Dr. Ruane has been conducting clinical trials for HIV since 1992, many of which have shifted to new HCV drugs and HCV-HIV trials to find co-existing regimens to simultaneously treat both conditions.

Deaths from Hepatitis C have increased steadily in the United States in recent years, in part because many people don't know they're infected. In fact, according to 1999 to 2007 data reviewed by the Centers for Disease Control and Prevention, more Americans have died from HCV than from HIV. Unlike HIV, Hepatitis C is curable. With rapidly advancing results coming from research and clinical trials with new drugs that target the virus directly, there is great hope.

"Patients are already gaining considerable benefits from the new regimens of protease inhibitors that were approved in 2011 by the FDA," said Dr. Ruane. "But these drugs are just the beginning. On Hepatitis Connect, I hope to keep the community up-to-date on the new options, especially clinical trials as they become available and offer my thoughts on trials in general and why participating in a clinical trial may be a good choice for a person to make."

As Patient Advocate for Hepatitis Connect, John Lavitt is proud to have Dr. Ruane on board as part of the community's team. "When I went through the clinical trial with Dr. Ruane," explained Lavitt, "his support and expertise helped me survive the difficult challenges and come out the other side of a tough experience that changed my life forever and for the better."

About Alliance Health Networks

Alliance Health Networks is building a free and independent social engagement platform that gives people the power to navigate their personal health journey. The company owns and operates more than 50 social networks and 20 mobile versions serving over 1.5 million registered members. Alliance Health leverages social networks to help consumers more actively manage their care through personal connections, powerful tools, and deeper insights. The company's investors include New World Ventures, Physic Ventures, Highway 12 Ventures, EPIC Ventures and Voyager Capital. For more information, visit: www.alliancehealthnetworks.com.





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Research and Markets: Sexual Health Partnering Terms and Agreements

DUBLIN--(BUSINESS WIRE)--

Research and Markets (http://www.researchandmarkets.com/research/v5b7pw/sexual_health) has announced the addition of the 'Sexual Health Partnering Terms and Agreements' company profile to their offering.

The Sexual Health Partnering Terms and Agreements report provides comprehensive understanding and unprecedented access to the sexual health partnering deals and agreements entered into by the worlds leading healthcare companies.

The report provides a detailed understanding and analysis of how and why companies enter sexual health partnering deals. The majority of deals are discovery or development stage whereby the licensee obtains a right or an option right to license the licensors sexual health technology. These deals tend to be multicomponent, starting with collaborative R&D, and commercialization of outcomes.

Understanding the flexibility of a prospective partner's negotiated deals terms provides critical insight into the negotiation process in terms of what you can expect to achieve during the negotiation of terms. Whilst many smaller companies will be seeking details of the payments clauses, the devil is in the detail in terms of how payments are triggered - contract documents provide this insight where press releases do not.

This report contains over 500 links to online copies of actual sexual health deals and contract documents as submitted to the Securities Exchange Commission by companies and their partners. Contract documents provide the answers to numerous questions about a prospective partner's flexibility on a wide range of important issues, many of which will have a significant impact on each party's ability to derive value from the deal.

In addition, a comprehensive appendix is provided with each report of all sexual health partnering deals signed and announced since 2007. The appendices are organized by company A-Z, stage of development at signing, deal type (collaborative R&D, co-promotion, licensing etc) and technology type. Each deal title links via Weblink to an online version of the deal record and where available, the contract document, providing easy access to each contract document on demand.

The report also includes numerous tables and figures that illustrate the trends and activities in sexual health partnering and dealmaking since 2007.

In conclusion, this report provides everything a prospective dealmaker needs to know about partnering in the research, development and commercialization of sexual health technologies and products.

Company profiles:

- Abbott

- Bayer

- GlaxoSmithKline

- Menarini

- Merck & Co

- Mylan

- Pfizer

- Roche

- Teva

- Valeant

- Warner Chilcott

- Watson

For more information visit http://www.researchandmarkets.com/research/v5b7pw/sexual_health





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HIV cases decline for black women, increase for gay men: CDC

ATLANTA (Reuters) - Fewer black women in the United States are being infected with HIV, but the number of young gay and bisexual men infected is rising, the Centers for Disease Control and Prevention said on Wednesday.

Between 2008 and 2010, the number of newly infected black women dropped 21 percent, according to the CDC report. Yet despite the decline, they still accounted for 70 percent of all new HIV cases among women, the federal health agency said.

The rate of new infections for black women was 20 times higher than the rate for white women, the CDC said.

The number of new infections among young gay and bisexual men increased by 22 percent during that same two-year period, the CDC said.

The number of new HIV infections diagnosed annually in the overall U.S. population remained unchanged between 2008 and 2010 at about 47,500, according to health officials.

Public information campaigns on HIV prevention and testing seem to be working in lowering the number of new infections among African-American women, said Joseph Prejean, chief of the Behavioral and Clinical Surveillance Branch in the CDC's division of HIV/AIDS Prevention in Atlanta.

'We are encouraged to see some declines among African-American women,' Prejean told Reuters. 'They've been one of the most severely affected populations. We're cautiously optimistic that this could be part of a longer-term trend.'

Among young gay and bisexual men, efforts to fight HIV have not been as effective, possibly because of advances in treatment for AIDS, the immune disorder caused by HIV, Prejean said.

'We do realize that many men who have sex with men do probably underestimate their personal risk and believe that treatment advances minimize the health threat,' Prejean said.

Even though treatment can prolong the life of an AIDS patient, Prejean cautioned that 'their life really does change. They then begin to take medication and will take medication for the rest of their lives,' he said.

HIV is an incurable infection that costs $400,000 to treat over a lifetime, CDC Director Dr. Thomas Frieden said last month after another government report showed more than half of young Americans infected with HIV were not aware they had it.

Young people ages 13 to 24 account for 26 percent of all new HIV infections in the United States, the earlier CDC report said.

The report released on Wednesday said nearly two-thirds of new HIV infections in 2010 resulted from men having sex with other men. Young black men who have sex with men account for more new infections than any other subgroup, government health officials said.

'Because gay men account for 66 percent of all new infections, we must increase the focus of our prevention programs for gay men, particularly young and black gay men,' said Michael Ruppal, executive director of The AIDS Institute.

(Editing by Colleen Jenkins and Dan Grebler)



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Nation's First Sex-Ed Standardized Testing Shows Students' Gaps

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Germany passes law to protect circumcision after outcry

BERLIN (Reuters) - German politicians passed a law on Wednesday to protect the right to circumcise infant boys in a show of support for Muslims and Jews angered by a local court ban on the practice in May.

The ban - imposed on the grounds that circumcision amounted to 'bodily harm' - triggered an emotional debate over the treatment of Jews and other religious minorities, a sensitive subject in a country still haunted by its Nazi past.

The outcry prompted Germany's centre-right government and opposition parties to draw up legislation confirming the practice was legal - overruling the decision by a court in the western city of Cologne.

The new law passed by an overwhelming majority in Bundestag lower house said the operation could be carried out, as long as parents were informed about the risks.

Jewish groups welcomed the move.

'This vote and the strong commitment shown ... to protect this most integral practice of the Jewish religion is a strong message to our community for the continuation and flourishing of Jewish life in Germany,' said Moshe Kantor, President of the European Jewish Congress.

Germany's Catholic Bishops Conference said it hoped the bill would help safeguard religious freedoms. No comment was immediately available from the country's Central Council of Muslims.

PAIN MINIMISED

The May ruling centered on the case of a Muslim boy who bled after the procedure and the ban only applied to the area around Cologne.

But some doctors in other parts of Germany started refusing to carry out circumcisions, saying it was unclear whether they would face prosecution.

Under the new law, a doctor or trained expert must conduct the operation and children must endure as little pain as possible, which means an anesthetic should be used. The procedure cannot take place if there is any doubt about the child's health.

Justice Minister Sabine Leutheusser-Schnarrenberger said no other country in the world country had made the religious circumcision of boys an offence.

'In our modern and secular state, it is not the job of the state to interfere in children's' upbringing,' she said.

Child welfare group Deutsche Kinderhilfe disagreed, saying the government had '(pushed) through the legalization of the ritual of genital circumcision ... against the advice of child right campaigners and the medical profession.'

(Reporting by Madeline Chambers; Edited by Stephen Brown and Andrew Heavens)



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Uncircumcised boys and men may face more UTIs

NEW YORK (Reuters Health) - Infections of the kidney, bladder and urethra happen in uncircumcised baby boys at ten times the rate of circumcised boys, and over a lifetime uncircumcised men are four times more likely to experience one, according to a new analysis of past research.

Urinary tract infections (UTIs) are most common in boys' first year of life, and circumcision was already known to make a difference in their risk, but how much and whether that carried through to adulthood was unclear, Australian researchers say.

They found that circumcision 'provides considerable protection and over the lifespan makes about a three- to four-fold difference by our prediction, which is quite striking in public health terms,' lead study author Brian Morris, professor of molecular medical science at the Sydney Medical School, University of Sydney, told Reuters Health.

Morris and a colleague examined 22 studies published between 1987 and 2012 that included a total of 407,902 males across the globe, a quarter of whom were uncircumcised.

Breaking down the results by age, they calculated that the likelihood of a UTI between birth and one year of age is 9.9 times higher in uncircumcised boys compared to circumcised boys. Between ages 1 and 16, uncircumcised boys are at 6.6 times higher risk, and after age 16 their risk is 3.4 times that of uncircumcised men.

Based on those findings, the researchers projected that doctors could prevent one UTI with every four circumcisions, 'which is astronomical,' Morris said.

The younger the infant, the more serious a UTI can be, the researchers note in their report, which is published in the Journal of Urology. Side effects of a UTI in infants can include kidney scarring, fever, pain and blood infections.

Health experts have mostly framed circumcision as a public health preventive measure focused on HIV and other sexually transmitted diseases.

In August, the American Academy of Pediatrics for the first time stated that the health benefits of circumcision outweigh the risks, but added that the decision to circumcise a child remains with parents.

The U.S. Centers for Disease Control and Prevention is currently evaluating the potential health impact of circumcision, according to a spokeswoman, but any recommendations that come of that will also be voluntary, she said.

The estimated health benefit Morris and his colleague found was several times larger than what was projected in two previous studies, which suggested 111 or 195 circumcisions would be needed to prevent one case of UTI in the first year of life.

One expert questioned the new findings based on the methods Morris' team used.

Zbys Fedorowicz, director of the Bahrain branch of the UK Cochrane Centre, a non-profit organization that evaluates medical studies, said that the 22-study analysis combined different types of studies and the researchers failed to assess their quality.

'It doesn't mean to say that these guys are necessarily wrong, it's just that we don't know because the methodological approach that they used isn't thorough enough, it's not transparent, it's not reproducible and it's not clear,' Fedorowicz said.

In November, Fedorowicz and colleagues published a report concluding that no existing study that examined the risk of urinary tract infections and circumcision was of high enough quality for any recommendation.

Dr. Robert Van Howe, clinical professor of pediatrics at the Michigan State University College of Human Medicine and vocal critic of circumcision, also found the new study problematic.

Van Howe said that diagnostic criteria for urinary tract infections differ between researchers and that the cost/ benefit analysis of circumcision as a preventive tool for infections doesn't add up.

At $200 each circumcision, preventing one urinary tract infection would cost $40,000, 'which you can treat with an $18 antibiotic; it's overkill,' Van Howe said.

'You would think we have long lists for dialysis in men because they're not circumcised, but it just isn't a problem, it's fear mongering,' Van Howe told Reuters Health.

A middle ground might be to let boys decide for themselves at age 14 or 16 to become circumcised, Van Howe suggested. 'You can leave this choice up to the person who has to live with the consequences,' Van Howe said.

Morris maintains that the study sends 'a really strong signal for advocacy of circumcision as a public health intervention in reducing these various - and in many cases very serious - conditions over the lifetime.'

SOURCE: http://bit.ly/TJjLqA The Journal of Urology, online, November 28, 2012.



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HPV tied to throat cancers: study

NEW YORK (Reuters Health) - A sexually transmitted infection usually thought of in connection to cervical cancer is also tied to a five times greater risk of cancer of the vocal chords or voice box, a new report suggests.

Combining the results of 55 studies from the past two decades, Chinese researchers found 28 percent of people with laryngeal cancers had cancerous tissue that tested positive for human papillomavirus (HPV).

But that rate varied widely by study, from no throat cancer patients with HPV to 79 percent with the infection.

'We're finding that HPV appears to be linked to a number of squamous cell carcinomas of the head, neck and throat,' said Dr. William Mendenhall, a radiation oncologist from the University of Florida in Gainesville who didn't participate in the analysis.

However, he told Reuters Health, 'I think the risk of HPV on laryngeal cancer is probably relatively low. Most of the patients we see currently that come in with laryngeal cancer have a strong history of cigarette smoking, also heavy drinking.'

Along with tobacco and alcohol, having a poor diet and exposure to certain chemicals can increase a person's risk of laryngeal and other head and neck cancers.

The American Cancer Society estimates 12,360 people will be diagnosed with laryngeal cancer in the United States in 2012 and that there will be 3,650 deaths from the disease.

Along with their larger review, researchers led by Dr. Xiangwei Li, from the Chinese Academy of Medical Sciences and Peking University Medical College in Beijing, analyzed 12 studies that compared cancerous and non-cancerous tissues from a total of 638 patients. They found the cancerous throat tissue had 5.4 times the odds of testing positive for HPV infection, compared to non-cancerous tissue.

The analysis was published last week in the Journal of Infectious Diseases.

Mendenhall said that of all head and neck cancers, HPV seems to play the biggest role not in laryngeal cancer, but in cancer of the tonsils and back of the tongue.

However, he added, 'the exposure is probably decades earlier. Someone who develops a base of tongue cancer when they're 50, they probably were exposed to the virus years before, in their teens or 20s.'

At least half of sexually-active people get HPV at some point in their lives, according to the Centers for Disease Control and Prevention (CDC), but the virus is usually cleared by the immune system. Only some of the 40-plus HPV strains have been tied to cancer.

Based on the current findings, it's difficult to know how many of the laryngeal cancers in the original studies were actually caused by the virus, researchers said.

But Mendenhall said extending HPV vaccination to boys and young men, as the CDC has recommended, 'will hopefully reduce at least some of these HPV-related cancers.'

(This story corrects to say 'squamous' instead of 'squalors' in paragraph 4 from story filed on Nov. 30)

SOURCE: Journal of Infectious Diseases, online November 21, 2012.



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Hormone disorder and the Pill tied to blood clots

NEW YORK (Reuters Health) - Women who have a hormone disorder called polycystic ovary syndrome (PCOS) and who take the birth control pill have twice the risk of blood clots than do other women on the Pill, according to a new study.

'For many women with PCOS, (the risks) will be small,' said Dr. Christopher McCartney, an associate professor at the University of Virginia School of Medicine in Charlottesville, who was not involved in the new work. 'For some women, they might be high enough to say we really shouldn't use the Pill, such as for women over 35 who smoke.'

The three to five percent of women in the U.S. with PCOS have a hormone imbalance, which can lead to irregular periods, extra hair growth and higher risks for being overweight and developing hypertension and diabetes.

They are often treated with oral contraceptives, many of whose labels already include warnings about blood clots. A blood clot, also called venous thromboembolism, can be deadly if it spreads to the lungs, although none of the cases of blood clots in the study were fatal.

Because women with PCOS already tend to have more heart disease risk factors, researchers wanted to see if the Pill adds any additional risk.

They used medical and pharmacy information from a large health insurance database, including 43,500 women with PCOS.

On average, over the course of a particular year, about 24 out of every 10,000 women with PCOS taking the Pill were diagnosed with a blood clot, compared to about 11 out of every 10,000 women without the disorder using the contraceptive.

'Am I particularly surprised by the findings? No,' said Dr. Shahla Nader-Eftekhari, a professor at the University of Texas Medical School at Houston, who treats women with PCOS but was not involved in the current study.

OBESITY PLAYING A ROLE?

The study, published in the Canadian Medical Association Journal, could not say for sure why women with PCOS are more likely to have a blood clot.

McCartney said he suspects that obesity has something to do with it.

At the beginning of the study in 2001 the percent of women with and without PCOS who were obese was the same - about 13 percent - but by the end of the study in 2009, 33 percent of women with PCOS and 21 percent of women without the disorder were obese.

'I really think that could be something that's contributing to the risk,' McCartney told Reuters Health.

'Weight not only contributes to the risks associated with the Pill, it also contributes to some of the symptoms of PCOS and some of the metabolic problems associated with PCOS,' he added.

McCartney pointed out that the risk of developing a blood clot, even among women with PCOS, is still considered small, and shouldn't necessarily discourage women from taking the Pill.

Steven Bird, the lead author of the study and an epidemiologist with the U.S. Food and Drug Administration, said that the importance of the findings is to raise awareness among women and their doctors that there is an increased risk for them if they take the Pill.

'Although the risk is small, prescribers should consider the increased risk for blood clots in women with PCOS who are prescribed contraceptive therapy,' Bird told Reuters Health by email.

McCartney agreed, and added that it's also a good reminder for doctors of women with PCOS to discuss the importance of maintaining a healthy weight.

SOURCE: http://bit.ly/VgvaOa Canadian Medical Association Journal, online December 3, 2012.



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Clinton Unveils PEPFAR Blueprint in Honor of World AIDS Day

U.S. Secretary of State Hillary Clinton unveiled the nation's new initiative to eradicate HIV and AIDS on Thursday. Dubbed the "President's Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation," the initiative is focused on improving both preventative measures and treatment options. Clinton presented PEPFAR during a special news conference in the Benjamin Franklin Room at the State Department.



Clinton's announcement was meant to coincide with World AIDS Day, which is Dec. 1. World AIDS Day was established in 1988 in order to shed light on the disease, its causes, and its prevention and treatment, as well as to push for comprehensive government intervention and research. The theme of this year's World AIDS Day is a continuation of last year's "Getting to Zero."



Here is some of the key information that emerged from Clinton's PEPFAR announcement.



* The State Department had announced Clinton's intention to present the plan in a press release issued on Tuesday.



* The press conference, which was streamed live by the State Department, featured opening remarks by Florence Ngobeni-Allen, who is the ambassador for the Elizabeth Glaser Pediatric AIDS Foundation, as well as remarks by Ambassador Eric P. Goosby, who is the U.S. Global AIDS Coordinator.



* Clinton reportedly had requested that the PEPFAR blueprint be drawn up after her visit to South Africa this past summer.



* As noted by The Hill, The PEPFAR Blueprint establishes several priorities in the nation's fight against AIDS, particularly mother-to-child transmission of HIV, increased access to condoms, and more HIV testing, among other factors.



* Clinton said in her remarks on Thursday that while "HIV may well be with us into the future," AIDS itself "need not be."



* She outlined what she referred to as two "broad goals" of the PEPFAR Blueprint and the nation's fight against AIDS -- to be able to fight new HIV infection rates to the point where globally more people are treated for an existing infection than are newly-diagnosed, and for the U.S. "to deliver" on its promises to continue to help lead the fight against the disease.



* Clinton also said that the nation's fight against AIDS would place more of its global focus on women and girls, as they are at a higher risk of infection due to "gender inequity and violence."



* According to the U.N. News Centre, the U.N. also has plans to mark World AIDS Day. U.N. Secretary-General Ban Ki-Moon reportedly plans to call for more focused initiatives and an ongoing global commitment "to get to zero."



Vanessa Evans is a musician and freelance writer based in Michigan, with a lifelong interest in health and nutrition issues.





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South Africa makes progress in HIV, AIDS fight

JOHANNESBURG (AP) - In the early '90s when South Africa's Themba Lethu clinic could only treat HIV/AIDS patients for opportunistic diseases, many would come in on wheelchairs and keep coming to the health center until they died.

Two decades later the clinic is the biggest anti-retroviral, or ARV, treatment center in the country and sees between 600 to 800 patients a day from all over southern Africa. Those who are brought in on wheelchairs, sometimes on the brink of death, get the crucial drugs and often become healthy and are walking within weeks.

'The ARVs are called the 'Lazarus drug' because people rise up and walk,' said Sue Roberts who has been a nurse at the clinic , run by Right to Care in Johannesburg's Helen Joseph Hospital, since it opened its doors in 1992. She said they recently treated a woman who was pushed in a wheelchair for 3 kilometers (1.8 miles) to avoid a taxi fare and who was so sick it was touch and go. Two weeks later, the woman walked to the clinic, Roberts said.

Such stories of hope and progress are readily available on World AIDS Day 2012 in sub-Saharan Africa where deaths from AIDS-related causes have declined by 32 percent from 1.8 million in 2005 to 1.2 million in 2011, according to the latest UNAIDS report.

As people around the world celebrate a reduction in the rate of HIV infections, the growth of the clinic, which was one of only a few to open its doors 20 years ago, reflects how changes in treatment and attitude toward HIV and AIDS have moved South Africa forward. The nation, which has the most people living with HIV in the world at 5.6 million, still faces stigma and high rates of infection.

'You have no idea what a beautiful time we're living in right now,' said Dr. Kay Mahomed, a doctor at the clinic who said treatment has improved drastically over the past several years.

President Jacob Zuma's government decided to give the best care, including TB screening and care at the clinic, and not to look at the cost, she said. South Africa has increased the numbers treated for HIV by 75 percent in the last two years, UNAIDS said, and new HIV infections have fallen by more than 50,000 in those two years. South Africa has also increased its domestic expenditure on AIDS to $1.6 billion, the highest by any low-and middle-income country, the group said.

Themba Lethu clinic, with funding from the government, the United States Agency for International Development and the United States President's Emergency Plan for AIDS Relief, is now among some 2,500 anti-retroviral therapy facilities in the country that treat approximately 1.9 million people.

'Now, you can't not get better. It's just one of these win-win situations. You test, you treat and you get better, end of story,' Mahomed said.

But it hasn't always been that way.

In the 1990s South Africa's problem was compounded by years of misinformation by President Thabo Mbeki, who questioned the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, who promoted a 'treatment' of beets and garlic.

Christinah Motsoahae first found out she was HIV positive in 1996, and said she felt nothing could be done about it.

'I didn't understand it at that time because I was only 24, and I said, 'What the hell is that?'' she said.

Sixteen years after her first diagnosis, she is now on anti-retroviral drugs and her life has turned around. She says the clinic has been instrumental.

'My status has changed my life, I have learned to accept people the way they are. I have learned not to be judgmental. And I have learned that it is God's purpose that I have this,' the 40-year-old said.

She works with a support group of 'positive ladies' in her hometown near Krugersdorp. She travels to the clinic as often as needed and her optimism shines through her gold eye shadow and wide smile. 'I love the way I'm living now.'

Motsoahae credits Nelson Mandela's family for inspiring her to face up to her status. The anti-apartheid icon galvanized the AIDS community in 2005 when he publicly acknowledged his son died of AIDS.

None of Motsoahae's children was born with HIV. The number of children newly infected with HIV has declined significantly. In six countries in sub-Saharan Africa - South Africa, Burundi, Kenya, Namibia, Togo and Zambia -the number of children with HIV declined by 40 to 59 percent between 2009 and 2011, the UNAIDS report said.

But the situation remains dire for those over the age of 15, who make up the 5.3 million infected in South Africa. Fear and denial lend to the high prevalence of HIV for that age group in South Africa, said the clinic's Kay Mahomed.

About 3.5 million South Africans still are not getting therapy, and many wait too long to come in to clinics or don't stay on the drugs, said Dr. Dave Spencer, who works at the clinic .

'People are still afraid of a stigma related to HIV,' he said, adding that education and communication are key to controlling the disease.

Themba Lethu clinic reaches out to the younger generation with a teen program.

Tshepo Hoato, 21, who helps run the program found out he was HIV positive after his mother died in 2000. He said he has been helped by the program in which teens meet one day a month.

'What I've seen is a lot people around our ages, some commit suicide as soon as they find out they are HIV. That's a very hard stage for them so we came up with this program to help one another,' he said. 'We tell them our stories so they can understand and progress and see that no, man, it's not the end of the world.'



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Photos: World AIDS Day 2012

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Health officials: Athens has spiraling HIV crisis

ATHENS, Greece (AP) - Athens is seeing an alarming increase in new HIV infections, particularly among intravenous drug users, health officials warned Friday, as Greece struggles through a protracted financial crisis in which funding for health care and drug treatment programs has been slashed.

While there were about 10-14 new HIV infections per year among Athens drug users from 2008 to 2010, that number shot up to 206 new cases last year and 487 new cases by October this year - a 15-fold and 35-fold increase respectively, officials said.

'There is no doubt we have a big and rapidly developing epidemic in Athens,' said Angelos Hatzakis, an epidemiology and preventive medicine professor at Athens University.

A total of 1,049 new cases of HIV infection were recorded in Greece in the first 10 months of this year, including the 487 drug users. Of the others, 256 were homosexual men, while 108 caught the virus through heterosexual intercourse, the figures showed.

'One of the reasons is the financial crisis,' said Marc Sprenger, director of the European Center for Disease Prevention and Control. 'There are more people who are vulnerable, marginalized' and who use drugs.

They turn to cheaper drugs and turn to injecting instead of smoking in order to get the same high from a smaller quantity, officials said.

'We are very concerned,' Sprenger said. 'What we see now is this increase, and if you don't really pay attention to this, it will become in the future a really huge burden.'

Greece has been hammered by a financial crisis since late 2009 that has left the country facing a sixth year of a deep recession and with a quarter of the workforce unemployed. The country relies on international rescue loans from other European countries that also use the euro and the International Monetary Fund to stay solvent.

But in return, the Greek government has imposed several rounds of spending cuts and tax hikes. Charities dealing with drug users and HIV sufferers have also struggled to find funds during the crisis.



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Ukraine fights spreading HIV epidemic

BUCHA, Ukraine (AP) - Andrei Mandrykin, an inmate at Prison No. 85 outside Kiev, has HIV. He looks ghostly and much older than his 35 years. But Mandrykin is better off than tens of thousands of his countrymen, because is he receiving treatment amid what the World Health Organization says is the worst AIDS epidemic in Europe.

Ahead of World AIDS Day on Saturday, international organizations have urged the Ukrainian government to increase funding for treatment and do more to prevent HIV from spreading from high-risk groups into the mainstream population, where it is even harder to manage and control.

An estimated 230,000 Ukrainians, or about 0.8 percent of people aged 15 to 49, are living with HIV, the virus that causes AIDS. Some 120,000 are in urgent need of anti-retroviral therapy, which can greatly prolong and improve the quality of their lives. But due to a lack of funds, fewer than a quarter are receiving the drugs - one of the lowest levels in the world.

Ukraine's AIDS epidemic is still concentrated among high-risk groups such as intravenous drug users, sex workers, homosexuals and prisoners. But nearly half of new cases registered last year were traced to unprotected heterosexual contact.

'Slowly but surely the epidemic is moving from the most-at-risk, vulnerable population to the general population,' said Nicolas Cantau of The Global Fund to Fight AIDS, Tuberculosis and Malaria, who manages work in Eastern Europe and Central Asia. 'For the moment there is not enough treatment in Ukraine.'

Stigma is also a big problem for those with HIV in Ukraine. Liliya, a 65-year-old woman who would give only her first name, recently attended a class on how to tell her 9-year-old great-granddaughter that she has HIV. The girl, who contacted HIV at birth from her drug-abusing mother, has been denied a place in preschool because of her diagnosis.

'People are like wolves, they don't understand,' said Liliya. 'If any of the parents found out, they would eat the child alive.'

While the AIDS epidemic has plateaued elsewhere in the world, it is still progressing in Eastern Europe and Central Asia, according to Cantau. Nearly 21,200 new cases were reported in Ukraine in 2011, the highest number since the former Soviet republic registered its first case in 1987, and a 3 percent increase over 2010. As a result of limited and often delayed treatment, the number of AIDS-related deaths grew 17 percent last year to about 3,800.

Two years ago, Mandrykin, the prisoner, was on the verge of becoming part of that statistic, with his level of crucial CD4 immune cells - a way to measure the strength of the immune system - dropping to 11. In a healthy person, the CD4 count is usually over 600.

'I was lying in the hospital, I was dying,' said Mandrykin, who is serving seven years for robbery, his fourth stint in jail. 'It's a scary disease.'

After two years of treatment in a small prison clinic, his CD4 count has risen to 159 and he feels much better, although he looks exhausted and is still too weak to work in the workshop of the medium-security prison.

The Ukrainian government currently focuses on testing and treating standard cases among the general population. The anti-retroviral treatment of more than 1,000 inmates, as well as some 10,000 HIV patients across Ukraine who also require treatment for tuberculosis and other complications and all prevention and support activities, are paid for by foreign donors, mainly the Global Fund.

The Global Fund is committed to spending $640 million through 2016 to fight AIDS and tuberculosis in Ukraine and then hopes to hand over most of its programs to the Ukrainian government.

Advocacy groups charge that corruption and indifference by government officials help fuel the epidemic.

During the past two years, Ukrainian authorities have seized vital AIDS drugs at the border due to technicalities, sent prosecutors to investigate AIDS support groups sponsored by the Global Fund and harassed patients on methadone substitution therapy, prompting the Global Fund to threaten to freeze its prevention grant.

Most recently, Ukraine's parliament gave initial approval to a bill that would impose jail terms of up to five years for any positive public depiction of homosexuality. Western organizations say it would make the work of AIDS prevention organizations that distribute condoms and teach safe homosexual sex illegal and further fuel the epidemic. It is unclear when the bill will come up for a final vote.

AIDS drug procurement is another headache, with Ukrainian health authorities greatly overpaying for AIDS drugs. Advocacy groups accuse health officials of embezzling funds by purchasing drugs at inflated prices and then pocketing kickbacks.

Officials deny those allegations, saying their tender procedures are transparent.

Much also remains to be done in Ukraine to educate people about AIDS.

Oksana Golubova, a 40-year-old former drug user, infected her daughter, now 8, with HIV and lost her first husband to AIDS. But she still has unprotected sex with her new husband, saying his health is in God's hands.

'Those who are afraid get infected,' Golubova said.



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Health officials tell Greece to act fast to control HIV

LONDON (Reuters) - A spiraling outbreak of HIV in debt-stricken Greece could run out of control if urgent action is not taken, European health officials said on Friday.

The European Centre for Disease Prevention and Control (ECDC) said infections with the AIDS-causing virus among drug users and other high-risk groups were rising fast, and that a failure to act would mean far higher costs in future.

ECDC director Marc Sprenger will meet Greek officials this week to say that free needles, syringes and opioid substitution projects must be stepped up, and testing and treatment for the human immunodeficiency virus made available to all.

'Immediate concerted action is needed in order to curb and eventually stop the current outbreak,' he told Reuters as the ECDC published a report on Greece's HIV problem.

Since 2009, recession in Greece has reduced economic output by a fifth and sent unemployment to a record high.

The healthcare system is under extreme pressure, making it harder for the poor, unemployed or homeless to get treatment.

While Greece has only 7.4 HIV infections per 100,000 people, compared to 10 per 100,000 in Britain or 27.3 in Estonia, rates have soared since 2011 in high-risk groups such as drug users.

From 2007 to 2010, there were only 10 to 15 cases a year of HIV infection in injecting drug users.

But during 2011, there were 256 such cases - or 27 percent of the total. Another 314 were reported between January and August 2012, most of them in the capital.

Combination drugs can give patients with HIV near-normal life expectancy, but the drugs must be taken for life, and cost 10,000 to 22,000 euros ($13,000 to $28,500) a year. Sprenger said Greece's costs were at risk of running out of control.

'If a scale-up (in prevention and testing) is not achieved, it's likely that HIV transmission among people who inject drugs in Athens will continue and even accelerate - and could eventually spread,' he said.

'The cost of prevention ... will be significantly less than the provision of treatment to those who become infected.'

The ECDC said it was unclear how much Greece's debt crisis has contributed to HIV outbreak.

Rates of other health problems such as depression and suicide have been rising in Greece, which is also battling the re-emergence of mosquito-borne diseases such West Nile Virus and malaria.

(Reporting by Kate Kelland; Editing by Kevin Liffey)



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J&J says it won't enforce AIDS drug patent in Africa

LONDON (Reuters) - Generic manufacturers are to be given a free rein to make cheap copies of Johnson & Johnson's HIV/AIDS drug Prezista for sale in Africa and other poor countries.

U.S. healthcare group J&J said on Thursday it would not enforce patents, provided generic firms made high-quality versions of the drug - known generically as darunavir - for sub-Saharan Africa and Least Developed Countries.

Prezista is a relatively new drug used when patients develop resistance to older antiretrovirals. The need for it was expected to grow rapidly as more patients in Africa stop responding to existing therapies.

Pharmaceuticals head Paul Stoffels said he expected Indian drugmakers, in particular, to take advantage of the patent move, adding that competition among different companies should drive prices down further.

J&J has an existing deal with South African group Aspen Pharmacare, which makes Prezista at a discounted price of $2.22 per day for Africa - a fraction of the western market price.

Its decision to act unilaterally on Prezista patents will, however, disappoint those calling for J&J to share intellectual property rights in the new Medicines Patent Pool, which aims to streamline generic production by pooling patents.

'We have chosen to go direct ... we think that is the best way,' Stoffels said in an interview.

'We want to reserve the right to reinforce patents if people are not providing the right quality of product, for example by bringing products to market that under-dose.'

International drugmakers are under growing pressure to make medicines more affordable in poor countries, after being attacked for not doing enough in the past.

J&J ranked second in a new analysis of how companies are performing in providing access to medicines - an improvement of seven places from two years earlier, following its purchase of Crucell, which makes vaccines for the developing world.

(Editing by Dan Lalor)



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J&J says won't enforce AIDS drug patent in Africa

LONDON (Reuters) - Generic manufacturers are to be given a free rein to make cheap copies of Johnson & Johnson's HIV/AIDS drug Prezista for sale in Africa and other poor countries.

U.S. healthcare group J&J said on Thursday it would not enforce patents, provided generic firms made high-quality versions of the drug - known generically as darunavir - for sub-Saharan Africa and Least Developed Countries.

Prezista is a relatively new drug used when patients develop resistance to older antiretrovirals. The need for it was expected to grow rapidly as more patients in Africa stop responding to existing therapies.

Pharmaceuticals head Paul Stoffels said he expected Indian drugmakers, in particular, to take advantage of the patent move, adding that competition among different companies should drive prices down further.

J&J has an existing deal with South African group Aspen Pharmacare, which makes Prezista at a discounted price of $2.22 per day for Africa - a fraction of the western market price.

Its decision to act unilaterally on Prezista patents will, however, disappoint those calling for J&J to share intellectual property rights in the new Medicines Patent Pool, which aims to streamline generic production by pooling patents.

'We have chosen to go direct ... we think that is the best way,' Stoffels said in an interview.

'We want to reserve the right to reinforce patents if people are not providing the right quality of product, for example by bringing products to market that under-dose.'

International drugmakers are under growing pressure to make medicines more affordable in poor countries, after being attacked for not doing enough in the past.

J&J ranked second in a new analysis of how companies are performing in providing access to medicines - an improvement of seven places from two years earlier, following its purchase of Crucell, which makes vaccines for the developing world.

(Editing by Dan Lalor)



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South Africa awards $667 million HIV drugs supply contract

JOHANNESBURG (Reuters) - South Africa on Thursday awarded a $667 million contract to supply life-prolonging HIV medicine to 12 international and domestic firms, to deal with its biggest health problem.

Companies that include Aspen Pharmacare, Abbott Laboratories and Adcock Ingram would share the contract, the health department said.

The 5.9 billion rand ($667 million) contract, effective from April next year, aims to increase the number of people on treatment by nearly 50 percent, to 2.5 million next year.

South Africa has nearly 6 million people infected with HIV -- one of the heaviest caseloads in the world. It also has one of largest treatment programs.

But drug makers are unlikely to rake in big profits from the government award, analysts have said, given the stiff competition in the bidding.

The health department said it saved 2.2 billion rand on the new contract, which it initially expected it would cost 8.1 billion rand.

Aspen Pharmacare, the country's biggest generic drugs maker, was awarded 20 percent of the contract while its closest domestic rival, Adcock Ingram was given 14 percent, the health department said.

Other contracts winners included Chicago-based Abbott Laboratories with 8.1 percent, and domestic firm Cipla Medpro with 9 percent.

(Reporting by Tiisetso Motsoeneng; editing by David Dolan)



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Cialis impotence drug helps muscular dystrophy patients

LONDON (Reuters) - Eli Lilly's erectile dysfunction drug Cialis can correct abnormal blood flow in patients with a certain type of muscular dystrophy and could in future be used to slow progression of the disorder, researchers said on Wednesday.

The findings suggest that while Cialis can't cure the condition, known as Becker muscular dystrophy, it could be used as a treatment to slow or prevent muscle weakening and help patients retain more function for longer.

Becker muscular dystrophy (BMD) is an inherited disorder that involves slowly worsening muscle weakness of the legs and pelvis. It is mostly found in boys and occurs in about 3 to 6 out of every 100,000 births.

Patients with BMD often have difficulties with walking that get worse over time. There is no cure for the condition, and by the age of 25 to 30 many patients are unable to walk.

In a small study involving men with the disorder, researchers from the Cedars-Sinai Medical Center, Los Angeles, in the United States took measurements when volunteers' forearm muscles were either rested or lightly exercised with a handgrip.

They found that almost all the patients had defective blood flow when they exercised. This lack of blood flow may contribute to muscle fatigue and weakness, the researchers wrote in a study in the journal Science Translational Medicine.

But after giving some of the patients a single oral dose of Cialis and comparing them to others given a placebo, or dummy pill, the scientists found that normal blood flow was restored to the muscles of 8 out of 9 patients who got the drug.

Like other erectile dysfunction drugs, Cialis, known generically as tadalafil, dilates blood vessels and is designed to increase blood flow. In the impotence drug market, it is a longer-acting alternative to Pfizer's blue pill, Viagra.

Sales of Cialis for erectile dysfunction brought in $1.875 billion for Eli Lilly in 2011, up 10 percent on 2010.

While using the drug in BMD may be a possibility in future, the researchers cautioned that doctors should not prescribe it for this indication until more, larger studies have been conducted to show whether the improved blood flow has a meaningful effect on dystrophic muscles.

(Reporting by Kate Kelland; Editing by Louise Heavens)



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In Israel, some rebel against circumcision

JERUSALEM (Reuters) - Circumcision is one of Judaism's most important laws and for generations of faithful it has symbolized a Biblical covenant with God.

But in Israel, more and more Jewish parents are saying no to the blade.

'It's such a taboo in Israel and in Judaism,' said Gali, nursing her six-week-old son, about the decision not to have him circumcised.

'It's like coming out of the closet,' she said, asking to be identified by her first name only because she had not told her relatives yet.

Nearly all baby boys in Israel are circumcised. Be their parents ultra-Orthodox or totally secular Jews, it is by far the most common choice. Most Israeli-Arabs also keep with a practice that is widespread in the Muslim world.

Jewish circumcisions are done when the baby is eight days old. The majority are performed by a mohel, a religious man trained in the procedure carried out in a festive religious ceremony called a 'brit', Hebrew for covenant.

But an increasing minority fear it is a form of physical abuse.

'It's the same as if someone would tell me 'it's our culture to cut off a finger when he is born',' said Rakefet Kaufman, who also did not have her son circumcised.

'People should see it as abuse because it is done to a baby without asking him,' she said.

When Gali learnt she was carrying a baby boy it was obvious to her that he would be circumcised. But she started to think again after a conversation with a friend whose son was uncircumcised.

'She asked me what my reason was for doing it, was it religious? I said no. Was it for health reasons? No. Social? No. Then it began to sink in. I began to read more about it, enter Internet forums, I began to realize that I cannot do it.'

PHENOMENON GROWING

'The phenomenon is growing, I have no doubt,' said Ronit Tamir, who founded a support group for families who have chosen not to circumcise their sons.

'When we started the group 12 years ago we had to work hard to find 40 families ... They were keeping it secret and we had to promise them we'd keep it secret,' she said. 'Then, we'd get one or two phone calls a month. Nowadays I get dozens of emails and phone calls a month, hundreds a year.'

Tamir believes Jews in today's Israel find it easier to break religious taboos.

'People are asking themselves what it means to be Jewish these days,' she said, and that leads some to question rules of all kinds, including circumcision.

In societies around the world who circumcise boys for non-religious reasons, out of habit or tradition or because of the perceived health benefits, the practice can be controversial.

Rates of circumcision in Europe are well under 20 percent, while in the United States, according to 2010 statistics cited by the Center for Disease Control (CDC), more than half of newborn boys continue to be circumcised.

The American Academy of Paediatrics said in August that the health benefits of infant circumcision - potentially avoiding infection, cancer and sexually-transmitted diseases - outweighed the risks, but said parents should make the final call.

But where the decision is ultimately a matter of personal choice for many families around the world, for Jews who question the tradition, it is more complicated.

'It is the covenant between us and God - a sign that one cannot deny and that Jews have kept even in times of persecution,' said one well-known mohel who has been performing circumcisions in Israel for more than 30 years. He asked not to be named to avoid being connected to any controversy.

He pointed to the Book of Genesis, where God said to Abraham: 'And you shall circumcise the flesh of your foreskins; and it shall be a sign of the covenant between me and you.'

It is this covenant that, the mohel said, that 'keeps the people of Israel together'.

The Bible goes on: 'And the uncircumcised male child whose flesh of his foreskin is not circumcised, that soul shall be cut off from his people; he has broken my covenant.'

Scholars have differed over the years what this means in practice.

BEING DIFFERENT

Tamir is unswayed by the ancient verses.

'This edict is painful, irreversible and maims,' she said. The Internet was helping to spread the word, she said, allowing parents to find information about circumcision and seek advice anonymously.

Some Jewish groups in the United States which oppose circumcision offer alternative religious brit ceremonies that do not include an actual circumcision.

'There is definitely a growing number of Jewish families in the U.S. who are choosing not to circumcise,' said Florida-based Rebecca Wald. In 2010 she started a website to connect parents who are unsure about what to do.

'Since then, in phone calls, emails, and on social networking sites I have connected with hundreds of Jewish people in the U.S. who question circumcision.' she said in an email interview. 'Many of them have intact (uncircumcised) sons or plan to leave future sons intact.'

Wald's son was not circumcised.

'I have a very strong sense of Jewish identity and, believe it or not, having an intact son has only deepened it,' she said.

In Israel, where the vast majority are circumcised, the dilemma may be particularly difficult.

Although she is confident of the choice she and her husband made, Gali still has one concern.

'The main issue which still troubles me a little is the social one, that one day he may come to me and say 'Mom, why did you do that to me? They made fun of me today',' Gali said.

The Health Ministry does not keep records on circumcisions but estimates about 60,000 to 70,000 are held in Israel every year, which roughly corresponds to the number of boys born in 2010, according to the Central Bureau of Statistics.

The ministry said it treats about 70 cases a year of circumcisions gone wrong, mainly minor complications such as excessive bleeding.

Kaufman said 'people were shocked' to learn that her son is not circumcised.

'In Israel everybody does it, like a herd,' she said. 'They don't stop and ask themselves about this specific procedure which has to do with damaging a baby.'

Watching her son rummage through a stack of toys, Kaufman said: 'The way he was born is the way his body should be.'

(Editing by Jeffrey Heller and Sonya Hepinstall)



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