Tuesday, July 31, 2012

Mom, Teen Daughter Pregnant Raises Questions

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Monday, July 30, 2012

HPV Test Beats Pap Long-Term: Study

MONDAY, July 30 (HealthDay News) -- Testing for HPV, the human papillomavirus linked to cervical cancer, can predict which women will stay cancer-free for a decade or more, a new study shows.

While both a positive HPV test and an abnormal result on a traditional Pap smear predicted which women would get precancerous lesions within two years of testing, the HPV test continued to predict which women were at risk for 10 to 18 years later, said study co-author Dr. Attila Lorincz, a professor of molecular epidemiology at Queen Mary University of London.

'HPV DNA testing detects more cervical precancers than the Pap test, and women who are negative for high-risk HPV DNA have improved protection from the risk of cervical cancer,' Lorincz said.

The study, which looked at nearly 20,000 women receiving routine Pap tests and HPV testing at Kaiser Permanente in Portland, Ore., is published in the July 30 issue of the Journal of Clinical Oncology.

The research does not suggest one test should replace the other, Lorincz stressed, but confirms the importance of both screenings. The main aims of the study, he said, 'were to see how many extra cases of precancer can be discovered by the additional use of HPV DNA testing as compared to routine Pap testing.'

The findings, he said, support recently revised guidelines suggesting that HPV testing, if negative, can allow for longer intervals between Pap testing for women over the age of 30. The findings also suggest that an alternate strategy, using HPV testing first, may work well, the researchers said.

According to American Cancer Society guidelines, the preferred screening for healthy women aged 30 to 65 is to do a Pap and HPV test every five years. Women under 30 are often infected with HPV, but clear it spontaneously. That is why the guidelines for the roles of HPV and Pap testing combined are for women aged 30 and older.

As more research is done, guidelines may change, said study co-author Dr. Andrew Glass, senior investigator at Kaiser Permanente Center for Health Research. 'It is likely that HPV testing will be more and more common and may in the future replace routine Pap testing,' he said.

Both the Pap test and the HPV test are done on samples of cells taken from the cervix. The Pap detects cell changes on the cervix that could become cancer if not treated appropriately.

HPV tests look for DNA, or genetic material, of the virus that can lead to precancerous changes.

In the study, women over 30 with a positive HPV at the start were more likely to have a precancer or cancer during the 10- to 18-year follow-up than those who had an abnormal Pap.

Women who tested positive for the two strains of HPV most strongly linked with cervical cancer were more likely to have precancer during the follow-up than HPV-negative women, regardless of their initial Pap test result.

Having a negative HPV more strongly predicted who would remain cancer-free than the Pap did, the investigators found.

The researchers also looked at the effect of lengthening the screening interval from three years to five in women over 30 who had negative HPV and normal Pap tests. Doing this did not increase the risk of precancer and cancers appreciably.

Both tests are commonly covered by insurance plans, sometimes requiring a co-payment. The typical cost for each test is about $40 to $70, according to Lorincz.

The study finding 'confirms the fact that you don't have to do a Pap smear every year in healthy women over 30,' said Dr. Mark Wakabayashi, director of the division of gynecologic oncology at the City of Hope, in Duarte, Calif.

However, he stressed the importance of checking in with a doctor. 'But you have to talk to someone who understands who does need a yearly Pap,' he said. 'This [finding] applies just to healthy women.'

The findings have nothing to do with whether you received the HPV vaccine or not, Wakabayashi said. 'A lot of people are thinking if they had the vaccine they don't need a Pap smear. Not true,' he said. While the HPV vaccine aims to protect against cervical cancer, screenings are still crucial.

Study leader Dr. Philip Castle, of the American Society for Clinical Pathology, does consultant work for Merck, which makes an HPV vaccine. Lorincz is a consultant for, and owns stock in, Qiagen, which makes HPV tests.

More information

To learn more about screening for cervical cancer, visit the U.S. Centers for Disease Control and Prevention.



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No evidence that sex spoils sport

LONDON (Reuters) - The ancient Greeks believed athletes should avoid sex before sport, but modern Olympians and scientists are torn over the merits of in-competition coitus and whether abstinence enhances performance.

For years coaches and athletes have practiced abstinence the night or even weeks before a big event, although all bets are off when the medal ceremony is over - 150,000 condoms are handed out to the 10,500 athletes competing at the London Games.

Boxer Muhammad Ali reportedly went without sex for 6 weeks before a big fight, and during the 1998 soccer World Cup, the then English coach Glenn Hoddle famously forbade his squad from having sex during the month-long event.

American Marty Liquori, the world's top 5000-metre runner four decades ago, was once quoted as saying: 'Sex makes you happy. Happy people don't run a 3:47 mile.'

Experts say the long-standing 'no sex before sport' myth has yet to be explored fully, however. Most research has been based on the physiological impact and, so far, having sex has not been found to reduce physical strength, power or endurance.

'When we test people in the lab, we are examining 'tests of performance' but in competition, psychology very likely plays a much more important role,' said Ian Shrier, a professor in the department of family medicine at McGill University in Canada.

'Those who claim it decreases performance usually say it is because it decreases focus or aggression or tension. There are no studies that have examined this.'

SWINGING FROM THE RAFTERS

A review of scientific studies on the issue published in the Clinical Journal of Sport Medicine suggested sex the night before competition has no effect on physiological test results.

In one study, 14 married male former athletes were given a maximum-effort grip strength test the morning after coitus, and the same test after at least 6 days without sex. The results showed neither strength nor endurance of the flexing muscles was adversely affected by sex the previous night.

A follow-up to this study was conducted by researchers at Colorado State University on 10 fit, married men aged between 18 and 45. In their tests for grip strength, balance, lateral movement, reaction time, aerobic power, and VO2 max - a measure oxygen efficiency - sex appeared to make no difference.

A third study conducted in 1995 found having sex 12 hours prior to a fitness test had no significant effects on maximal aerobic power, oxygen pulse or blood pressure.

A theory that sexual frustration makes people more aggressive, and that ejaculation draws testosterone, an athletic performance-related hormone, from the body, has yet to be scientifically proven.

'Even if that theory is correct, most people currently believe there is an optimal level of aggression or focus - too little and you don't do well, too much and you don't do well,' said Shrier.

Martin Milton, an expert in psychotherapeutic and counseling psychology at the University of Surrey, said the effect of sex would depend very much on who's doing it, how often, for how long and in what way.

'If it's 'up all night swinging from the rafters' type sex we're talking about, then obviously the athlete is not going to be getting enough sleep or rest and their mind isn't on the job,' he said in a telephone interview.

'So that might well be more the issue than whether or not being involved in a short period of sex might be detrimental to someone's performance.'

LET'S TALK ABOUT SEX

At the London 2012 Games, while there might not be much sex being had, it's certainly being talked about.

Even London Mayor Boris Johnson is getting in on the act, telling reporters last week he wants the Olympics to 'inspire a generation' not 'create a generation'.

The Australian team hit the headlines when its committee decided shooter Russell Mark could not share a room in the athletes' village with his wife and fellow shooting competitor Lauryn Mark.

Mark, a six-time Olympian and double trap gold medalist in the 1996 Atlanta Games, said he was planning to sneak off in the night to see his wife.

The Australian Olympic Committee played down the furor, saying allowing the couple to share would inconvenience other female athletes.

In Italy, sports fans have been fascinated by the pre-race activities of the nation's best-known sportswoman, Federica Pellegrini, who won a gold medal in the 200 meters freestyle at the Beijing 2008 Games.

Her boyfriend, fellow Italian swimmer Filippo Magnini, told magazine Chi they would be avoiding sex before Pellegrini's London races.

Pellegrini, 23, who once appeared naked and painted in gold on the cover of Vogue, was not so sure.

'Abstinence!' she said. 'Are you mad?'

(Editing by Sonya Hepinstall)



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Namibia illegally sterilized HIV-infected women

WINDHOEK (Reuters) - A Namibian court on Monday ruled state hospitals illegally sterilized three HIV-positive women, opening the door for suits from other women who claim they were coerced into the procedure because they were infected with the virus that causes AIDS.

The court ruled the three were sterilized without being adequately informed, but in this case found no grounds to link the procedure to their HIV status.

'There should be unhurried counseling in a language that is clearly understood by the patient,' Windhoek High Court Judge Elton Hoff said. 'I am not convinced that informed consent was given'.

Women who were sterilized say they were forced into the procedure to slow down the spread of HIV and AIDS in the southern African country.

'These three cases represent only the tip of the iceberg because numerous HIV positive women have come forward alleging they were similarly subjected to coerced sterilization at public hospitals in Namibia,' said Nicole Fritz of the Southern Africa Litigation Centre.

The women said they were presented forms for sterilization just before and after delivering babies through caesarian sections without being told what they were signing.

According to U.N. data, Namibia has one of the higher rates of HIV infection in the world with HIV prevalence of about 17 percent among pregnant women.

(Reporting by Servaas van den Bosch; Editing by Jon Herskovitz and Angus MacSwan)



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Court: Namibia HIV sterilizations violated rights

JOHANNESBURG (AP) - A legal aid group says a court in Namibia has ruled that the government there sterilized three women infected with HIV without getting proper consent.

The Southern Africa Litigation Centre said Monday that the Namibia High Court ruling will see monetary damages awarded to the three women affected. The center said the court ruling found the government forced women into agreeing to the procedure while they were in severe pain or in labor.

The lawsuit, filed in 2010, comes as activists say that other HIV-infected women have been coerced into being sterilized.

UNAIDS estimates there are some 180,000 people living with HIV in Namibia, a country of 2.1 million people.

Sterilization is a drastic tactic to treat HIV-positive women, as mother-to-child transmission of HIV/AIDS can be prevented with medication.



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Saturday, July 28, 2012

Multifaith call in Austria for circumcision clarity

A row over religious circumcision in Austria that has spread from Germany made more waves Saturday after an unprecedented joint call by Jews, Muslims and Christians for unequivocal government support.

The Jewish Community (IKG), the Islamic Community of Austria (IGGiOe) and Catholic and Lutheran bishops called on Friday on Vienna to 'issue a clear commitment to religious freedom and to the legality of male circumcision.'

'All sides welcome that the health and justice ministries see no need to change (the legal situation) but what is missing is a clear commitment from the highest level, in other words from government leaders,' the statement said.

The call came after the premier of Vorarlberg issued a provisional recommendation to hospitals in the state not to perform circumcision operations, even when it is on religious grounds, prompting considerable media coverage.

The centre-right Markus Wallner issued the call following a highly contentious June ruling by a court in the German city of Cologne that circumcision of young boys was tantamount to grievous bodily harm, a criminal act.

Unsure of its legal standing, Germany's chief medical association advised doctors who routinely perform circumcisions on baby boys on behalf of parents citing religious grounds to refrain.

The Cologne verdict provoked uproar from religious and political leaders in Israel as well as Muslim countries, with Chancellor Angela Merkel reportedly saying it risked making Germany a 'laughing stock'.

This month German MPs adopted a cross-party motion calling on the government to protect the practice. Diplomats said the court ruling was 'disastrous' to Germany's international image, particularly in light of its Nazi past.

'I see no need to act,' Austrian Justice Minister Beatrix Karl said on Friday. 'In Austria circumcision is not an illegal act. There also exists the fundamental right to religious freedom.'

In Graz, capital of the southeastern Austrian state of Styria, the children's hospital has also decided not to carry out any more circumcisions that have not already been scheduled.

Two Swiss hospitals have also called a provisional halt.

Both Muslims and Jews practise circumcision, although the Koran does not impose it, unlike the Torah which says the procedure must be done before the eighth day of a child's life.

The Austrian IKG's honorary president Ariel Muzicant reportedly even went as far as to say that a ban 'would be an attempt at another Shoah (Holocaust) ... just this time with intellectual means.' The comment drew widespread criticism.



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Friday, July 27, 2012

Catholic business owners win temporary halt to Obama birth control mandate

(Reuters) - A Colorado business owned by a Catholic family does not have to comply with President Barack Obama's new healthcare mandate that private employers provide employees with insurance coverage of birth control, a Colorado federal judge ruled on Friday.

District Judge John Kane in Denver temporarily blocked the government from the enforcing the contraception requirement against the religious owners of Hercules Industries Inc, a private manufacturer of heating, ventilation and air conditioning equipment.

The ruling only affects this plaintiff but opens the door for any company to seek relief on religious grounds. Lawyers for the Department of Health and Human Services argued that a temporary exemption for Hercules would interfere with the government's ability to implement the law. But Kane was not persuaded.

'This harm pales in comparison to the possible infringement upon (the Newman family's) constitutional and statutory rights,' the judge wrote. He noted that the government had already created numerous exceptions for religious employers, exempting over 190 million health plan participants.

The law posed an imminent harm to the company's owners by forcing them to support contraception, sterilization and abortion in violation of their religious beliefs or face steep fines, Kane said.

Members of the Newman family, which owns Hercules, sued in April, challenging the provision that is part of the new health care law, the Affordable Care Act of 2010.

Roman Catholic bishops and many Republican lawmakers oppose the provision. The Catholic Church launched a campaign against it from Sunday Mass pulpits across the country. Catholic Church doctrine opposes artificial contraception but most American Catholics do not adhere to church policy.

Hercules provides a self-insured group plan for its 265 full-time employees that does not cover birth control, sterilization or abortion-inducing drugs. But the new regulation would require Hercules to provide such coverage by November 1, the ruling said.

Department of Health and Human Services Secretary Kathleen Sebelius expressed disappointment with the decision in a statement.

'This lawsuit was not brought by a religious organization. Rather, it was brought by a for-profit commercial enterprise whose purpose is to sell HVAC equipment,' she said, adding that healthcare decisions should be between women and their doctors, not their employers.

'Every American, including family business owners, should be free to live and do business according to their faith,' Matthew Bowman, a lawyer for Hercules with the Alliance Defense Fund, said in a statement.

More than 20 lawsuits are pending around the country against the birth control mandate, brought by organizations including the University of Notre Dame, Catholic University of America and the Archdiocese of New York.

On July 17, another federal judge in Nebraska dismissed a similar lawsuit brought by seven states, two Catholic individuals and three Catholic non-profit institutions, finding that the plaintiffs did not face any immediate harm from the law.

(Reporting by Terry Baynes in New York; Editing by Greg McCune and Lisa Shumaker)



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Only 1 in 4 Americans With HIV Has Virus Under Control: CDC

FRIDAY, July 27 (HealthDay News) -- Among the 1.1 million Americans living with HIV, just one in four has the virus under control, U.S. health researchers say.

In a report presented Friday at the International AIDS Conference in Washington, D.C., researchers from the U.S. Centers for Disease Control and Prevention said the problem applies to patients of all ages, races and ethnic groups, but especially to young people and blacks.

'This is the first time that we have ever looked at the outcome of continuum of care across all patient groups,' said CDC epidemiologist Irene Hall. 'And what we found is that, overall, too few people with HIV have viral suppression.' People with viral load suppression are healthy and less likely to transmit the virus to others.

'Only if we get everyone under regular care for HIV/AIDS can we recognize the full benefits of treatment and prevention,' said Hall, chief of the HIV incidence and case surveillance branch in the CDC division of HIV/AIDS prevention.

For the report, Hall and her colleagues pored through 2009 data collected by the CDC, which included rates of HIV testing, patient participation in the health care system, continuity of care for HIV, treatment prescribed, and the patient's viral load status in terms of suppression.

Overall, about 82 percent of all those infected with HIV know their status, meaning that more than 200,000 Americans now infected with HIV are not aware of their condition.

Two-thirds of the nation's HIV patients do have some relationship with a care provider, the report indicates, and more than one-third (37 percent) receive continuous HIV care, while one-third are treated with antiretroviral therapy.

But just over one-third of black patients were found to have ongoing care, compared with 37 percent to 38 percent of Latinos and whites. Similarly, just a little over one in five black patients was found to have viral load suppression, compared with 26 percent of Latinos and 30 percent of whites.

Blacks infected with HIV were the least likely to find out they were infected in the first place and the least likely to get any care for HIV, Hall added.

Younger HIV patients were also much less likely than older patients to know their HIV status and to obtain routine care, Hall said.

Suppression rates were also poorer among younger patients, with just 15 percent of those aged 25 to 34 having their virus under control compared with 36 percent among those aged 55 to 64.

No significant differences were seen between males and females in terms of diagnosis, treatment or disease control.

For now, the report authors can only theorize about what lies behind these differences in HIV care.

'Our study did not look at the reasons for why people are not in care, or are not prescribed [antiretroviral therapy] or don't have viral suppression,' Hall noted. 'But in general we do know there are differences in access to care and in insurance status. There is also a stigma associated with [HIV], and some people might distrust the medical system.'

As for young people, they may not feel at risk and may not go to the doctor as often, she added.

'The treatment options certainly are much better today than in the past, but it is still a very serious disease,' she said. 'And it's very important that people know their status and that people who are infected get regular care.'

This is not only so they can have optimum health, she said, but also 'because if we want a national strategy for prevention we do need to have people with a suppressed viral load and in care so we can stop transmission of the virus.'

Chris Collins, vice president and director of public policy at the American Foundation for AIDS Research (amfAR) in Washington, D.C., said that the CDC report 'sounds consistent' with previous assessments of the current HIV picture across the country.

'One in five are living with HIV and don't know it,' he noted. 'And many other people are estranged from the health system. They don't think they can get quality care or don't have access, and we haven't done enough outreach.'

Complacency about AIDS is an obstacle to ending the disease in America, said Collins. 'The science is telling us that we have the opportunity to begin to end this epidemic in America,' he said. 'But Americans have to realize that while we have drugs that can save lives, we have failed to get them to half of the people that need them.'

More information

For more on HIV care, visit the U.S. Centers for Disease Control and Prevention.



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Only 1 in 4 Americans With HIV Have Virus Under Control: CDC

FRIDAY, July 27 (HealthDay News) -- Among the 1.1 million Americans living with HIV, just one in four has the virus under control, U.S. health researchers say.

In a report presented Friday at the International AIDS Conference in Washington, D.C., researchers from the U.S. Centers for Disease Control and Prevention said the problem applies to patients of all ages, races and ethnic groups, but especially to young people and blacks.

'This is the first time that we have ever looked at the outcome of continuum of care across all patient groups,' said CDC epidemiologist Irene Hall. 'And what we found is that, overall, too few people with HIV have viral suppression.' People with viral load suppression are healthy and less likely to transmit the virus to others.

'Only if we get everyone under regular care for HIV/AIDS can we recognize the full benefits of treatment and prevention,' said Hall, chief of the HIV incidence and case surveillance branch in the CDC division of HIV/AIDS prevention.

For the report, Hall and her colleagues pored through 2009 data collected by the CDC, which included rates of HIV testing, patient participation in the health care system, continuity of care for HIV, treatment prescribed, and the patient's viral load status in terms of suppression.

Overall, about 82 percent of all those infected with HIV know their status, meaning that more than 200,000 Americans now infected with HIV are not aware of their condition.

Two-thirds of the nation's HIV patients do have some relationship with a care provider, the report indicates, and more than one-third (37 percent) receive continuous HIV care, while one-third are treated with antiretroviral therapy.

But just over one-third of black patients were found to have ongoing care, compared with 37 percent to 38 percent of Latinos and whites. Similarly, just a little over one in five black patients was found to have viral load suppression, compared with 26 percent of Latinos and 30 percent of whites.

Blacks infected with HIV were the least likely to find out they were infected in the first place and the least likely to get any care for HIV, Hall added.

Younger HIV patients were also much less likely than older patients to know their HIV status and to obtain routine care, Hall said.

Suppression rates were also poorer among younger patients, with just 15 percent of those aged 25 to 34 having their virus under control compared with 36 percent among those aged 55 to 64.

No significant differences were seen between males and females in terms of diagnosis, treatment or disease control.

For now, the report authors can only theorize about what lies behind these differences in HIV care.

'Our study did not look at the reasons for why people are not in care, or are not prescribed [antiretroviral therapy] or don't have viral suppression,' Hall noted. 'But in general we do know there are differences in access to care and in insurance status. There is also a stigma associated with [HIV], and some people might distrust the medical system.'

As for young people, they may not feel at risk and may not go to the doctor as often, she added.

'The treatment options certainly are much better today than in the past, but it is still a very serious disease,' she said. 'And it's very important that people know their status and that people who are infected get regular care.'

This is not only so they can have optimum health, she said, but also 'because if we want a national strategy for prevention we do need to have people with a suppressed viral load and in care so we can stop transmission of the virus.'

Chris Collins, vice president and director of public policy at the American Foundation for AIDS Research (amfAR) in Washington, D.C., said that the CDC report 'sounds consistent' with previous assessments of the current HIV picture across the country.

'One in five are living with HIV and don't know it,' he noted. 'And many other people are estranged from the health system. They don't think they can get quality care or don't have access, and we haven't done enough outreach.'

Complacency about AIDS is an obstacle to ending the disease in America, said Collins. 'The science is telling us that we have the opportunity to begin to end this epidemic in America,' he said. 'But Americans have to realize that while we have drugs that can save lives, we have failed to get them to half of the people that need them.'

More information

For more on HIV care, visit the U.S. Centers for Disease Control and Prevention.



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Going Gray With HIV, a Complicated Affair

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Austria's religious leaders defend circumcision

VIENNA (Reuters) - Austria's Catholic, Protestant, Jewish and Muslim leaders united in defense of circumcision on Friday, condemning calls from two provincial leaders to limit the practice as an attack on religion and demanding that the government clarify its legality.

The row follows weeks of emotional debate and outrage in Germany where a regional court in Cologne banned the procedure on June 27 as physical abuse.

The Justice Ministry in Vienna has expressed surprise that a German verdict should be thought to have any relevance in Austria, and the health minister has played down the importance of what he called an overhyped debate imported from Germany.

Peter Schipka, general secretary of the Roman Catholic Austrian Bishops' Conference, told journalists on Friday: 'We are concerned about all attempts to exploit the debate that has been triggered by the Cologne verdict to promote a hostile attitude in Austria towards Judaism, Islam or religion in general.'

Protestant leader Michael Buenker noted there had been no similar attacks on other practices that were also physical interventions on children, such as ear piercing or vaccinations.

The right to religious freedom is protected in the Austrian constitution and can only be changed in law by a two-thirds majority in parliament.

Those seeking to ban circumcision argue a competing right to freedom from physical harm should take precedence, and that infants are unable to consent to being circumcised.

The four leaders called on the government to make a clear statement in defense of religious freedom and the lawfulness of male circumcision - an obligation in both Judaism and Islam.

Oskar Deutsch, leader of Austria's Jewish communities, said the law was clear that parents had a right to bring up their children in accordance with their faith.

'Nonetheless, the government is asked here very clearly to repeat this once more and to clarify that this will not be challenged in this country,' he said.

A spokesman for Austrian Chancellor Werner Faymann was not immediately available for comment.

Germany's lower house of parliament moved quickly to pass a motion protecting the religious circumcision of infant boys last week after the Cologne court verdict.

But an Austrian provincial chief nonetheless advised state-run hospitals this week to stop circumcisions, saying the legal position in Austria needed to be clarified, and the far-right governor of another province called for a federal ban.

According to the CIRCS organization, which collects global published data on circumcision, 37 percent of all males are circumcised. Few circumcisions are carried out in hospitals.

The four religious leaders said on Friday it was impossible to live in Austria as a Muslim or a Jew without the ability to practice traditions that were fundamental to religious identity.

Austria's Jewish community has shrunk to just 9,000, or about 1 percent of the population, from about 200,000 before Nazi Germany annexed Austria in 1938. A debate still simmers over whether the country was Hitler's first victim or a willing accomplice.

About half a million Muslims live in the country, many of them migrant workers from Turkey.

(Reporting by Georgina Prodhan; Editing by Louise Ireland)



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Merck quarterly earnings beat forecasts

(Reuters) - Merck & Co Inc reported better-than-expected quarterly earnings despite the negative impact of the stronger dollar, with solid sales growth from its vaccines and treatments for diabetes and HIV.

The No. 2 U.S. drugmaker said on Friday it earned $1.79 billion, or 58 cents per share, in the second quarter. That compared with $2.02 billion, or 65 cents per share, in the year-earlier period.

Excluding special items, the company earned $1.05 per share. Analysts, on average, expected $1.01 per share.

Company sales rose 1 percent to $12.31 billion, topping estimates of $12.15 billion. Sales would have risen 5 percent if not for the stronger dollar, which lowers the value of sales in overseas markets.

Despite the negative impact of foreign exchange, Merck reaffirmed it expects earnings of $3.75 to $3.85 per share for the full year, excluding special items. That compares with last year's profit of $3.77 per share.

Merck is girding for the U.S. patent expiration next month on its biggest product, asthma drug Singulair, which will open the flood gates to cheaper generics and hurt results for the rest of the year.

Singulair sales rose 6 percent in the second quarter to $1.43 billion.

(Reporting By Ransdell Pierson; editing by Jeffrey Benkoe; Editing by Gerald E. McCormick)



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Thursday, July 26, 2012

Small breakthroughs offer big hope of AIDS 'cure'

Small but significant breakthrough studies on people who have been able to overcome or control HIV were presented at a major world conference on ways to stem the three-decade-old disease.

One study focused on a group of 12 patients in France who began treatment on antiretroviral drugs within 10 weeks of becoming infected with human immunodeficiency virus, but then stopped the therapy after nearly three years.

The virus has stayed away for a median of six years in the group, known as the Visconti Cohort, which stands for 'Virological and Immunological Studies in CONtrollers after Treatment Interruption.'

This unique group of people did not completely eliminate HIV, but continued to possess it at an extremely low level in their cells and did not become sick.

'These results suggest that the antiretroviral treatment should be started very early after infection,' said Charline Bacchus, lead researcher of the study at France's national AIDS research agency ANRS.

'Six years after interruption of treatment, patients treated early on in the post-infection period present a perfect ability to control the HIV infection.'

Scientists are continuing to study the immune characteristics of this group for clues as to why they do not need prolonged medication. For most HIV patients, antiretroviral drugs must be taken for life.

There are currently 34 million people living with HIV worldwide. In low- and middle-income nations, which are the most affected by the pandemic, about eight million people are now taking antiretrovirals for treatment, about half those in need.

The second study involved two HIV-positive men whose DNA showed no trace of the virus eight and 17 months respectively after receiving stem cell transplants from an outside donor as treatment for blood cancer.

The men have been followed for two and three and a half years respectively, with no sign of the virus's return. Researchers have also noted they experienced a sharp decline in HIV antibodies, suggesting the virus is gone.

Their cases are different from the well-known 'Berlin patient,' American Timothy Brown, who is considered cured of HIV and leukemia five years after receiving similar bone marrow transplants from a rare donor naturally resistant to HIV, or lacking a CCR5 receptor.

The two men in the study received transplants from donors with the CCR5 receptor, which acts as a gateway allowing HIV to penetrate the cells, so they were not afforded protection against the virus by that mutation.

Researchers believe that by continuing to treat the men with antiretroviral drugs during the process, the medicine prevented the donor cells from becoming infected until they were able to provide the men with new immune defenses.

The study was presented at the 19th International AIDS Conference by Daniel Kuritzkes, professor of medicine at Brigham and Women's Hospital in Massachusetts.

Reacting to the news, Brown expressed 'joy' at the potential for two more men to be free of HIV.

'As I have said many times before, I want everyone to be cured of this disease. We can only hope that this case and today's development represents the beginning of the end of this plague,' he said in a statement.

A third study on how a cancer drug helped purge HIV from the cells of patients was described by lead researcher David Margolis of the University of North Carolina.

Researchers used the chemotherapy drug vorinostat to revive and so unmask latent HIV in the CD4+ T cells of eight trial patients who were also taking antiretroviral drugs to stop the virus from multiplying.

Margolis, whose study was published Wednesday in the British journal Nature, told reporters that researchers are energized toward the goal of finding a cure for HIV, even if it remains many years away.

'You cannot argue with the value of the goal and we cannot get there without working on it and I cannot say how long it will take,' he said.

'But I think there is a clear path and we can make progress.'



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Wednesday, July 25, 2012

Cancer Drug May Flush Out 'Hidden' HIV: Study

WEDNESDAY, July 25 (HealthDay News) -- Medications can eliminate any sign of HIV from the bloodstream, but the virus that causes AIDS never vanishes for good. Instead, it hides in the body, waiting to strike again.

Now, researchers report that they may have discovered a way to use a cancer drug to make the infected cells more visible, potentially allowing them to be killed.

It's too early to know if the approach will actually help patients get rid of the virus forever. The optimistic hopes of scientists, who are forever seeking an AIDS cure, could be snarled by side effects or some other medical hitch.

But the findings are a promising start, said study author Dr. David Margolis, a professor of medicine at University of North Carolina at Chapel Hill.

'We just wanted to show that we could get the virus to come out and show itself,' he said. 'This doesn't tell you that we have a cure for AIDS that everyone can take tomorrow. It begins us on a road to accomplish that goal.'

At issue is HIV's ability to hide in the body. Scientists suspect that the virus 'hijacks' certain kinds of immune cells -- the ones that remember how to deal with certain kinds of germs -- and lurk inside them. Thanks to this hijacking ability, medications and the immune system itself can't find and kill the virus or prevent it from multiplying.

The virus can move out of the immune cells if AIDS medications fail or if patients stop taking them. That means HIV can't currently be cured.

In the new study, researchers gave single doses of a skin cancer chemotherapy drug called vorinostat (Zolinza) to eight HIV-infected patients. The drug seemed to flush out the hidden virus so it was more easily visible.

None of the patients reported side effects, but they only took one dose.

Manufacturer information for cancer patients who take the drug lists serious side effects including dehydration, clots (rare), low red blood cell levels and high blood sugar.

As far as AIDS treatment, the next steps will be to figure out the best dose of the cancer drug and discover if medications or the immune system will kill the virus once it's loose.

'We don't know how to use this drug yet, and we don't know if we have to use it all the time every day for weeks or months and months,' study author Margolis said. 'We may just need to use it a few days here, then rest, on and off, until we get to the goal we need to get to.'

One big question is whether it's possible to fully eliminate the 'reservoir' of hidden virus in the body, said AIDS researcher Joseph Kulkosky, an associate professor of biology at Chestnut Hill College, in Philadelphia. Still, he said, it may be possible to at least get at some of it.

Another AIDS researcher, Alberto Bosque, a research assistant professor at the University of Utah School of Medicine, praised the study but cautioned that 'we are at the beginning of the race towards HIV eradication, where the unknowns and uncertainties exceed our knowledge.'

The study appears in the July 26 issue of the journal Nature.

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Women with HIV too often unseen: US advocate

As a black American woman with HIV, Linda Scruggs said Wednesday that she represents a group that is disproportionately affected by the pandemic and must get more involved in advocacy and research.

In the United States, black heterosexual women made up the next largest group of new infections after gay men of all races in 2009, with about 5,400 cases according to data from the US Centers for Disease Control and Prevention.

And worldwide, AIDS remains the top killer of women of reproductive age, said a UNAIDS report released last week, signaling that women of all races are particularly vulnerable to the 30-year-old disease.

Scruggs was first diagnosed with HIV 22 years ago, when she was 25 years old and took a routine blood test related to her pregnancy.

She was 13 weeks along, and recalls her doctors telling her she was HIV positive and could either have the baby and perhaps live three years, or abort the fetus and maybe live for about five years.

Scruggs expressed her pride for the son she decided to have, Isaiah, who recently turned 21 and was born without HIV, as she began her talk to the International AIDS Conference aimed at highlighting the struggles of women.

'We are not asking you. We are telling you. It is time to address the inequality of women globally ... we need to be part of the solution,' she told a cheering auditorium at the world's largest meeting on HIV/AIDS.

The political backdrop to the pandemic is inescapable in Washington. The US capital is struggling with its own soaring HIV rates and embroiled in partisan bickering over healthcare reform.

Washington's city-wide prevalence rate of 2.7 percent (nearly 15,000 people) exceeds that of many developing countries.

Among the city's black population, about half the city's residents, the prevalence rate is 4.3 percent. One in 32 black US women can expect a diagnosis of HIV in her lifetime, the CDC has said.

AIDS advocates say President Barack Obama's plan to reform healthcare could help turn the tide on an epidemic that predominantly affects poor and minority communities by extending coverage to more people.

However, Obama's Republican foes say the costs would be too high and as many as 13 state governors are vowing to opt out of a plan to expand Medicaid coverage to the poor.

'This is an epidemic of communities of color,' said Daniel Montoya, deputy executive director of the National Minority AIDS Council, saying minorities tend to have less access to healthcare, which can make them more vulnerable.

Nationwide, black women make up 60 percent of new cases among women and face infection rates that are 15 times the rate in white women, according to C. Virginia Fields, president of the National Black Leadership Commission on AIDS.

'We still need to have that national outrage to bring those numbers down,' Fields said, referring to remarks in 2007 by Secretary of State Hillary Clinton, who was at that time a presidential candidate.

Reacting to CDC data showing HIV/AIDS as the top cause of death in black women aged 25 to 34, Clinton had said: 'If HIV/AIDS were the leading cause of death of white women between the ages of 25 and 34, there would be an outraged outcry in this country.'

While many groups are jostling for the spotlight at the conference, which has drawn more than 20,000 experts, policy makers and advocates to the US capital, Scruggs said her appeal should not take away from the need to help gay men, traditionally the focus of efforts to halt the disease.

Instead, it is time for women to take a greater role in research and leadership, and to express the complexities of their lives that may contribute to their high infection rates.

'My life had never been a cup of tea,' said Scruggs, who recounted being molested by an uncle and raped multiple times as a young woman. She does not know which event may have infected her with HIV.

'I understood why me. I understood there were things in my life and my past that would get me there,' she said.

Her own healing process took root in the 1990s when she was asked to stand in for a speaker and tell her story to a doctors' conference.

Afterwards, she realized talking publicly about her ordeal was helping to free her of a long-held burden.

But she also acknowledged that plenty of stigma remains, and women too often stay silent about their condition.

'We are here and we are a force to be reckoned with. We are changing the game,' said Scruggs. 'We don't have another 30 years. We don't need another 30 years. We need you to do it now.'



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European rabbis fear circumcision row could spread

BERLIN (AP) - A group of Orthodox rabbis warned Wednesday that the ancient Jewish practice of infant male circumcision could face further restrictions in Europe after some hospitals in Austria and Switzerland suspended the procedure by citing a German court ruling that it could amount to criminal bodily harm.

Last month's verdict by a regional court in Cologne didn't ban circumcision. But it prompted angry protests from Jewish and Muslims groups, especially after the German Medical Association advised doctors not to perform unnecessary circumcisions until the legal situation is clarified - something Germany's government has pledged to do soon.

Two weeks ago, a hospital in the Swiss city of Zurich also suspended circumcisions, saying it wanted to investigate public concerns about the procedure, which involves cutting off a boy's foreskin. Anti-circumcision campaigners say the act breaches the child's right to bodily integrity, while faith groups insist it is part of their religious freedom.

"Of course we in Switzerland aren't directly affected by the Cologne ruling, but it sparked a debate about how to deal with the medical and ethical issues involved," said Marco Stuecheli, a spokesman for Zurich's Children's Hospital.

On Tuesday, the governor of Vorarlberg province in Austria told state-run hospitals to stop circumcisions except for health reasons until the legal situation is clarified. He said he sees the German decision, which arose from the case of a child whose circumcision led to medical complications, as a "precedence-setting judgment."

"Our fears that the court ruling in Cologne could have a knock-on effect across Europe are now being realized," said Pinchas Goldschmidt, the president of the Conference of European Rabbis.

He said Jewish leaders across the continent would seek out lawmakers and government officials to impress on them how central the practice is to their faith, and to forestall further restrictions elsewhere.

While Muslims, too, commonly circumcise their sons at a young age, in Judaism the procedure must take place eight days after birth. According to religious law, an uncircumcised male isn't considered fully part of the Jewish community, Goldschmidt said.

"In order to change that we would have to convene a supreme Jewish religious court, which has not convened for the last 2,000 years," he told The Associated Press.

The German government is expected to propose a bill this fall which would ensure that circumcision remains legal in the country.

The Children's Hospital in Zurich said it hopes to reach a decision next month about whether to resume circumcisions. So far, the suspension has delayed only two planned operations, because many Jewish parents prefer to have their sons circumcised privately, Stuecheli said.



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Being cured of HIV is 'wonderful,' US man says

The only person believed to have been cured of HIV infection through a bone marrow transplant says he feels wonderful and is launching a new foundation to boost research toward a cure.

Timothy Ray Brown, 47, an American from Seattle, Washington, rose to fame as the so-called 'Berlin patient' after doctors tried a novel technique to use an HIV-resistant donor for a stem cell transplant to treat Brown's leukemia.

Since 2007, he has had two high-risk bone marrow transplants and continues to test negative for HIV, stunning researchers and offering new pathways for research into how gene therapy may lead to a more widely acceptable approach.

'I am living proof that there could be a cure for AIDS,' Brown told AFP in an interview. 'It's very wonderful, being cured of HIV.'

Brown looked frail as he spoke to reporters in Washington where the 19th International AIDS Conference, the world's largest meeting of scientific experts, policymakers and advocates is taking place.

The bone marrow transplant he received carried significant risks and may be fatal to one in five patients who undergo it. But he said his only complaint these days is the occasional headache.

He also said he was aware that his condition has generated some controversy, but disputed the claims of some scientists who believe he may still have traces of HIV in his body and may remain infectious to others.

'Yes, I am cured,' he said. 'I am HIV negative.'

Brown said he fully supports more aggressive efforts toward finding a universal cure, and has met with a number of top scientists in recent days who have treated him 'like a rock star.'

He said he hopes to harness some of that fame to encourage donors to fund more research, and noted that Europe and China spend far more on cure research than the United States.

'There are thousands of very able researchers who cannot get funded for research, so I want to change that. And there are a lot of researchers who are willing to work to find a cure for HIV.'

Brown was a student in Berlin, Germany, when he tested positive for HIV in 1995 and was told he probably had about two years to live.

But combination antiretroviral therapy emerged on the global market a year later, and eventually transformed HIV from a death sentence into a manageable condition for millions of people worldwide.

Brown tolerated the medications well but due to persistent fatigue he visited a doctor in 2006 and was diagnosed with leukemia. He underwent chemotherapy, which led to pneumonia and sepsis, nearly killing him.

His doctor, Gero Huetter, had the idea of trying a bone marrow transplant using a donor who had a CCR5 receptor mutation.

People without that receptor appear to be resistant to HIV because they lack the gateway through which the virus can enter the cells. But such people are rare, and are believed to consist of one percent of the northern European population.

It would be an attempt to cure cancer and HIV at the same time.

Brown's leukemia returned in 2007, and he underwent a bone marrow transplant using stem cells from a CCR5 mutation donor, whom he has never met in person. He stopped taking antiretrovirals at the same time.

He soon had no HIV detectable in his system. His leukemia returned though, and he underwent a second bone marrow transplant in 2008, using stem cells from the same donor.

Brown said his recovery from the second operation was more complicated and left him with some neurological problems, but he continues to be free of leukemia and HIV.

Asked if he feels like his cure was a miracle, Brown was hesitant to answer.

'It's hard to say. It depends on your religious belief, if you want to believe it's just medical science or it was a divine intervention,' he told AFP. 'I would say it's a little bit of both.'



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Tuesday, July 24, 2012

Study of anti-AIDS vaginal ring begins in Africa



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Researchers to test monthly vaginal ring for HIV prevention

WASHINGTON (Reuters) - Two large clinical trials in Africa are ramping up to test the effectiveness of a vaginal ring that releases an HIV-fighting drug for a month or more, offering women at high risk a discreet way to protect themselves from the virus that causes AIDS.

The studies will test the effectiveness of a vaginal ring containing the antiretroviral drug dapivirine in thousands of women in several African countries to evaluate its ability to prevent new HIV infections and its long-term safety.

If effective, the ring will add 'a long-acting, female-initiated technology to the existing toolkit of HIV prevention options,' said Dr. Zeda Rosenberg, chief executive officer of International Partnership for Microbicides (IPM), a nonprofit group founded by Rosenberg which is developing the ring.

Because it only needs to be replaced once a month, the ring may help address some of the problems with getting women to consistently use vaginal gels each time they have sex, Rosenberg said during a briefing at the International AIDS Conference in Washington.

Irregular use is thought to be the reason a large study of the microbicidal gel containing the anti-HIV drug tenofovir failed to prevent infections in women in sub-Saharan Africa.

IPM has a royalty-free licensing agreement with Johnson & Johnson's Janssen unit in Ireland to use its dapivirine antiretroviral product in gel and ring forms to prevent HIV infections in low and middle income countries.

Dapivirine is part of a class of antiretroviral drugs that have long been used to treat HIV and prevent mother-to-child transmission of the virus.

NIH PARTNERSHIP

The IPM study will enroll 1,650 women aged 18 to 45, who will be randomly assigned to use the ring or a placebo in four sites in South Africa, with plans to expand to sites in Rwanda and Malawi.

It is being conducted in partnership with the U.S. National Institutes of Health-backed Microbicide Trials Network, which just started enrolling women in a separate trial called ASPIRE.

'Developing scientifically proven forms of HIV prevention that women can control is essential,' said Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Disease.

'Because the vaginal ring is a long-acting intervention, it has a potential added benefit in that women may find it relatively easy to use.'

The ASPIRE study will test the ring in 3,476 women aged 18 to 45 in Malawi, South Africa, Uganda, Zambia and Zimbabwe.

Women in the studies will be offered condoms and counseling on HIV prevention, and taught how to insert the vaginal ring. At monthly visits, researchers will keep track of whether women are still using the ring and give them a replacement.

Those women who become pregnant during the study will discontinue use of the ring, and their safety and that of their child will continue to be monitored.

Dr. Saidi Kapiga of the London School of Hygiene and Tropical Medicine, who is coordinating the ring study in Africa and has also conducted tests of vaginal gels for HIV protection, said there are already signs that women prefer the new option.

'It is acceptable,' Kapiga told the briefing. 'The fact that they use it only once in four weeks was a major advantage.'

Both trials are designed to detect at least a 60 percent reduction in HIV risk, but researchers said they hope for even better results, which are expected in 2015.

'If proven to be effective, I think this will really revolutionize prevention for women,' Dr. Sharon Hillier, who heads the Microbicide Trials Network at the University of Pittsburgh School of Medicine, told the briefing.

(This story corrects Rosenberg's first name to Zeda in paragraph 3 and number of women in study to 1650 in paragraph 8)

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Eric Walsh)



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Survey Finds Big Drop in Sexual Activity Among Black Teens

TUESDAY, July 24 (HealthDay News) -- Black teenagers in the United States have become much less sexually active over the past two decades, and those who do have sex appear to be more likely to use condoms, a new survey has found.

The declines are 'dramatic,' said report author Laura Kann, who studies adolescent health for the U.S. Centers for Disease Control and Prevention.

The numbers don't disclose anything about why black teens might have changed their behavior. 'This tells us what kids do, but not why,' Kann said.

Overall, teens of all racial and ethnic groups are about as sexually active as they were a decade ago. And the rate of condom use by teens -- just six in 10 used them the last time they had sex -- hasn't changed much since the 1990s.

By contrast, the numbers for black teens are strikingly different. The percentage who reported ever having sex fell from 82 percent in 1991 to 60 percent in 2011. Kann said the numbers coincide with drops in teen pregnancy and births.

Increased education about HIV/AIDS among blacks, leadership in the black community and a public health focus on black Americans could explain the change, Kann said.

The new CDC teen-sex survey also reveals that:

  • The percentages of students who've had sex have remained fairly stable over the last 20 years for Hispanic students (49 percent in 2011) and whites (44 percent in 2011).
  • Overall, 47 percent of all teens surveyed said they'd ever had sex, down from 54 percent in 1991. The rate has barely changed since 2001.
  • About one-third of students said they'd had sex within the past three months, and 15 percent said they'd had sex with four or more partners.
  • The percentage of sexually active teens who use condoms grew from 46 percent in 1991 to 60 percent in 2011, although the number hasn't changed much in recent years. Black teens are more likely to use condoms: their rate is 65 percent.
The recent stabilization of condom use could have something to do with less focus on HIV, which has largely become a treatable disease, Kann said. Also, 'the percentage of high school students overall who have had HIV education has dropped since 1997. That hasn't helped any either.'

The new survey results come from the CDC's National Youth Risk Behavior Survey of students in grades 9 through 12 from both public and private schools. About 15,000 students take the surveys each year.

Jennifer Manlove, area director of Fertility and Family Structure with the Child Trends advocacy group in Washington, D.C., said the survey shows that much of the evolution toward less sexual activity occurred in the 1990s, even among black teens.

'There's been a little bit more since 2000, but not really that much. The big news in the 1990s was the real focus on the AIDS epidemic and a lot of attention given to that,' she said.

Dr. David Katz, director of Yale University's Prevention Research Center, said the study 'is a mix of good news and persistent causes for concern.'

Nearly half of teens in this country are still sexually active, 'and a third or more (of those) did not use condoms most recently,' he said. 'This means that a very large population of our young people remains vulnerable to all of the perils of unprotected sex, HIV included. So this report is not a cause for celebration. It tells of a job that can be done when we address it well, and of a mission far from accomplished that deserves our more devoted attention.'

He added: 'No child should get HIV because our society is squeamish about the readily available means of preventing that.'

The survey findings were scheduled to be released Tuesday at the International AIDS Conference in Washington, D.C., and published in the CDC's Morbidity and Mortality Weekly Report.

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Genital warts on the decline among Swedish women

NEW YORK (Reuters Health) - Genital warts have been on the decline among women in Sweden after the country began offering subsidized HPV vaccinations to teenage girls in 2007, new research shows.

Rates of the sexually transmitted infection dropped by 17 percent among women ages 15 to 25 from 2006 to 2010, although there was no change among men over the same period.

The findings are 'in all likelihood' a sign the vaccine is working, said Amy Leval of Karolinska Institutet in Stockholm, who worked on the study. But they also suggest that not enough women have been vaccinated for men to be protected indirectly - a phenomenon known as herd immunity - she told Reuters Health by email.

Genital warts are caused by human papillomavirus, or HPV, which in rare cases can also lead to cervical, penile and anal cancers. Health authorities in the U.S. recommend that all preteen girls and boys get an HPV vaccine.

A U.S. expert without ties to the research welcomed the results from Sweden, but also sounded a cautious note.

'It's exactly what we would like to see,' said Dr. Michael Brady, an expert in pediatric infectious diseases at Nationwide Children's Hospital in Columbus, Ohio. 'But it is a little early to suggest that we know this is a vaccine response.'

It's possible that something else, such as better education or an increased media focus, could also have influenced how the disease spread during the study, Brady explained.

'In order to really document this was related to the vaccine, you have to look at those who got the vaccine and those who didn't,' he said.

Leval said her work, published in the Journal of Infectious Diseases, is the first to use data from the entire population of a country to estimate the rate of genital wart infections. Such a study would not be possible in the U.S., because there are no nationwide data on the condition.

The Swedish researchers linked two national registries - one on prescription drug use and one on hospital visits - to get estimates of how many people ages 10 to 44 were treated for genital warts.

Their results are likely to be lower than the real rates because the registries don't include people who got non-drug treatments at private practices, such as having their warts frozen off.

Women were most at risk of a new infection around age 20, whereas the rate peaked a few years later in men.

Initially, there was little difference in yearly infection rates between men and women - at 399 and 387 per 100,000 people, respectively. But that began to change after 2007.

While genital warts appeared to become more common among men, the rate dropped off among women, particularly teenagers and young adults.

Leval said HPV vaccinations were recommended for Swedish women up to age 26 during the study, and partially subsidized for girls between 13 and 17.

Twenty-seven percent of girls between 17 and 19 years old were fully vaccinated, she said, and the rate of new infections dropped by a quarter in this age group.

'We see no decline among men yet, indicating no herd immunity effect here when the portion of the population vaccinated is only roughly one-third in the recommended age-groups,' Leval said

She added that studies have found signs of herd immunity in men from Australia, where vaccine uptake in girls is about 80 percent.

HPV is the most common sexually transmitted infection in the U.S. According to the Centers for Disease Control and Prevention, at least half of all sexually active people will catch genital HPV at some point, although the virus usually goes away on its own without causing any symptoms.

Researchers estimate that HPV types 16 and 18 are responsible for about 7,000 cases of cancer in men every year in the U.S. and 15,000 cases in women.

Clinical studies show HPV vaccines shield boys and girls against genital warts and cancers, although the protection isn't complete. U.S. health regulators have found no serious side effects apart from soreness at the injection site.

The new results suggest genital warts are the second-most common STI in Sweden after chlamydia, said Leval. This year, the Scandinavian country has replaced its earlier on-demand vaccination strategy with 'a school-based and catch-up vaccination program,' she added.

SOURCE: http://bit.ly/NU1BPU Journal of Infectious Diseases, online July 18, 2012.



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Study of anti-AIDS vaginal ring begins in Africa

WASHINGTON (AP) - U.S. researchers are beginning to study several thousand women in Africa to see if inserting a vaginal ring coated with an anti-AIDS drug can protect them from HIV infection.

Giving women a tool to protect themselves when their partners won't use a condom is crucial for battling the epidemic. Half of the 34.2 million people with HIV worldwide are female.

Previous research found an anti-AIDS vaginal gel could protect women but using it every time they had sex was a hurdle. The vaginal ring, in contrast, would have to be inserted just once a month for continuous protection. Unlike contraceptive rings sold in the U.S., it contains no birth control.

The study, announced Tuesday at the International AIDS Conference, will be conducted in Malawi, Uganda, South Africa, Zambia and Zimbabwe.



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Researchers report more condom use among teenagers

WASHINGTON (AP) - More high school students are using condoms than 20 years ago - but progress has stalled with a lot of work still needed to protect young people from the AIDS virus, government researchers reported Tuesday.

Today, 4 of every 10 new HIV infections occur in people younger than 30, according to the Centers for Disease Control and Prevention - and the teen years, just as youths become sexually active, are key for getting across the safe-sex message.

Using a long-standing survey of high school students' health, the CDC tracked how teen sexual behavior has changed over 20 years. The results are decidedly mixed.

About 60 percent of sexually active high school students say they used a condom the last time they had sex, researchers said Tuesday at the International AIDS Conference. That's an improvement from the 46 percent who were using condoms in 1991.

"This is good news," said Dr. Kevin Fenton, director of CDC's HIV prevention center. But, "we need to do a lot more."

The problem: Condom use reached a high of 63 percent back in 2003.

Black students are most likely to heed the safe-sex message, yet their condom use dropped from a high of 70 percent in 1999 to 65 percent last year, the study found.

If mom and dad get antsy about discussing condoms, well, about half of high school students have had sex, a proportion that hasn't changed much over the two decades, the CDC reported. Today, 47 percent say they've had sex, down just a bit from 54 percent in 1991. Again, black teens made the most progress, with 60 percent sexually active today compared with 82 percent two decades ago.

The average age when teens begin having sex: 16, CDC said.

The more partners, the more risk. Fifteen percent of high school students say they've had four or more partners, down from 19 percent in 1991.

Fenton said part of the problem is that many school systems don't have strong enough sex education policies that include teaching teens about how to prevent HIV. But he cautioned that the CDC study can't link the abstinence-only policies pushed by Congress through the late 1990s and early 2000s to the stalled progress.

Focusing on individual risk behaviors is just part of the story. Increasingly, HIV is an infection of the poor, and specialists at the world's largest AIDS meeting all week are making the point that tackling it globally will require broader efforts to address problems of poverty including better access to overall health services and fighting stigma.

In the U.S., where new infections have stubbornly held at about 50,000 a year for a decade, complacency is part of the problem, Fenton added.

"We have to generate a new sense of urgency," he said.

Overall, though, a characteristic of the young is to think they're invincible, Fenton added.

Lawrence Stallworth II, 20, of Cleveland can attest that they're not. He learned he was infected with HIV at age 17, when he was a high-school senior, after a hospitalization. A black gay man, he's among one of the nation's highest-risk groups.

He's now an Ohio AIDS activist who works to teach young people that they need to protect themselves, and how.

"I want people to have the tools to keep themselves safe," said Stallworth, who at this week's AIDS conference is working with the nonprofit Advocates for Youth to increase young people's awareness of an epidemic that in the U.S., today gets little publicity.

Part of that involves our society getting "better at being more open about being able to talk about sex," Stallworth added. "It's still a taboo issue."

Indeed, at this week's conference, the world's largest AIDS meeting, young gay men are emerging as a population in special danger from rising HIV infections worldwide, and young black gay men especially in the U.S.

Black gay and bisexual men account for 1 in 500 Americans but 1 in 4 new HIV infections. The odds that a black man who has sex becomes infected rise from 1 in 4 at age 25 to a stunning 60 percent by age 40, said Phill Wilson of the Black AIDS Institute.

But they're not the only ones at risk. The CDC recommends that everyone in the U.S. ages 13 to 65 be tested for HIV at least once. Those at increased risk - such as people who have multiple sex partners or men who have sex with men - should be tested more frequently, at least once a year.

In South Carolina, 18-year-old Quinandria Lee offers an example of the safe sex practices that CDC says more young people should adopt.

Lee was frustrated at her school's abstinence-only focus. She learned about both male and female condoms from the South Carolina Contraceptive Campaign, and last year her principal allowed her to teach her classmates about them. Condoms are the only contraceptive that also protect against HIV infection.

But Lee credits her mother's frank talk about sex with this key protective step: Lee persuaded her boyfriend to go with her to a clinic where both got a clean bill of health before they ever had sex. Still, they use a condom every time.

"It's hard," she said of that get-tested conversation. But "you can't be too sure."



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Monday, July 23, 2012

Bill Gates says much more work needed to turn tide of AIDS

WASHINGTON (Reuters) - Philanthropist and AIDS prevention advocate Bill Gates said on Monday there had been significant advances in the fight against HIV/AIDS, but he was not ready to say the world was 'turning the tide' on the disease, the theme of this week's International AIDS Conference.

Gates said the trajectory of the disease had certainly improved, noting figures the United Nations released last week showing global AIDS deaths last year fell to 1.7 million, down from 1.8 million in 2010.

But that still means far too many people are dying from AIDS, the multibillionaire co-founder of Microsoft Corp told Reuters in an interview at his offices in Washington, the host city of this year's AIDS conference.

'Is the end clearly in sight? No. Do we have the tools that will bring about the end? No,' said Gates.

He said wealthy nations, which have been the primary engine for funding the research and the delivery of life-saving drugs to 8 million poor people, faced financial challenges that threatened AIDS funding.

If anything, now is the time to make sure AIDS remains a funding priority 'despite the toughness that is out there,' he said.

According to the U.N. report, funding for HIV prevention and treatment totaled $16.8 billion last year, with $8.2 billion coming from wealthy international sources, including the United States, which donated nearly half of it.

But poor and middle-income countries are shouldering more of the HIV burden, spending $8.6 billion last year, surpassing the contributions of affluent donor nations for the first time.

So far, the Bill and Melinda Gates Foundation has handed out $2.5 billion in HIV grants, and committed a further $1.4 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The biggest chunk of the foundation's HIV spending is on an HIV vaccine, one of the tools Gates sees as essential to ending the AIDS epidemic.

Gates, who met with vaccine experts on Monday, said they were making 'really good progress,' but they still needed to come up with a good vaccine candidate and then test it in a series of clinical trials.

'There is a very good chance it will be a decade plus before we'll have the thing,' he said.

(Reporting by Julie Steenhuysen; Editing by Peter Cooney)



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Fighting AIDS: US donates an extra $150 million

WASHINGTON (AP) - Science now has the tools to slash the spread of HIV even without a vaccine - and the U.S. is donating an extra $150 million to help poor countries put them in place, the Obama administration told the world's largest AIDS conference Monday.

"We want to get to the end of AIDS," declared the top U.S. HIV researcher, Dr. Anthony Fauci of the National Institutes of Health.

How long it takes depends on how quickly the world can adopt those tools, he said - including getting more of the millions of untreated people onto life-saving drugs that come with the bonus of keeping them from infecting others.

"No promises, no dates, but we know it can happen," Fauci told the International AIDS Conference.

Part of the challenge will be overcoming the stigma that keeps high-risk populations from getting needed AIDS treatment and services.

"We have to replace the shame with love," singer Elton John told the conference. "We have to replace the stigma with compassion. No one should be left behind."

Some 34.2 million people worldwide are living with HIV, and 2.5 million were infected last year.

Secretary of State Hillary Rodham Clinton said the goal is an AIDS-free generation. That would mean no babies would be born infected, young people would have a much lower risk than today of becoming infected and people who already have HIV would receive life-saving drugs so they wouldn't develop AIDS or spread the virus.

"I am here today to make it absolutely clear the U.S. is committed and will remain committed to achieving an AIDS-free generation," Clinton told the more than 20,000 scientists, people living with HIV and policymakers assembled for the conference.

But it will require smart targeting of prevention tools where they can have the greatest effect. "If we want to save more lives, we need to go where the virus is," she said.

First, Clinton said it's possible to virtually eliminate the transmission of HIV from infected pregnant women to their babies by 2015, by getting the mothers onto anti-AIDS drugs. HIV-infected births are rare in the United States and are dropping steadily worldwide, although some 330,000 children became infected last year. Clinton said the U.S. has invested more than $1 billion toward that goal in recent years and is providing an extra $80 million to help poor countries finish the job.

Much of the AIDS conference is focused on how to get treatment to all people with HIV, because good treatment can cut by 96 percent their chances of spreading the virus to sexual partners. Fauci pointed to South Africa, where healthy people who live in a region that has increased medication now have a 38 percent lower risk of infection compared with neighbors in an area where HIV treatment is less common.

Drugs aren't the only effective protection. Fauci said male circumcision is "stunningly successful," too, at protecting men from becoming infected by a heterosexual partner. Clinton said the U.S. will provide $40 million to help South Africa reach its goal of providing voluntary circumcision to half a million boys and men this year.

A tougher issue is how best to reach particularly high-risk populations: gay and bisexual men, sex workers and injecting drug users. In many countries, stigma and laws that make their activities illegal drive those populations away from AIDS programs that could teach them how to reduce their risk of infection, Clinton said.

"If we're going to beat AIDS, we can't afford to avoid sensitive conversations, and we can't afford not to reach the people who are at the highest risk," she said.

So the U.S. will spend an additional $15 million on research to identify the best HIV prevention tools to reach those key populations in different countries, and then launch a $20 million challenge fund to support country-led efforts to implement that science.

Better prevention for gay and bisexual men is a huge issue in the U.S. as well - and a striking study presented Monday added evidence that those men are especially at risk if they're young and black.

Government-funded researchers tracked black gay and bisexual men in six U.S. cities and found that 2.8 percent a year are becoming infected, a rate 50 percent higher than their white counterparts. Worse, the rate was nearly 6 percent a year in those men who are 30 or younger.

Phill Wilson of the Black AIDS Institute said these men are engaged "in a raging epidemic" that doesn't get enough attention. He estimated that nearly 60 percent of black gay men are infected by age 40.

The world spent $16.8 billion fighting AIDS in poor countries, the hardest-hit, last year, and the United States is the leading donor.

But Bill Gates, the Microsoft founder and philanthropist, said the world is facing incredible uncertainty about whether wealthy nations will continue funding AIDS programs with the same vigor as in the past.

"As these budget tradeoffs are made, the voices of the AIDS community and the global health community are going to have to be louder than ever," said Gates, whose Bill & Melinda Gates Foundation has pledged more than $1 billion to global AIDS efforts.

Another $7 billion a year is needed to get to 15 million people in low- and middle-income countries by 2015, a United Nations goal. A record 8 million received potentially life-saving drugs last year.

"This gap is killing people," UNAIDS chief Michel Sidibe told the conference. "My friends, the end of AIDS is not free. It is not too expensive. It is priceless."

The prices of generic AIDS drugs in developing countries are dropping every year. One philanthropy, the Clinton Health Access Initiative, said 70 countries in Africa, Asia, Eastern Europe, Latin America and the Caribbean that participate in its drug-procurement program now can purchase the main combination for less than $200 a year.

"We have to be innovative," said Sheila Tlou, the former health minister of Botswana, now with UNAIDS. "We have to look at new ways of funding."

Speaking to the conference via video, French President Francois Hollande said his country was doing that by beginning what's called a financial transaction tax next month. The tax idea has received a lukewarm reception in other parts of Europe and the U.S.

___

Associated Press Writer Joshua Lederman contributed to this report.



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Black American Men Have High Rates of HIV Infection: Study

MONDAY, July 23 (HealthDay News) -- A new study finds disturbingly high rates of new HIV infections among American black men who are gay or bisexual, particularly those aged 30 and younger.

HIV is the virus that causes AIDS.

Researchers with the HIV Prevention Trials Network looked at nearly 1,600 black gay and bisexual men in six cities -- Atlanta, Boston, New York, Los Angeles, San Francisco and Washington, D.C. -- between 2009 and 2011.

The overall rate of new HIV infection among the men was 2.8 percent per year, which is nearly 50 percent higher than in white gay and bisexual men in the United States. The rate among black gay and bisexual men 30 and younger was 5.9 percent per year.

The overall rate of new HIV infection among black gay and bisexual men in the United States is comparable to rates in the general populations of countries in sub-Saharan Africa that have been hardest hit by the HIV/AIDS epidemic.

The study was to be presented Monday at the International AIDS Conference in Washington, D.C. Data and conclusions presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

'We have known that black [gay and bisexual men] are affected by HIV at disproportionately higher rates when compared to other [gay and bisexual men] in the U.S., but the [study's] HIV incidence rates were extremely high,' study co-chairman Darrell Wheeler, dean of the School of Social Work at Loyola University in Chicago, said in an HIV Prevention Trials Network news release. 'They make it very clear that we must urgently find and implement ways to stem the spread of HIV among black gay men in this country, and critically among young black gay men.'

Other early analyses from the study show that HIV infection in black gay and bisexual men in the United States was associated with both poverty and high rates of untreated sexually transmitted infections.

'The study findings are a sobering wake-up call,' Dr. Wafaa El-Sadr, co-principal investigator for the HIV Prevention Trials Network, said in the news release. 'These results -- and others to be garnered from further analysis of the study -- highlight the enormity of the challenges ahead and offer important insights into how to design research studies and programs for prevention of HIV among black [gay and bisexual men].'

The researchers are continuing their analysis of data from the study in order to determine whether HIV risk among black gay and bisexual men might be affected by childhood experiences, social and sexual networks, discrimination, homophobia, health care and incarceration.

More information

The U.S. Centers for Disease Control and Prevention has more about HIV and AIDS in the United States.



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Sec'y Clinton lauds headway in battle against AIDS

WASHINGTON (AP) - Secretary of State Hillary Rodham Clinton says it's possible to virtually eliminate HIV-infected births and the U.S. is donating $80 million in new funding to help poor countries reach that goal.

Treating HIV-infected women so that they protect their babies is a key part of the Obama administration's goal of an AIDS-free generation.

Clinton told the International AIDS Conference Monday that the new money will help get those life-saving drugs to women who now slip through the cracks.

Clinton also says the U.S. is investing millions more to study what works best to protect the highest-risk population in hard hit countries- gay and bisexual men, sex workers and injecting drug users.

Her message: "If we're going to beat AIDS, we can't afford to avoid sensitive conversations."

Earlier, Dr. Anthony Fauci, the leading U.S. AIDS researcher, told the conference that science has provided the tools needed to slash new infections even without a vaccine - if countries will put them in place.

Fauci said it won't be easy or happen overnight. In his words, "no promises, no dates but we know it can happen."

Fauci said "we want to get to the end of AIDS" but that "a lot of people, a lot of countries, a lot of regions have a lot to do."

Topping that list of tools is better treatment of people who already have HIV, so they're less likely to spread the virus. But Fauci also called male circumcision a "stunningly successful" step, pointing to part of Uganda that's stressing that step.

Researchers, doctors and patients attending the conference are urging the world's governments not to cut back on the fight against the epidemic when it is at a turning point.

There is no cure or vaccine yet, but scientists say they have the tools to finally stem the spread of this intractable virus - largely by using treatment not just to save patients but to make them less infectious, too.

"Future generations are counting on our courage to think big, be bold and seize the opportunity before us," said Dr. Diane Havlir of the University of California, San Francisco, a co-chair of the International AIDS Conference.

"We must resolve together never to go backwards," Dr. Elly Katabira, president of the International AIDS Society, told the conference's opening session late Sunday.

More than 20,000 scientists, people living with HIV and policy-makers are meeting this week to figure out how to turn some scientific advances into practical protections, valuable additions to those tried-and-true condoms.

Studies show that treating people with HIV early, before they're sick, not only is life-saving for them but lowers their chances of spreading the virus through sex.

On another front, healthy people can take the daily AIDS medicine Truvada to lower their risk of infection from a sexual partner. Hard-hit countries are grappling with how to try that protection in their highest-risk populations.

Other goals include getting more HIV-infected pregnant women treated to protect their babies, and getting more men circumcised in developing countries to protect them from heterosexual infection.

But money is a big challenge during a global recession - and for countries weary of the fight against a disease with an ever-growing number of people who need care. Today, there are 34.2 million people living with HIV, and while infections are dropping slowly, still 2.5 million are infected every year.

The world spent $16.8 billion fighting AIDS in poor countries, the hardest-hit, last year. But that's still $7 billion a year shy of the amount needed to nearly double the 8 million people getting life-saving drugs by the world's goal of 2015.

"This gap is killing people," UNAIDS chief Michel Sidibe told the conference. "My friends, the end of AIDS is not free. It is not too expensive. It is priceless."



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