New drug shows promise

Source: AIDSMAP

There are currently over 20 drugs available to treat HIV, but there is still a need for new drugs. This is mainly because HIV can become resistant to the drugs used to treat it. Researchers are not only trying to develop drugs that have a powerful effect against HIV, but that are also easy to take and cause fewer side-effects than those that are currently available.

CCR5 inhibitors are a new class of anti-HIV drug. They prevent HIV from binding to the surface of key CD4 immune system calls. One CCR5 inhibitor, maraviroc (Celsentri) has already been approved and another, vicriviroc, is doing very well in clinical trials.

Researchers are working on another type of drug that targets CCR5. It uses a special type of human antibody called “monoclonal antibodies.” Their main advantage could be that they only have to be taken every two weeks, or possibly even just once a month, but still have a powerful anti-HIV effect.

The safety and effectiveness of an experimental drug that uses this technology, called HGS004, was examined in a small study involving 63 HIV-positive patients. They were not taking any other anti-HIV drugs. The patients were randomised and given a single injection consisting of one of five different doses of the drug or a placebo.

Three of the doses led to big falls in viral load, that lasted as long as 28 days in some of the people who received the higher dose. The drug appeared safe. A similar drug that is also in development called HGS101 is thought to be five to ten times more powerful.

Cutting Funding Equals Cutting Lives

A statement by AIDS Service Organizations in Alberta, Quebec and Ontario
TORONTO, March 18 /CNW/ - A life saving post card campaign is being launched by people living with HIV/AIDS, their friends, families and service organizations in Alberta, Ontario and Quebec after the Federal government slashed community HIV funding across the country.
This HIV funding is used to provide direct services to the 62,000 Canadians living with HIV/AIDS and for implementing education programs designed to prevent new HIV infections. 2,508 Canadians were diagnosed with HIV in 2006, 14% more than were diagnosed in 2001. It is estimated that approximately 4,000 Canadians are actually newly infected with HIV each year. There still is no cure for AIDS; it continues to be a debilitating and fatal illness.
Ontario alone lost 30% of its promised federal funding with a $1 million cut in funding for programs to prevent HIV and to provide support services for people who are already infected. Quebec lost 24% of its funding and Alberta AIDS Service Organizations still have no commitment from the federal government to continue their funding which expires March 31, 2008.
AIDS Service Organizations in Alberta, Quebec and Ontario are united in urging Canadians to send a message to Prime Minister Stephen Harper and to their Members of Parliament that, Cutting Funding=Cutting Lives.
"Given a commitment by all of Canada's major political parties to double the funding by 2008 we were shocked when we learned of the cuts" said Sue Cress, Chair of the Alberta Community Council on HIV. "Alberta AIDS Service Organizations have not received an increase in funding since 2004. Instead of an expected increase this year, we will have a decrease from last year's amounts."
The Federal Initiative on HIV/AIDS promised to increase funding from $42.2 million to $84.5 million by 2008-09. The government's own figures show that $7 million will be cut from front-line service organizations at the national and regional levels over a 5 year period. These cuts are occurring as HIV/AIDS-related programs and services are experiencing dramatic increases in demand both because of the number of new infections and because people with HIV are living longer. In fact there was a 43% increase in demands for service between 1993 and 2003.
Lyse Pinault, General Director of Quebec's Coalition des Organismes Communautaires Quebecois de Lutte Contre le SIDA (COCQSIDA) stated, "Quebec has never before received a funding cut to our HIV/AIDS prevention and support services from any previous Federal government. The cost of preventing HIV is much cheaper than the cost of expensive medications to treat it."
Every HIV infection that is prevented saves approximately three quarters of a million dollars in direct and indirect costs.
On July 31, 2006, Minister of Health Tony Clement stated in a press release "...HIV/AIDS remains an issue of significant concern for Canada". Despite this assurance AIDS organizations were not given any notice that cuts were coming or a clear explanation as to why these cuts were needed. Information on the Public Health Agency of Canada's website advises that funds have been diverted to a new HIV vaccine program announced by the Prime Minister and Bill Gates on February 20, 2007.
According to Rick Kennedy, Executive Director of the Ontario AIDS Network, "Vaccine research is important for our future, but it should not come at the expense of people who are infected with HIV/AIDS. Our lives should not be any more expendable than people living with other serious health conditions. It is hard to imagine the government cutting support services for people with cancer or other very serious diseases to invest in research that may or may not prove life saving. An AIDS vaccine is many, many years into the future. What happens to our health now?"
Twenty-two years ago on December 10, 1986 a World Health Organization specialist announced that human testing of an AIDS vaccine would begin the following year. A vaccine for AIDS is still decades away. We need more vaccine research and ultimately a cure. However, Canada must not regress and reduce its efforts to prevent new HIV infections and save lives now, before a vaccine is found. Cutting Funding=Cutting Lives. Funding must be restored to the levels promised in the Federal Initiative.
We are calling on all Canadians to join us in letting the Prime Minister and his government know that these cuts are hurting Canada's ability to stop AIDS.
Send a message to the Prime Minister and Members of Parliament that HIV prevention, education and support services are important. Postcards for the "Cutting Funding=Cutting Lives" campaign can be obtained in French or English at www.increaseaidsfunding.ca

New journal received: AIDS Education and Prevention, Vol. 20, no 1, February 2008

In this issue:

Cultural Adaptation of the Focus on Kids Program for College Students in China
Authors: Xiaoming Li, Bonita Stanton, Bo Wang et al.
pp. 1-14
Abstract

HIV Serostatus Disclosure to Sexual Partners among HIV–Positive Methamphetamine-Using Gay, Bisexual, and Other Men Who Have Sex With Men
Authors: Karen C. McCready and Perry N. Halkitis
pp. 15-29
Abstract

Experiences and Sexual Behaviors of HIV–Infected MSM Who Acquired HIV in the Context of Crystal Methamphetamine Use
Authors: Matthew J. Mimiaga, Andrew D. Fair, Kenneth H. Mayer et al.
pp.30-41
Abstract

In the Shadows of a Prevention Campaign: Sexual Risk Behavior in the Absence of Crystal Methamphetamine
Authors: Christian Grov, Jeffrey T. Parsons and David S. Bimbi
pp. 42-55
Abstract

Gender Differences in Intimate Partner Violence on Substance Abuse, Sexual Risks, and Depression among a Sample of South Africans in Cape Town, South Africa
Authors: Frank Y. Wong, Z. Jennifer Huang, Julia A. DiGangi, et al.
pp. 56-64
Abstract

Self–Reported HIV Testing Behaviors among a Sample of Southeast Asians in an Urban Setting in the United States
Authors: Zhihuan Jennifer Huang, Frank Y. Wong, Jordana M. De Leon and Royce J. Park
pp. 65-77
Abstract

“Let's Talk About Sex”: Pilot Study of an Interactive CD–ROM to Prevent HIV/STIS in Female Adolescents
Authors: Kristin E. Ito, Sri Kalyanaraman, Carol A. Ford, et al.
pp 78-89
Abstract

Contact the library to request copies of articles.

The nearly forgotten plague

Source: The Globe and Mail

Cutting-edge AIDS medications have lengthened patients' lives and given many a better existence than they would have had 10 years ago, but these advances have helped push the disease out of mainstream consciousness. Health-care workers point to continuing problems that need attention: 'premature aging,' lack of bed space and failure to make sure everyone - especially the poor - gets medicine

ROD MICKLEBURGH March 15, 2008

VANCOUVER -- In the lobby of the gleaming Dr. Peter Centre for patients with AIDS, a man of indeterminate age is moaning.

"If I go out there, I'll die," he says to himself.

Another man shuffles past, his face pinched and gaunt. He looks 75 years old but isn't.

Later, a third man, Tom Griffin, came into a room to talk. Or rather, he was wheeled in by his friend, Spencer Dane. He has difficulty keeping his head up. His voice is weak. Conversation often drops off from fatigue and emotion. And this is a good day for the once-vigorous restaurateur, Mr. Dane said.

It's a face of AIDS not seen much any more. As breakthrough medications lengthen lives, saving tens of thousands of infected Canadians from a terrible, premature death, the news media have moved on to other stories. But a visit to Dr. Peter's, or a talk with anyone on the treatment front lines, is a sobering reminder that Old Man AIDS, the deadly viral trickster, hasn't gone away. People are still being infected, still suffering and still dying.

The picture is not pretty. Although more people than ever before are living with AIDS and HIV, many are far from healthy. Woeful gaps in care remain, between those stable enough to maintain life-prolonging antiretroviral therapy and those who remain on the wild side. Despite the best efforts of dedicated outreach workers and physicians, 40 per cent of the 1,436 British Columbians who died of HIV-related causes from 1997 to 2005 made no attempt to access the drugs, even though they were free.

Another 2,500 individuals in B.C. are estimated to be HIV-positive without knowing it, greatly increasing the risk of passing the lethal virus on to others. (...)

Click here to read the complete article.

Study uncovers HIV 'mini-epidemics'

Source: Channel 4 News

HIV is spreading among gay men in mini-epidemics, a study has found.

Data from more than 2,000 infected men in London showed distinct clusters or "bursts" of the disease.

Researchers now believe targeted local campaigns in bars, nightclubs and via the internet could be the most effective way of curbing the spread of the disease by sexual contact.

The University of Edinburgh study was carried out with Chelsea and Westminster Hospital in London, using data collected between 1997 and 2003. It found many men who became infected with the virus passed it on within a few months, often before they themselves had been diagnosed as HIV positive.

Professor Andrew Leigh Brown of the University of Edinburgh's School of Biological Sciences, who led the study, said: "By studying changes in the virus over time, we have been able to pinpoint its progress in stages through the groups of men affected, which until now has not been done effectively. What we have discovered is that some of the spread occurred in bursts, with groups of people becoming infected within a short period of time."

Prof Leigh Brown said such a pattern had been seen occasionally among HIV-infected drug users but had not been identified in sexual transmission until now. (...)

The study is published in PLoS Medicine. Click here to access it.

Manitoba HIV rate almost quadruples among women

Source: CBC News

The rate of HIV infection is rising dramatically in Manitoba among women and First Nations communities, according to a new report by Manitoba Health. The proportion of newly diagnosed HIV cases among women has almost quadrupled in the past decade, compared with the previous one, the report says.

Of cases where the ethnicity of the patient is reported, one-third of all new infections were diagnosed in aboriginal people in the past seven years. Dr. Pierre Plourde, medical officer of health for the Winnipeg Regional Health Authority, said one reason for the increase could be a change in attitude about HIV (the human immunodeficiency virus).

"We think that one of the reasons for that could be that HIV has now become seen as just a chronic condition that is manageable," he said.

"It's not the death sentence it used to be, and people's sexual behaviours are reflecting that now. There are much more risky sexual behaviours occurring in men and in women."

The trend for HIV infection on Manitoba First Nations appears to be mimicking the way infection has spread across sub-Saharan Africa, Plourde said.

Like sub-Saharan Africa
"If you look at the numbers among First Nations, the ratio of men-to-women cases is almost equal, which is more reflective of the type of dynamic that is seen in sub-Saharan Africa, suggesting similar forms of transmission, i.e. men and women transmitting it to one another through sexual means," he said.

Between 1985 and 1995, about 65 per cent of new HIV cases were believed to have been transmitted among men having sex with men, the report says, while reported heterosexual transmissions made up just nine per cent. But in cases reported in the past decade, homosexual transmission cases had dropped to 18 per cent, while heterosexual transmission cases climbed to 32 per cent. Women accounted for a third of all new HIV cases in the past decade, compared with eight per cent in the previous one. Of the cases over the past seven years in which ethnicity of the patient was reported, 32 per cent of patients said they were aboriginal, 27 per cent white, and 20 per cent black. The number of people infected with HIV in Manitoba is still very low compared with other countries, Plourde said, but Manitoba has one of the highest per-capita rates of HIV infection in Canada.

82 new cases in 2007
A total of 1,477 people in Manitoba tested positive for HIV between 1985 and the end of 2007, according to the report. Eighty-two new cases were reported in 2007. More than 260 cases of AIDS have been reported since 1985, the report says; nearly three-quarters of them have died. More than 80 per cent of all HIV cases were reported among residents of Winnipeg. Positive HIV test results must, by law, be reported to provincial officials. AIDS cases and deaths are also reportable.

Last year, the provincial government made it possible for Manitobans to be tested anonymously for HIV and other sexually transmitted infections, a move that was expected to encourage people who otherwise might not have been tested to do so.

HIV infections expected to rise

Source: ABC News

A study focusing on HIV infection trends in Australian gay men is predicting a substantial increase in HIV infection in some states over the next seven years.

The report released today by the National Centre in HIV Epidemiology and Clinical Research predicts a 73 per cent rise in HIV infections in Victoria and a 20 per cent rise in Queensland by 2015.

But the infection rate is predicted to show a slight decrease in New South Wales.

Researcher Dr David Wilson says reduced condom usage and a rise in other sexually transmitted diseases is expected to contribute to the increase.

"If somebody's HIV positive and have another infection such as syphilis, gonorrhoea, chlamydia, herpes, then they are 200 to 500 per cent more likely to transmit HIV to a susceptible person," he said.

Dr Wilson says increased promotion of safe sex is the most effective way to stop the rise HIV transmission.

Gene could stop spread of HIV

Source: The Edmonton Sun

New research reveals from U of A
By KEVIN CRUSH, SUN MEDIA

New research out of the University of Alberta shows that a gene found in the human body could be used to stop the spread of HIV.
“It’s very exciting for patients who are infected with HIV,” said researcher Dr. Stephen Barr. “It gives them another target or hope that there is another gene that can help them out in their fight.”

News that there could be another weapon against HIV/AIDS is indeed a big deal, said Debra Jakubec, executive director of HIV Edmonton.

“It’s exciting research. It is still probably a far ways from getting it out of clinical research but it is exciting,” added Jakubec.

Three years ago while at the University of Pennsylvania, Barr, 32, began his work on a gene called TRIM22 – work that continued when he moved to the University of Alberta’s department of medical microbiology and immunology two years ago.

TRIM22 is a gene in humans that fights viruses. For a reason still unknown, TRIM22 doesn’t work in patients with Human Immunodeficiency Virus (HIV).

But lab tests have shown that when TRIM22 is turned on in cell cultures infected with HIV, the gene stops the assembly of the virus and essentially locks the virus in the cell like a prisoner in a cage. If it can’t get out of the cell, the spread of HIV is stopped in its tracks.

“This gene works particularly at preventing the virus from getting out of cells. So it can’t stop the virus from getting in (to the cell) but it can lock it in so it can’t get out,” said Barr, whose research is being published in the medical journal PloS Pathogens.

It’s not a cure, cautioned Barr. It hasn’t been tried in live patients so it’s not known if TRIM22 could be turned on in a person or what would happen, but it could be a major step towards finding a cure.

“One hope is that if you can trap the virus in the cell, other defence mechanisms in the cell will try to get rid of it,” said Barr.

Another possibility is researchers may be able to develop drugs that mimic TRIM22 to be used to block the spread of HIV or even to possibly cure it.

“If we include TRIM22 in our therapies, it can be used in combination with drugs to make them more effective at blocking and killing the virus,” said Barr.

Jakubec is hopeful this research will help in finding a cure or vaccine, but she also cautions that cure is still a long ways off.

“If something does come out that’s a preventative vaccine, we would still want people to know just how effective it is and still practice safer sex,” she said.

She noted that Alberta is seeing rising rates of sexually transmitted diseases such as gonorrhea and syphilis. Even the number of HIV infections in Alberta appears to be on the rise. New infections in the province used to average 170-180 per year, but in 2006 that rose to 218.

Barr is also cautioning that this is just a step in the fight against AIDS.

“We’re really in the infancy of the research. This is the initial discovery and we need to go in and find out how the virus is interacting with TRIM22, such as does the virus have a way of killing TRIM22 so that it can survive?”

Zimbabwe: Canada Donates C$2,4m for HIV/Aids Project

Source: All Africa

Harare

THE Canadian government on Wednesday injected C$2,4 million into the Expanded Support Programme for HIV and Aids Prevention, Treatment and Care in Zimbabwe while the Conglomerate of Farm and Industry has launched an HIV programme for the workplace.

ESP, an initiative of the United Nations Development Programme, has 16 districts in Zimbabwe. The Zimbabwe National HIV and Aids Strategic Plan will also benefit from the donation.

Canadian Ambassador to Zimbabwe Mrs Roxanne Dubé handed over the money to UNDP on Wednesday in Harare. UNDP will then disburse the money to ESP's 16 districts for the benefit of about 20 000 people, most of them in rural areas. Speaking at the handover ceremony, Mrs Dubé hailed Zimbabweans for their efforts in to curb the incidence of HIV and Aids. "I appreciate the work being done by Zimbabweans and other stakeholders in addressing the prevalence of HIV and Aids in the country," she said.

Mrs Dubé said the donation would not only help to support the infected with drugs, prevention services, treatment and care but also the ESP.

"As partners in development, Canada is concerned with the welfare of the people of Zimbabwe. On issues of such critical humanitarian importance and for the direct benefit of the most vulnerable people, we are pleased to collaborate with the dedicated staff in both civil society and the national health system in rural and urban Zimbabwe," she said.

Ambassador Dubé said the initiative was consistent with the government of Canada's priorities to scale up universal access to HIV and Aids services reiterated at the United Nations General Assembly Special Session on HIV and Aids of 2006. National Aids Council director Dr Tapiwa Magure hailed Canada for its continued support in the national multi-sectoral response to HIV and Aids.

Meanwhile, the Conglomerate of Farms and Industry has launched a programme of HIV and Aids awareness in the workplace in Harare. CFI comprises 12 companies, among them Town and Country, Farm and City, Victoria Foods, Suncrest, Hubbard, Agrifoods as well as Dore and Pitt.

CFI group human resources director Mr Edwin Murwira said they launched the awareness programme because the rate at which people were perishing at workplaces on farms and in industry had reached alarming levels. He said they were not going to assist financially as yet because people needed to be taught first.

"We want people to know that they must abstain, use condoms or be faithful to thwart the spread of HIV and Aids in the workplace," he said.

Although Mr Murwira said the programme was the first of its kind, he expressed confidence that it would yield beneficial results. Speaking at the same workshop, National Aids Council finance director Mr Albert Manenji challenged the business community to help in HIV and Aids issues.

"NAC needs US$38 million to procure anti-retroviral drugs," he said.

New journal received in the library: AIDS Patient Care& STDs, Vol. 22, no 1, January 2008

In this issue:

Case Report: Bilateral Renal Aspergillosis in a Patient with AIDS: A Case Report and Review of Reported Cases
A.W. Oosten, H.G. Sprenger, J.T.M. van Leeuwen, N.E.L. Meessen, S. van Assen
pp. 1-6.
Abstract

Viro-Immunologic Response to Ritonavir-Boosted or Unboosted Atazanavir in a Large Cohort of Multiply Treated Patients: The CARe Study
Maria Mercedes Santoro, Ada Bertoli, Patrizia Lorenzini, Adriano Lazzarin, Roberto Esposito, Giampiero Carosi, Giovanni Di Perri, Gaetano Filice, Mauro Moroni, Giuliano Rizzardini, Pietro Caramello, Renato Maserati, Pasquale Narciso, Antonietta Cargnel, Andrea Antinori, Carlo Federico Perno, the CARe Study Group
pp. 7-16.
Abstract

Concurrent HIV/AIDS Diagnosis Increases the Risk of Short-Term HIV-Related Death among Persons Newly Diagnosed with AIDS, 2002–2005
David B. Hanna, Melissa R. Pfeiffer, Lucia V. Torian, Judith E. Sackoff
pp. 17-28.
Abstract

Prior Illicit Drug Use and Missed Prenatal Vitamins Predict Nonadherence to Antiretroviral Therapy in Pregnancy: Adherence Analysis A5084
Susan E. Cohn, Triin Umbleja, Joseph Mrus, Arlene D. Bardeguez, Janet W. Andersen, Margaret A. Chesney
pp. 29-40.
Abstract

Predictors of the Initiation of HIV Postexposure Prophylaxis in Rhode Island Emergency Departments
Roland C. Merchant, Kenneth H. Mayer, Bruce M. Becker, Allison K. Delong, Joseph W. Hogan
pp. 41-52.
Abstract

A Qualitative Study Among Injection Drug Using Women in Rhode Island: Attitudes Toward Testing, Treatment, and Vaccination for Hepatitis and HIV
Michelle A. Lally, Sydney A. Montstream-Quas, Sara Tanaka, Sara K. Tedeschi, Kathleen M. Morrow
pp. 53-64.
Abstract

Vaccination in Brazilian HIV-Infected Adults: A Cross-Sectional Study
Yeh Li Ho, Thatiana Enohata, Marta Heloisa Lopes, Sigrid De Sousa Dos Santos
pp. 65-70.
Abstract

Self-Reported Adherence to Antiretroviral Treatment among HIV-Infected People in Central China
Honghong Wang, Gouping He, Xianhong Li, Aiyun Yang, Xi Chen, Kristopher P. Fennie, Ann Bartley Williams
pp. 71-80.
Abstract

Letter to the Editor: Medical Care of HIV-Infected Individuals in Poland: Impact of Stigmatization by Health Care Workers
Dorota Rogowska-Szadkowska, Alicja Małgorzata Ołtarzewska, Jolanta Sawicka-Powierza, Sławomir Chlabicz
pp. 81-84.

Contact the library to request copies of articles.

New approach stops HIV at earliest stage of infection

Source: Science Daily

ScienceDaily (Feb. 28, 2008) — Researchers at The Scripps Research Institute have developed a new two-punch strategy against HIV and they have already successfully tested aspects of it in the laboratory.

Their study, which appears in the online Early Edition of the Proceedings of the National Academy of Sciences, may re-energize attempts to create a preventive/therapeutic vaccine against HIV, say the authors. To date, more than a dozen candidate vaccines, which have attempted to raise immunity against the spiky proteins on the viral envelope, have all failed in clinical testing.

The investigators have created devices they call glycodendrons that are designed to do two things at once: inhibit the transport of HIV from where it traditionally enters the body, preventing it from moving deeper inside where it can infect immune cells; and set up an immune antibody response to a unique carbohydrate structure on the surface of the virus.

"This paper is about a new direction in HIV vaccine design," said the study's lead investigator, Scripps Research Chemistry Professor Chi-Huey Wong. "Results we have so far are very promising."

To date, he says the devices have been able to stimulate the immune system of mice to induce antibodies against HIV surface glycoprotein, and, in laboratory studies, have been able to block the virus from infecting immune cells. (...)

Click here to read the complete article.

B.C. study shows 40 per cent of HIV sufferers died without getting treatment

Source: The Canadian Press

VANCOUVER - Forty per cent of the people who died of HIV-AIDS in British Columbia never accessed life-saving treatment even though it was free, according to a new study released Friday.

The study by the B.C. Centre for Excellence in HIV-AIDS looked into more than 1,400 HIV-related deaths in the province between 1997 and 2005.

In that period of time, a total of 567 people died without ever receiving the highly effective antiretroviral treatment.

"We have a problem," said Dr. Julio Montaner, director of the centre. "The treatments are available for free but something is wrong because the people that most need the treatment, they're not always accessing the treatment."

Low income was strongly associated with the delay in starting therapy and the ensuing high mortality rate.

Residence in a poor neighbourhood was associated with an increased risk of mortality among HIV patients, Montaner said.

"Factors such as a lack of housing or transportation, mental illness, illegal activity and language barriers play a role in an individual's ability to access treatment," he said.

Twenty-five per cent of those infected with HIV in Canada are not aware of their infection, according to the centre.

The centre distributes the cocktail of antiretroviral medications to all eligible British Columbians, free of charge, through the provincewide Drug Treatment Program, funded by Pharmacare.

Yet ensuring access to the treatment remains an elusive goal, he said.

"We have found that over the last several years there is a persistent number of people dying with HIV in our midst, where treatment and health care is supposed to be readily available," Montaner said.

Typical examples are single mothers who don't have the resources to get a babysitter or a homeless, mentally ill drug addict who lives on the Downtown Eastside and doesn't even know he's HIV-positive, he said.

And it's not just Vancouver, Montaner said. It's a problem right across the country and the percentage could even be worse in smaller communities where fewer resources are available.

Ann Livingston, spokeswoman for the Vancouver Area Network of Drug Users, called the study shocking.

Four in 10 people in Vancouver's Downtown Eastside live outside and many among them are sick with AIDS, she said.

Some live in substandard hotels that are often infested with cockroaches and unsafe but people stay there because welfare payments don't provide enough money for decent housing for those who are too ill to work, Livingston said.

"And they have no general practitioner. That's another nightmare," she said.

Ken Buchanan, of the British Columbia Persons with AIDS Society, said the long-term solution is to bring some stability to the lives of HIV-AIDS sufferers.

"For a person who is homeless, taking medications, even free medications, is pretty low in their priorities," he said.

Buchanan warned that access to medication isn't enough. A person who begins treatment and doesn't maintain the proper dose regime will build up a resistance to the drugs and end up more likely to die.

"You can't take them for a few days and then stop for a few days," he said. "If your life is chaotic ... you don't have the ability or the need or the desire to take your meds."

The centre has a proposal before the provincial government to form outreach teams that would take rapid-response testing to the most vulnerable and offer treatment.

But "free health care is not necessarily enough to address this problem," he said.

"We need to bring the treatments to the people and we need to create the programs that are going to help these individuals to take the treatment," he said.

It is not only the ethical and human thing to do, he said, it's also better for society at large because it reduces HIV-related illnesses that drain the health care system.

"By treating these people we're doing what is right for them, we're doing what is right for the system and we're also going to decrease HIV transmission," Montaner said.

"This is the right thing to do both in an ethical sense and also in a business sense."

Previous research by the centre and by researchers in Taiwan showed a 50 per cent reduction in new HIV cases that they felt was due to access to the highly active antiretroviral therapy.

The treatment consists of three or more antiretroviral drugs on a daily basis for life and it requires a very high level of adherence in order to be fully effective.

It has been the standard of care for the treatment of HIV-AIDS since 1996.

Study: Gel Fails to Stop HIV Infection

Source: The Associated Press

The first anti-AIDS vaginal gel to make it through late-stage testing failed to stop HIV infection in a study of 6,000 South African women, disappointed researchers announced Monday.

The study was marred by low use of the gel, which could have undermined results, they said. Women used it less than half the number of times they had sex, and only 10 percent said they used it every time as directed.

Scientists are still analyzing the results to see if this made a difference. They also plan more tests on a revamped gel containing an AIDS drug that they hope will work better.

The gel used in the current study did prove safe, however, and researchers called that a watershed event.

But for now, the effort is the latest disappointment in two decades of trying to develop a microbicide — a cream or gel women could use to lower their risk of getting HIV through sex. A female-controlled method is especially needed in poor countries where women often can't persuade men to use condoms.

A year ago, scientists stopped two late-stage tests of a different gel after early results suggested it might raise the risk of HIV infection instead of lowering it. (...)

Click here to read the complete article.

Test Detects Sensitivity to HIV Drug

Source: US News & World Report

Test Detects Sensitivity to HIV Drug Could be first step toward personalized medicine, experts say
By Randy Dotinga

WEDNESDAY, Feb. 6 (HealthDay News) -- New research suggests that an expensive blood test could help a small minority of HIV patients discover whether they should avoid a common AIDS drug that can sometimes cause serious side effects.

The test detects sensitivity to the medication abacavir by checking to see if a patient's genetic makeup is linked to poor reactions to the medicine.

"This is very important news in relation to the great hopes from the work with the Human Genome Project," said Magnus Ingelman-Sundberg, a professor at Karolinska Institutet in Sweden, who wrote a commentary about the research. The genome project aims to analyze the genetic blueprint of humans.

At issue is the AIDS drug abacavir, also known by the brand name Ziagen, which is found in compound drugs known as Trizivir and Epzicom. The drug is known as a nucleoside reverse transcriptase inhibitor and works by preventing the AIDS virus from going through the motions of multiplying.

About 8 percent of patients suffer from hypersensitivity to the drug, said study author Simon Mallal, a researcher at Murdoch University & Royal Perth Hospital in Australia. His report on the results is published in the Feb. 7 issue of the New England Journal of Medicine. The problems typically occur within the first six weeks that patients use the drug, he added.

According to the study, the side effects include fever, rash, gastrointestinal symptoms and other problems.

By testing patients for a genetic trait that was found in 5.6 percent of 1,956 female and male patients, the researchers found they could spot potential cases of sensitivity to abacavir.

The test's use could allow doctors to do a better job of personalizing drugs for individual patients, Mallal noted. (...)

Click here to read the complete article

Drug Helps Prevent Breast-Feeding Moms From Passing on HIV

Source: US News and World Report

6 weeks of nevirapine greatly reduced infant infections in Africa, India, study found
Posted 2/6/08

WEDNESDAY, Feb. 6 (HealthDay News) -- The antiretroviral drug nevirapine greatly reduces the risk that HIV-infected mothers will pass the virus to their babies during breast-feeding, according to a study conducted in Africa and India.

Nevirapine is already in widespread use in developing countries to prevent HIV-positive women from infecting their newborns during childbirth, note researchers at Johns Hopkins University, in Baltimore.

In this study, the Hopkins team and colleagues in Ethiopia, India and Uganda gave daily doses of the drug to breast-feeding infants when they were 8 to 42 days old.

By the time they reached 6 weeks of age, the rate of HIV infection among infants who received the drug daily was about half that of infants who received a single dose of nevirapine at birth, which is the current standard of care.

After six months, the infants who'd received the six-week drug treatment were almost a third less likely to suffer HIV infection or death than those given the single dose at birth.

The study included about 2,000 infants and was conducted from 2001 to 2007. It's one of the first randomized controlled trials to show that a drug can prevent HIV transmission in infants being breast-fed by HIV-infected mothers.

The findings were presented Monday at the Conference on Retroviruses and Opportunistic Infections, in Boston.

Breast-feeding is a major cause of HIV infection in the developing world. Each year, about 150,000 infants are infected with HIV through breast-feeding, according to the World Health Organization.

Moms Pre-Chewing Food Gave HIV to Kids

Source: The Associated Press

By MIKE STOBBE

ATLANTA (AP) — For the first time, health officials report that the AIDS virus can be spread by a mother pre-chewing her infant's food, a practice mainly seen in poor, developing countries.

Three such cases were reported in the United States from 1993-2004, government scientists said Wednesday in a presentation in Boston at a scientific conference.

It's blood, not saliva, that carried the virus because in at least two of the cases the infected mothers had bleeding gums or mouth sores, according to investigators at the U.S. Centers for Disease Control and Prevention.

CDC officials say more study is needed. But they are asking parents and caregivers with HIV not to pre-chew infants' food, and are trying to educate doctors about this kind of transmission.

Health officials believe chewed-food transmission is rare in the United States, where such behavior is considered unusual. In some countries, mothers do it because they have no access to baby food or a means of pulverizing food for toothless infants.

"But even one case is too many," said the CDC's Dr. Ken Dominguez, who helped investigate the U.S. cases. (...)

Click here to read the complete article.

Circumcising HIV positive men may increase HIV infections in female partners, but fewer STIs seen

Source: AIDSMAP - 15th Conference on Retroviruses and Opportunistic Infections, Boston USA - February 2008

There was a trend towards higher HIV incidence in the wives of HIV positive men who were circumcised compared with wives of men left uncircumcised, in the latest prevention study conducted in Rakai province, Uganda, investigators revealed at a press conference on the opening day of the Fifteenth Conference on Retroviruses and Opportunistic Infections in Boston.

In 2006, a randomised trial of circumcision in Rakai reported that circumcision led to an almost 50% reduction in a man’s risk of acquiring HIV through heterosexual sex. The impact of male circumcision on transmission of HIV to the female partner remains unknown, and the study reported today set out to examine the effects.

In the Gates Foundation-funded study, 1015 HIV positive men were randomised either to immediate circumcision or circumcision delayed by two years. Of these 770 were married and were asked to invite their wives into the study; 566 wives enrolled of whom 245 (43%) were HIV-negative and therefore in a serodiscordant relationship.

The annual HIV incidence rate in the wives of the men who were circumcised was 14.4% over two years of follow-up compared with 9.1% in women whose partners remained uncircumcised. This result may be due to chance as it was not statistically significant, but was described as “unexpected and somewhat disappointing” by lead investigator Maria Wawer of Johns Hopkins University, Baltimore. It was not due to behavioural disinhibition; condom use was the same in both arms.

Wawer said that these results were an additional challenge to the rolling-out of mass circumcision programmes in Africa, which are expected following the positive results from three randomised controlled trials of circumcision in HIV negative men, one of them conducted within the Rakai community.

She said: “It is inevitable that some HIV positive men will seek circumcision. It is the only HIV prevention modality that leaves a mark, and no one wants to be the only guy in the village who is uncircumcised if it becomes regarded as a mark of HIV.” (...)

Click here to read the rest of the article.

New Issue of JANAC received: Vol. 19, no 1, Jan/Feb 2008

The Journal of the Association of Nurses in AIDS Care covers the spectrum of nursing issues in HIV/AIDS: education, treatment, prevention, research, practice, clinical issues, awareness, policies and program development. This peer-reviewed journal is a forum for nurses and other health care professionals whose focus is the care and treatment of individuals infected and affected by HIV/AIDS.
The Journal of the Association of Nurses in AIDS Care offers the latest information in the areas of health care delivery, program implementation and research analysis and application.

In this issue:

Editorial
Women and HIV Infection
Lucy Bradley-Springer
pages 1-2

Features

Low-Income HIV-Infected Women and the Process of Engaging in Healthy Behavior
Tracy A. Riley, Brenda M. Lewis, Mary Pat Lewis, Joseph L. Fava
pages 3-15
Abstract

Adaptation of an HIV Prevention Curriculum for Use With Older African American Women
Judith B. Cornelius, Linda Moneyham, Sara LeGrand
pages 16-27
Abstract

African American Women's Experience of Infection With HIV in the Rural Southeastern United States
Caroline Mallory
pages 28-36
Abstract

Health Concerns of Mature Women Living With HIV in the Midwestern United States
Maithe Enriquez, Nancy Lackey, Jacki Witt
pages 37-46
Abstract

Women's Voices: The Lived Experience of Pregnancy and Motherhood After Diagnosis With HIV
Lorraine B. Sanders
pages 47-57
Abstract

Improving Women's Adjustment to HIV Infection: Results of the Positive Life Skills Workshop Project
Carol Bova, Tobey Nestor Burwick, Maritza Quinones
pages 58-65
Abstract

The Centers for Disease Control and Prevention Revised Recommendations for HIV Testing: Reactions of Women Attending Community Health Clinics
Joe W. Burrage, Gregory D. Zimet, Dena S. Cox, Anthony D. Cox, Rose M. Mays, Rose S. Fife, Kenneth H. Fife
pages 66-74
Abstract

Promoting Adaptive Coping by Persons With HIV Disease: Evaluation of a Patient/Partner Intervention Model
Betsy L. Fife, Linda L. Scott, Naomi S. Fineberg, Beth E. Zwickl
pages 75-84
Abstract

Contact the library to request copies of articles.

Judge’s ignorance of AIDS draws fire

Source: The Toronto Star

Witness with HIV forced to wear a mask in court, groups complain

An Ontario judge is at the centre of a misconduct investigation after insisting a witness who is HIV-positive and has Hepatitis C don a mask while testifying in his courtroom.

Three groups have complained to the Ontario Judicial Council about the conduct of Barrie judge Justice Jon-Jo Douglas, who later moved the case to a bigger courtroom in order to create more distance between the witness and the bench. The judge refused to accept Crown counsel Karen McCleave's entreaties there was no need for such measures.

"The HIV virus will live in a dried state for year after year after year and only needs moisture to reactivate itself," Douglas insisted, according to a transcript of the Nov. 23 trial proceedings.

"This is outlandish," Bluma Brenner, an assistant professor at the McGill AIDS Clinic at McGill University in Montreal, said yesterday. A drop of human immunodeficiency virus drying on the floor "would be inactivated within 20 minutes," Brenner said in an interview.

But Douglas, a former Crown attorney appointed to the Ontario Court of Justice 10 years ago, was not prepared to continue the trial until he was satisfied "the safety and integrity of this courtroom" was protected.

"I mean, he speaks within two feet of me with two serious infectious diseases," Douglas told McCleave. "Either you mask your witness and/or move us to another courtroom or we do not proceed." (...)

Click here to read the article.

HIV rate soars among Vancouver's native drug users

Source: The Globe & Mail

Startling new research reveals that aboriginal drug users living in Vancouver's Downtown Eastside are contracting HIV-AIDS at twice the rate of non-aboriginal users.

Over the four-year study, 18.5 per cent of aboriginal men and women who injected such drugs as cocaine and heroin became HIV-positive, compared with 9.5 per cent of non-aboriginal intravenous drug users.

"This is a tragedy," Evan Wood, a research scientist at the B.C. Centre for Excellence in HIV/AIDS, said in an interview. "Many people in the aboriginal community are reaching out for care and the care isn't there."

Dr. Wood, the lead author of the research, said the higher rates of infection among natives are not due to biological factors but rather to patterns of social networking: The fact that aboriginal people interact principally with other aboriginals heightens their exposure and speeds the spread of HIV-AIDS.

Better social programs tailored to aboriginals could help alleviate that situation, he said.

In fact, even before researchers started tracking new infections, they found that the proportion of aboriginal drug users with HIV-AIDS was already higher - 25.1 per cent versus 16 per cent for non-aboriginals. (...)

The entire article is available here.
Click here for an abstract of the research article.

Briton sentenced to 14 years in prison for infecting women with HIV in Sweden

Source: The Canadian Press

STOCKHOLM, Sweden - A British man was sentenced Friday to 14 years in prison for infecting two young women with HIV and putting 13 more at risk of infection.

News agency TT reports that thirty-two-year-old Christer Aggett, also convicted of six counts of having sex with minors, was ordered to pay more than $428,000 in damages. The two HIV-infected women will receive the equivalent of about $134,000 - each. Aggett was charged in October with two counts of aggravated assault for allegedly infecting two girls during sex without telling them he was HIV-positive.

Solna District Court in November had found Aggett guilty of the charges but him to undergo psychiatric examination before sentencing. He also was charged with aggravated assault, or "exposing others to danger," by having unprotected sex with more than a dozen other women between 2001 and 2006 - six of them under the age of 15. They were not infected with HIV.

He confessed to most of the charges, but not to having had sex with underage girls, saying he was unaware they were so young. Aggett's lawyer, Jonas Granfelt, said his client is likely to appeal the ruling. Police suspect that Aggett had been in contact during the five-year period with at least 130 women he met via Internet chat rooms.

UK patients to get new HIV drug

Source: BBC News

The first in a new class of HIV drugs has become available in the UK.
It means doctors will have a further treatment option for patients who have built up resistance to existing drugs. Raltegravir is an integrase inhibitor, which works by blocking an enzyme essential for HIV to be able to replicate itself.

An estimated 73,000 people live with HIV in the UK. Raltegravir will be reserved for those who have stopped responding to other treatment.

Resistance to HIV medication is becoming increasingly common - more than one in 10 UK patients with HIV has some level of resistance to at least one drug before they have even begun therapy, research has shown.

A clinical trial of Raltegravir published last year found it to be effective in patients who had been taking regular antiretroviral HIV drugs for about 10 years.

Treatment for HIV is helping people to live longer but, in the UK, one of the biggest challenges is the threat of resistance.

Integrase is one of three HIV enzymes the virus uses to multiply.

It inserts viral genes into the DNA of the host cell, effectively making it a "factory" for producing more of the virus. Without this, the virus cannot multiply and infect other cells as easily, reducing the amount of virus present in the blood.

The complete article is available on BBC's Website

Sexually transmitted diseases soar in the Outaouais

Source: CBC News

Cases of sexually transmitted diseases increased sharply in Quebec's Outaouais region between 1996 and 2006, alarming public health officials.

Provincial statistics for the western Quebec region that includes Gatineau show that over 10 years, chlamydia infections more than doubled, from 275 cases in 1996 to 590 cases in 2006 (about 170 cases per 100,000). Gonorrhea infections are also on the rise and syphilis, which had almost disappeared from the region, is making a comeback. There was only one case of syphilis in 2001, but around a dozen in 2006. In the case of hepatitis C, there were 95 cases in 2006, up from 49 in 1996, but down from a high of 118 in 2003.

The growth in sexually transmitted diseases was particularly large among 15- to 35-year-olds, said Denis Carrier, a spokesman for the Outaouais public health agency. He blames the growth on young people failing to use protection such as condoms.

"Because there's some new pills or new treatments, people consider there's no big risk anymore," he said.

However, he warned that unprotected sex can have serious health consequences, and he said the health agency is launching a campaign to send home that message.

According to Health Canada's website, even chlamydia and gonorrhea, which can be treated with antibiotics, can potentially have serious effects such as pelvic inflammatory disease in women, which can cause internal abscesses and long-lasting pain. They can also lead to infertility among both men and women, and in some cases, a type of arthritis that affects joints throughout the body.

Sores associated with syphilis greatly increase the chance of contracting HIV. And if left untreated, syphilis can cause a wide range of symptoms ranging from fever to joint pain to hair loss, Health Canada said.

The agency also warns that AIDS is still incurable and fatal, and hepatitis C, which is also incurable, can lead to serious liver damage or liver cancer.

Immunologists find better way to boost the immune system

Source: Science daily

Immunologists have discovered how to manipulate the immune system to increase its power and protect the body from successive viral infections.

Published in Viral Immunology, these findings may point the way toward developing new and more effective vaccines against diseases like influenza or HIV and enhance new developments in immunology.

The study suggests that scientists can boost the body’s resistance and fend off successive viral infections by taking components of the virus and indirectly activating specific populations of killer T cells – the body’s virus-killing cells. The virus components are introduced through a process known as “cross priming” whereby virus molecules are engulfed by immune cells to activate killer T cells.

“With this mechanism in mind, we can develop better tools to make more successful and effective vaccines,” says Sam Basta, Queen’s professor of Microbiology and Immunology, and the principal investigator of the study. The other members of the research team are master’s students Attiya Alatery and Erin Dunbar.

The researchers hope to build on their findings by next studying which immune cells do a better job of protecting the body while using this mechanism.

“The answer to this question is like having the Holy Grail of immunotherapy and vaccine design within our grasp,” says Dr. Basta.

Dr. Basta suggests that by fully understanding this new mechanism, researchers should be able to shuttle the appropriate viral components to the right immune cells.

The study was funded by Natural Sciences and Engineering Research Council of Canada and the Franklin Bracken Fellowship program.

Adapted from materials provided by Queen's University.

Study of teen sex finds more education needed on transmitted diseases

Source: The Canadian Press

TORONTO - Most teens are responsible when it comes to sexuality, but lack of knowledge about sexually transmitted infections and their consequences is a concern, says a new study.

The research, published in the January issue of Pediatrics and Child Health [abstract], found that 27 per cent of teens were sexually active at a mean age of 15 years. The last time that they had sex, 76 per cent had used a condom, according to the findings.

"They don't know about many of the STIs that are common and they don't know about the consequences of the STIs," author Dr. Jean-Yves Frappier, head of the Adolescent Medicine Division at Sainte-Justine University Health Centre, said Monday in an interview from Montreal.

Five per cent of the sexually active teens said they had been diagnosed with an STI.

The teens surveyed overestimated the prevalence of HIV compared to other sexually transmitted infections, Frappier said.

"They don't know about chlamydia, which is much much more common," he said.

"Very few teens will be HIV positive but a certain percentage will be chlamydia positive in their teens. And that, they don't mention it."

Sixty-nine per cent of teens surveyed could not find information they were looking for about sex, and 62 per cent reported obstacles in getting information.

Online interviews were conducted in October 2005 by Ipsos Reid with 1,171 Canadian teenagers aged 14 to 17. As well, 1,139 mothers of teenagers were interviewed, but these weren't the mothers of the teens who were surveyed. The results are considered accurate to within 2.9 percentage points, 19 times out of 20.


Click here to read the complete article.

Charges dropped in Canada HIV tainted-blood scandal

Source: AFP

MONTREAL (AFP) — Canadian prosecutors on Friday dropped all charges against a former director of the Canadian Red Cross who had been implicated in the distribution of HIV-contaminated blood. Crown prosecutors told a court in Hamilton it would be virtually impossible to prove the case against Dr Roger Perrault which dates back to the 1980s and was Canada's worst health scandal.

"We have concluded that there no longer remains a reasonable prospect of conviction in this case," prosecutor John Pearson told the court.

Perrault had already been acquitted by the Ontario Superior Court in Toronto in October that ruled he was not criminally negligent in a separate case involving the contamination of seven children suffering from hemophilia, a bleeding disorder.

Two other Canadian doctors, an executive of Armour Pharmaceuticals, and the US firm itself were also acquitted in that case. It was the first criminal trial in the scandal in which more than 20,000 people contracted human immunodeficiency virus and hepatitis C in the 1980s and 1990s. At least 3,000 people died, including 800 from AIDS. In the second trial, Perrault had faced six charges of negligence for failing to take the necessary measures to protect patients from contracting HIV and to inform the public about the dangers of blood products.

Perrault has not made any comment on the case. But his lawyer Eddie Greenspan said his client may sue the Canadian government for damages.

"Not every tragedy requires a scapegoat. Dr Perrault should have never been named for the tainted blood crisis," he said.

New HIV drug sanctioned when others fail

Source: US News

Blocks enzyme that virus needs to multiply

MONDAY, Jan. 21 (HealthDay News) -- The anti-HIV medication entravirine has been approved by the U.S. Food and Drug Administration for adults who have failed treatment with other antiretrovirals.

Sold under the trade name Intelence, entravirine is a non-nucleoside reverse transcriptase inhibitor, which helps block an enzyme that the AIDS-causing virus needs to multiply, the FDA said in a statement. This is aimed at reducing the amount of HIV in the blood and boosting infection-fighting white blood cells.

In clinical testing, 599 adults who received entravirine and additional antiviral therapy had greater reductions in blood HIV levels than adults who received a non-medicinal placebo and the same additional therapy. The most common side effects reported were rash and nausea.

The long-term effects of entravirine haven't been studied, nor have the drug's effects in pregnant women or among people age 16 or younger, the agency said.

Entravirine is distributed by Tibotec Therapeutics, whose parent firm -- Ortho Biotech Products -- is based in New Jersey.

More information on FDA's Website.

Aging Baby Boomers and seniors are at risk for HIV

Source: The Chicago Tribune

KANSAS CITY, Mo. - Jane Fowler thinks it's about time college students had "the talk" with their grandparents. She doesn't mean grandmothers and grandfathers explaining the facts of life. She wants kids to explain safe sex to their elders.

It's part of a broader message the 72-year-old has advocated for more than a decade. Ever since she contracted HIV when she was in her 50s, Fowler has made it her mission to help aging Baby Boomers and members of her generation avoid her mistakes.

"Once people get past their own embarrassment and understand grandparents today are still sexually active, they realize I'm right," said Fowler, who spoke at a recent safe-sex event at Kansas State University. "Their grandparents face the same risks of sexually transmitted diseases as they do."

The over-50 crowd is a relatively small segment of the nation's at-risk group for sexually transmitted diseases. Approximately four times as many HIV diagnoses occurred in people ages 25 to 44 as in those 50 and older, according to a 2005 report by the Centers for Disease Control and Prevention.

Still, medical experts agree that older Americans often are among the most overlooked and, therefore, one of the more vulnerable populations.

Click here to read the article.

Antiretroviral drugs may prevent vaginal transmission of HIV

Source: US News and World Report

Mouse study shows they could protect against spread of disease

Antiretroviral drugs used to treat people with HIV might also prevent vaginal transmission of the virus, claims a study by researchers at the University of Texas Southwestern Medical Center at Dallas.

The vast majority of new HIV infections worldwide, which total about 6,800 new transmissions daily, occur through unprotected vaginal sex with an infected partner.

For this study, the researchers used special mice with fully developed human immune systems that produced the infection-fighting cells specifically targeted by HIV in people. The Texas team found that daily doses of antiretroviral drugs before and after exposure to HIV can prevent vaginal transmission of the virus.

HIV was introduced vaginally into the mice. None of the mice that received the antiretroviral drugs emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) showed any evidence of infection, while 90 percent of mice that didn't receive the drugs became infected by HIV.

The study was published in the Jan. 14 online issue of PLoS Medicine.

Click here to read the article


The study published in PLoS Medicine, Antiretroviral Pre-exposure Prophylaxis Prevents Vaginal Transmission of HIV-1 in Humanized BLT Mice, is available here.

Syphilis on the rebound in Europe

Source: The Toronto Star

Risky sexual behaviour, especially among gay men, spark fears 19th-century scourge will spread

Maria Cheng - ASSOCIATED PRESS

LONDON–Syphilis is back: The sexually transmitted disease long associated with 19th-century Bohemian life is making an alarming resurgence in Europe.

"Syphilis used to be a very rare disease," said Dr. Marita van de Laar, an expert in sexually transmitted diseases at the European Centre for Disease Prevention and Control. "I'm not sure we can say that any more."

Most cases of syphilis are in men, and experts point to more risky sex among gay men as the chief cause for the resurgence. But more cases are being seen among heterosexuals, both men and women, too. Syphilis was the sexual scourge of the 19th century, and is believed to have killed artists like poet Charles Baudelaire, composer Robert Schumann, and painter Paul Gauguin. But the widespread use of penicillin in the 1950s all but wiped it out in the Western world.

In the last decade, however, syphilis has unexpectedly returned, driven by risky sexual behaviour and outbreaks in major cities across Europe, including London, Amsterdam, Paris and Berlin. In Britain, syphilis cases have leapt more than tenfold for men and women in the past decade to 3,702 in 2006, according to the Health Protection Agency. Among men in England, the syphilis rate jumped from one per 100,000 in 1997 to nine per 100,000 last year.

In Germany, the rate among men was fewer than two per 100,000 in 1991; by 2003, it tripled. In France, there were 428 cases in 2003 – almost 16 times the number just three years earlier. Similar trends have been seen in the United States and Canada. In 2006, Ontario counted 350 syphilis cases, two-third in Toronto.

In 2000, syphilis infection rates were so low that the U.S. Centers for Disease Control and Prevention embarked on a plan to eliminate the disease. But about 9,800 cases were reported in 2006. In Europe, Van de Laar said syphilis's reappearance was so surprising that many doctors initially had trouble diagnosing it. Though these days it mainly affects urban gay men, experts worry that the disease could also rebound in the general population.

In 2005, British authorities reported that syphilis was spreading across the entire country, and that more heterosexual men and women were being infected. Pregnant women with syphilis can pass it on to their babies. Nearly half of all babies infected with syphilis while they are in the womb die shortly before or after birth.

Syphilis is a bacterial disease causing symptoms that include ulcers, sores and rashes. In extreme cases, it can result in dementia or fatally damage the heart, respiratory and central nervous systems. Syphilis is treatable with antibiotics if caught early. Once there are more than just a few isolated cases, containing the disease is difficult. Advances made in treating AIDS may have inadvertently boosted syphilis's spread.

"The evidence points to an increase in unsafe sexual behaviour since anti-retrovirals for AIDS came along in 1996," said van de Laar.

After decades of being instructed to use condoms and to limit the number of sexual partners, some people are probably suffering from "safe sex fatigue," van de Laar said. The Internet has also allowed people to find sexual partners more easily than before, and some experts link the rise of dating websites to the jump in syphilis cases. Amid this resurgence, some officials are now attacking the disease online.

See also Syphilis outbreak - cases continue to rise in Alberta.

H.I.V. rises among young gay men

Source: The New York Times

AIDS appears to be making an alarming comeback. The Journal of the American Medical Association reports that the incidence of H.I.V. infection among gay men is shooting up, following an encouraging period of decline. The rise of infections among younger gay men, especially black and Hispanic men, is troubling, and the study carries the clear implication that people at high risk of contracting the disease are becoming less cautious.

Statistics gathered by New York City health officials show that new diagnoses of H.I.V. infection — the virus that causes AIDS — in gay men under age 30 rose 32 percent between 2001 and 2006. Among black and Hispanic men, the figure was 34 percent. Most troubling, the number of new diagnoses among the youngest men in the study, those between ages 13 and 19, doubled.

New York officials say increased alcohol and drug use may be partly responsible since they make unprotected sex more likely. Other basic precautions, including finding out whether a potential partner is infected, are also apparently being ignored.

The one bright spot in this bleak picture was the 22 percent decline in infections among men over 30 in the New York study. Awareness of the disease’s devastating effects, as much as maturity, may explain the difference. A large number of these older men came of age when AIDS was all but untreatable. They may have buried friends who died after being horribly ill.

When the disease was new and terrifying, the gay community helped change behavior by preaching loudly against taking sexual risks. From San Francisco to New York, bathhouses notorious for promoting casual sex changed the way they did business or closed down. Condoms were encouraged, and so was H.I.V. testing. “Silence equals death” was the motto of the day.

Silence now seems to be winning the day. Nearly 6,000 gay men died of AIDS in the United States in 2005; still, many young men appear to have persuaded themselves that the infection is no longer such a big deal. It is true that antiretroviral therapy has improved the outlook for anyone who becomes infected. But the treatments are still too new to know whether they can work much beyond a decade. Public health officials need to continue to distribute condoms, encourage testing and treat those who are ill. Leaders in the hardest-hit communities need to start speaking out again. The fight against AIDS is far from over.

HIV a stigma in aboriginal communities

Source: The Toronto Star

Rates of infection among Canada's native people grossly disproportionate to their total numbers

Emily Mathieu - Staff Reporter

HIV rates among Canada's aboriginal community continue to rise at alarming rates – and women face the highest risk. That's where Catherine Beaver comes in.

A wry, outspoken, slip of a woman who walks with a bit of a limp, Beaver is a public speaker with 2-Spirited People of the First Nations in Toronto, a gay, lesbian and transpositive organization that conducts HIV/AIDS outreach for the community.

"The way I look at it is, I am not ashamed or afraid of it," says Beaver, 28, who is HIV-positive. She tells her story nationwide to try to stem the epidemic spread of HIV in the aboriginal community – mostly connected to intravenous drug use.

In November, the Public Health Agency of Canada released its latest stats on the spread of HIV and AIDS in this country. The report reveals aboriginal people (Inuit, Métis and First Nations) accounted for more than a quarter of all positive HIV tests reported in 2006, even though they only make up about 6 per cent of the total population in the 12 provinces and territories included in the stats. (Ontario and Quebec are excluded because they do not collect ethno-specific HIV data.) And, for the third year in a row, women accounted for more than half of the positive test results among aboriginal people. In her talks, Beaver explains how she became infected 2 -1/2 years ago through intravenous drug use. She talks about being adopted, of her isolation while living on the streets, losing custody of her two children, substance abuse and prostitution.

"You know, when the whole world just disintegrates, goes black, like in TV shows ... and you are just standing there by yourself..."

After years of treatment, she is no longer an addict but still struggles to fight the occasional setback. Beaver uses her story to make a point.

"I'm not scared of people reacting," she says, insisting not enough aboriginal people are speaking out, which is why the number of infections continues to rise.

According to the Public Health report, intravenous drug use was the main cause of HIV infection among aboriginal people, at 64 per cent. Heterosexual contact was the other main cause, at 34 per cent. That's the reverse of the national averages for HIV-positive tests, where 74 per cent of new cases are attributed to heterosexual contact and 24 per cent to intravenous drug use.

Click here to read the article

Genomic Screen Nets Hundreds Of Human Proteins Exploited By HIV

Source: Science daily

In some ways, HIV resembles a minimalist painter, using a few basic components to achieve dramatic effects. The virus contains just nine genes encoding 15 proteins, which wreak havoc on the human immune system. But this bare bones approach could have a fatal flaw. Lacking robust machinery, HIV hijacks human proteins to propagate, and these might represent powerful therapeutic targets.

Using a technique called RNA interference to screen thousands of genes, Harvard Medical School researchers have now identified 273 human proteins required for HIV propagation. The vast majority had not been connected to the virus by previous studies. The work appears online in Science Express on Jan. 10.

Drugs currently used to treat the viral infection interact directly with the virus itself, and it's quite simple for the rapidly mutating virus to avoid destruction by altering how it interacts with these chemicals. Patients use a cocktail of HIV inhibitors because the virus is less likely to evolve resistance to multiple drugs at the same time. But some HIV strains have still managed to evade particular drugs. These could eventually develop resistance to several drugs, especially among patients who don't adhere to their regimens. (...)

Click here to read the article.

New issue of JAIDS: Vol. 46, no 5, Dec 15, 2007

December 15, 2007, Volume 46, Issue 5
Each issue of JAIDS publishes vital information on the advances in diagnosis and treatment of HIV and non-HIV infectious, as well as the latest research in the development of therapeutics and vaccine approaches.

In this issue:

Commentary
Bystander Effects: Children Who Escape Infection But Not Harm.

Basic Science
Differentiation of Monocytes Into CD1a- Dendritic Cells Correlates With Disease Progression in HIV-Infected Patients.
pp. 519-528
Abstract

Redistribution of FOXP3-Positive Regulatory T Cells From Lymphoid Tissues to Peripheral Blood in HIV-Infected Patients.
pp. 529-537
Abstract

Clinical Science
Carraguard Vaginal Gel Safety in HIV-Positive Women and Men in South Africa.
p. 538-546
Abstract

Racial Differences in Virologic Failure Associated With Adherence and Quality of Life on Efavirenz-Containing Regimens for Initial HIV Therapy: Results of ACTG A5095.
pp. 547-554
Abstract

Directly Administered Antiretroviral Therapy for HIV-Infected Drug Users Does Not Have an Impact on Antiretroviral Resistance: Results From a Randomized Controlled Trial.
pp. 555-563
Abstract

HIV-Associated Alterations in Normal-Appearing White Matter: A Voxel-Wise Diffusion Tensor Imaging Study.
pp. 564-573
Abstract

Effects of a Behavioral Intervention on Antiretroviral Medication Adherence Among People Living With HIV: The Healthy Living Project Randomized Controlled Study.
pp.574-580
Abstract

A Randomized, Multicenter, Open-Label Study of Poly-L-Lactic Acid for HIV-1 Facial Lipoatrophy.
pp.581-589
Abstract

Brief Report
Clinical Science
Evaluation of Filter Paper Transfer of Whole-Blood and Plasma Samples for Quantifying HIV RNA in Subjects on Antiretroviral Therapy in Uganda.
pp. 590-593
Abstract

Chinese Pediatric Highly Active Antiretroviral Therapy Observational Cohort: A 1-Year Analysis of Clinical, Immunologic, and Virologic Outcomes.
pp. 594-598
Abstract

Epidemiology and Social Science
Maternal Disease Stage and Child Undernutrition in Relation to Mortality Among Children Born to HIV-Infected Women in Tanzania.
pp. 599-606
Abstract

Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy: Collaborative Analysis of Cohorts of HIV-1-Infected Patients.
pp. 607-615
Abstract

HIV Prevalence and Incidence in Rural Tanzania: Results From 10 Years of Follow-Up in an Open-Cohort Study.
pp. 616-623
Abstract

HIV-1 Infection in Patients Referred for Malaria Blood Smears at Government Health Clinics in Uganda.
pp. 624-630
Abstract

Risk Factors for Herpes Simplex Virus Type 2 and HIV Among Women at High Risk in Northwestern Tanzania: Preparing for an HSV-2 Intervention Trial.
pp. 631- 642
Abstract

Circumcision Status and HIV Infection Among Black and Latino Men Who Have Sex With Men in 3 US Cities.
pp. 643-650
Abstract

Brief Report
Epidemiology and Social Science
Subclinical Mastitis, Cell-Associated HIV-1 Shedding in Breast Milk, and Breast-Feeding Transmission of HIV-1.
pp. 651-654
Abstract

Contact the library to request copies of articles

Sexually active gay men no longer allowed to donate organs

Source: CBC

A number of organ donation groups said Monday that they are unaware of new Health Canada regulations that mean sexually active gay men, injection drug users and other groups considered high risk will no longer be accepted as organ donors. The new rules, which came into effect in December, are similar to the regulations for determining who can donate blood. Those rules exclude groups that are at high risk of transmitting infectious diseases such as HIV and hepatitis C and B.

Officials at several transplant programs in the country said because they were unaware of the new regulations, they would continue to consider all potential donor organs.

"We have not been informed, first of all, that Health Canada is considering this," said Dr. Gary Levy, who heads Canada's largest organ transplant program at Toronto's University Health Network. "Obviously if Health Canada wishes to discuss that, we would hope they would engage all stakeholders."

Dr. Peter Nickerson, director of Transplant Manitoba, which procures organs in that province, said transplant programs must now by law interview family members of the donor as part of the screening process.

"We'll be asking about things like travel, history of infectious disease, whether they've [donors] been in jail — that puts you at increased risk," Nickerson said. "Have they been an IV drug abuser in the past? Have they had tattoos? There's a whole list of questions we go through."

They are also asked about the donor's sexual orientation. The donor will be excluded if the donor is a man who had sex with another man in the previous five years. Health Canada had contracted the Canadian Standards Association in 2003 to come up with standardized guidelines to ensure the safety of the organ donation system.

Transplant programs have been screening potential donors, but in some cases use organs from people in high-risk groups if they've tested negative for diseases. The new legislation means that practice must stop.

A spokeswoman for Health Canada confirmed the new regulations in an e-mail, but the department didn't make anyone available to explain the changes. (...)

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Canadian AIDS Society HIV/AIDS Education Survey

The Canadian AIDS Society is launching its HIV and AIDS Education survey. CAS wants to know more from parents/guardians, educators and students to improve HIV/AIDS education in Canada. You can help! Please take some time to fill out the survey. After you're finished, spread the word. Please tell others about this important survey and encourage them to participate!

Surveys for:

Parents/guardians

Educators

Students

The survey closes December 30, 2007.

Fighter for addicts ready to quit

Source: The Tyee

Ann Livingston of VANDU is wearied by death.
By Sarah Ripplinger
Published: December 13, 2007

After spending the past 13 years trying to save Vancouver's poor from the filthy alleys of the Downtown Eastside, Ann Livingston doesn't have a pension plan or any significant savings, but she has decided to quit her job.

Livingston, a star of the widely shown documentary Fix [video available in the library], has spent the last nine years co-ordinating the Vancouver Area Network of Drug Users (VANDU), a non-profit operated by addicts. She's done a lot to help drug users get their voices heard. But she says she is tired of Vancouver's hypocrisy. While the host of the 2010 Olympics is termed the world's "most liveable city" by The Economist magazine, its poorest neighbourhood grapples with an epidemic of HIV/AIDS comparable to Botswana's.

After devoting more than a decade of her life helping people in the Downtown Eastside, Livingston says she hasn't noticed improvements in living conditions or a decrease in the demand for aid. In fact, she says, things just seem to be getting worse.

"Yeah, people did change, but then they died," Livingston remembers thinking to herself last spring. "I started to realize, I do leadership development with people who are very likely to die and there's more dead people now that I've worked with than live people." (...)

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Woman Misdiagnosed With HIV Gets $2.5 M

Source: The Associated Press

BOSTON (AP) — A jury awarded $2.5 million in damages to a woman who received HIV treatments for almost nine years before discovering she never actually had the virus that causes AIDS.

In her lawsuit against a doctor who treated her, Audrey Serrano said the powerful combination of drugs she took triggered a string of ailments, including depression, chronic fatigue, loss of weight and appetite and inflammation of the intestine. Serrano, 45, said she cried after hearing the verdict Wednesday in Worcester Superior Court and was gratified that the jury believed her.

"I'm going to finish my school and I am going to continue to help others," Serrano said in a telephone interview from her Fitchburg home. "I am going to find another doctor that will help me."

Serrano's attorney, David Angueira, said Dr. Kwan Lai, who treated his client at the University of Massachusetts Medical Center in Worcester's HIV clinic, repeatedly failed to order definitive tests even after monitoring of Serrano's treatment did not show the presence of HIV in her blood. (...)

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Figures on H.I.V. rate expected to rise

Source: The New York Times

By GARDINER HARRIS
Published: December 2, 2007

WASHINGTON, Dec. 1 — More people in the United States are infected each year with the AIDS virus than previously thought, according to federal health officials, in a finding that could affect the debate over how much money should be spent on prevention efforts. No one is yet sure whether more people have actually been infected in recent years or the figures, still undergoing peer review, are simply a better estimate than the old ones.

For 14 years, the Centers for Disease Control and Prevention used informal methods to estimate that about 40,000 people annually in the United States are newly infected with H.I.V. In recent years, federal officials have worked to set up a more accurate assessment technique. The numbers from the new system are now in, although the agency has not released them. The Washington Blade, a gay newspaper, reported on Nov. 14 that the new estimates showed infection rates were 50 percent higher than previously believed, with 58,000 to 63,000 infected in the most recent 12-month period. The Washington Post and The Wall Street Journal had similar reports on Saturday.

“We currently have a paper going through a scientific review process,” Tom Skinner, a C.D.C. spokesman, said Saturday, “and until that process is complete, we’re not in a position to say one way or another whether the numbers will actually be up from current estimates.”

A federal official who would not speak for attribution about the new numbers because of the review process said they were indeed higher than the old estimate, but not by as much as The Blade and The Post reported. It has been clear for at least a year that the old estimate would have to be revised upward, said David R. Holtgrave of Johns Hopkins University, a former director of one of the C.D.C.’s principal AIDS prevention programs. From 2001 to 2005, more than 186,000 people in 33 states received diagnoses of H.I.V. or AIDS, according to figures. That amounts to more than 37,000 new cases each year from just two-thirds of the country.

“With just a little simple math, you get more than 40,000 new cases,” Dr. Holtgrave said.

Whether the number of infections is higher than previously believed and whether infection rates are rising are both politically charged issues. President Bush has increased financing for AIDS treatment and prevention programs abroad, but spending for domestic prevention efforts dropped 19 percent in inflation-adjusted terms from 2002 to 2007.

Julie Davids, executive director of the Community H.I.V./AIDS Mobilization Project, a national advocacy group, said it planned to protest Tuesday in front of the C.D.C. headquarters in Atlanta to demand that the agency release the new figures and step up prevention efforts. “We don’t know whether infection rates are rising or they’ve just been higher than we thought,” Ms. Davids said. “But either way, this shows that prevention efforts are insufficient.”

Doctors and states are required to report cases of full-blown AIDS, but only some states report positive results on tests for H.I.V. infection to the agency. It takes years for someone who is infected to develop symptoms; many people have been infected for years before they are tested. Under the C.D.C.’s new surveillance system, 19 states and cities are performing two different blood tests of H.I.V. antibodies — the first indication of an infection. One test is highly sensitive and is able to spot an infection even in its earliest months. The other test is cruder, and patients must nurse an infection for many months before it can be identified with this test. When a blood sample receives a positive result on the first test and a negative result on the second, officials have decided that this person was probably infected recently. By adding up these mixed results and projecting them across the country, the agency is able to come up with an estimate for new infections. The agency sent out a letter to scientists on Nov. 26 describing the new system and urging patience as the numbers are reviewed.

Donald G. McNeil Jr. contributed reporting from New York.

New event at PARC: HIV and Nutrition

The PARC library and
BCPWA Treatment Information Program (TIP)
are hosting an event on
Nutrition and HIV

Videos on nutrition will be presented:
Wednesday, December 12th and Tuesday December 18th, 12:00PM 3:00PM.

There will also be a book display until Thursday, December 20th.

Come and get your copy of the new
"Practical guide on
nutrition for people living with HIV"
published by CATIE!

Lawmakers Protest HIV/AIDS Travel Rule

Source: Yahoo News
By ERICA WERNER, Associated Press Writer

WASHINGTON - On World AIDS Day last month the White House said new rules would soon make it easier for people with HIV/AIDS to travel to the United States. Democratic lawmakers and gay rights groups are complaining that the regulations proposed by the Homeland Security Department could actually create more barriers.

Sen. Ted Kennedy, D-Mass., said Tuesday that the proposal "offers little of value to HIV-positive applicants."

"It imposes strict requirements that unfairly limit travel to the United States," Kennedy said after chairing a Senate health committee hearing on the Bush administration's international AIDS efforts. "It is mired in the past, a past where people feared HIV as a contagious disease that could not be controlled or effectively managed."

Bebe Anderson, HIV project director at the gay civil rights group Lambda Legal, said the rules were "inappropriate based on medicine and public health concerns."

Gay rights advocates have long opposed a 1993 federal law that strictly restricts travel and immigration to the U.S. by HIV-positive people, arguing it's discriminatory. Foreigners with the virus can obtain visas only after receiving a waiver from the Homeland Security Department in a cumbersome process that requires approval from DHS headquarters.

The White House says it wants to make the process easier for HIV-positive people seeking 30-day stays. As President Bush observed World AIDS Day on Nov. 30, the administration announced the publication of regulations meant to speed up the process. (...)

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