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The
HIV/AIDS eNews is published by the British Columbia Persons With AIDS
Society. This publication is a compilation of various articles
collected from numerous news sources. Opinions and information
expressed are those of the individual authors and not necessarily those
of the Society.
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Whoosh!
In Whistler this weekend? Take part in Whoosh!, where 50% of proceeds will be donated to BCPWA:
Where: Hilton Resort and Spa, Whistler
When: 8pm-12am, Saturday, February 7
For tickets, visit skiOUT.com, The Love Nest, or the winter PRIDE ticket centre.
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Calling all proposals!
Positive Gathering is a three-day, all-inclusive event where HIV+ British Columbians come together to learn and share with their peers in a safe, open & constructive environment.
Time is running out for Workshop Proposal applications!
Click here to learn more and apply now. |
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 Creative Writers' Workshop
Join this upbeat, supportive opportunity to craft your stories and point of view. A light-hearted challenge for new and experienced dreamers and writers.
Where: BCPWA's Training Room (Level1)
When: Fridays 1–3pm, February 6, 13, 20, 27/ March 6, 13.
RSVP: (required) 604.893.2200 |
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AmBigYouUs
Are you HIV+ and Trans? Join us at AmBigYouUs, a weekly mingling and networking event specifically for the HIV+ Trans community.
Where: BCPWA's Training Room (1st Floor)
When: Wednesdays, 6-8pm (Next event, February 4)
For more information, please call 604.893.2258 |
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Volunteer at BCPWA
Volunteer Event Organizer
Do you enjoy talking and meeting new people?
Some Responsibilities:
- Assist with the coordination of the Annual Volunteer Recognition Event in April
- Securing door prizes from local sponsors
- Strong communication skills to call and meet people
- Providing administrative support to the Coordinator
* 6 month Volunteer commitment required (1 position) start December
Please see Marc Seguin-Coordinator Volunteer Services BC Persons With AIDS Society, for more information; marcs@bcpwa.org 604-893-2298 |
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HIV stigma radiates from behind the bench
ANALYSIS / How a murder conviction in the Aziga case will make everything worse
In
the 1999 Cuerrier decision the Supreme Court of Canada ruled that
people who fail to tell their sex partners that they are HIV-positive
before having unprotected sex with them could be charged with sexual
assault under the Criminal Code.
On Oct 6 of last year the trial of Johnson Aziga began in Hamilton.
As Xtra goes to press the trial is ongoing. Aziga is accused of failing
to disclose his HIV-positive status to at least 13 women before having
unprotected sex with them. Two of the women reportedly later died of
HIV-related cancers. Aziga is charged with one count of first-degree
murder in connection with each of their deaths.
He is the first in Canada to face murder charges for HIV nondisclosure
and a conviction in his case would have enormous implications for AIDS
activists, gay men, women and people of colour.
John Webster
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In a just culture we must carefully differentiate between criminal
actions and those that are simply deplorable. If the allegations
against Aziga are true, he committed a despicable act. But deception —
a choice to lie about (or deny the reality of) your sexual health — is
one thing; murder is another thing altogether.
I do not of course mean to minimize the tragedies lived by the poor
women who died. It is the moral principles behind the criminalization
of HIV that concern me.
If there is any lesson to be learned from horrible scenarios like those
raised in the Aziga case, it is that no one can be counted on to tell
the truth about sex. And as much as it may satisfy a deep, obsessive,
all-too-human longing for justice it is irresponsible to blame one
person for another’s death from disease. We don’t charge those who
refuse treatment or counselling for tuberculosis or hepatitis under the
Criminal Code. We don’t see sensationalized news accounts or manhunts
for those suspected of transmitting syphilis or human papilloma virus.
We don’t expect murder or assault charges against any store clerk who
knowingly sells cigarettes to children. It would naturally be
ridiculous and unjust to do so.
The faulty moral reasoning involved here is not the only issue. The
Aziga case has staggering racist, sexist and homophobic implications as
well.
Aziga is Ugandan. In the late ’80s Charles Ssenyonga, another Ugandan,
became one of Canada’s first AIDS criminals. He too was accused of
knowingly infecting women with HIV. Canadian journalist June Callwood
attacked Ssenyonga in her 1995 bestseller, Trial Without End: A
Shocking Story of Women and AIDS.
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Among
those who have been charged with spreading HIV in Canada there are at
least three much-discussed cases involving black men, including
well-known Canadian Football League player Trevis Smith.
The
fantasy of the black male as AIDS killer and rapist is rooted in a
deep-seated North American suspicion that black men are dangerous to
white women. This fantasy sells books, newspapers and magazines and it
allows some to conclude that, by not disclosing his HIV status, Aziga
committed rape.
I say that criminalizing HIV-positive men who fail to disclose to
female sex partners only serves to disempower women. If men are to be
held entirely responsible for disclosure, it implies that women don’t
have complete responsibility for their bodies, choices or sexual health.
What happened to our bodies, our choice? Women are not — under the law or otherwise — passive, mute playthings.
Safer sex is about the liberating notion that all people — male and
female, top and bottom — are either responsible to protect themselves
by insisting on safer sex or to assume the risk that they may become
HIV-positive if they don’t.
Nobody deserves to become HIV-positive but Aziga’s so-called victims could have chosen to insist on the use of condoms.
For gay men the most compelling argument against the criminalization of
HIV is the propensity of those who hate us to use AIDS fear as a weapon
against our civil liberties. The rhetoric employed against Aziga is the
same used to characterize gay men as dangerous: That promiscuous gay
men are filthy purveyors of disease bent on recruiting innocents;
morally bankrupt subhumans with no ability to control their disgusting
carnal desires. Good and decent people need to draw the line. They must
be rooted out and stopped.
Fear and revulsion about gay sex is at the root of that hatred.
McGill University AIDS Centre director Mark Wainberg wrote a striking
example of this in his essay, The Virus that Won’t Go Away, in The
Globe and Mail last year.
“This issue of nonfidelity is, of course, at the heart of the problem,
as exemplified in almost all Western countries by the fact that a
majority of new HIV transmissions now occur within gay male
populations,” he wrote.
Ridiculous. I called him on his bigotry in a rebuttal piece in The Globe.
“Not all people who get AIDS are libertines, and not all learn
redemption,” I wrote. “North American (mainly white and heterosexual)
AIDS scientists — somewhat overzealously, I think — analyze lifestyles
and collect data about the sex lives of gay men and Africans, meanwhile
convincing everyone that their lurid invasions into the privacy of
their subjects is about saving lives. But is it merely a coincidence
that a transhistorical fear of same-sex desire among males and the
Western obsession with colonizing Africa have merged to become a single
discourse called The War on AIDS? Even if scientists were to find out
conclusively that white heterosexual North Americans are models of
monogamy, attempts by crusading colonizers to teach the rest of the
world abstinence are historically doomed to failure. Human beings are
sexual (which sometimes means promiscuous) and even an evangelical
devotion to transforming the aberrant sexualities of mankind will not
change that, or the course of this disease. Nonjudgmental, factual
information based on conclusive scientific evidence can, has and will.”
“I am among the few in the HIV field who have publicly espoused both
same-sex marriage and the right of uninfected gay men to donate blood,”
wrote Wainberg in response. “The appropriate noncondescending phrase to
characterize my strong language in advocating for safer sex practices
among gay men, whom I cherish and respect, is probably ‘tough love.’”
Unfortunately this arrogant paternalism — tough love — is just a short
step from persecution of homosexuals for our dangerously randy ways.
There was a time in the very recent past when it was perfectly
acceptable in Canadian society to treat gay men — for our own good —
with chemicals and psychotherapy. There was a time when gay sex was
criminal.
Wainberg still holds tight to his position that promiscuity is a
villain in the fight against HIV. But even he has come to believe that
criminalization is not part of the solution.
In a December 2008 editorial in the journal Retrovirology, Wainberg
finally adds his voice to the growing chorus of activists and
researchers who recognize that criminalization is ineffective and
dangerous.
“We need to recognize that the current criminalization of HIV
transmission is not doing any good and, probably acts as a deterrent to
HIV testing, thereby, in effect, promoting HIV transmission by people
who do not know or don’t want to know that they are infected,” he
writes.
But Wainberg doesn’t let go of his misguided view that promiscuity is at the root of the issue.
“How can society resolve this problem, while not, in effect,
encouraging sexual promiscuity and risk behaviour?” he writes.
Homophobia unleashed by the criminalization of HIV isn’t the exclusive
domain of heterosexuals. Some gay men are deeply frustrated with other
gay men who fail to disclose. These days too many upscale fags imagine
themselves as good, monogamous gay men and feel no compunction about
demonizing bad, promiscuous gay men.
If Aziga is convicted many more gay guys will feel empowered to accuse
their ex-partners of aggravated sexual assault. Gay men who do this
unwittingly endanger their own civil liberties.
In the face of all this nonsense the AIDS service community has so far
been too timid in its objections to criminalization and the charges
against Aziga.
“Using the criminal law in this kind of way is not particularly
helpful,” Richard Elliott, executive director of the Canadian HIV/AIDS
Legal Network, told the Canadian Press after Aziga was charged.
“What we’re questioning is the suitability of using the criminal
justice system this way,” said Betty Anne Thomas, then executive
director of the Hamilton AIDS Network.
A conviction in the Aziga case will only complicate HIV-prevention
efforts and make the things worse for those living with the virus.
I challenge jurists, HIV/AIDS service organizations, HIV/AIDS
researchers and everyone who is living with HIV to do the right thing:
Condemn the criminalization of HIV in all its forms. Declare
unequivocally that it is an approach that does not work and that only
perpetuates injustice. Demand that Aziga be acquitted of the charges
against him.
Sky Gilbert holds a University Research Chair
in creative writing and theatre studies at the University of Guelph.
His play, I Have AIDS, opens on Thu, Apr 23 at Buddies in Bad Times Theatre.
Take action
What you can do to fight the criminalization of HIV
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TPWAF settles into new digs
More space, easier access but out of the village for Toronto PWA Foundation Offices
January 29, 2009
There are boxes to sort through and paintings to hang, and the internet connection can be a bit spotty at times.
But Murray Jose, executive director of the Toronto People with AIDS
Foundation (TPWAF), says staff are ready for business at their new
location at 200 Gerrard St E.
“I’ve still got some unpacking to do,” Jose says, pointing to a
collection of files and pamphlets piled on a desk inside his corner
office, “but we’ve been fully up and running for a few weeks now.”
In December TPWAF relocated from the AIDS Committee of Toronto
building, where it has been a tenant since 1993, to a newly renovated
9,000-square-foot space near the Sherbourne Health Centre.
The new accommodations include the building’s street-level floor, which
houses TPWAF’s food bank and Food for Life programs, and the third
floor, which contains offices and community space.
The move was part of TPWAF’s ongoing Strategic Planning process,
launched on the foundation’s 20th anniversary in 2007 to identify ways
of improving service to the roughly 5,000 clients it assists annually.
In particular Jose says the foundation wanted an area that would reduce
crowding and foster a sense of community that was highly valued by
those using TPWAF’s programs.
“When we talked to clients through this [consultation] process we
learned that, without specifically intending to, we had created a home,
a place where people would feel comfortable… we wanted a physical space
to match what we’d created in a psychological sense,” he explains.
Accessibility was high on the list of criteria for a new office, Jose
says. Unlike its old quarters, both floors can be reached by elevator
and the foundation has sought final approval to construct a wheelchair
ramp leading into the building.
The accommodations include a spacious reception area, rooms for
community classes and an abundance of office space — far more than the
roughly 20 TPWAF staff could possibly occupy on their own.
TPWAF says it plans to use the extra room to host other community AIDS
organizations in the hopes of becoming a “point of access” for HIV
support services. So far, the Black Coalition for AIDS Prevention, Fife
House and McEwan Housing Support have been given offices, and Jose says
there is the potential for further partnerships in the future.
Jose notes that while the move involves tradeoffs, like moving farther
away from the Church-Wellesley area, the organization remains proud of
its history of involvement in the gay and lesbian communities and will
continue its close relationship with the AIDS Committee of Toronto.
“We’re still every bit as compatible and committed to each other’s goals as we’ve always been,” he says.
Andrew Brett, ACT’s communications director, echoes that sentiment in an email to Xtra.
“ACT will continue to work collaboratively with TPWAF to provide
complementary services to people living with HIV/AIDS,” Brett writes.
He adds that ACT is in the process of finding a new tenant to take over the sublease.
An estimated 15,000 people living with HIV call Toronto home, nearly a quarter of Canada’s HIV-positive population.
For more on the Toronto People with AIDS Foundation check out Pwatoronto.org.
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Martin Delaney: An AIDS Warrior Passes the Torch
One
of the US nation’s brightest and most accomplished AIDS activists,
Martin Delaney has passed away from liver cancer. His influence on AIDS
research and the patient empowerment movement will be lauded for years
go come. David Evans, a fellow activist and editor with AIDSmeds and
POZ, explains Delaney’s legacy and the challenges he left to a new
generation of activists
January 27, 2009
When Martin Delaney, a
longtime AIDS activist, died of liver cancer on January 23 at the age
of 63, people with HIV lost one of their greatest champions. From
the early 1980s—when he became a one-man information clearing house
about experimental treatments and started smuggling promising drugs
from Mexico to the United States for desperate men and women—until the
day he died, Marty never gave up on the hope and possibility of a cure
for HIV disease. Though not HIV-positive himself, he kept up the
pressure on scientists, politicians and other activists to continue
talking about the possibility of a cure, even when such talk became
unpopular. The passing of his vision, passion and hope will be
impossible to replace.
I had the honor to call Marty my friend. Though he’d be uncomfortable
with some of the praise that has been printed since his passing, it is
important that people with HIV know what Marty accomplished and what
we’ve lost due to his death. He was a brilliant thinker, educator and,
above all, a negotiator; for 27 years, he shared those gifts selflessly
and unceasingly on behalf of people with HIV. He was also a complex and
imperfect man—just like the rest of us—and like any good activist, he
managed to ruffle some feathers along the way.
In the late 1980s and early 1990s, Marty was sometimes at odds with
activists on the East Coast about the proper course of AIDS research,
how that research should be governed and the most appropriate people to
lead the charge. Though they didn’t always agree, Marty, along with ACT
UP chapters around the country and the Treatment Action Group from New
York, played a prominent role in helping speed up access to
experimental medications and approval of those drugs for people with
HIV.
Over nearly three decades, Marty was a guiding force in research on the
immune system, therapeutic vaccines and HIV drug development. He played
a key role in the development of protease inhibitors and a number of
other HIV drugs. While publicly advocating that pharmaceutical
companies continue to invest in HIV research, he led a group, called
the Fair Pricing Coalition, to lower or freeze the prices of existing
HIV drugs. His skill and experience as a negotiator to big business
allowed him to effectively advocate on behalf of people with HIV with
the heads of industry and government.
Marty also worked tirelessly to give people with HIV the information
and resources they needed to be proactive about their health care. He
founded Project Inform, one of the country’s first nonprofits devoted
to HIV treatment advocacy and information. At the height of the
epidemic in the early 1990s, Project Inform’s treatment hotline
received up to 100,000 calls a year from people with HIV and their
friends and family members. I had the privilege of working with Marty
to bring informational town meetings to cities big and small all across
the United States. Over and above such formal activities, Marty also
helped hundreds of people individually who called at all hours of the
day and night seeking his help and advice. He used his knowledge and
influence to help people access experimental drugs and advocate for
better treatment from their health care providers, who were often
inexperienced in treating HIV. I couldn’t begin to count the number of
people who came up to Marty after a town meeting to talk with him in
person for the first time and to tell him that he’d literally saved
their lives.
Not long after meeting Marty in 1991, he and I took an impromptu road
trip in the desert. We were in Las Vegas for some reason, and Marty,
being a huge sci-fi and UFO buff, wanted to drive out to a spot that
some people claimed was the site of an alien landing in the 1950s, kept
top secret, of course, by the federal government. I loved the desert,
and adventure, so I was game.
We left the glaring neon monotony of the casinos around noon. About 25
miles north of Las Vegas, Marty pulled off on a two-lane road and
started heading into a wilderness of sand and scrub. I happened to
glance at the dashboard as we curved around the highway off ramp and
noticed that we had less than a quarter tank of gas. I suggested that
we drive to a gas station first before embarking on our trip into the
desert, but Marty said not to worry. I was skeptical, because he wasn’t
totally sure where we were going and we hadn’t consulted a map, but I
decided to let it go.
We stopped now and then to take photos of jackrabbits and mesas and the
massive sky filled with winter cloud formations. After a while, we
found the mile marker and the dirt road that led to the alleged UFO
landing site, but it was gated shut about 100 yards in. We stopped for
a minute, and Marty actually contemplated trying to break through the
gate, but eventually we decided to get back in the car. It was at this
point that I noticed the light on the gas gauge was blinking. We were
down to empty. We hadn’t seen another vehicle on the road for over half
an hour. The only sign of human habitation had been dirt side roads
leading off into the desert. I was ready to pull over and wait to be
rescued. I didn’t say the words, “I told you so,” but I came pretty
close.
Marty said, “Don’t worry,” then pulled out onto the road and started
heading deeper into the desert. I told him that he was insane and that
we should go back to the highway, but he said to trust him. I spent the
next 20 minutes fuming, as we slowly climbed up a stretch of low
foothills. I was certain that we were going to be stranded, perhaps for
hours. Eventually the car coughed and shuddered a bit, and then Marty
shifted the car into neutral and turned off the ignition, letting
gravity pull us along. The road began to decline, and we coasted
quietly, barely making it over the top of the slight rises, as we
rounded the curves of the hills. Then, as we floated around
another turn, a gas station sign appeared over top of the next hill in
the distance. As Marty gently eased up to the pump at the old station,
he pulled the emergency brake, turned to me and cracked a huge smile. I
just rolled my eyes, and told him he’d gotten very lucky. But that’s
how Marty approached everything, including AIDS activism: with a quiet
certainty that he was headed in the right direction, even when others
raucously criticized him for being on a fool’s errand. He also didn’t
hesitate to break the rules when he felt he was right. The most
frustrating and wonderful thing about Marty is that he almost always
turned out to be right in the end.
A couple of days before Marty died, when he was still a little bit
responsive to our voice and touch, a top AIDS researcher with whom
Marty had become friends over the years came to say goodbye. He thanked
Marty for all he’d done and promised to keep science moving forward,
but Marty protested, “I haven’t done enough.”
What Marty meant is that we still haven’t found a cure for HIV and that
millions of people worldwide still don’t have access to the treatments
we do have. As hard as it will be to move forward without Marty’s
confidence, energy and insight, those are two battles that we must
continue to fight.
With the world economy in shambles, it’s going to be tough to keep up
the pressure to roll out expanded HIV treatment in the developing
world. The pharmaceutical industry is complaining that there’s little
incentive for them to stay in AIDS research. Scientists have largely
given up on a cure, and confidence in finding an effective vaccine has
sunk to an all-time low. It is when things seemed darkest, however,
that Marty always fought the hardest and stubbornly headed off into the
unknown desert instead of toward the safe highway. I hope that Marty’s
spirit and example will give those of us he’s left behind the courage
to go in unexpected directions and fight the difficult battles ahead.
It’s the least we can do.
By Chris Evans, http://www.aidsmeds.com
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Obama Administration Requests Dybul To Resign as PEPFAR Administrator
President
Obama on Friday issued an executive order repealing the "Mexico City"
Policy, which banned U.S. funding for international health groups that
use their own funds to perform abortions, lobby their governments in
favor of abortion rights or provide counseling about terminating
pregnancies, the Washington Post reports.
January 26, 2009
President Obama on Friday issued an executive order repealing the "Mexico City" Policy, which banned U.S. funding for international health groups that use their own funds
to perform abortions, lobby their governments in favor of abortion
rights or provide counseling about terminating pregnancies, the Washington Post reports. Obama also said that he would work with Congress to restore funding to the United Nations Population Fund to prevent HIV/AIDS, reduce poverty, and improve health care access for
women and children in 154 countries. The Post reports that Obama's
decision was praised by women's health advocates, family planning
groups and others for allowing USAID to fund programs that offer HIV prevention and care, birth control and medical services (Stein/Shear, Washington Post, 1/24).
According to Reuters,
critics of the "Mexico City" Policy say that the restrictions have
resulted in large reductions in funding for organizations worldwide
that provide family planning services and basic health care. For
example, the Center for Reproductive Rights reports that in Ethiopia and Lesotho, some nongovernmental
organizations are not able to offer comprehensive and integrated health
services to people living with HIV/AIDS (Mason/Charles, Reuters, 1/23).
In a related San Francisco Chronicle opinion piece, Shalini Nataraj of the Global Fund for Women writes of one operation in Ghana that lost funding because it refused
to adhere to the "Mexico City" Policy, resulting in an estimated
600,000 people losing access to HIV/AIDS prevention education,
counseling and family planning services.
The effects of the policy have been "compounded" by a requirement in the President's Emergency Plan for AIDS Relief that organizations receiving funding must oppose commercial sex work,
Nataraj writes, adding that the "reasoning behind this pledge is that
by denying services or outreach to those who work as" commercial sex
workers, such work "will be abolished and HIV/AIDS will be reduced."
She writes that the "reality is otherwise, because women enter sex work
for a variety of deeply entrenched sociocultural and economic reasons
that must be addressed before [commercial sex work] can be reduced.
This means that organizations that work with sex workers are threatened
with a loss of funding for serving those most in need of information
and protection from HIV/AIDS" (Nataraj, San Francisco Chronicle, 1/26).
http://www.kaisernetwork.org
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Terrence Higgins Trust makes recommendations to police about HIV transmission cases
"We
believe that investigations need to be fair and consistent, based on
fact rather than fears and conducted in a manner that minimises
distress to all parties involved and reduces the current high levels of
wasted police resources."
also: Nebraska Bill Would Criminalize Intentional Transmission of HIV/AIDS, Other Diseases
January 27, 2009
THT has produced a report on HIV transmission cases
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London - A leading sexual health charity has said that the application
of the criminal law in HIV transmission cases is poorly understood by
some police officers.
Terrence Higgins Trust's report Policing Transmission examines how
police across England have handled allegations of HIV transmission.
It is based on police records of actual cases that were investigated between 2004 and 2007.
Staff from Asociation of Chief Police Officers and the Metropolitan
Police Service compiled reports from notes of cases identified by THT
and other HIV support organisations.
ACPO and the Met worked with THT and a Community Advisory Panel to draw lessons and make recommendations.
The panel produced the recommendations and oversaw the writing of the review.
It found that both HIV and the use of the criminal law in relation to its transmission were often poorly understood.
This in turn led to disparities in the application of the law and a
lack of common practice in the manner in which allegations were
investigated.
Lisa Power, Head of Policy at Terrence Higgins Trust said:
"Currently, many allegations - probably hundreds - are investigated but the vast majority rightly never end up in court.
"Increasingly, inappropriate cases are pursued for months or even
years, only to be dropped because police are unfamiliar with guidelines
for prosecution or the complexities of HIV transmission.
"We believe that investigations need to be fair and consistent, based
on fact rather than fears and conducted in a manner that minimises
distress to all parties involved and reduces the current high levels of
wasted police resources."
The report is aimed primarily at police forces but also includes
observations for community groups and clinicians who encounter
allegations and investigations.
http://www.pinknews.co.uk
also: Nebraska Bill Would Criminalize Intentional Transmission of HIV/AIDS, Other Diseases
January 26, 2009
Nebraska State Sen. Pete Pirsch (R) on Wednesday introduced a bill (LB 625) that would make having sex with the intent of transmitting HIV a felony, the AP/KPTMNews.com reports. The bill also would make it illegal to donate or sell organs
and bodily fluids, including blood and semen, or share a needle with
the intention of spreading HIV/AIDS and other diseases. People who
violate the law would be committing a Class 1B felony, which carries a
minimum 20-year prison sentence and a maximum sentence of life in
prison, the AP/KPTMNews.com reports (AP/KPTMNews.com, 1/21).
12 Nebraska Residents on ADAP Waiting List
In related news, about 12 Nebraska residents are on the state's AIDS Drug Assistance Program waiting list, the University of Nebraska Medical Center said Thursday, the Omaha World-Herald reports. Susan Swindells, medical director of the center's HIV clinic,
said the "federal support is vital because these drugs are expensive,
and many of our patients do not have the means of paying for this
medicine otherwise" (Ruggles, Omaha World-Herald, 1/22).
http://www.kaisernetwork.org
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UK's Leading Figures In HIV Health And Welfare Take Growing HIV Issues Head-on
The
Government has committed to a large-scale reduction in the numbers of
people receiving benefits like the Disability Living Allowance and
Incapacity Benefit, which could have both long and short-term effects
on the ability of people living with HIV and AIDS to feed, clothe and
shelter themselves.
January 29, 2009
Just days after MPs debated controversial changes to the welfare
system, Crusaid, one of the UK's leading HIV and AIDS charities, is
uniting stakeholders from across the country to discuss the impact that
these new rules will have on some of the country's most vulnerable
people.
Crusaid's second HIV and Poverty conference, taking
place from 3 - 4 February at The Amnesty International Human Rights
Action Centre, will bring together clinicians, social workers,
Citizen's Advice Bureau staff and other professional advocates, who
represent clients living with HIV and AIDS.
The Government has committed to a large-scale reduction in the numbers
of people receiving benefits like the Disability Living Allowance and
Incapacity Benefit, which could have both long and short-term effects
on the ability of people living with HIV and AIDS to feed, clothe and
shelter themselves.
With keynote speeches from clinicians, lawyers and Labour MP, Neil
Gerard, chair of the All Party Parliamentary Group on Refugees (APPGR),
the conference, sponsored by The Monument Trust, will highlight and
explore the complex issues that HIV-health, immigration status and
social stigma combine to create.
Crusaid, through The Crusaid Hardship Fund, is acutely aware of the
conditions that exist as a result of living with HIV and AIDS. As the
single largest source of financial help in the UK for people living in
poverty as a result of HIV and AIDS, it has helped one in three of
those living with the virus. Many of Crusaid's beneficiaries are in
receipt of sickness-related benefits and have seen all or part of their
income cut, suddenly.
Crusaid's Head of Grants and Projects, Steven Inman, said: "The Crusaid
Hardship Fund, is already having to prop up a failing welfare system
that lets people living with HIV and AIDS fall through gaps in the
process to find themselves in poverty.
"Crusaid is committed to helping people enjoy an independent life where
they have the opportunity to manage their own HIV health. Getting back
into the workplace can often be a powerful step towards this, however,
it's not always that simple: discrimination, legal status and varying
health can be insurmountable barriers for some. Rather than pulling the
rug from underneath people who are already facing challenges, we need
to, collectively, find a route which properly supports individuals to
transition from joblessness into sustainable employment."
He added: "This conference is an opportunity to share the common
experiences of groups that are often isolated and identify the emerging
patterns, for example, where people are seeing their benefits reduced
but their fuel bills rising. We can then examine which ideas can be
pushed forward by the UK HIV sector to ensure a joined-up response from
both statutory and non-statutory agencies alike."
Crusaid's second HIV and Poverty conference takes place from 3 - 4
February 2009 at the Amnesty International Human Rights Action Centre,
17-25 New Inn Yard, Shoreditch, EC2A 3EA. It brings together leading
stakeholders in the support of people in poverty living with HIV and
AIDS in the UK and allows them to share experiences and learn best
practice. The event is sponsored by The Monument Trust.
The Crusaid "Poverty Without Borders" report, to be launched at the
conference is sponsored by GlaxoSmithKlein's Positive Action and is
available by request to:
About Crusaid
Crusaid is a pioneering grant-maker,
supporting poor and marginalised people and communities affected by HIV
and AIDS. Crusaid works in the UK and internationally to provide
knowledge & prevention, economic support, emotional support, social
support and access to treatment and services.
Our UK projects have provided support across the UK sector to raise the
quality of clinical care, promote education and awareness of the virus
and support community projects in the advancement of good practice and
advocacy.
By funding innovative, community-based projects internationally, we are
able to lay the foundations to long term change. For example a rundown
railway station in Sir Lowry's Pass, east of Cape Town has been turned
into a centre where 300 people a day - including many children orphaned
by AIDS - come to eat, wash and get emotional and practical support.
Since 1986 Crusaid has raised over £33 million to support charitable programmes.
Crusaid, http://www.medicalnewstoday.com
|
New diabetic retinopathy therapy possible
"These
findings represent a pivotal step towards understanding the importance
of plasma kallikrein as a target in diabetic eye disease and how its
inhibition may support the development of a safe and effective therapy
for diabetic retinopathy," said Barbara Araneo, director of
complications research for the Juvenile Diabetes Research Foundation.
January 26, 2009
Boston -- U.S. scientists say they've developed a new therapy that may
be effective in treating diabetic retinopathy -- a common eye-related
complication of diabetes.
Researchers from the Joslin Diabetes Center in Boston and ActiveSite
Pharmaceuticals Inc. in San Francisco say they've demonstrated a
specific inhibitor of the protease plasma kallikrein -- ASP-440,
developed by ActiveSite Pharmaceuticals -- might provide such a new
therapeutic approach.
Led by Harvard University Associate Professor Edward Feener, the
researchers discovered continuous systemic administration of ASP-440
proved effective in decreasing hypertension-induced increased retinal
vascular permeability in rodents by as much as 70 percent. The
scientists said increased retinal vascular permeability is a primary
cause of diabetic macular edema, a leading cause of visual impairment
associated with diabetes.
ASP-440 was also found to be effective in lowering the elevated blood pressure in the animals.
"These findings represent a pivotal step towards understanding the importance of plasma kallikrein as a target in diabetic eye disease and how its inhibition may support the development of a safe and
effective therapy for diabetic retinopathy," said Barbara Araneo,
director of complications research for the Juvenile Diabetes Research
Foundation.
The research is reported in the February issue of the journal Hypertension.
United Press International, Inc.
|
Ignorance and stigma provide foundation for gay men's support of criminalisation of HIV transmission
A
total of 8152 men answered questions indicating whether they agreed,
disagreed, or were not sure about prosecutions. A clear majority of men
(57%) indicated that they thought that it was “a good idea to imprison
people who know they have HIV [and] pass it on to sexual partners who
do not know they have it”.
January 26, 2009
The majority of gay men in the UK support the use of the criminal law
to punish people who infect a sexual partner with HIV, a new report
published by Sigma Research shows.
Overall, 57% of gay men supported the prosecution and imprisonment of
people with HIV who had recklessly infected a sexual partner with the
virus.
The report, titled Sexually charged,
showed that men who had never been tested for HIV were the group most
likely to support the use of the criminal law in this way. Earlier
research has shown that men who have never tested for HIV are the group
of gay men least likely to know somebody with HIV, and often feel that
HIV is not present in either their social circles or everyday life.
Men who supported prosecutions generally regarded the responsibility to
prevent HIV infections during sexual encounters as being vested solely
with the HIV-positive partner. They also held strongly stigmatising
views about HIV and appeared to have little appreciation of the
effectiveness of HIV treatment.
The report’s authors note that few gay men thought that prosecutions
would help reduce the transmission of HIV and express concern that such
cases have created unrealistic expectations that people who know they
are HIV-positive will disclose this to their sexual partners.
Since 2001, the criminal law in England and Wales and in Scotland has
been used to prosecute and imprison individuals for the reckless
transmission of HIV. The cases have involved individuals who did not
inform their partner (or partners) that they were HIV-positive before
having unprotected sex that resulted in HIV transmission.
In 2006, men completing the annual Gay Men’s Sex Survey were asked a
series of questions to assess their attitudes towards these
prosecutions. There was considerable mainstream media reporting of such
prosecutions at this time.
A total of 8152 men answered questions indicating whether they agreed,
disagreed, or were not sure about prosecutions. A clear majority of men
(57%) indicated that they thought that it was “a good idea to imprison
people who know they have HIV [and] pass it on to sexual partners who
do not know they have it”.
Just over a quarter of men (26%) said they opposed this and 18% said they were unsure.
There were significant differences in the characteristics of men who
supported, opposed or were not sure about the use of the criminal law
to punish transmission of HIV.
Men who had never tested for HIV were the group most likely (64%) to
express their support and HIV-positive men were the group most likely
to oppose (49%) imprisonment. A majority (57%) of men who said they
were HIV-negative supported imprisonment.
Support of prosecutions was also related to demographic, social and
behavioural characteristics. Most notably, men with over 30 sexual
partners a year, were the only group where a clear majority opposed
imprisonment (54%), even though researchers excluded men who were
HIV-positive.
The majority of men supporting imprisonment provided information
explaining why they held this position. The harm caused by HIV
transmission emerged as the major factor why individuals supported
prosecution.
Many respondents emphasised the risk of death that they perceived as
resulting from infection with HIV. Some individuals equated the
transmission of HIV with murder.
“These responses reveal the perception that there is little capacity
for living well or longevity among people with diagnosed HIV”, write
the researchers, “getting HIV is regarded as utterly disastrous.” There
was little appreciation of the effectiveness of HIV treatment.
Moral harm also emerged as a theme amongst respondents supporting
imprisonment. For example, a 22 year old from Wales who had never been
tested for HIV wrote, “to have sex with someone when you know you are
HIV+ without telling them is one of the worst things that could ever be
done. These people should be given life sentences.”
It was also clear that those who supported imprisonment viewed the
responsibility of preventing HIV transmission as being vested solely
with the HIV-positive partner. As one HIV-negative man from southern
England wrote, “once you contract HIV it is your responsibility to
ensure that you do not transmit it.”
By contrast, men who opposed imprisonment often believed that the
responsibility to prevent HIV transmission should be shared between
partners, one HIV-negative man from London summing up his position
thus: “it takes two to tango”.
The view was also expressed that prison was an inappropriate punishment
for this offence, with one HIV-negative respondent from Scotland
writing “it’s not a good idea, it’s reactionary.”
Approximately an eighth of those who opposed imprisonment indicated
that they did so because of the impact prosecutions could have on the
HIV epidemic. A significant proportion of these men expressed the
opinion that such action only served to increase the stigma and
discrimination surrounding HIV. “Living with the virus is bad enough
without locking people up who have it”, wrote a 33-year-old man with
HIV from the English Midlands. He noted the exceptional way that HIV
was treated by the criminal law, “we do not lock up people who pass on
colds, flu or even more serious viruses. The approach of the courts/CPS
is another example of prejudice towards HIV sufferers.”
Some men expressed the belief that criminalisation would discourage HIV testing.
About a quarter of men were unsure about criminalisation. The answers
of these men indicated that forming an opinion would depend on the
circumstances of the case, including issues such as shared
understanding and intent. When the researchers looked at the responses
of these men in detail, it became apparent that as many as a third of
men who said that they were unsure actually gave responses that
suggested that they had very grave doubts about the imprisonment of
people for transmission of HIV.
The researchers believe that the findings of the report have important
implications for HIV health promotion. They note “most the men who
supported prosecutions considered HIV to be invariably fatal”. They
express concern that “the perception that HIV equals certain death
helps to maintain the stigma related to HIV, which in turn, negatively
impacts on the environment in which prevention interventions occur.”
And concern is also expressed by the researchers that individuals
supporting prosecutions seem to expect their HIV-positive sexual
partners to disclose their status. The researchers note that this is
unrealistic given that a third of gay men with HIV are unaware that
they have the infection and that large numbers of diagnosed men find
disclosure problematic. Furthermore, they write that an expectation of
disclosure, “presumes that men without HIV have no part to play in
protecting themselves from infection.”
Addressing the evident stigma with which many men regard HIV was also
another theme emerging from the report that the researchers believe
needs to be addressed. They write: “the degree to which the reality of
living with HIV is misunderstood, and the fear and loathing with which
men characterise those ‘other’ gay men and bisexual men with HIV is
clearly evident”. The researchers conclude, “the othering of HIV
continues to be the largest underlying challenge to our HIV response.”
Reference
Dodds C et al. Sexually charged: the views of gay and bisexual men on criminal prosecutions for sexual HIV transmission. Sigma Research, 2009.
By Michael Carter, http://www.aidsmap.com
|
Gay men who have group sex get better STI care if they feel confident
about being open about this with their doctor
January 26, 2009
Approximately a third of Australian gay men
report having unprotected anal sex with a partner assumed to be of a
different HIV status during group sex sessions, according to a study
published in the February edition of Sexually Transmitted Infections.
Engaging in unprotected sex during group sex was associated with
increased levels of testing for HIV and other sexually transmitted
infections. Moreover, gay men who told their doctors about their group
sex behaviour had more tests for sexually transmitted infections than
men who did not disclose such behaviour. The investigators suggest that
encouraging an honest and trusting relationship between gay men and
their healthcare providers would ensure that men receive appropriate
testing and care.
Overall, 90% of gay men in Australia have had an HIV test and it is estimated that approximately two-thirds have annual tests.
Group sex among gay men has been associated with a risk of HIV and
other sexually transmitted infections. Investigators therefore wished
to establish a better understanding of recent HIV and sexual health
testing amongst gay men engaging in group sex.
The study involved 436 men. Most (80%) were recruited online. The men
provided details of their most recent group sex encounter, including
the number of men present at this encounter and the sexual behaviour
they had engaged in. The men then provided details of what sexual
health tests they had had since their last group sex encounter and were
asked if they had discussed having had group sex with the doctor who
provided their sexual health care.
Participants had a mean age of 40 years (range, 18-67) and the majority (57%) had a university education.
An HIV test was reported by 90% of men, in accordance with general
levels of HIV screening for Australian gay men. Just over two-thirds
(67%) of men reported that they were HIV-negative, the remaining 23%
saying they were HIV-positive.
Over a quarter (29%) of men said there had been three men present at
their last group sex encounter (a threesome), with 51% saying there had
been four or more men present. The majority of men (63%) said that they
knew at least some of the men with whom they had had group sex.
Unprotected anal sex during group sex was reported by 145 men (33%).
The majority of men said that they had had unprotected sex with a
non-regular partner whom they assumed had a different HIV status to
their own.
Half the men reported having had a sexual health test within a month of their last group sex encounter.
Factors associated with seeking such tests included: engaging in
unprotected anal sex with a non-regular partner (p = 0.008); at least
four other men being present at the group sex session (p = 0.014);
having previously met any of these men (p = 0.006); and having less
than a university education (p = 0.019).
The investigators then restricted their analysis to men who reported
being HIV-negative or of unknown HIV status. Only having unprotected
sex with a non-regular partner (p = 0.001) and there being at least
four men present at the group sex encounter (p = 0.035) were
significantly associated with seeking a test for HIV or other sexually
transmitted infections.
Approximately half (52%) the men said that they had discussed having
had group sex with their doctor, with 17% saying they did so frequently.
Discussing such behaviour with healthcare providers was associated with
a greater level of testing for sexually transmitted infections. Men who
did not tell their doctor that they had engaged in group sex had a mean
of 2.58 such tests, compared to a mean of 3.52 tests for men who had
discussed engaging in group sex, and a mean of 4.05 tests for men who
frequently discussed their group sex behaviour with their doctor.
Of the 342 men who said that they were HIV-negative or of unknown HIV
status, 94 (28%) said that they had had an HIV test since the last time
they had engaged in group sex. Men who had had unprotected anal sex
with a non-regular partner were more likely to have had an HIV test
than men who had not engaged in this high-risk behaviour (p < 0.001).
The investigators also conducted in-depth interviews with 16 men about their testing behaviour.
One man (who reported being HIV-negative) expressed the belief that as
he tested for infections every three months, and had not been diagnosed
with any infections, he felt reassured that he had not put himself at
risk. However, he also indicated that he had engaged in unprotected
anal sex with men during group sex and that he did not know the HIV
status of these men. He told the investigators: “I just don’t think it
is that risky to have unprotected sex, for the insertive partner…And I
get tested regularly, and I haven’t caught anything yet.”
It was also clear that some men felt uncomfortable discussing group sex
behaviour with a healthcare provider. One man told the investigators
that his doctor did not understand his need to be tested for sexually
transmitted infections every three months. He told the investigators:
“My doctor tries to get me to test every six months, and so I alternate
his visit with a visit to the Sexual Health Clinic, and that makes me
seem like a bit less of a slut”.
“Our findings confirm that gay men who engage in group sex are at a
high risk of transmission and infection with HIV and other STIs and
that consideration of potential risks figure highly in their decisions
about testing”, write the investigators. They add, “one possible factor
for improving the quality of this testing is the relationship between
such men and their doctors. Promoting an open, non-judgemental and
trusting relationship with doctors with whom they can feel safe
discussing all aspects of their sexual behaviour may lead to improved
testing decisions.”
Reference
Prestage GP et al. Testing for HIV and sexually transmissible infections within a mainly online sample of gay men who engage in group sex. Sex Transm Infect 85: 70-74, 2009.
By Michael Carter, www.aidsmap.com
|
IAVI and Algonomics to Collaborate on HIV Protein Design Project
January 26, 2009
Gent Belgium & New York - The International AIDS Vaccine Initiative
(IAVI) and Algonomics today announced a collaboration to modify an HIV
protein in order to improve immune responses elicited by HIV vaccine
candidates that include the protein as an insert. The project utilizes
a proprietary antigen design technology developed by Algonomics and
will be funded by IAVI’s Innovation Fund, a funding mechanism that
seeks out novel and typically high-risk technologies that could provide
breakthroughs in the design and development of novel AIDS vaccine
candidates.
To develop vaccine candidates capable of controlling HIV infection,
experts are searching for ways to improve upon the immune responses
that have been elicited in candidates tested to date. In its natural
state, the HIV Gag protein has not generated immune responses that are
sufficient to keep HIV in check in the body. Experts hope that by
modifying the protein in a rational way, they can provoke the immune
system to develop stronger and more effective responses.
Under the agreement, Algonomics and IAVI will collaborate to alter
epitopes in the HIV gag protein to broaden immune responses and direct
them towards conserved regions of the protein. The project utilizes
Epibase®, a tool to identify T-cell epitopes, those parts of the HIV
Gag protein that generates T-cell responses. The newly designed protein
will be tested for its ability to generate broader T-cell responses.
Algonomics will perform in vitro testing of immune responses using its
Epibase-IV technology.
“We are delighted to collaborate with Algonomics to apply their protein
design technology to help improve T-cell responses against HIV,” said
Dr. Hansi Dean, IAVI’s Director of New Alliances. “Rational
modification of the HIV inserts in vaccines designed to elicit cellular
immune responses that can control HIV infection is a critical component
of IAVI’s vaccine design program.”
Philippe Stas, CEO of Algonomics, adds: “Entering this collaboration
with IAVI’s world-class research teams further expands our commitment
to biotherapeutics design. Contributing to the development of a novel
type of vaccine to help in the fight against HIV/AIDS is a strong
motivator for our scientists.”
A vaccine that protects against HIV infection will most likely need to
stimulate both arms of the immune system, generating both neutralizing
antibodies and cell-mediated immunity (CMI). Despite significant
efforts to develop an effective AIDS vaccine based on CMI, no candidate
to date has been able to generate an effective and robust T-cell
response that reduces viral load or protects against HIV infection.
Further improvements in CMI approaches are urgently needed, and
emerging data suggest that immune responses that comprise a broader
range of epitopes result in lower viral load. The redesign of the HIV
gag protein is expected to result in a broader immune response against
the protein. If this project succeeds, additional HIV proteins used in
HIV vaccine candidates will be considered for modification to further
optimize immune responses.
The project is funded through IAVI’s Innovation Fund. Targeted
primarily to small- and medium-sized biotechnology companies, the fund
proactively seeks out and finances nascent technologies that could help
solve some of the main technical and scientific hurdles facing AIDS
vaccine science and ultimately lead to the development of novel
candidates. The fund has an initial three-year commitment of US$10
million, half of which will be financed by a US$5 million grant to IAVI
from the Bill & Melinda Gates Foundation. The Innovation Fund is
the latest addition to IAVI’s extensive research and development
infrastructure, which includes a network of labs worldwide, three
consortia comprised of leading AIDS researchers and a network of
state-of-the-art clinical research centers and supporting programs.
Since its founding in 1996, IAVI has introduced a series of pioneering
approaches to AIDS vaccine R&D, which has already resulted in the
design of six novel vaccine candidates that have entered human trials
in 11 countries in Asia, Africa, Europe and North America.
About Algonomics
Algonomics is a Belgium-based biotech company providing integrated
immunogenicity services to support companies in the development of
biotherapeutics. Algonomics’ broad range of services includes
specialized modeling, characterization and structure annotation studies
for therapeutic proteins and antibody-based therapeutics. For more
information about Algonomics visit http://www.algonomics.com.
About Epibase® and Epibase-IV
Epibase® combines in silico methodologies and in vitro assays to assess
the immunogenicity of biotherapeutics, such as therapeutic antibodies,
biosimilars and vaccines. While the computer based algorithms focus on
lead selection and optimization, the in vitro tests allow the
comparison of lead formulations and formats, by challenging donor
derived cells with protein therapeutics.
About IAVI
The International AIDS Vaccine Initiative (IAVI) is a global
not-for-profit organization whose mission is to ensure the development
of safe, effective, accessible, preventive HIV vaccines for use
throughout the world. Founded in 1996 and operational in 24 countries,
IAVI and its network of collaborators research and develop vaccine
candidates. IAVI's financial and in-kind supporters include the Alfred
P. Sloan Foundation, the Bill & Melinda Gates Foundation, the
Foundation for the National Institutes of Health, The John D. Evans
Foundation, The New York Community Trust, the James B. Pendleton
Charitable Trust, The Rockefeller Foundation, The Starr Foundation, The
William and Flora Hewlett Foundation; the Governments of Canada,
Denmark, India, Ireland, The Netherlands, Norway, Spain, Sweden, the
United Kingdom, and the United States, the Basque Autonomous Government
as well as the European Union; multilateral organizations such as The
World Bank; corporate donors including BD (Becton, Dickinson &
Co.), Bristol-Myers Squibb, Continental Airlines, Google Inc., Henry
Schein, Inc., Merck & Co., Inc., Pfizer Inc and Thermo Fisher
Scientific Inc.; leading AIDS charities such as Broadway Cares/Equity
Fights AIDS and Until There's A Cure Foundation; other private donors
such as The Haas Trusts; and many generous individuals from around the
world. For more information, visit www.iavi.org.
Algonomics
Philippe Stas, +32-9-241 11 00
Chief Executive Officer
OR
International AIDS Vaccine Initiative
Hester Kuipers, (Europe): +31 648981340
Rachel Steinhardt, (US): +1 6465781672
http://www.earthtimes.org
|
Aspirin now touted as your liver's friend
Study
says drug's growing list of curatives includes shielding organ from
ravages of alcohol, drugs. Aspirin may also allow people whose livers
are harmed by such drugs as cholesterol-fighting statins and
AIDS-abating anti-retrovirals to keep taking those life-saving
medications.
January 27, 2009
New research suggests aspirin may actually protect the liver, as well as the heart.
Hamilton Spectator file photo
Aspirin is at it again. And this time it is the liver's turn to benefit.
A staple in millions of medicine cabinets, the multi-tasking tablet is
already used to prevent or alleviate arthritic inflammation, heart
attacks, stroke, male urinary problems and several types of cancer –
not to mention headaches and other common pain.
According to a Yale University study, you can likely add liver
protection from drugs, alcohol and other blood-borne toxins to the
seemingly endless list of medical benefits acetylsalicylic acid can
claim.
"It just keeps getting better and better," lead study author Dr.
Wajahat Mehal says of the pill's medicinal prowess. "It has all these
(good) effects on our body that we are discovering." The paper appeared
yesterday in the Journal of Clinical Investigation.
Mehal's team found Aspirin's anti-inflammatory properties appear to be
especially potent on the liver and may well help protect the
blood-cleansing organ from the damaging effects of everything from drug
overdoses to binge drinking. Like banging your thumb with a hammer,
injuries to the liver from blood-borne toxins are followed by an
inflammatory response in the organ, says Mehal, an associate professor
in medicine at the New Haven school.
"The inflammation prolongs the injury to the liver and it amplifies
it," he says. "What the Aspirin is doing is switching off the
inflammation and decreasing the overall injury." Mehal says the liver
is especially susceptible to such injuries – and thus to the benefits
of Aspirin – because it is so easily inflamed.
"The liver is really on a hair's trigger," he says. "I don't expect
that Aspirin is going to help with injury to every organ ... but any
injury to the liver you get a very strong inflammatory response."
In the study, researchers examined mice that had been given overdoses
of acetaminophen, most commonly sold as Tylenol and in cold elixirs.
Mehal says such medications are by far the leading source of drug
overdoses in the developed world and the leading cause of liver
failure. And while safe in recommended dosages, acetaminophen can
easily accumulate in the body with the unwitting use of several
medications at once.
Ironically, its rival in the pain relief market – ASA – can apparently come to the rescue.
Mehal says the anti-inflammatory benefits of Aspirin seen in the
Tylenol case would also apply to alcohol and other liver-harming agents.
Aspirin may also allow people whose livers are harmed by such drugs as
cholesterol-fighting statins and AIDS-abating anti-retrovirals to keep
taking those life-saving medications. While the study needs to be
brought to the human level, Aspirin's ubiquitous use will make that
research easy and short-term, Mehal says.
By Joseph Hall, Toronto Star
|
New Cream Disables Herpes Virus
Noting
that “a vaginal microbicide able to protect against herpes simplex
virus-type 2 transmission could contribute significantly to controlling
sexually transmitted diseases,” researchers say they have developed a
cream that may protect against the virus for up to one week.
January 26, 2009
Herpes viruses -- HSV-2, which causes genital herpes; herpes simplex
virus-type 1, which causes cold sores; and varicella, which causes
chicken pox and shingles -- target nerve cells. The viruses stay latent
in the host person or animal, often causing periodic outbreaks.
Acyclovir and similar drugs can suppress symptoms and are available as
both creams or pills. However, these treatments have not been shown to
prevent infection.
Deborah Palliser of Harvard Medical School and Albert Einstein College
of Medicine and colleagues worked with Alnylam Pharmaceuticals to
develop the cream using small interfering RNAs (siRNAs). These
molecules can silence microRNAs, tiny strands of ribonucleic acid that
help to turn genes into proteins. The cream targets a gene called
nectin-1; mice engineered to lack this gene are less likely to be
infected with HSV-2.
However, the researchers found that the cream took one day or so to
“silence” nectin-1. Attacking a second gene, UL29, which is found in
the herpes virus itself, provided immediate protection, they noted.
Incorporating both genes into the cream provided protection for
approximately one week, they said. A type of cholesterol was employed
to help carry the siRNAs, and the cream did not irritate the mice’s
vaginas.
While stressing that the cream is still in development and more
research is needed, the researchers told Reuters that “topically
applied siRNAs might be useful to treat and prevent reactivation and
sexual transmission of clinically latent HSV-2 infection.”
The study, titled “Durable Protection from Herpes Simplex Virus-2
Transmission Following Intravaginal Application of siRNAs Targeting
Both a Viral and Host Gene,” was published in the journal Cell Host and Microbe.
http://www.hivplusmag.com
|
HIV Treatment Boosts Lung Cancer Survival in People With HIV
Lavolé’s
team found that ARV therapy increased an individual’s survival time by
60 percent: nine months for ARV-takers compared with a little more than
four months for the others. They concluded that the increased survival
rate resulted from some effect of ARV treatment on the cancer, rather
than simply from ARV’s ability to reduce AIDS-related complications.
January 27, 2009
HIV-positive people with lung cancer have increased survival if they
are receiving antiretroviral (ARV) treatment along with cancer
treatment, according to a study published online in the journal Lung Cancer and reported by aidsmap.com. This is one of the first studies to find a direct
impact of ARV treatment on surviving a non-AIDS-related cancer.
While ARV therapy directly affects survival with AIDS-related cancers such as Kaposi’s sarcoma,
its impact on non-AIDS related cancers is less clear. Experts have
concluded that the enhanced survival seen with these other cancers was
likely due to protection from opportunistic infections and other
HIV-related complications. The current study reached different
conclusions.
To determine the impact of ARV therapy, Armelle
Lavolé, MD, from the Université Paris in France and her colleagues
studied the medical records of 49 people with HIV who were diagnosed
with non-small cell lung cancer. The researchers analyzed patients’ ARV
therapy use, smoking history, age and other factors associated with
lung cancer survival. Most of the patients were men. The average age
was 46, and most had been smoking for nearly 30 years. Some of the
patients had surgery, and most tried chemotherapy. The overall survival
rate one year after lung cancer diagnosis was 34 percent; after five
years, it was 7 percent.
Lavolé’s team found that ARV therapy increased an individual’s survival
time by 60 percent: nine months for ARV-takers compared with a little
more than four months for the others. They concluded that the increased
survival rate resulted from some effect of ARV treatment on the cancer,
rather than simply from ARV’s ability to reduce AIDS-related
complications. “To our knowledge, this is the first study demonstrating
that [ARV treatment] is a good prognostic factor for survival in
HIV-infected patients with non-small cell lung cancer,” said the
authors.
They recommend that infectious disease specialists and oncologists work
as a team to care for people with HIV who are diagnosed with lung
cancer.
http://www.aidsmeds.com
|
Study suggests that HIV infection and use of antiretroviral therapy both can have negative effects on arteries
Since
the late 1990s, when treatment advances greatly reduced AIDS-related
mortality in wealthy countries, there has been widespread concern about
whether using anti-HIV drugs, particularly protease inhibitors, puts
people at higher risk for heart attack, stroke and related health
problems. Meanwhile, there is growing evidence that HIV itself harms
the cardiovascular system
January 28, 2009
Dutch researchers have found associations
between HIV infection and unfavourable changes in the arteries,
contributing to the ongoing effort to understand why some people with
HIV appear to be at elevated risk for cardiovascular problems. Their
cross-sectional study, reported in the February 1st edition of the Journal of Acquired Immune Deficiency Syndromes,
measured artery wall thickness and artery stiffness in HIV-positive
individuals and in a control group of HIV-negative people. HIV
infection was independently associated with both of these indicators of
cardiovascular risk, and there was also an association between
antiretroviral therapy (ART) use and artery stiffness.
Since
the late 1990s, when treatment advances greatly reduced AIDS-related
mortality in wealthy countries, there has been widespread concern about
whether using anti-HIV drugs, particularly protease inhibitors, puts
people at higher risk for heart attack, stroke and related health
problems. Meanwhile, there is growing evidence that HIV itself harms
the cardiovascular system. Because numerous factors may contribute to
cardiovascular risk in HIV-positive people, it is difficult to isolate
specific causal pathways.
The Dutch study enrolled 77 HIV-positive men and 52 healthy
HIV-negative men. Twenty-two members of the HIV-positive group had
never taken antiretroviral therapy. Twenty-three members of the
HIV-positive group had lipodystrophy.
Researchers measured several properties of the arteries. The thickness
of the wall of an artery in the neck (carotid artery intima-media
thickness, C-IMT) was of interest because this is recognised as an
indicator of atherosclerosis, a disease characterised by the build-up
of plaque in the arteries. The study also assessed the distensibility
coefficient (DC) and compliance coefficient (CC) – both indicators of
the stiffness of arteries and markers of cardiovascular risk - for the
carotid (neck), femoral (thigh) and brachial (upper arm) arteries.
After adjusting for key confounding factors such as age, body mass
index and smoking, researchers found that HIV-positive study
participants had significantly greater C-IMT than healthy controls,
i.e., greater thickness in the carotid artery, which averaged 0.69 mm
rather than 0.62 mm (p = 0.001).
HIV-positive people also had lower DC and CC values for the carotid and
femoral arteries, indicating greater artery stiffness (adjusted mean
differences as percentages, HIV-positive versus control: –13.6% for
carotid artery DC, –14.1% for carotid artery CC, –29.5% for femoral
artery DC, and –31% for femoral artery CC).
HIV infection was independently associated with C-IMT; carotid artery
DC and CC; femoral artery DC and CC; and brachial artery CC. The
current CD4 cell count levels, nadir (lowest-ever) CD4 cell count
levels, and viral load levels of HIV-positive study participants were
not associated with C-IMT or arterial stiffness.
When HIV-positive people who were treatment-experienced and those who
were treatment-naïve were compared to each other, there was no
significant difference in C-IMT. However, the treatment-experienced
group had significantly increased femoral artery stiffness as reflected
by both DC and CC measures (adjusted mean differences as percentages,
ART-experienced versus ART-naïve: –25.9% and –21.7% for femoral artery
DC and CC, respectively). Analysis of the full HIV-positive cohort
indicated that use of HIV treatment was independently associated with
femoral artery stiffness, as were cumulative use of protease inhibitors
and nucleoside reverse transcriptase inhibitors.
No significant differences were found between patients with and without
lipodystrophy, but the small size of the lipodystrophy subgroup and the
use of lipid-lowering drugs by some study participants with
lipodystrophy may have contributed to this result.
The researchers note that chronic inflammatory diseases such as
rheumatoid arthritis have been shown to increase C-IMT, as have chronic
infections. They propose that “chronic HIV infection may therefore also
lead to vascular endothelial damage and increase in vessel wall
thickness by sustaining a low degree of inflammation.” The endothelium
is a smooth layer of tissue lining the insides of blood vessels.
There is not enough knowledge currently to determine why antiretroviral
therapy appears to affect femoral artery stiffness but not carotid or
brachial artery stiffness. Furthermore, the researchers express
uncertainty about the causal pathway for this outcome: the drugs may be
damaging the femoral artery directly, or the stiffening may result from
metabolic side-effects of the drugs. At the same time, by reducing the
inflammation caused by HIV infection, antiretroviral therapy may
simultaneously protect the arteries.
“The balance between the beneficial effects of diminishing active
infection/inflammation and the negative effects of ART such as
dyslipidemia may be essential to determine the net effect in an
individual patient and in different arterial segments,” the researchers
observe.
Protease inhibitors have long been suspected of increasing
cardiovascular risk, in part because they appear to cause changes in
blood fat levels. A large cohort study published in 2007 reported that study participants taking protease inhibitors were slightly more likely to experience heart attacks than those who were not. However, a 2008 analysis of data from another large cohort found that the use of anti-HIV drugs did not increase the risk of serious cardiovascular illness.
The matter remains unresolved, and there is also ongoing debate about whether one of the nucleoside reverse transcriptase drugs, abacavir, elevates heart attack risk. At the same time, other evidence has emerged to show that in some ways antiretroviral therapy may benefit cardiovascular health.
As for the role of HIV itself, a lower CD4 count has been associated
with higher cardiovascular risk, and researchers have also tied HIV
infection to specific biomarkers of cardiovascular functioning such as
endothelial activation levels. However, much remains unknown about the
specific mechanisms that might enable the virus to damage blood vessels.
Although the debate about the negative effects of particular anti-HIV
drugs is ongoing, the overall benefits of treatment far outweigh the
potential drawbacks for most people. It is hoped that by developing
greater insight into the interplay between HIV infection,
antiretroviral therapy and other factors including heredity and
lifestyle, researchers and clinicians will be able to identify the best
strategies for managing cardiovascular risk in HIV-positive people in
accordance with individual risk profiles.
Reference
Van Vonderen MG et al. Carotid
intima-media thickness and arterial stiffness in HIV-infected patients:
the role of HIV, antiretroviral therapy, and lipodystrophy. J Acquir Immune Defic Syndr 50: 153-161, 2009.
By Kelly Safreed-Harmon, www.aidsmap.com
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Circumcised HIV-negative men more likely to clear HPV infection
Circumcised
men appear more likely to clear human papillomavirus (HPV) infections,
including those with oncogenic (cancer-causing) strains, according to a
prospective US cohort study published in the Journal of Infectious
Diseases. Men with higher numbers of sexual partners were more likely
to be infected with HPV, but also appeared more likely to clear
oncogenic infections.
January 30, 2009
Circumcised men appear more likely to clear human papillomavirus (HPV)
infections, including those with oncogenic (cancer-causing) strains,
according to a prospective US cohort study published in the Journal of Infectious Diseases.
Men with higher numbers of sexual partners were more likely to be
infected with HPV, but also appeared more likely to clear oncogenic
infections.
HPV is a sexually transmitted virus that can cause genital and anal warts; prolonged infection with certain
(oncogenic) strains can lead to anal, cervical and penile cancer.
The HPV Infection in Men study recruited 18- to 44-year-old men in
Tucson, Arizona, with no history of genital warts, penile or anal
cancer, and no current sexually transmitted infections (including HIV
and hepatitis C). Of 377 men screened between 2003 and 2005, data from
at least two study visits was available for 285 (median follow-up, 15.5
months). Most (88%) were circumcised, 26% had previous sexually
transmitted infections (STIs), and 41% had not used condoms in the past
three months.
No data on the sex of the men's sexual partners was provided, and
the study only investigated penile, not anal, HPV infection. Over
twelve months, 29.2% of the men acquired a new HPV infection: 19% with
oncogenic and 16% with non-oncogenic strains (some men acquired both).
In multivariate analysis (adjusting for all other factors), only the
total number of lifetime sexual partners affected the risk of new
(incident) HPV infections. Men with more than 16 partners were more
likely to become infected with HPV (adjusted hazard ratio [AHR], 2.8;
95% confidence interval [CI], 1.1 – 7.1), oncogenic HPV (AHR, 9.6; 95%
CI, 2.4 – 37.8) and non-oncogenic HPV (AHR, 3.6; 95% CI, 1.3 – 9.9)
than men with zero to four partners (p < 0.05). (Note that these
figures refer to new HPV infections, not the cumulative risk of sustained HPV infection overall.)
The estimated median time to clearance of new infections was roughly
six months. (However, as study visits were six months apart, shorter
times could not be distinguished.) By multivariate analysis,
circumcised men were three times more likely to clear HPV infections
(AHR, 3.1; 95% CI, 1.2 – 8.2) and six times more likely to clear
oncogenic infections (AHR, 6.5; 95% CI, 2.1 – 19.7). Men with over 16
lifetime sex partners were five times more likely (AHR, 4.9; 95% CI,
1.2 – 19.8) to clear oncogenic HPV infection than those with zero to
four partners, even though these men were also more susceptible to HPV
infection.
Other studies have also found a link between the number of sexual
partners and, firstly, the risk of infection and, secondly, the
likelihood of clearance. Previous researchers have suggested that
previous exposures may lead to a greater antibody response to new HPV
infections, increasing the chance of clearance. However, it is unclear
why previous exposure might also increase the susceptibility to new
infection. The reason that circumcision protects against persistence of
infection, rather than protecting against infection itself, is also
unclear, although it is also consistent with findings of other studies.
Study limitations included the relatively small sample and the
uncertainty as to the exact dates of infection and clearance, due to
the six-month study visit interval. Nevertheless, the authors concluded
that "the key factor associated with acquisition of HPV infection of
all types … was lifetime number of sex partners, whereas the most
important determinant of clearance of any [penile] HPV infection and of
clearance of oncogenic HPV infection was circumcision."
Reference:
Lu B et al. Factors associated with acquisition and clearance of human papillomavirus infection in a cohort of US men: a prospective study.J Infect Dis 199:362-71, 2009.
By Derek Thaczuk, www.aidsmap.com
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