AIDS prevention requires community effort

Friday, July 30, 2010
written by Dr. Hulon Crayton

PANAMA CITY HIV and AIDS aren’t comfortable subjects. In fact, they’re subjects that most of us don’t talk about. And we certainly don’t want to be affiliated with an AIDS Service Organization (ASO) like BASIC NWFL, our local ASO. But the fact is that most of us know someone who has HIV or has died of an AIDS-related illness. If it’s not a family member or friend, it’s a friend’s brother, sister, or child.

Though we don’t want to acknowledge it, this disease affects all of us — men, women, children, and babies. It’s not a gay disease and it doesn’t respect socioeconomic status. Women are disproportionately impacted by this disease because they may be victims of domestic abuse or may lack the skills to negotiate safer sex.

No other organization does what BASIC does in the communities we serve. Not a single one. In Bay, Washington, Jackson, Holmes, Gulf, and Calhoun counties, no other organization provides coordination of treatment of those living with HIV and AIDS. No other organization reaches out to offer the education critical to prevention—especially to those most at risk.

Prevention begins with testing and continues through education, teaching ways of protecting people from contracting and transmitting this disease for which there is no cure. What prevention means in dollars is that each case of prevented HIV saves an estimated $355,000 that would have been spent on care and treatment in the lifetime of each HIV positive person. This is $355,000 that would fall on local hospitals and physicians across the counties BASIC serves and ultimately on the taxpayers.

These are terrible economic times. Everyone has been impacted negatively, and non-profits have suffered dramatically by having to cut services, programs, and staff. Talk with anyone connected to an area non-profit, and you’ll hear how many programs, services, and staff have lost due to loss of funding. BASIC is no different. This small organization has lost funding for all prevention programs for women, our most vulnerable population. Testing and education are critical that is critical to stemming the incidence of HIV/AIDS.

It’s vitally important that BASIC recover the programs lost. The alternative is an increasing incidence of HIV/AIDS throughout our communities. Where there is no testing and education, there is no prevention.

BASIC needs your help.

As members of the board of directors of BASIC, we’re proud of our affiliation with this agency that does so much good, unsung and unpublicized good, for our service communities. Our board asks now for individual, corporate and institutional financial support to allow us to continue these prevention programs. What we do is of significant importance for our communities.

For more information, call BASIC at 850-785-1088. All donations are tax-deductible. Donations may also be made anonymously or in honor or memory of someone loved. Our street address is 432 Magnolia Ave., Panama City, Fla., 32401, and our mailing address is P.O. Box 805, Panama City, Fla., 32402.

Dr. Hulon Crayton, M.D., is president of the board of directors of BASIC.

Read more: http://www.newsherald.com/articles/aids-85787-requires-effort.html#ixzz1eGzsmoPu

Article accessed from: News Herald

HIV Prevention Receives Funding Boost From Health Reform's Prevention & Public Health

Monday, August 09, 2010
written by Michael

Washington, DC – Health and Human Services Secretary Kathleen Sebelius announced last week that HIV prevention in the United States will receive approximately $30 million from this year’s Prevention and Public Health Fund, which was established by the Patient Protection and Affordable Care Act.

“With over 56,000 new HIV infections each year in the United States, these additional resources will help reduce the number of new HIV infections at a time when overall funding for HIV prevention has been dropping,” commented Carl Schmid, Deputy Executive Director of The AIDS Institute.

Prevention experts and the CDC have all recommended that a significant scale up in resources will be necessary to considerably reduce the number of new infections in the United States. After years of cuts and flat funding, CDC’s HIV prevention budget grew by $36 million this year. President Obama is recommending a smaller increase for next year at the same time the Administration will be implementing a National HIV/AIDS Strategy. Due to the economic downturn, state funding for HIV prevention has dramatically fallen, resulting in an overall drop for HIV prevention. “We thank the Secretary and the Obama Administration for their commitment to the domestic HIV epidemic and for acknowledging the immediate crisis in funding HIV prevention with the addition of these resources,” added Schmid.

The Prevention and Public Health Fund was created by the historic health reform law in recognition by the Congress that our nation must do more to address prevention and keep people healthy so that they will not need to get sick in the first place. The lifetime cost of treating 56,000 HIV infections is approximately $9.5 billion. In fiscal year 2010, the Fund totals $500 million, next year the amount will increase to $750 million, and will increase annually until it reaches $2 billion in fiscal year 2015.

Promising CAPRISA 004 Trials

Monday, August 09, 2010
written by Michael

The results of the first tenofovir gel study designed to test whether its use could prevent HIV in women, CAPRISA 004, were to be announced in Vienna at the International AIDS Society (AIDS 2010) meeting tomorrow (July 20) by our colleagues Quarraisha and Salim Abdool Karim, along with a rapid online publication by the journal Science. Given that a news organization has broken the embargo, Science and AIDS 2010 have agreed to release the results now.

There is good news. These results have brought us what we have long hoped for and all along believed in our hearts and minds was possible – proof of concept that a topical product can interrupt HIV transmission in women. Today marks a major turning point in our efforts to prevent HIV.

The study found tenofovir gel used in a dosing regimen timed before and after sex reduced HIV infections by 39 percent, a finding that is statistically significant and is sure to elicit excitement among the community of people engaged in HIV prevention research globally. Additional materials are attached that provide further information about these exciting results.

The study also indicated that use of the gel reduced the risk of herpes simplex virus 2 by 51 percent among women participating in the trial. an interesting observation that will be important to investigate further.

We want to congratulate Quarraisha and Slim and the entire CAPRISA team on this remarkable achievement, for invigorating an entire field and giving women real hope of having an effective method that they can control. The study was conducted in exemplary fashion at every step of the way. CAPRISA 004 was a double-blind, randomized controlled trial that enrolled 889 HIV-uninfected women at two sites in urban and rural KwaZulu-Natal, South Africa. The trial started in late May 2007 and enrollment was completed in early January 2009. Study exit visits were completed at the end of November 2009. Women were on product on average 18 months and study retention was 95.2 percent. While the overall reduction in HIV risk was 39 percent, there was a trend toward higher effectiveness – a 54 percent reduction – among women who reported the best adherence to product use. Analyses for safety identified no significant concerns. The vast majority of the participants (97.4 percent) found the gel acceptable.

Not only has CAPRISA 004 raised the bar for VOICE, but the study has brought us to a critical crossroads where the responsibility is clearly ours to answer among the most vitally important questions in HIV prevention, particularly in women. VOICE will tell us about the safety and efficacy of daily use of tenofovir gel, information that will serve to complement CAPRISA’s study. While a statistically significant reduction of 39 percent is an outstanding result, many of us hold the hope that more frequent daily dosing could provide an even higher level of effectiveness. Moreover, the oral arms of VOICE will tell us about safety and efficacy of daily use of the ARVs tenofovir and Truvada. We have taken pride in VOICE’s unique design. Now, with the results of CAPRISA 004, there should be no doubt that VOICE is more relevant than ever. Continuing the study to completion is essential to corroborate CAPRISA’s findings and to obtain the level of evidence to support the possible licensure and widespread use of any of these approaches. We have nearly 1,000 women now enrolled in VOICE and 15 of 16 sites screening or enrolling participants. Our colleagues in Blantyre, Malawi, just completed a week of study implementation training. We are well on our way.

We hope to engage in any discussion about product availability and carefully consider – in partnership with our clinical trial sites and communities – any implications for VOICE. Typically, availability of a new drug within a country depends on regulatory approval and scaled-up production and distribution. These steps usually take several years after effectiveness has been confirmed.

The VOICE team will be represented in a stakeholder meeting being convened by WHO and UNAIDS in South Africa in the near future to discuss next steps with tenofovir gel.

CAPRISA 004 has given rise to a new HIV prevention landscape. It has given us hope and inspiration that the time will come when we have multiple tools and approaches that can be used by men and women at risk of HIV to reduce their risk of infection. But, our friends and colleagues, we must work harder than ever before to realize the promise. All eyes will be on VOICE and we must renew our resolve to implement this study with the highest level of study conduct and to complete the study as soon as possible. We can do it.

On behalf of the entire MTN family, we want to thank and congratulate the CAPRISA team for their important contribution and for leading the way for VOICE and other HIV prevention trials.

With great joy and hope,

Sharon Hillier

Ian McGowan

Study Finds Condom-Use Is Highest For Young

Thursday, October 14, 2010
written by Michael

A wide-ranging study of Americans’ sexual behavior, based on the largest nationally representative survey since 1992, finds that condom-use is becoming the norm for sexually active teenagers.

Indeed, they are more responsible than adults about using condoms, the researchers report in a study coming out on Monday. A vast majority of sexually active 14- to 17-year-olds — 80 percent of boys and 69 percent of girls — said they had used a condom the last time they had intercourse, compared with well under half of adults involved in casual liaisons.

“I think that just as teenagers quickly develop an expectation that they’re going to learn to drive no matter where they live,” said a co-author of the survey, Dr. J. Dennis Fortenberry, a professor of pediatrics at the Indiana University School of Medicine, “there’s the same general widespread sense among contemporary teenagers that as you get to the point where you start thinking about having sex, condoms are going to be part of that decision.”

The new study, the first to include participants as young as 14 and as old as 94, finds that decades after the sexual revolution, the gap between men’s and women’s sexual satisfaction persists.

While most men said they had experienced orgasm the last time they had sex, and 85 percent believed their partner had also, only two-thirds of the women surveyed said they had achieved orgasm the last time they had sex. And a startling number of women — almost one-third — said they had experienced pain the last time they had sex (only 5 percent of men did).

The report is drawn from the National Survey of Sexual Health and Behavior, carried out by researchers at the Center for Sexual Health Promotion at Indiana University. It was based on responses from 5,865 individuals, including about 800 under 18.

The report was welcomed by health providers and sex educators, who say the field has had little data to go on, even as monumental social changes — the gay rights movement, increases in cohabitation, later marriage and childbearing, the AIDS epidemic and the widespread use of drugs for erectile dysfunction, among others — have transformed sexual attitudes.

Government agencies and private foundations are reluctant to pay for studies of sexual behavior that do not focus on reproduction, experts say; the last broad sex survey, the 1992 National Health and Social Life Survey, was started under a governmental contract, but Congress cut off financing and it was completed with support from private sources.

“There’s been an enormous explosion of research in virtually all areas of medicine except the entity called sexual medicine,” said Dr. Irwin Goldstein, editor in chief of The Journal of Sexual Medicine, which is devoting its entire issue to papers from the study and commentaries by experts. “We can’t get the funding.”

Even though Americans are bombarded with sexual imagery, they have little access to reliable information about sexual behavior, said Monica Rodriguez, president of Siecus, the Sexuality Information and Education Council of the United States, a nonprofit group based in New York. “That’s why this is so important — it gives us a sense of what’s really happening, instead of all this, ‘Well, my sex life must not be normal, because I don’t do this or only do this.’ ”

The new study was financed by Church & Dwight, the maker of Trojan condoms. Researchers said that while they had shared information with the sponsor during the course of the study, the company had not exerted influence over the way it was conducted, except to offer advice on how to phrase questions to accurately gauge condom-use.

The study also found that while only about 7 percent of men and of women identified themselves as “other than heterosexual,” a much higher percentage reported having had sex with a member of the same sex. Among women in their 30s, for example, 14 percent said they had performed oral sex on another woman at some point in their lives; 13 percent of men over 40 said they had performed oral sex on another man.