This is a very excellent animation which explains the hiv replication very clearly.
For more medical animations (not all of them are HIV related) please visit his YouTube page.
This is a very excellent animation which explains the hiv replication very clearly.
For more medical animations (not all of them are HIV related) please visit his YouTube page.
Three international organizations have negotiated reductions on key first- and second-line, and paediatric antiretrovirals (ARVs) that will help countries save at least US$600 million over the next three years.
The deal expected to affect most of the 70 countries comprising CHAI’s Procurement Consortium, features notable reductions in the prices of tenofovir (TDF), efavirenz, and the second-line ritonavir-boosted atazanavir (ATV/r) used in HIV patients who have failed initial, or “first-line”, regimens.
As part of the deal, the three bodies set price ceilings for more than 40 adult and paediatric ARVs with eight pharmaceutical manufacturers and suppliers, including Cipla Ltd, Matrix Laboratories and Autobindo Pharma.
Together these eight companies account for most ARVs sold in countries with access to generic drugs, according to David Ripin, scientific director of CHAI’s Drug Access Programme.
As a result, the cost of ATV/r is down by two-thirds from just three years ago. Meanwhile, a once-a-day fixed-dose combination (FDC) pill containing TDF and efavirenz will now cost countries less than US$159 per patient per year. In 2008, low-income countries paid about $400 per patient per year for the same pill.
How did they do it?
According to UNITAID and CHAI, this success is a product of increased demand for these drugs and more efficient manufacturing of the active ingredients, which are estimated to account for as much as 75 percent of generic ARV costs.
“When you make an active ingredient, you use a multistep chemical process, to reduce costs, you can look for a less expensive source of raw materials of which there are a few examples, including TDF … or you can tinker with the chemical process used to make the product to make them more efficient.” -Ripin.
But Ripin added that doing either comes at a cost for pharmaceutical companies, for whom a change in raw material suppliers or manufacturing processes means re-applying for approval of the drug with regulatory bodies.
“Any time you change anything with the way you make a drug, you need to get regulatory approval,” he said. “You have to do a fair amount of work to prove that your product works just as well now as it did before. “The pharmaceutical companies and generic manufacturers are fantastic at making these types of improvements… [but] they have a limited set of research and development resources available to them. They often need to make a decision where they are going to get a higher return on that research and development, and typically that comes from the introduction of new products on the market.”
According to Ripin, the key is providing companies with data on the large and growing markets for ARVs.
“We help companies evaluate for themselves whether it’s a worthwhile business opportunity, the second key factor they have to consider is the competitive marketplace for their drugs, where there is an incentive for lower [production] costs and lower-priced products as they want to maintain their market share.”
CHAI also provides countries with data on best market prices for drugs to help inform national procurement, as was the case with South Africa’s recent ARV tender. Although South Africa is not expected to benefit from the new price cuts, the country has the largest ARV tender in the world, and could secure the drugs at competitive prices. In terms of the CHAI agreement, lower prices are available to members of the Procurement Consortium but are dependant on volumes ordered.
How low can we go?
TDF has become an important drug for many countries, including South Africa, hoping to implement the 2009 World Health Organization (WHO) HIV treatment guidelines, which recommend starting HIV patients on treatment sooner but also a shift away from more toxic ARVs to TDF.
However, the high cost of earlier treatment and better drugs has prohibited many countries from fully implementing the WHO recommendations. According to a recent report released by Médecins Sans Frontières (MSF), both Malawi and Zimbabwe reversed their move to WHO guidelines due to financial constraints.
While new price reductions bring TDF’s price closer to that of the long-time and widely adopted first-line ARV Zidovudine, further drops in TDF’s price will have to be logged to ensure widespread uptake, said Brenda Waning, coordinator of market dynamics for UNITAID.
For Waning and others like MSF, the issue of sustainable funding for the HIV response looms large ahead of the June UN meeting on HIV/AIDS in New York, rumoured to be the last for years to come, according to MSF’s report.
“There has been a lot of attention on commodities and not at other major drivers of cost,” she told IRIN/PlusNews. “We have to look at other places in the health system where we can capture cost-effectiveness.”
In particular, Waning pointed to the potential savings associated with the roll-out of new point-of-care diagnostics, which, although not high on the global agenda, will help countries task shift such testing away from scarce doctors.
Although the cost remains high, introducting FDC would help governments save on ARV shipping, transportation and storage, while improving adherence and patient outcomes.
If a gay or bisexual man seeks sex or dating online, the type of partner or relationship he wants is a good indicator of whether he’ll engage in safe sex, a new study suggests.
Gay men seeking long-term romance online are more likely to engage in safe sex than men who want a sexual encounter only, the study shows. This is valuable information because it helps HIV-prevention counselors design more effective sexual health interventions, says Jose Bauermeister, assistant professor at the University of Michigan School of Public Health and director of the Sexuality and Health Research Lab.
June marks the 30th anniversary of the discovery of the pneumonia-like illness that later emerged as HIV/AIDS.
Bauermeister says that dating sites for gay men are no longer reserved only for sexual hookups and that many sites today exist for men who also seek love, intimacy and long-term romance. Unfortunately, even today the assumption is that gay men use the Internet solely to find sex, and that HIV-prevention counselors don’t talk with clients about love and relationships, he says.
A pair of papers from Bauermeister’s research group are among the first to identify and look at four categories of online dating, ranging from hookups only to long-term romance, and the risk behavior associated with each category.
“The takeaway here is just because I go online doesn’t mean I’m engaging in risk,” Bauermeister said. “It’s what kind of partner I’m looking for (that matters), so for HIV prevention purposes if I were going to try to develop an intervention, I need to take that into account.”
Much of the literature about online dating looks at the sex-only encounter, which is “predictably unsafe,” Bauermeister says. Not much research exists about the other categories of online dating and how they associate with risk behavior.
In one study, men who reported seeking hookups only engaged in more unprotected sex than men who reported only looking for romance online.
“It’s interesting because as a test counselor if you have five or 10 minutes, you need to talk about how to include conversations about love,” Bauermeister said. “If you aren’t hooking up very often and looking for Mr. Right, you may be engaging in very particular behaviors that decrease your risk of HIV.
“The bigger question is should we include components about romantic relationships into HIV prevention. Those components are not usually included now.”
A second paper looks at different dimensions of love, passion, intimacy and commitment to see if different configurations of love could be correlated to different risk behaviors. Young men who think about their future and their love in the future are less likely to engage in risky sex in the present, Bauermeister says.
“This is important because counselors, rather than assuming young men only seek hookups, can make a point to discuss the role that romance plays in their lives,” Bauermeister said. “For counselors testing for HIV, one of the ways to decrease the risk is by reducing the number of partners. One of the ways to do this is emphasize relationships in HIV prevention.”
The University of Michigan School of Public Health has been promoting health and preventing disease since 1941, and is ranked among the top public health schools in the nation. Whether making new discoveries in the lab or researching and educating in the field, SPH faculty, students and alumni are deployed around the globe to promote and protect our health.
A post we made last week suggested a new vaccine can protect macaques against the monkey equivalent of HIV, however the vaccine using the common virus cytomegalovirus (CMV) as the vector or container of proteins from the simian immunodeficiency virus (SIV) protected none of a group of 24 rhesus macaques from infection. But in 13 of the monkeys vaccinated, it did produce infections characterised by an undetectable viral load.
This profound viral suppression led to an apparent decline in the number of SIV-infected cells over a period of two years after infection to the point that SIV-infected cells were undetectable in 72% of monkeys with controlled viremia. Despite this, there was no apparent waning of immune responses to SIV in the all-important effector-memory CD8 and CD4 lymphocytes over this time in twelve of the 13 monkeys.
The researchers comment that their vaccine seems to have produced “an unprecedented level of SIV control and even the possibility of progressive clearance of SIV infection over time.”
The question now is how to make a safe analogue of this vaccine for use in humans.
The benefits of meditation are many, as anyone who meditates knows and a good study from a meditation centre in Colorado, US, suggests that the practice can actually add years to your life.
Reported effects of meditation include lowering blood pressure, healing psoriasis, boosting immunity in those who are vaccinated or have cancer, preventing relapse into recurrent depression, plus slowing down the progression of HIV.
What’s more, it seems that meditation can now actually help our cells to survive in the body for longer.
The answer lies in our telomeres – a vital component of every cell. They play a key role in the ageing of cells. Every time a cell divides, they get shorter unless an enzyme called telomerase builds them up again.
People with short telomeres are at greater risk of heart disease, diabetes, arthritis, depression and osteoporosis. They also die younger.
The study shows after a meditation course, people had significantly higher levels of the enzyme present suggesting their telomeres were being protected. This changes our view of meditation as simply a state of relaxation. It’s a lifesaver.
Brain studies show that meditation can even trigger physical changes in brain centres involved in learning, memory, emotional regulation, thinking and mood control.
It just so happens that chronic stress will shortern our telomeres causing cell ageing.
The action of meditation is to de-stress us and in doing so, protect our telomeres.
The two kinds of meditation that have been studied are mindfulness meditation, where you become acutely aware of your thoughts and your surroundings, and compassion meditation, where you focus on feelings of love and affection for others.
Both of these types cut down on the stress hormone cortisol. Most of us don’t have time to spend months meditating, but there are mini-meditations we can do like focusing on breathing and being aware of our surroundings several times a day.
While meditation may be effective in reducing stress and in protecting your telomeres, there are other ways if you have no interest in meditation. Exercise can buffer the effects of stress on telomeres and so do stress management programmes.
Psychologists would say that meditation gives you an increased sense of control and purpose in life, and these two things are more important than meditation itself.
Just doing something we enjoy and love – be it meditating, gardening, listening to music or painting – will go a long way to protect us from stress and even help us to live longer.
Since 2001, people living with HIV in the UK have been prosecuted for the reckless transmission of HIV. There are real concerns that these prosecutions are undermining efforts to stop the spread of HIV in the UK and are increasing stigma around HIV.
The National AIDS Trust are campaigning for an end to prosecutions of reckless transmission of HIV through consensual sex. This is because of the need to affirm the individual’s responsibility for his or her own sexual health; the human rights of those people living with HIV and the difficulties of disclosure; the public health considerations and the potential for further discrimination against people living with HIV and disadvantaged groups such as migrants.
Whilst prosecutions continue, they are working to ensure that the best possible guidance is available to prosecutors, lawyers, police, support organisations, healthcare workers, people living with HIV and the organisations which support them.
As a result of pressure from NAT, the Crown Prosecution Service (CPS) carried out a public consultation on its ‘Policy for Prosecuting Cases Involving Sexual Transmission of Infections which causes Grievous Bodily Harm’ in 2006. In 2008 the CPS published new guidance for prosecutors to explain how it deals with cases involving the intentional or reckless transmission of an infection.
The full CPS guidance can be read on the CPS Website.
h3. Police Investigation of HIV Transmission: A guide for people living with HIV in England, Wales and Northern Ireland
The Association of Chief Police Officers (ACPO) published ‘Investigation Guidance Relating to the Criminal Transmission of HIV’.
NAT has produced a leaflet for people living with HIV in England, Wales and Northern Ireland explaining key points of the ACPO Guidance and what to expect and do if you find yourself involved in a police investigation.
Changes have been proposed to legal aid and will remove whole areas from the scheme, leaving many people little choice but to go it alone. Make sure you know how to represent yourself in court if you ever need to.
Want more? or subscribe to our blog
When people face a traumatic event or experience in life they often seek solace in something they believe in; something that will offer potential solutions and fill the emotional and spiritual vacuum when everything else has failed. As you’d expect, many people living with HIV seek solace in their religious faith, and for some that becomes their whole life’s focus. However, religious faith and HIV continue to have a challenging relationship, to say the very least.
At the beginning of the HIV epidemic back in the Eighties, some faith leaders preached that only ‘sinners’ contracted the virus, advising that the only solution for those living with HIV was to pray hard for forgiveness. While many faith leaders have since realised that HIV is simply a virus that can affect anyone, unfortunately some haven’t. In fact, a few have gone even further, telling those in their congregations who are living with HIV to stop taking their Antiretroviral treatment (ARVs) and instead concentrate on praying because that’s the only way they will experience emotional and physical healing.
Whether praying to be healed from HIV is being preached in select churches, or some church-goers living with HIV are misinterpreting what their faith leaders are telling them, a number of HIV positive people have died as a result of stopping their HIV medication. What remains unclear is how many people are being converted to this way of thinking. Is this a big problem warranting a global intervention, or are we making a mountain out of a molehill? I personally don’t know the definitive answers to these questions, but what I can say is that where prayer and HIV healing are concerned, I have witnessed and have heard of some pretty bizarre behaviour among people living with HIV, particularly within African communities in the UK and in some parts of Africa.
ARV treatments save lives and many of us who are taking them now would not even be here today to tell the tale if we didn’t have access to them. We now have scientific evidence from recent trials to confirm that these drugs not only save lives but can also act as an effective barrier to HIV transmission. This is by no means new information for those living with HIV and or working in the HIV sector, but having sound evidence to back our experiences up is always a bonus.
Despite such compelling evidence, there are always some who, for one reason or another, continue to reject anti-HIV medication. I have had conversations with people who have told me that they’d originally tested HIV positive but miraculously no longer carry the virus as a result of prayer and rejection of ARV treatment. I have also heard of HIV positive people who have actually testified at their places of worship that they have been ‘cured of HIV through prayer’, as well as a small minority of faith leaders who somehow manage to convince their followers that taking ARVs will kill them outright. Some HIV positive people also visit witch doctors, sangomas, and/or traditional healers, and are predictably told that no trace of HIV exists in their blood, encouraging them to abandon their ARVs altogether. In fact, the discussion about witch doctors and HIV deserves a blog of its own!
Overall, I respect the fact that faith is very individual and private, and whatever people want to believe is entirely up to them. However, this can make it very difficult to monitor any negative impacts that religious faith might have on the lives of vulnerable populations targeted by those who wish to exploit them and extort what little money they have. How many people are targeted, I don’t think anyone knows, but I strongly feel that this is a worrying phenomenon that deserves much more attention, and possible interventions, if we are to continue to help save lives.
What I am very clear about is that ARV treatment and prayer should complement each other, not compete against each other. Above all else, the God I have faith in is a generous one and helps those who help themselves by taking advantage of the opportunities presented to them
An estimated 86,500 adults are living with HIV in the UK, according to figures from 2009, but up to a quarter of those people haven’t been diagnosed, which means they don’t know they’re infected and this is one of the main reasons why a new clinic has opened in Corby this month.
The Knowledge Clinic, which is free and confidential, launched last week at Great Oakley Medical Centre in Corby. The clinic is the result of a partnership between health and voluntary services and is being run by local voluntary organisation, Sunrise for two hours every Monday afternoon, from 12.30pm.
Dr Joanne Watt, a GP from Great Oakley Medical Centre, who has instigated the project, said: “I started looking into this because I have been a GP and sexual health doctor for eight years and we have had a sexual health clinic here for the last three years, so it seemed like a natural progression.
“I knew someone from LASS, the Leicester Aids Support Service [sic], and I was aware that they had been offering a drop-in clinic for HIV testing for a couple of years, and I just thought it would be good to bring it to Corby.
“For Northamptonshire, up to four in every 1,000 will be HIV positive, with some areas being higher or lower than others. There is a slightly higher prevalence in Corby compared to the rest of the county, so we thought it was a good place to start the pilot scheme.”
HIV is short for Human Immunodeficiency Virus, and it attacks a person’s immune system. A healthy immune system provides a natural defence against disease and infection. If the immune system is damaged by HIV, it increases the risk of developing a serious infection or disease, such as cancer.
HIV is spread through the exchange of bodily fluids. This most commonly happens during unprotected sexual contact, such as vaginal, oral and anal sex. People who inject illegal drugs and share needles are also at risk of catching HIV. The condition can also be spread from a mother to her unborn child.
Dr Watt said: “It can be unprotected sex between men and women or men and men but it can be many years before anyone has any symptoms of HIV.”
“One in three people with HIV do not know that they have it, so anyone who has ever had unprotected sex should have a test, as people look completely normal until it’s very advanced and so there is no way of being able to tell before it gets to that stage.”
The HIV test available at the Knowledge Clinic involves just a simple finger-prick blood test, the results of which can be seen within minutes.
Dr Watt said: “It’s like a pregnancy test in the sense that the results appear before your eyes. if the result comes back as reactive, the person will be seen that day at the sexual health clinic within the surgery, where they will have the second test to confirm it”.
“The finger-prick test is a new technology for the test, and so we will always check it against the more traditional test carried out at the sexual health clinic, but it’s still very reliable and is being used more widely.
“It’s completely confidential – the information won’t go on your medical records or anything – and if people want to just come along and find out more about HIV and the test before they actually have it, that’s absolutely fine, too; we will see anyone.
“People don’t need to be referred by their GP, and the clinic isn’t just there for Corby residents.anyone from the county can come along and have the test if they wish. Our aim is to just make sure as many people know their HIV status as possible, because if they know their status, they can stay well. it’s all about having the knowledge”.
“If someone finds that they have HIV, as long as they take their medication, they can stay well, but if they don’t know they have it, that’s when they get poorly, and for how simple the test is, it’s really not worth that risk.”
The Knowledge Clinic is open at Great Oakley Medical Centre every Monday, between 12.30pm and 2.30pm. No appointment is needed
LASS also offer a completely free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test. We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies.
Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995
Leicestershire Aids Support Services has been nominated for a major national prize at the UK charity sector’s most prestigious awards scheme, The Charity Awards.
LASS provide support, information and advocacy to people affected by HIV and AIDS as well as working to prevent the spread of the disease through community action, awareness raising and training. We have been shortlisted in the Healthcare & Medical Research category. We are hoping to pick up the coveted award at an awards ceremony in London on 9th June attended by personalities including comedian Hugh Dennis, author Monica Ali, star of Strictly Come Dancing Bruno Tonioli and newsreaders Krishnan Guru Murthy and Andrea Catherwood.
Chosen from a record number of entries, LASS has been shortlisted by the Charity Awards judges for its Rapid HIV testing service, a drop-in service set up in 2009 to provide tests for local people as soon as they make the decision to have one. Leicester City has the highest rising HIV rate in the East Midlands and 6th highest in the country, due in part to the number of people living locally who are unknowingly infected. Since opening its doors, the Rapid HIV testing service has delivered more than 400 tests, helping to prevent late diagnosis and onward transmission. If we win this category, we will also be in the running to pick up the Overall Award for excellence in charity management – a prestigious award given to the best of the 10 category winners.
Patrick Bowe Chair of LASS Board of Trustees said:
‘I am delighted that LASS such a small charity had been shortlisted in such a big field. This is a testament to the high quality work of the volunteers and staff.’
The annual Charity Awards ceremony, sponsored by the Charities Aid Foundation, The Leadership Trust and The Times, is the highest profile event in the charity calendar. Since launching 12 years ago, the awards have honoured hundreds of charities, large and small, from across the UK, acknowledging their outstanding work and achievements and the tireless commitment of the people behind them. The charities, which submit their own entries, are each shortlisted for specific initiatives which have improved the delivery of their charitable objectives and which demonstrate outstanding examples of best practice from which other charities can learn.
Jenny Hand CEO at LASS said:
‘We are all very proud of the real difference our support services, awareness raising and HIV testing is making to so many local people. We have been judged to be one of the best 32 Charities in the Country by the Charity Awards panel. This is a real achievement by our volunteers and staff in a particularly challenging year with so many threats to funding sources.’
The Charity Awards 2011 is organised by Civil Society Media, the leading publishing and training company for the voluntary sector. The distinguished panel of judges includes Andrew Hind CB, former chief executive of the Charity Commission, Dr John Low CBE, chief executive of the Charities Aid Foundation, Dame Mary Marsh, founding director of the Clore Social Leadership Programme and former chief executive of the NSPCC, Sir Christopher Kelly, chair of the King’s Fund, Lesley-Anne Alexander, chief executive of RNIB and Martin Brookes, chief executive of New Philanthropy Capital.
Daniel Phelan, organiser of the Charity Awards 2011 comments:
“The Charity Awards recognise and reward the exceptional work that takes place within the voluntary sector right across the UK and beyond. This year, our 12th, has seen a record number of organisations decide that it is their time to take a bow, demonstrating that charities, rather than being disheartened by the challenging times we face, are finding strength and inspiration in adversity. It is a great testimony to the spirit of the sector and makes the acknowledgement of the major and selfless contribution they make to society, more important than ever.
By being shortlisted, LASS has already demonstrated that it is amongst the best managed charities in the UK. I wish everyone involved the best of luck on the night.”
LASS offer a completely free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test. We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies.
Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995