Tag Archives: prevention

The NHS urgently needs to make PrEP available

preptabs

Two European studies of pre-exposure prophylaxis (PrEP), PROUD1 and IPERGAY2, reported early results in October 2014. Both studies showed that PrEP was so effective at preventing HIV transmission that everyone in these studies has now been offered PrEP. The comparison arms, which respectively offered delayed PrEP or a placebo, have been closed.

In light of this news, together with data on continued high rates of new infections3, the NHS urgently needs to make PrEP available.

Although an NHS England process to evaluate PrEP is underway, any decision to provide PrEP will probably not be implemented until early 2017, which is too long to wait. We are calling for earlier access to PrEP. The NHS must speed up its evaluation process and make PrEP available as soon as possible. Furthermore, we call for interim arrangements to be agreed now for provision of PrEP to those at the highest risk of acquiring HIV.

What is PrEP?

PrEP stands for Pre-Exposure Prophylaxis. It involves a person who doesn’t have HIV taking pills regularly to reduce their risk of HIV infection. Several studies show that PrEP works.

PrEP is currently only available in the UK to people enrolled in the PROUD study,4 but has been available in the US since 2012.

Why do we need PrEP?

There are now over 100,000 people living with HIV in the UK. 5 We need to improve HIV prevention.

Tens of thousands of HIV transmissions have been prevented by condom use.6  However many people do not use condoms all of the time and each year there are thousands of new infections. PrEP has the potential to prevent new infections among some of those at greatest risk of acquiring HIV.

Condom use will remain a core strategy in HIV prevention. PrEP gives people who already find it difficult to consistently use condoms an additional way to protect their health.

Due to the high rate of HIV infections, there is a particular need for the NHS to make PrEP available to gay men. However it should be available to all people who are at high risk of acquiring HIV.

How effective is PrEP?

Research suggests that PrEP is as effective as condoms in preventing HIV transmission, as long as the pills are taken regularly, as directed. Evidence from a large international study suggests that gay men who maintained at least four doses a week had 96% fewer infections.7 8 Preliminary results from separate studies of PrEP in the UK9 and France10 both show that PrEP substantially reduces infections among gay men. Full results are expected early in 2015. PrEP has also proven effective for heterosexual couples in which one partner is HIV positive and not on HIV treatment.11

PrEP does not prevent other sexually transmitted infections or pregnancy. It allows someone to protect their own health, irrespective of whether their partner uses a condom. Because it is taken several hours before sex, it does not rely on decision-making at the time of sex.

Why take HIV treatment to avoid taking HIV treatment?

People living with HIV need to take lifelong treatment. PrEP consists of fewer drugs and people only need to take it during periods when they are at risk of HIV. Many people find that their sexual behaviour changes over time, for example when they begin or end a relationship.

Does PrEP have side-effects?

Any medicine can have side-effects, so taking PrEP is a serious decision. The drugs in PrEP have been used as part of HIV treatment for many years. This has shown that they have a low risk of serious side-effects. Most people taking PrEP don’t report side-effects. Some people have stomach problems, headaches and tiredness during the first month but these usually go away. People taking PrEP have regular check-ups at a clinic.

Does PrEP mean people take more risks?

The full results of the PROUD study will help us understand the impact of PrEP on condom use among gay men in the UK. But other studies of PrEP have consistently reported that being on PrEP did not result in people adopting riskier behaviours. 12 13  14 Instead it gives people who already find it difficult to consistently use condoms a way to protect their health.

                                                        

References

  1. http://www.proud.mrc.ac.uk/PDF/PROUD%20Statement%20161014.pdf
  2. http://www.aidsmap.com/SecondEuropeanPrEPstudyclosesplaceboarmearlyduetohigheffectiveness/page/2917367/
  3. Public Health England. HIV in the United Kingdom: 2014 Report. London: Public Health England. November 2014.
  4. For more information, http://www.proud.mrc.ac.uk
  5. Public Health England. HIV in the United Kingdom: 2014 London: Public Health England. November 2014.
  6. Phillips AN et al. Increased HIV Incidence in Men Who Have Sex with Men Despite High Levels of ARTInduced Viral Suppression: Analysis of an Extensively Documented Epidemic. PLoS ONE 8(2): e55312. doi:10.1371/journal.pone.0055312.
  7. Grant RM et al. Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. New England Journal of Medicine 363:2587-2599, 2010.
  8. Anderson PL et al. Emtricitabinetenofovir concentrations and preexposure prophylaxis efficacy in men who have sex with men. Science Translational Medicine 4: 151ra125, 2012.
  9. http://www.proud.mrc.ac.uk/PDF/PROUD%20Statement%20161014.pdf
  10. http://www.aidsmap.com/SecondEuropeanPrEPstudyclosesplaceboarmearlyduetohigheffectiveness/page/2917367/
  11. Baeten JM et al. Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women. New England Journal of Medicine 367: 399-410, 2012.
  12. Marcus JL et al. No Evidence of Sexual Risk Compensation in the iPrEx Trial of Daily Oral HIV Preexposure PLoS ONE 8: e81997, 2013.
  13. Mugwanya KK et al. Sexual behaviour of heterosexual men and women receiving antiretroviral preexposure prophylaxis for HIV prevention: a longitudinal analysis. Lancet Infectious Diseases 13: 1021–28, 2013. 14 Grant RM et al. Uptake of preexposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infectious Diseases 14: 820-829, 2014.

Via NAM

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Young, British, and Living With HIV

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“I remember not getting out of bed other than to use the loo. My friend had to stay with me just to make sure I was eating,” says ​Niyi Maximus Crown, a 25-year-old man who was diagnosed HIV positive in December 2011. “I didn’t even recognize my own thinking voice. I felt like I was going to be single for the rest of my life. The feelings of worthlessness made me angry and I started to hate myself.”

Last week, ​Public Health England (PHE) released its ​latest report on HIV. “In the UK there are 107,800 people living with HIV,” says Eleanor Briggs, Assistant Director of Policy and Campaigns at National AIDS Trust. In London, almost one in eight gay and bisexual men are HIV positive. Based on the stats from PHE, Briggs adds, “We can say about a third of people living with HIV infection, both diagnosed and undiagnosed, were resident in London.”

What’s more frightening is that PHE estimates that 24 percent of the people in the UK with HIV are currently undiagnosed.

Brandon Wardell Is a 22-Year-Old Comic Who’s Already Done an Album with Bob Odenkirk

Early diagnosis of HIV is crucial. Briggs states that a late diagnosis can mean treatment becomes less effective, reducing a person’s lifespan. Medication also helps stop the spread of HIV by lowering the amount of HIV virus in a positive person to undetectable levels so they are ​unlikely to pass it on.

And yet few people are talking honestly about HIV. In terms of everyday knowledge on the gay scene, HIV exists somewhere in limbo between the grim ​tombstone adverts of the 80s, statistics that get bounced around annually from numerous health organizations and the raw realities of chemsex-fuelled bareback sessions. The subject usually makes an appearance in the media once a year when ​World AIDS Day rolls around. A leading HIV consultant ​told the BBC that there’s a “complete lack of awareness” of the risks among many gay men in the UK.

As gay venues up and down the country prepare to mark World Aids Day (on December 1) with fundraising events for various LGBT charities, though, how many people do you know are comfortable with talking openly about being HIV positive? Do you even know anyone that’s openly HIV positive?

The truth is that, as a community, we still drive people who live with HIV into the closet. It’s not surprising that most gay men feel they want to keep their status private. Many struggled during their lives to come out as gay to their friends, families or work colleagues, and they may not even be out in all aspects of their lives. Having to then deal with the stigma that still exists around being HIV positive is akin to having to deal with a second coming out and, once again, another round of judgement and shame.

A few HIV negative people share their thoughts. “If you get HIV from unprotected sex you deserve it,” said one. Many might privately agree with him. But does that mean they deserve to feel forever alienated by society?

Niyi is better known in London’s gay clubs as Maximus Crown. He is one of the only DJs that is publicly out about being HIV positive, which is a big deal. The UK gay scene has very few openly HIV positive DJs, drag queens or promoters. But Niyi didn’t really have the choice of whether he should put his status out there—his best friend at the time decided to go public with it on Facebook for him.

“My best friend stayed with me every day to make sure that I wasn’t alone, didn’t starve or try and kill myself,” Niyi recalls. “Six months later I decided to distance myself from him because I started to notice things about our friendship that I wasn’t OK with. To get back at me he went onto the Facebook event page for a party I was booked to DJ at and posted a series of comments about me being HIV positive.”

The comments included accusations that Niyi had been having unprotected sex while aware he was HIV positive. “When it happened I wasn’t angry, I just wanted to log out of the universe. If I could have closed my eyes and stopped existing I would have, but it forced me to own my status, which in turn made me more comfortable discussing it publicly.”

If you are old enough to remember ​the campaigns of the 80s, then safer sex and the issues around HIV would have been drummed into your consciousness. But with the advent of combination therapy and the dramatic development of antiretroviral drugs that revolutionized care over the last fifteen years, AIDS-related deaths dropped substantially. Between 2001 and 2011, the rate of new infections ​dropped by 20 percent.

As the number of deaths fell, though, so too did government resources that educated people about HIV. Schools barely touched on the subject. To most people, it was seen as a disease that only affected poorer countries. It’s no wonder that the number of infections in young people has risen comparatively steeply compared to other age groups. As the ​United Nations Population Fund say, young people remain at the centre of the HIV epidemic in terms of rates of infection, vulnerability, impact, and potential for change. The young have grown up in a world changed by AIDS, but so many still lack the correct knowledge about how to prevent HIV infection. ​

For many recently infected guys, getting their head around living with HIV is one of the biggest challenges.

James Hanson-McCormick, 24, who was 18 when he was diagnosed with HIV said “I had no idea what HIV was or how it was contracted. I have had six years to think about my status, and not a single day goes by without me thinking about it. It’s so hard. I wish I knew more [then], I wish I had been better educated and that I knew enough to try and prevent it happening.”

It might sound naïve, but James isn’t alone in his experience. ​Luke Alexander is from Oldbury, a small town outside Birmingham, and was diagnosed HIV positive in June 2013. He was 18. “If I was in a sexual relationship with a guy when I was 15 or 16 it was monogamous,” he tells me. “When I hit 18 I treated myself to a fancy phone and discovered these apps and clubs. You’re new to everything and people say ‘download this’ and you find people want to hook up with you. It’s validation. You become quite promiscuous.”

Luke’s candidness took me aback. “I became incredibly egotistical and quite narcissistic,” he admits. “Add drugs and alcohol into the equation and it becomes quite a habit. One thing led to another and I didn’t take any precautions.”

Will Harris, Head of Media for ​Terrence Higgins Trust, says that while research shows that most gay men use condoms most of the time, it only takes one instance of unprotected sex for HIV to be passed on. “Condom use has to be consistent… It’s basic human nature to under-estimate risk, so our community needs to keep finding ways to reinforce the message that ‘He looks fine, it’ll probably be OK’ won’t give you the protection that a condom will.”

Earlier this year, Luke ​made headlines when he went on ITV’s This Morning to discuss his HIV status. “I never heard anything about HIV in school,” he said. “You can become a bit reckless when you come of age, but it’s far worse if you have no basis of knowledge to refer to.”

Like James, Luke’s ​sex and relationship education in school was virtually non-existent. “It lasted a few hours. If people weren’t there, they didn’t receive it. While they stressed the importance of contraception, it was for pregnancy. When I asked about anal sex, they said, ‘We don’t recommend it.’ I felt embarrassed. I just wanted to hear their perspective.”

Harris agrees that the education system has failed in this regard, saying that:

“Young gay men are generally frozen out by the current approach to sex education in schools.”

“The past is the past, though, and you can’t change that,” James reasons. “The great thing now is I’m healthy and happy. I’ve been on meds for five years now and doing so well. My health, in general, is alright.”

But living with HIV isn’t just about monitoring your physical wellbeing. The emotional strain of the constant check-ups and coming to terms with the virus can also present its own psychological strain.”Physically I’m fine,” James says. “I do suffer with depression, but that’s down to several things—not just my HIV. Sometimes it’s difficult juggling lots of meds every day. Often my depression gets bad and tells me I’m worthless and to not take it. But I have faith in medicine that one day there will be a cure.” His biggest wish is more altruistic still: “More knowledge and understanding around HIV and AIDS.”

For many recently infected guys, getting their head around living with HIV is one of the biggest challenges. Stigma is a major issue.

“Robert,” 29, (not his real name), has been HIV positive since 2007. A casual partner sexually assaulted him when he was passed out after a heavy drugs session. Only his closest friends and immediate family are aware of his status. He puts this down to the assumptions that people make about those who are positive. “It’s not the fact that it’s an unattractive quality [to be HIV positive], it’s that people think you had a choice. You hear a lot about bareback parties and people who think that those who have a lot of condom-less casual sex ‘deserve’ to get HIV. I don’t judge anybody but I don’t want to be put in that category. I’m not ashamed of being HIV positive, but it does affect how people perceive you if they don’t know you.”

Robert has told around ten partners about his status when they’ve asked about barebacking. “I don’t have unprotected sex unless we are both aware of our status,” he says. Even so, he says it’s still common for HIV positive guys to be afraid to disclose their status to others in the same position: “I’ve even met positive guys who I’ve been honest with, but they have lied about being positive because they don’t want to say they are.”

It’s upsetting to think that we are forcing so many thousands of gay men into a situation where they feel alienated by their own community. It takes a strong person to rise up against a tide of possible condemnation and be among the first to speak up.

Luke lost friends after going public about his diagnosis. People stopped answering his calls. He believes it was because they were afraid to be associated with somebody that was openly HIV positive. Similarly, when he confided in a friend about his status, she was more concerned that she’d shared his wine glass than how Luke was feeling. (Incidentally, if you labor under similar misconceptions, HIV cannot and ​will not be spread by sharing glasses.)

Sadly, despite it now being considered to be a very manageable long-term health condition, HIV is still widely misunderstood. “You can sit on a park bench and talk for two hours with someone about your diabetes,” Luke says. “But you can’t do that with HIV because you’ll often get a look of fear and shock.”

Niyi eventually reached a point when he had enough of feeling ashamed. “I woke up one day and was like, life isn’t always going to be easy. Self-pity isn’t fierce and it isn’t fun. Doing things and being around people that encouraged me to feel good about myself was such a big help.”

There is one hurdle that remains for him, though, and that’s relationships. He’s been single for seven years. “The thought of being rejected by a guy because of it terrifies me. I feel that it will always hold me back until I am able to get past that final fear.”

James has been luckier in love. He met his boyfriend 18 months ago and they married last August.

Niyi, Luke and James are heroes!  They have decided that it’s time to challenge the stigma that looms around HIV for no other reason than people are not talking about an issue that affects us all. The education system is broken, so they’ve taken it upon themselves to speak out about it. They have taken a situation that could have stripped them completely, that could, if they let it, absolutely define them, but instead have turned it into something powerful.

As his fears subsided, Luke was inspired by another HIV activist and started blogging about his experience. “It got a lot of attention. I wanted to help people understand and it was a feeling of empowerment. The good reactions that followed confirmed it was the right thing to do,” he says. He now also writes monthly about the subject for Gay Times.

Niyi agrees. “There are so many people suffering unnecessarily because they feel that being HIV nullifies everything good about who they are, but it really doesn’t. Everybody deserves to wake up feeling like they are of value and if all I have to do is talk about my situation in order for people to see that, then that’s what I will do. People need to know that someone’s HIV status is not an indication of what kind of person they are.”

Story via Vice

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Human Genome Tinkering Could Be Our Best Bet to Beat HIV

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The human immunodeficiency virus (HIV) is a crafty little beast, constantly mutating to mask itself from our body’s defenses, but always entering cells through the same molecular door. The design of that cellular door is governed by our DNA, so why not change the lock by modding our genetic code?

In 2006, a minor medical miracle occurred. HIV-positive leukemia patient Timothy Ray Brown—the second Berlin Patient—received a bone marrow transplant that saved his life in more ways than one. The marrow that he received was from a donor with a unique double mutation to a gene on the 3rd chromosome known as CCR5. This gene codes for the surface protein that the HIV virus uses to gain entry into our white blood cells (specifically, CD4+ T-cells); however the double mutation shuts down these sites and provides a natural immunity to HIV. This mutation is exceptionally rare, only occurring in about one percent of Caucasians and nowhere else. It’s been hypothesized that it’s this same natural immunity that allowed a small portion of Europeans to make it through the Black Plague unscathed.

While that was fantastic news for Brown, who nearly a decade later remains off of his retroviral drug regimen and maintains an undetectable level of the virus in his system, it’s not of much use to the rest of us. With both the mutation prevalence and bone marrow compatibility matches in general being so rare, there was no effective means of using transplants as delivery vectors for this beneficial genetic condition. And it’s worth noting that the very process of becoming HIV-free nearly killed Brown. But that’s where Professor Yuet Kan’s team at UCSF comes in.

Kan figured that if integrating this double mutation wouldn’t work on the macro level—that is, replacing a patient’s bone marrow with that of a naturally HIV-immune person’s—maybe it would at the molecular level, thereby allowing researchers to confer the benefits while cutting out the marrow donation. To that end, he and a team of researchers from the University of San Francisco are employing cutting-edge genetic editing techniques to snip out the beneficial length of DNA coding and integrate it with a patient’s own genome.

The technique they’re using is known as CRISPR (Cas9) genome-editing. CRISPRs, (clustered regularly interspaced short palindromic repeats) are DNA delivery vectors that replace the existing base codes at a specific part of a specific chromosome with new base pair sets. Cas9, on the other hand are the “molecular scissors” that Kan’s team employs to first cut out the offending DNA. It sounds easy, sure—just find the string of DNA you want to replace, then snip it out with Cas9 DNA scissors, and install some new DNA using a CRISPR—however the nuts and bolts of the process are far more technically challenging.

The patient’s own blood cells would be employed as a precursor. Researchers would then have to convert those cells into induced pluripotent stem (iPS) cells by modulating a number of genetic switches, thereby instigating their regression to more basic stem cells. After that, the offending CCR5 gene would need to be knocked out and replaced with the better, double-mutated version before the now fortified blood cells were transfused back into the patient. Not only is there no chance of the body rejecting the new cells (they are the patient’s own after all), the technique also neatly sidesteps the whole embryonic stem cell issue.

While the technique is still in its early stages of development and no human trial dates have yet been set, it holds huge promise. Not just for the 35 million people annually infected by HIV, but also sufferers of sickle cell anemia and cystic fibrosis—two deadly diseases caused by a single protein deformation—could benefit from similar techniques. By figuring out which genes do what on our iPS cells, we could even theoretically grant everyone on Earth immediate immunity to any number of diseases.

Of course, being able to update and augment our genetic code opens up a whole slew of potential concerns, objections, and abuses. Just look at the ire raised over the use of embryonic stem cells in the early 2000s. People were lost their minds because they thought scientific progress was being built on the backs of fetuses. Researchers had to go and invent an entirely new way of making stem cells (the iPS lines) just to get around that one moralized sticking point, so you can bet there will be plenty of chimera, master race, and Island of Dr. Moreaureferences bandied about should we ever begin seriously discussing the prospect of upgrading our genes. And could certainly slow progress in this specific research.

That’s not to say that the hysteria that accompanies seemingly every news cycle these days is completely off base. Like cars, styrofoam, pressure cookers, and thermonuclear bombs, this technology can be used for evil just as easily as it can be for good. And while we’re not nearly as genetically complex as, say, an ear of corn, wrangling the myriad of interactions between our various genes is still an incredibly complex task and one with severe consequences should something go awry—even if we can avoid creating unwanted mutations through stringent testing and development methodology as we do with today’s pharmaceutical development. So why not turn ourselves into the ultimate GMOs? It certainly beats everyone becoming cyborgs.

Article via Gizmodo

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Baby Cured of HIV – Here’s the real message..

caduceus-and-red

Late Sunday night, the world media started to report about a baby, born with HIV had been cured.  Everybody got talking; scientists, people of faith, doctors, the public, HIV experts, me, you!

It’s easy to get caught up in the excitement of a cure, I honestly didn’t think I’d be writing the phrase ‘HIV Cure’ for at least a few more years yet, but as it were, we were given a flurry of media reports about how this case was set to change the HIV treatment paradigm, prevent babies from being infected, and, to quote the principal author of the study, Dr Deborah Persaud, “transform our current treatment practices in newborns worldwide”.

There are reports that parents and guardians are asking if this means that children who are infected at birth can stop their drugs.  People are very over-optimistic, and have been calling their doctors and specialists raising the question of whether they, or their child could also be cured!

More Data Needed

We need to slow down, and get some perspective.  The news was only announced five days ago.

To quote a famous professor of HIV pharmacology: “We need more data.” We need to take stock, get the facts right, and allow for scrutiny of the case by the scientific community.

There are many questions to be asked of the case. For instance, was the baby truly infected in the first place? From reviewing the data presented at the conference, it certainly seems possible. But how established was this infection? Had it established itself in so-called long-lived memory T cells?

Furthermore, when was the actual point of infection? This is not clear. Could it have been just prior to delivery? If so, it is possible that by serendipity the doctors intervened with drugs just as the virus was trying to become established.

A Cure, or PEP?

It’s imperative, then, that we attempt to understand when exactly this baby was infected. Was it just before birth, or several months before birth? The longer the period of time, the more interesting the case becomes.

However, if the intervention simply aborted the establishment of infection then Dr Persaud’s results are less exciting.

If drugs were introduced very shortly after infection, the treatment may have actually acted as PEP (post-exposure prophylaxis) – a strategy already used by HIV doctors to try and avoid establishment of infection

Think of a fire which has just caught alight, but has yet really to take hold. Pouring a bucket of water on it at this point may kill the fire dead. Was there actually a flame, or the presence of detectable virus, in this case? Yes, of course. But this bucket of water may not have worked had you allowed the ‘fire’ to become properly established.

The case being described by many as a ‘cure’ may in fact be like this bucket of water – effective, but only because it was delivered so early.

Taking the fire analogy further, after we have put out the flames we may still see the residues it left behind. It might even reignite at a later point in time. The Mississippi baby has been off anti-retroviral drug treatment [ARVs] for less than a year – there are currently no flames, but we are waiting to see if the embers are truly burned out.

Currently, and beyond this headline case, we have no way to completely put out the fire of HIV once it has caught hold. Our current ARV treatments, then, are the firemen who keep the flames of HIV at bay. As long as they are there, you can begin to rebuild the house – a fact born out by the fact that hundreds of thousands of our patients have been on totally suppressive regimens for up to twenty years.

Currently, it is a truth that, if you stop therapy, the virus inevitably rebounds when you –cease medication usually within two weeks. Admittedly, there are a very few rare cases where the virus may simply smoulder away at very low levels for many years (so-called “post treatment controllers”).

All of these considerations and unanswered questions mean that we have a long way to go yet before we fully understand this case. We must fully explore the baby’s immune make-up. What about the characteristics of the mother’s virus, which was curiously low for someone not on treatment? There are so many questions before we should really call this a cure.

Other than the potential of Dr Persaud’s research to stimulate further investigations, then, what is the best thing that can come of all this media frenzy?

The great hope is that this moment represents the greatest mass HIV awareness campaign since the Don’t Die of Ignorance ‘tombstone’ campaign of the 1980s. Rarely does HIV make such headlines, and we have a real chance to educate people whilst their interest is piqued.

We must tell people that the story of HIV is very different now, and we must take this opportunity to communicate new messages through the media whose attention we currently have – messages which can correct people’s out-dated misconceptions.

  • Let’s talk about testing, and the importance of early diagnosis.
  • Let’s talk about effective drugs, which when prescribed early enough can help a patient live a long and full life.
  • Let’s talk about condoms and prevention.
  • Let’s tackle stigma!

Today there is no reason for any baby to be become HIV positive, if the mother is tested and diagnosed early in pregnancy – and if she and the baby have access to effective treatments which can prevent transmission. Sadly, 590,000 babies every year are still born HIV-positive in the developing world: an unnecessary tragedy.

We can do something about that right now, with the tools we have – If we increase testing and make it more regular and consistent. In the UK, 95% of women take the HIV tests during pregnancy. And with effective treatment the chance of the baby being born positive is less than 0.5%. We should be aiming for the same success all over the world

Above and beyond a media storm about a supposed ‘cure’, there are good news stories we can make happen today.

Is the ‘cure’ story exciting? Yes. Is it scientifically plausible? Yes. Will it stimulate more research? Almost certainly. But it is extremely premature to hail it as a cure that will translate into routine clinical care any time soon. We need much more data.

So if you or your child are HIV-positive, then please… don’t stop taking your tablets. And if you have had unprotected sex, take the test. Condoms, education, testing, and access to treatment are our real weapons against HIV, and we need to learn to use these correctly if we want to make a real impact today.

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We offer offer a completely free and confidential rapid HIV test (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 after  contact for detecting HIV 1 and 2 antibodies.  We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not necessary, call us (0116 2559995) we’re here to help.

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New Law in Los Angeles – Adult Movie Actor’s Required To Wear Condoms


Actors making pornographic movies in Los Angeles will be required to use condoms while filming, under a new law signed by the city mayor.

The new regulation has been welcomed by health officials but pornography industry leaders say it could force them to abandon the city.

LA’s San Fernando Valley is considered the capital of the multibillion-dollar US adult film industry.

Correspondents say it is not yet clear how the new law will be enforced.

The LA-based Aids Healthcare Foundation welcomed the move saying it was crucial in protecting adult film actors from HIV and other sexually transmitted diseases.

The foundation, which has campaigned for the measure for six years, said it would now seek similar condom requirement elsewhere in the US.

“The city of Los Angeles has done the right thing. They’ve done the right thing for the performers,” said foundation president Michael Weinstein.

He said his group would also be vigilant in keeping track of where porn producers might move to.

Several of the industry’s biggest adult filmmakers have said they might consider moving just outside city boundaries.

They insist that adult films featuring condoms are not as popular and that some actors prefer not to use them.

The new law was signed by Los Angeles Mayor Antonio Villaraigosa on Monday.

The city council has now asked the police, city attorney’s office and workplace safety officials to figure out how they enforce the rule, the Los Angeles Times reports.

Industry experts estimate as many as 90% of all pornographic films produced in the US are made in Los Angeles.

Last year, pornographic film productions across the US were temporarily shut down after an adult film performer tested positive for HIV – the virus that causes Aids.

Above article via BBC News

Our message is clear!

Condoms provide the best protection from HIV and other sexually transmitted infections.  HIV stands for human immunodeficiency virus. It was identified in the early 1980s and it belongs to a group of viruses called retroviruses.

Normally, the body’s immune system would fight off an infection, but HIV prevents the body’s immune system from working properly. HIV infects key cells in the body’s natural defences called CD4 cells, which co-ordinate the body’s response to infection. Many CD4 cells are destroyed by being infected, and some stop working as they should.

Although HIV can’t be cured, it can be treated. Modern HIV treatment means that many people with HIV are living long, healthy lives and can look forward to a near-normal lifespan.

AIDS
If HIV isn’t treated, the gradual weakening of the immune system leaves the body vulnerable to serious infections and cancers which it would normally be able to fight off. These are called ‘opportunistic infections’ because they take the opportunity of the body’s weakened immunity to take hold.

If someone with HIV develops certain opportunistic infections, they are diagnosed as having AIDS. The term ‘AIDS’ stands for acquired immune deficiency syndrome. People diagnosed as having AIDS can become unwell with a range of different illnesses, depending on the specific opportunistic infections they develop. This is why AIDS is not considered a disease, but a syndrome – a collection of different symptoms and illnesses, all caused by the same virus, HIV.

Most people who have HIV have not had an AIDS diagnosis. Also, if someone develops an AIDS-defining illness this doesn’t mean that they are on a one-way path to illness and death. Thanks to HIV treatment, many people who were once diagnosed as having AIDS are now living long and healthy lives.

Have you ever had a HIV test?

If you’re interested in having a HIV test, we 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. We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

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Questions on Tactics to Prevent HIV [PrEP]

PrEP is short for PreExposure Prophylaxis and may be part of comprehensive HIV prevention services in which HIV negative people who are at high risk, take antiretroviral medication daily to try to lower their chances of becoming infected with HIV if they are exposed to it.

To date, PrEP has been shown to be effective in men who have sex with men (MSM) and heterosexual men and women.

The effectiveness of biomedical approaches to prevent HIV infection was a key theme of the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011), held July 17-20, 2011, in Rome.

Among the major studies presented, Robert Grant from the Gladstone Institute of the University of California at San Francisco described final data from the iPrEx trial, which showed that pre-exposure prophylaxis (PrEP) using tenofovir/emtricitabine (Truvada) reduced new HIV infections by 42% overall, and by more than 90% among people who demonstrated good adherence.

The US Centers for Disease Control and Prevention (CDC) has recommended testing patients for HIV before they begin taking the drugs and again at two- to three-month intervals. The FDA could also require drug companies to set up a registry of patients taking the drugs and ask that patients provide proof of a negative HIV test before getting their medications refilled.

Deciding who to treat with PrEP could also be a challenge. The CDC reported on 3 August that rates of new HIV infection in the United States are stable overall, but are rising in young men who have sex with men. Yet if these men aren’t using the prevention measures already available, there’s little reason to think doctors will have an easier time convincing them to take a daily pill.

The question of who should get PrEP is more difficult in many developing nations, which cannot even afford to treat everyone currently infected with HIV. PrEP would cost hundreds of dollars per patient per year in developing countries, and many thousands of dollars in rich nations.

Even with regimens costing less than £1 per day, developing nations will be forced to choose between providing more treatment for those who already need it and potentially preventing new infections. Myron Cohen, a doctor and researcher at the University of North Carolina at Chapel Hill, points out that half of young girls in some parts of sub-Saharan Africa become infected with HIV by their mid-twenties. “That’s unacceptable, so I see that as one potential population for PrEP,” says Cohen.

Although the cost-effectiveness of PrEP increases in higher-risk populations, it will be politically dicey for financially strapped countries to justify distributing drugs to those in these groups. “Even if you thought the best use of the pills would be for sex workers, it would be very difficult to take a limited supply of pills and give them to high-risk populations at the expense of people who are dying of infection,” says Cohen.

In the past year, three landmark clinical trials have shown that a daily dose of the antiretroviral medication Truvada can protect individuals from infection with H.I.V.— a significant discovery, given the failure so far of all efforts to develop a vaccine against the virus.

Now researchers in San Francisco and Miami are planning to test this prevention strategy, called pre-exposure prophylaxis, or PrEP, in a pilot study supported by the National Institutes of Health. The researchers will soon recruit up to 500 uninfected men who have sex with men, especially those considered to be at greatest risk of infection, such as younger gay men and, in particular, African-Americans.

The men will be asked to take Truvada daily, and the researchers will monitor their compliance with the regimen, their sexual behavior and their health status. Already, though, the prospect of antiretroviral drugs’ being used for prevention as well as treatment is raising complex questions for researchers and advocates.

Will healthy uninfected people consistently take an expensive and powerful drug that can cause a range of side effects? Is it fair to provide medications to H.I.V.-negative individuals when so many of those already infected do not have access? Will those receiving the drug be more likely to engage in risky sex because they believe they are protected — even if they do not always take it as prescribed?

The issues are more than academic: According to anecdotal reports, some doctors are already prescribing the medications to some H.I.V.-negative patients, said Dr. Kenneth Mayer, a chairman of the Fenway Institute, a research and advocacy center for  gay, lesbian, bisexual and transgender health in Boston, who has been involved in research into PrEP.

“I think that’s going to increase, but it’s very incremental,” said Dr. Mayer, who believes PrEP is an important new weapon in the H.I.V. prevention arsenal. “People have a lot of questions.”

AIDS advocates have generally expressed optimism that the strategy, if applied carefully, could help reduce the approximately 50,000 new H.I.V. infections that occur annually in the United States. But one major provider of services to people with H.I.V., the AIDS Healthcare Foundation in Los Angeles, has initiated a media and ad campaign raising serious concerns.

The foundation’s president, Michael Weinstein, noted that participants in the first round of PrEP research were counseled extensively that not following the protocol could reduce any protective effect, and yet many still failed to take their pills as prescribed. Adherence to the regimen is likely to be even worse under real-world conditions, he said.

“We deal with tens of thousands of patients here who are positive, and a high percentage of them have adherence issues,” said Mr. Weinstein. “So the idea that young gay men who don’t have this disease are going to take this routinely is highly questionable.”

Mr. Weinstein is particularly concerned that the Food and Drug Administration could soon approve Truvada for use in H.I.V. prevention as well as treatment, which would undoubtedly lead to greater use of the drug. Gilead Sciences, the company that makes the drug, has said it is likely to file such an application with the F.D.A. early next year.

Once the F.D.A. approves a drug for any use, doctors can legally prescribe it “off-label” for other purposes. Drug companies, however, are allowed to promote their products only for indications specifically approved by the agency.

In one of the three earlier clinical trials, among men who have sex with men, PrEP reduced new infections by 44 percent over all. Among men who adhered closely to the prescribed daily regimen, however, protection against infection was greater than 90 percent.

Some researchers worry that sexually active individuals who only sporadically adhere to the PrEP regimen may not realize that they are still at risk for infection; at the same time, feeling “protected,” they may be less vigilant about practicing safe sex and getting regular H.I.V. testing.

And inconsistent use of medications among those who do not realize they are infected could encourage new drug-resistant forms of H.I.V., some experts fear.

Dr. Grant Colfax, director of H.I.V. prevention and research at the San Francisco Department of Public Health, said he hopes that the new research will yield important information about how best to use the emerging strategy.

“The question is, will people be able to maintain the regimen?” said Dr. Colfax, whose agency is a major partner in the study. “What are the risks and benefits outside of a randomized clinical trial? Will they want to take the pill, will there be changes in their risky behavior, will they come back to get H.I.V. testing on a quarterly basis?”

Dr. Howard Jaffe, chairman and president of the Gilead Foundation, acknowledged that adherence was a problem in earlier studies. But he said that participants in the upcoming research, unlike those in the trials, will all know that they are receiving the actual drug, not a placebo, and that the drug can prevent H.I.V. infection if taken as directed. That critical new information, he said, could help motivate them to stick to the prescribed regimen.

The three recent PrEP trials focused on different populations: heterosexual couples in East Africa in which one person was H.I.V.-positive and the other was not; sexually active young adults in Botswana; and men who have sex with men in the United States and five other countries. (A fourth trial, among African women, was stopped early because PrEP was not found to be working.)

The trial involving the East African couples reported that the infection rate was 73 percent lower in the group taking Truvada; among the group in Botswana, there was a 63-percent drop.

“Now that it’s been proven to be effective, the discussion is a much different discussion than when you’re enrolling people for a placebo-controlled trial,” Dr. Jaffe of the Gilead Foundation said.

Truvada combines two antiretroviral drugs, Viread and Emtriva, both also made by Gilead. Besides the upcoming study in the United States, results from additional research into the use of Truvada as H.I.V. prevention are expected over the next few years.

The drug currently costs thousands of dollars a year. A recent editorial in the medical journal Lancet Infectious Diseases raised ethical concerns about the new approach, noting that many people with H.I.V. do not have access to the lifesaving medications.

“How can these drugs be provided as prevention to those high-risk populations, while people with the disease in need of treatment continue to go without?” said the editorial.

In response, proponents of PrEP say that it would be unethical not to explore the new approach, given its potential to reduce infection rates, especially among vulnerable populations whose members have often found it difficult to consistently practice safe sex.

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THT Asks Government to Legalise and Regulate HIV Home Testing Kits

Almost two-thirds of people would consider using HIV home testing kits if they were legally available and regulated, according to a survey.

The poll, by Terrence Higgins Trust (THT), comes as the charity urged the Government to legalise and regulate home testing in a bid to cut the number of cases of undiagnosed HIV in the UK.

The sale of HIV home testing kits is currently illegal in the UK. While they can be bought over the internet, THT says they are unregulated, often of poor quality and do not direct users to places where they can get support.

Of 490 people surveyed who have not tested HIV-positive, 63% said they would consider using the kits if they were legalised and 51% thought legalisation would make them test more often.

Among gay men, one of the groups most at risk of HIV in the UK, 60% thought legalisation would make them test themselves more often.

In 2009, 22,200 people were estimated to be living with undiagnosed HIV in the UK.

Lisa Power, policy director for THT, said: “Reducing undiagnosed HIV is a major challenge. A quarter of those with HIV in the UK remain undiagnosed, and so are more likely to pass the virus on. One way to bring this number down is by increasing the opportunities for people to test outside of traditional settings.”

A spokeswoman for the Department of Health said: “We are considering our current policy on HIV home testing and whether we need to repeal the current regulations.

“Key to any repeal will be the availability of a quality-assured testing kit suitable for home use. We are working with the THT and others in taking forward our review.

“HIV testing is widely available from open-access NHS sexual health clinics. Our advice is clear – if you think you might be at risk from HIV, contact your local sexual health service or your GP for a test.”

Original Article by the Press Association

The Terence Higgins Trust policy document: HIV and Sexual Health: 12 things the Government can do was launched a few days ago, at this year’s Conservative Party Conference. The document, which includes a section on home testing, is available to download from here www.tht.org.uk/12things.

Are you interested in having a HIV test?  We 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. We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

STAY UPDATED

or subscribe via email