12 JUNE 2015 VOLUME 16 ISSUE 24

In the wake of the innovations of the early AIDS era, new-drug approvals by the FDA have become the fastest in the world, and the agency has introduced new mechanisms such as fast-track and breakthrough drug designations that are increasingly being used to speed lifesaving new treatments to market. But the 21st Century Cures Act could substantially lower the standards for approval of many medical products, potentially placing patients at unnecessary risk of injury or death.

South Africa’s first national HIV stigma index has found that seven percent of HIV-positive women surveyed reported being sterilised against their will and about 40 percent reported contraception was a pre-requisite of accessing antiretrovirals (ARVs)....Commissioned by the South African National AIDS Council (SANAC), the [stigma] report also showed that 14 percent of surveyed women living with the virus reported not receiving ARVs during pregnancy despite national policies.

With new research showing that one third of people living with HIV suffered stigma, Deputy President Cyril Ramaphosa urged South Africans to speak out against discrimination....Before the conference, Ramaphosa visited Gugu Dlamini Memorial Park, named after the KwaMashu woman stoned to death in 1998 after publicly disclosing her HIV positive status....Mandisa Dlamini, 13 when her mother was murdered,...has gone on to establish the Gugu Dlamini Foundation, helping young women living in KwaMashu to make informed life choices.

An international team of researchers from Europe and the US looked at HIV-related service use, need and behaviours among 175,000 gay or bisexual men living in 38 European countries with differing levels of national homophobia. They found that men in homophobic countries had fewer sexual partners and were less likely to be diagnosed with HIV. However, they also found those men knew less about HIV, were less likely to use condoms and are at greater potential risk of getting HIV when they do have sex.

A single dose of the human papillomavirus vaccine Cervarix may offer a similar level of protection against HPV-16/18 infections...as current two- and three-dose schedules, according to new research combining data from two large phase 3 trials. "Our findings... suggest a one-dose schedule should be further evaluated....This is especially important in less developed regions of the world where more than 80% of cervical cancer cases occur," says author Aimée Kreimer, National Cancer Institute.

HIV was once a virus that flourished in cities, but it has been moving to rural areas. The small town of Austin, Indiana, is the site of one outbreak....Since December, 150 people have been diagnosed with HIV, raising concerns of public health officials and the state government. Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, talks with Here & Now’s Jeremy Hobson about what can be done to prevent rural HIV outbreaks like the one in Austin, Indiana.

According to new analysis from the Global Burden of Disease Study 2013, worldwide the proportion of lost years of healthy life due to illness rose from around a fifth in 1990 to almost a third in 2013....The main drivers of increases in the number of years lived with disability were musculoskeletal, mental, neurological, and substance abuse disorders, and chronic respiratory conditions. HIV/AIDS was a key driver of rising numbers of years lived with disability in sub-Saharan Africa.

India's Cipla recently got FDA approval for a pediatric formulation of the combo drug lopinavir/ritonavir to treat HIV/AIDS in the developing world, but not in the US, where market exclusivity rules apply. The oral pellets can be sprinkled on sweetened porridge for administration to infants, who often have difficulty swallowing tablets and spit out bad-tasting liquid formulations. The pellets received expedited approval under the President's Emergency Plan for AIDS Relief.

How most babies are protected from acquiring HIV from their infected mothers has been a matter of scientific controversy. Now researchers at Duke Medicine provide new data identifying an antibody response long discounted as inadequate to confer protection...."We hope this will be a major clue to making a vaccine to effectively prevent all mother-to-child HIV transmission, since these antibodies are the type that our current experimental HIV vaccines can boost," said M. Anthony Moody, Duke Human Vaccine Institute.

Yesterday, Wednesday, June 3, the Sexual Offences Bill, sponsored by Senator Christiana Anyanwu, was passed into law by the Nigerian Senate.The new law contains a number of problematic provisions relating to “HIV or any other life threatening sexually transmitted disease(s)” that were added between the 2012 draft and the 2013 draft that became law yesterday.

New genetic studies that compare different HIV isolates with each other are allowing researchers to create sophisticated maps of transmission networks. These phylogenetic transmission maps, in turn, are pinpointing where prevention efforts can get the most bang for their buck.

The Academy of Science of South Africa has published a comprehensive study on the science of human sexuality and the implications for policy. The report demolishes the political lie that anti-gay laws are supported by scientific evidence. And it shows that, contrary to the public-health claims of politicians who want to criminalize homosexuality, such laws hamper efforts to combat the spread of HIV and other sexually transmitted infections.

From 2004 to 2013, PEPFAR programmes provided support for a cumulative number of 24,565,127 adults and children on ART, 4,154,878 medical male circumcisions, and ART for PMTCT among 4,154,478 pregnant women in 16 PEPFAR countries. Based on findings from the model, these efforts have helped avert 2.9 million HIV infections in the same period....Our estimates do not account for the impact of the PEPFAR-funded non-biomedical interventions.

We compared HIV clinical outcomes and stigma before and after implementation of the Same-Sex Marriage Prohibition Act. Reported history of fear of seeking health care was significantly higher in postlaw visits than in prelaw visits, as was avoidance of health care. The negative effects of HIV treatment and care in MSM reinforce the unintended consequences of such legislation on global goals of HIV eradication. Strategies to reach MSM in highly stigmatised environments are needed.

Recent findings on the initial steps in viral entry and establishment of a productive local infectious nidus in the vaginal epithelium has provided important clues for HIV prevention in the female genital tract....Nonhuman primate studies demonstrate that broadly neutralizing HIV mAbs can protect rhesus macaques from...SHIV infection....If potent broadly neutralizing mAbs are effective in preventing HIV infection in women, this outcome could fill an important gap in HIV prevention technologies for young women, especially in Africa.