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18 November 2016 VOLUME 17 ISSUE 46

Media Coverage

  • TB/HIV gender assessment workshop underway

    The National AIDS Secretariat (NAS) and partners yesterday kicked off a two-day workshop on gender HIV and TB assessment. The outcome of the workshop...would be part of gender-specific measures included in the National HIV Strategic Plan and other relevant national documents. Alpha Khan, deputy director of NAS, said tuberculosis, and HIV and AIDS are still major public health and development challenges in The Gambia.

    November 17, 2016
    New Gambia

  • Fake news alert: Medical male circumcision not linked to penile cancer

    In South Africa, a fake news story claiming that male circumcision puts men at risk of cancer of the penis has surfaced online,...published by a site called iMzansi and shared nearly 12,000 times on Facebook. The article claims that the South African government has published a warning that “UK scientists have discovered a new type of cancer called forpenal cancer”....The South African department of health has moved swiftly to dismiss the article as a “hoax” that “must be ignored”.

    November 17, 2016
    Voluntary Medical Male Circumcision
    Bhekisisa

  • Nigeria: NACA to hold conference on HIV prevention in Nigeria

    An experimental vaginal ring that continuously releases the anti-HIV drug dapivirine has potential to save lives. But what's it going to do to sex lives? That's a question researchers posed as part of the ASPIRE study, which tested the rings with women ages 18 to 45 in Malawi, South Africa, Uganda and Zimbabwe....The encouraging news from staff interviews with 214 of the 2,629 participants is that sex with the ring wasn't much different — at least physically. What happens in people's bedrooms, however, is also psychological.

    November 17, 2016
    EABizInfo

  • ASTMH 2016: HIV cure trials can meet challenges in Africa, researcher says

    The challenges the quest for an HIV cure faces include failure of every strategy so far, dissension surrounding patient selection for trials, and a reservoir of HIV virus that will only dissipate of its own accord...in most HIV-infected individuals....While the technology necessary to evaluate the size of the HIV reservoir in HIV patients is costly, complex and generally not available in Africa, Dr. Robert Murphy of Northwestern University argued that simple adaptive clinical trials can and will move forward on the continent most affected by the pandemic.

    November 17, 2016
    Science Speaks

  • Scientists have identified an antibody that neutralises 98% of HIV strains

    Scientists have discovered an antibody produced by an HIV-positive patient that neutralises 98 percent of all HIV strains tested, including most of the strains that are resistant to other antibodies of the same class. Researchers from the NIH found that the antibody, called NG, was able to maintain its ability to recognise the HIV virus even as the virus morphed and broke away from it. It’s also up to 10 times more potent than VRC01, an antibody in the same class as N6, which has progressed to phase II clinical trials in human patients.

    November 17, 2016
    Science Alert

  • Boston clinic sees steep rise in STIs among men with HIV or on PrEP

    People accessing health care from Fenway Health in Boston have seen rising rates of gonorrhea, syphilis and chlamydia, aidsmap reports. HIV-positive men who have sex with men and MSM on pre-exposure prophylaxis attending the clinic have particularly high sexually transmitted infection rates....It’s unclear, however, whether going on Truvada as pre-exposure prophylaxis led men who have sex with men to contract more STIs.

    November 17, 2016
    PrEP
    POZ

  • Germany's first dedicated HIV research hub opens in 'exciting times' for vaccine

    Scientists at Germany's first research center dedicated to HIV, which opened at Essen University Hospital Friday, will work with international partners in the United States, Africa and Asia to develop new HIV treatments and hopefully a vaccine....Dr Hendrik Streeck, director of the new institute, says Germany has a responsibility to other countries, too. Streeck returned to Germany in 2015 from the United States, where he worked with the US Military HIV Research Program, now a key partner of his institute.

    November 17, 2016
    MSN

  • Landmark report by Surgeon General calls drug crisis ‘a moral test for America’

    A landmark report released Thursday by US Surgeon General Vivek Murthy places drug and alcohol addiction alongside smoking, AIDS and other public health crises of the past half-century....“I want to call our country to action around what has become a pressing public health issue [and] to understand the magnitude of this crisis. I’m not sure everyone does", Murthy said.

    November 17, 2016
    Washington Post

  • Health communication’s role in HIV/AIDS treatment outcomes: JAIDS Supplement launch December 13, 2016

    HC3, PEPFAR and CFAR (Center for AIDS Research at JHSPH) sponsor the launch of a special supplement in the Journal of Acquired Immune Deficiency Syndromes. This supplement focuses on the role of health communication in the treatment of HIV and AIDS. More information will be available soon.

    November 17, 2016
    Health Comm Capacity

  • Biomedical research leaders urge Trump administration to quickly appoint an NIH director

    This week a science star–studded group including two former directors of the National Institutes of Health released recommendations aimed at making NIH run better....The 27-page report...urges NIH to shore up basic research,...fund more investigators based on their track records,...rely more heavily on fellowships and training grants,...[and] review NIH’s structure of 27 institutes and centers mostly based on organs or disease.

    November 16, 2016
    Science

  • Shine a light

    Terrinieka Powell's epiphany came seven years ago in Flint, Michigan,...talking with young people about...messages they heard in church....The adolescents’ remarks made plain that many African-American churches in Flint and nationwide were...stigmatizing homosexuality and refusing to talk about sex and drugs—even as the HIV/AIDS epidemic devastated their communities. Powell’s conversation with church youth [led] her to partner with churches to provide evidence-based sexual health programs for youth in their congregations and community.

    November 16, 2016
    Public Health

  • HIV/HCV outcomes good in real world

    In patients infected with both HIV and hepatitis C (HCV), direct-acting antiviral agents produced high rates of 12-week HCV viral eradication, particularly in patients without decompensated cirrhosis, a Spanish investigator reported at the annual meeting of the American Association for the Study of Liver Diseases. In a real-world analysis, the efficacy was accompanied by a good safety profile.

    November 16, 2016
    MedPage Today

  • Scientists are building an HIV vaccine from the molecule up

    “We’ve got a sort of new revolution going on now,” says Dr. Barney Graham at the National Institutes of Health. “It involves the ability to not just design antigens at the atomic level but to conceive of novel ways to deliver them. Vaccinologists before studied viruses. Today they are more structural biologists, protein biochemists and immunologists”...[and] new technologies are what really let the scientists put their creativity to work.

    November 16, 2016
    HIV Vaccine
    True Viral News

  • Why are HIV Groups Charging Gilead with Bad Behavior in New PrEP Trial?

    Gilead is not following the accepted standard for community engagement in its new pre-exposure prophylaxis (PrEP) trial, and we are among a coalition of HIV activists and organizations from Europe and North America calling them out on their bad corporate behavior. We root our criticism in the Good Participatory Practice (GPP) guidelines that were inspired, in part, by controversies in earlier PrEP trials.

    November 16, 2016
    The Body

  • Will quackery guide Trump's global health policy?

    But in the red, white and blue aftermath of one of the country’s most divisive presidential campaigns, many are wondering what a Trump administration will mean for global health. The answer may be far from clear, but activists are likely to keep a close watch on the science guiding policy, HIV funding and generic medicines.

    November 16, 2016
    Bhekisisa

  • ASTMH 2016: Fungal infections still kill too many people with HIV

    By the time the vast majority of people who have HIV reach testing and treatment for the virus, they have had it long enough, Greg Greene of the US CDC said here today, that they are vulnerable to deadly fungal infections. One, cryptococcal meningitis, causes 11 percent of HIV-related deaths globally, alone. In sub-Saharan Africa where 500,000 cases occur annually, the toll is much higher, and in South Africa, the fungal infection causes 29 percent of HIV-related deaths.

    November 15, 2016
    Science Speaks

  • Experimental vaginal ring fights HIV, but will women wear it?

    An experimental vaginal ring that continuously releases the anti-HIV drug dapivirine has potential to save lives. But what's it going to do to sex lives? That's a question researchers posed as part of the ASPIRE study, which tested the rings with women ages 18 to 45 in Malawi, South Africa, Uganda and Zimbabwe....The encouraging news from staff interviews with 214 of the 2,629 participants is that sex with the ring wasn't much different — at least physically. What happens in people's bedrooms, however, is also psychological.

    November 14, 2016
    Microbicides
    Biospace

  • Who’s afraid of Mr Trump?

    Will billions of dollars in US aid be slashed or redirected under President Trump? For aid agency planners, only one thing...is certain right now: uncertainty....Speculation surrounds who the new administration will appoint to key positions that have a major influence on the direction of aid programmes. These include the top administrators at USAID and PEPFAR.

    November 14, 2016
    IRIN

  • Diabetes is no longer a rich-world disease

    Every six seconds a person somewhere in the world dies as a consequence of diabetes, according to estimates by the International Diabetes Federation. In 2015 5m lives were lost to the disease, more than were claimed by AIDS, tuberculosis and malaria combined....Nearly half of these deaths are among people younger than 60. In parts of Africa, where the condition is much less likely to be diagnosed, that share is more than four-fifths.

    November 14, 2016
    Economist

  • Indigenous HIV rates double while falling among wider population, new research shows

    An annual report by the University of New South Wales' Kirby Institute found the reported cases of HIV in Indigenous men, who make up three per cent of the country's population, doubled in the past five years from 6.2 per cent to 12.4 per cent. Meanwhile non-Indigenous rates of HIV fell by 12 per cent. The research found more cases of HIV in the Indigenous population were attributed to heterosexual contact and intravenous drug use than in non-Indigenous people.

    November 14, 2016
    ABC Online

  • Nurses can help parents talk to their teens about HIV risk

    The parent–child sex talk is almost always awkward. But with rising rates of HIV, especially in young black men who have sex with men, it has become essential, experts said here at the Association of Nurses in AIDS Care 2016....Nurses at pediatric and adolescent health centers can help...parents understand that their child might not be heterosexual...and help parents talk to their children about sexual-health risks specific to men who have sex with men.

    November 13, 2016
    Medscape

  • Which drug makers do a good job getting poor patients access to their medicines?

    The pharmaceutical industry is regularly chastised for failing to do enough to ensure that people in low and middle-income countries have access to its medicines. Yet the real picture is actually more nuanced, according to a newly released report....There were no signs of improvement in a key measure of affordability....Ischemic heart disease replaced HIV/AIDS as the disease with the most products with equitable pricing. Gilead Sciences had the highest proportion of products...with equitable pricing strategies that target priority countries.

    November 13, 2016
    STAT

  • Drugmakers improve access for poor, GSK ranked top

    The world's top drugmakers have improved access to medicines in developing countries but need to do more to make a wider range of products affordable, according to...the Access to Medicine Index,...which ranks the 20 leading pharmaceutical companies every two years. GlaxoSmithKline led the pack for the fifth time, followed by Johnson & Johnson, Novartis and Merck KGaA. The independently compiled index...has helped focus executives' attention on...getting life-saving treatments to people in poor countries.

    November 13, 2016
    Reuters

  • HIV test on USB stick could be start of consumer revolution in disease monitoring

    What if you could measure the amount of HIV in your blood as easily as you check your weight on the scale in your bathroom or take your blood pressure using a home cuff? That’s the vision of a team of scientists from the Imperial College London and DNA Electronics, who announced Thursday that they had developed a potentially revolutionary gadget to detect an HIV patient’s viral load.

    November 11, 2016
    Washington Post

  • The CDC is stepping up in the global fight against infectious disease

    The Centers for Disease Control and Prevention in Atlanta, Georgia, is increasingly focused on health concerns outside the United States as the world becomes more interconnected. And its international mission goes well beyond fighting global infectious diseases like Zika and HIV....As the WHO’s role has diminished, the CDC has been filling the void.

    November 11, 2016
    PRI

  • Trump likely to be indifferent to Africa

    The US President's Emergency Plan for Aids Relief has been central to South Africa's efforts....The fund committed to giving $500-million for South Africa's Aids response in 2012 [and] will provide $250-million next year. New York HIV/Aids activist Mitchell Warren said Trump's relative silence on global HIV/Aids...has left the health community with "understandable anxiety". "[The emergency plan] has strong bipartisan support in the US and we have to hope that President Trump does not derail these precious resources."

    November 10, 2016
    Times Live

  • New therapeutic vaccine approach holds promise for HIV remission

    A new study has demonstrated that combining an experimental vaccine with an innate immune stimulant may help lead to viral remission in people living with HIV. In animal trials, the combination decreased levels of viral DNA in peripheral blood and lymph nodes, and improved viral suppression and delayed viral rebound following discontinuation of anti-retroviral therapy.

    November 9, 2016
    Science Daily

  • Toxoplasma infection associated with neurocognitive impairment in HIV

    Toxoplasma gondii infection was associated with neurocognitive impairment among patients with HIV, according to a study recently published in Clinical Infectious Diseases. The association was particularly strong in those with higher CD4 counts, the researchers reported.

    November 4, 2016
    Healio

  • Rapid Response Fund aims to maintain HIV service access for sexual minorities

    After Nigeria passed its 2014 law banning gay people from gathering, and criminalizing organizations that supported them, programs providing HIV services for [MSM] and other sexual minorities...saw numbers of new clients drop by half, then dwindle to none....Now a Rapid Response Fund will provide emergency grants [and] funding...to support action countering barriers to health and health access faced by sexual minorities in 29 countries.

    October 5, 2016
    Science Speaks

Published Research

  • The effect of a conditional cash transfer on HIV incidence in young women in rural South Africa (HPTN 068): a phase 3, randomised controlled trial

    Between March 2011 and December 2012, we recruited 10,134 young women and enrolled 2537 and their parents or guardians to receive a cash transfer programme, or not. At baseline, the median age of girls was 15 years and 672 reported to have ever had sex. 107 incident HIV infections were recorded during the study....HIV incidence was not significantly different between those who received a cash transfer and those who did not. School attendance significantly reduced risk of HIV acquisition, irrespective of study group.

    December 1, 2016
    Lancet

  • Human papillomavirus vaccine approval in China: a major step forward but challenges ahead

    The bivalent human papillomavirus (HPV) 16/18 vaccine was approved by the China Food and Drug Administration in July 2016,...a ground-breaking decision by the Chinese authorities....In 2015, there were an estimated 98,900 incident cases of cervical cancer and 30,500 deaths attributed to cervical cancer in China....Several issues should be considered to ensure the success of HPV vaccine programmes in China.

    December 1, 2016
    Lancet

  • Sex-specific maps of HIV epidemics in sub-Saharan Africa

    Here we show the importance of sex-specific epidemic surface prevalence (ESP) maps....UNAIDS previously constructed...an HIV ESP map for Lesotho. We used the same method and analysed the same data. However, we constructed two HIV ESP maps; one shows the geographical variation in HIV prevalence in women, the other in men....[Both] show considerable differences between women and men,..quantitative and qualitative. Throughout the country, HIV prevalence is always substantially higher in women than in men.

    December 1, 2016
    Lancet

  • Cost-effectiveness analysis of pre-exposure prophylaxis for HIV-1 prevention in the Netherlands: a mathematical modelling study

    Within the context of a stable HIV epidemic, at 80% effectiveness and current PrEP pricing, PrEP can cost as much as €11 000 per quality-adjusted life-year (QALY) gained when used daily, or as little as €2000 per QALY gained when used on demand....The use of PrEP is most cost-effective when the price of PrEP is reduced through on-demand use or through availability of generic PrEP, and can quickly be considered cost-saving.

    December 1, 2016
    PrEP
    Lancet

  • Rwanda feels the pinch as donors slash health aid

    Rwanda has made major public-health strides since the country's genocide against the Tutsi people ended in June 1994, but declines in foreign aid now threaten that progress. Donors such as PEPFAR and the Global Fund...have reduced assistance to Rwanda by 40% over the past three years, jeopardizing advances in a country seen as a development success story. The situation will be hotly discussed at the annual meeting of The World Academy of Sciences in Kigali on 14–17 November.

    November 17, 2016
    Nature

  • Digital pharmacovigilance and disease surveillance: combining traditional and big-data systems for better public health

    The digital revolution has contributed to very large data sets (ie, big data) relevant for public health....Adrover et al...used a combination of crowdsourced human assessment and machine-learning algorithms to identify the tweets of individual reports about adverse drug reactions (ADRs) with HIV drugs....Tweets, despite their limitation of 140 characters, can still convey much more information than a search query, containing valuable information that can put potential ADRs in a specific and possibly relevant context.

    November 17, 2016
    J Infect Dis

  • Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model

    Our model conceptualizes opportunities to monitor and quantify primary HIV prevention efforts and, importantly, illustrates the interplay between an outcomes-oriented primary HIV prevention process and the HIV care continuum to move aggressively forward in reaching ambitious reductions in HIV incidence. To optimize the utility of this outcomes-oriented HIV prevention continuum, a key gap to be addressed includes the creation and increased coordination of data relevant to HIV prevention across sectors.

    November 17, 2016
    JIAS

  • Rethinking the ban--the U.S. blood supply and men who have sex with men

    After the June 12, 2016 massacre at the Pulse nightclub became clear,...thousands volunteered to give blood....Yet after this attack that specifically targeted the LGBT community, one group was notably absent from these donation lines: men who have sex with men, prohibited from donating blood in the United States since 1985....One week later, 24 US senators wrote to FDA Commissioner Robert Califf asking the agency to revisit this ban and on July 28, the FDA announced a call for input about changes to this policy.

    November 16, 2016
    NEJM

  • Interventions to improve adherence to antiretroviral therapy: a systematic review and network meta-analysis

    We obtained data from 85 trials with 16≥271 participants. Short message service interventions were superior to standard of care in improving adherence for all study settings. Multiple interventions showed generally superior adherence to single interventions, indicating additive effects. For viral suppression, only cognitive behavioural therapy and supporter interventions were superior to standard of care. For all study settings, the time discrepancy was an effect modifier..., suggesting that the effects of interventions wane over time.

    November 15, 2016
    Lancet

  • Actionable adherence monitoring to optimise intervention

    Steve Kanters and colleagues identify several practical and effective adherence interventions for antiretroviral therapy regimens. Specifically, they report that supportive and behavioural strategies (eg, peer support, text messaging, counselling, and training) improve adherence (and in some cases viral suppression) compared with standard of care....As [they] note, many programmes are already implementing these interventions. However, the observed benefit is probably limited because we often do not know who needs them or when they need them.

    November 15, 2016
    Lancet

  • Swaziland HIV Incidence Measurement Survey (SHIMS): a prospective national cohort study

    The Swaziland HIV Incidence Measurement Survey (SHIMS) provides the first national HIV incidence estimate based on prospectively observed HIV seroconversions....Swaziland has the highest national HIV incidence in the world. Incidence was nearly twice as high in women as in men....Among women, significant predictors included not being married, having a spouse who lives elsewhere, and having a partner in the past 6 months with unknown HIV status.

    November 15, 2016
    Lancet

  • Assessing progress with HIV incidence in national cohorts

    At the national-level, reliable estimates of both prevalence and incidence are required to appreciate the changing dynamics of HIV infection. Although data for HIV prevalence are common and routinely available,...very few prospectively measured HIV incidence rates are available, beyond HIV prevention trials, at the district, national, or regional level. Instead, mathematical models or laboratory assays for recent infection are most often used to calculate HIV incidence on the basis of data or samples from one or more seroprevalence surveys.

    November 15, 2016
    Lancet

  • Timing of initiation of antiretroviral therapy and adverse pregnancy outcomes: a systematic review and meta-analysis

    We included 11 studies with 19 189 mother–infant pairs. The benefits of ART for maternal health and prevention of perinatal transmission outweigh risks, but data for the extent and severity of these risks are scarce and of low quality. As use of ART before conception rapidly increases globally, monitoring for potential adverse pregnancy outcomes will be crucial.

    November 15, 2016
    Lancet

  • The Lancet Commissions: Essential medicines for universal health coverage

    The findings of the Lancet’s Commission synthesise lessons learned from the development of essential medicines policies over the past 30 years, and implementation after the landmark Nairobi Conference on the Rational Use of Drugs in 1985....This Commission explores and addresses ongoing questions...[and] makes actionable recommendations to make essential medicines a central pillar of the global health agenda, and translate policies into meaningful and sustainable health gains for populations worldwide.

    November 7, 2016
    Lancet

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