21 August 2015 VOLUME 16 ISSUE 34

Globally adolescent girls in low and middle-income countries continue to face unmet needs when it comes to their sexual and reproductive health, according to a report published by the Guttmacher Institute.

Due to wide variation in immunization reimbursement, administration of recommended vaccines to appropriate candidates at urban HIV clinics could result in potential net losses of $100,000 annually for each clinic, according to recent findings. Michael S. Saag, MD, University of Alabama at Birmingham, and colleagues investigated the estimated cost of vaccinating 2,887 eligible patients with Gardasil, Prevnar and Zostavax at a US Ryan White Part C academically affiliated HIV clinic in Alabama in 2013.

A multifaceted farming intervention can reduce food insecurity while improving HIV outcomes in patients in Kenya, according to a randomized, controlled trial led by researchers at UC San Francisco. The study found that participants in the intervention arm, who received agricultural and financial support, were able to increase the quantity and quality of food consumed, their CD4 T-cell counts increased, and their rate of viral suppression increased by about one half. In contrast, both tCD4 cell counts and rate of suppression fell for those in the control arm.

Gilead Sciences Inc., basking in the success of its cure for hepatitis C, is setting ambitious goals to vanquish two other major viral scourges: HIV and hepatitis B....The biotech giant’s executives say Gilead is trying to maintain its position on the front lines of battle against the viral illnesses, even as it branches out into new disease areas such as cardiovascular and respiratory conditions.

Since the specific virus was identified in 1984, nearly three dozen vaccines have been tested, without success. Now another is being clinically tested in labs around the country and the only testing site in Texas is here in Austin. Tekton Research is launching a two year study of the new vaccine. They are taking on willing volunteer subjects over the next few months.

People with hepatitis B virus (HBV) infection did not experience liver inflammation 'flares' or other adverse events when they used or stopped using Truvada for HIV pre-exposure prophylaxis (PrEP), according to an analysis from the iPrEx study presented at the Eighth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) last month in Vancouver.

Beliefs about possible toxic interactions between ART and illicit drugs are causing large numbers of people living with HIV who use drugs to intentionally miss doses of their HIV treatment when planning drug use, investigators report in Journal of Acquired Immune Deficiency Syndromes online. The prospective study involved 530 people reporting current drug use in Atlanta. This planned non-adherence was associated with sub-optimal compliance to treatment and poor control of viral load.

This updated fact sheet examines the global HIV/AIDS epidemic, highlighting the latest global estimates from UNAIDS, strategies for treatment and prevention, and US government and global responses.

Here, we describe a novel core–matrix intravaginal ring (IVR), the MZCL IVR, which effectively delivered...four active pharmaceutical ingredients (API): MIV-150 (targets HIV-1), zinc acetate (ZA; targets HIV-1 and HSV-2), carrageenan (CG; targets HPV and HSV-2), and levonorgestrel (LNG; targets unintended pregnancy). Results demonstrate proof-of-concept of a novel core–matrix IVR for sustained and simultaneous delivery of diverse molecules for the prevention of HIV, HSV-2 and HPV acquisition, as well as unintended pregnancy.

Less than half of sexually active HIV-infected women accessing ART in rural Uganda reported using effective contraception, of whom 44% relied exclusively on the male condom. Use of contraception was more likely when both the male and female partner expressed concordant desires to limit future fertility, emphasizing the importance of engaging men in reproductive health programming. These findings highlight the need to expand access to a wider range of longer-acting, female-controlled contraceptive methods.

In Cameroon, median CD4+ cell counts at ART initiation increased from 140 cells/μl in 2007–2009 to 163 cells/μl in 2010. Estimated average time from seroconversion to ART initiation decreased from 10.4 years to 9.8 years [and] delay in ART initiation increased from 3.4 years to 5.8 years. The estimated time to initiate ART and delay in ART initiation indicate that progress in Cameroon is insufficient. These indicators should help monitor whether public health interventions to accelerate ART initiation are successful.

Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether score predicted infection status. More females (N=836) than males (N=558) provided voluntary risk scores. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI. Results of a participant's own risk quiz score independently predicted STI positivity for women, but not for men.

Reductions in HIV incidence with pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) will require significant coverage of those at risk. We propose a simplified framework, similar to the HIV care continuum, to achieve protection with PrEP as follows: 1. At-risk MSM; 2. Awareness of and willingness to take PrEP; 3. Access to healthcare; 4. Receiving a prescription; and 5. Adhering to effective PrEP. We evaluated the PrEP care continuum on an Atlanta cohort of MSM and projected how many MSM might achieve protection from HIV.

Although previous globally significant outbreaks, such as those of the human immunodeficiency virus, influenza, and the severe acute respiratory syndrome, highlighted many...weaknesses, the political will needed to reform the global public health framework has failed....An independent, multinational Commission on a Global Health Risk Framework for the Future has been established to recommend a more effective global architecture for mitigating the threat of epidemic infectious diseases.

This review summarizes issues raised during a satellite session at the first HIV Research for Prevention (R4P) conference, held in Cape Town, on October 31, 2014. We explore key STIs challenging public health today, new biomedical prevention approaches including multipurpose prevention technologies (MPTs), and the scientific and regulatory hurdles that must be overcome to make combination prevention tools a reality.

Over 10 years, a programme of PrEP and ART for high-risk serodiscordant couples was projected to avert 43% of HIV infections compared to current practice with an incremental cost-effectiveness ratio (ICER) of $1340 per infection averted. This was comparable to ART expansion alone, which would avert 37% of infections with an ICER of $1452....The annual cost of PrEP in this programme is less than $100 per serodiscordant couple if implemented in public clinics.