23 November 2016 VOLUME 17 ISSUE 47

In much of Africa, HIV is no longer the medieval plague it used to be. Which is not to say the virus still doesn’t pose a significant threat to the continent’s future. HIV is a wily fiend and our hard-earned gains can be quickly eroded if complacency slips in. Thankfully, as Kenyan HIV activist Jacqueline Wambui explains, science is helping keep the virus at bay by giving women greater control in the bedroom than they've traditionally had.

Decades of unchecked mining and militarization in Papua, Indonesia, have resulted in an HIV epidemic linked to rampant sex trade and inadequate health services. In 2013, Indonesia’s health ministry found the infection rate in the small western province 20 times the national average—and 88% of people infected unaware of their condition. A key source: Brothels at mining sites where some 80% of sex workers are estimated to be HIV positive.

In advance of World AIDS Day, a new [UNAIDS] report finds more people with HIV than ever before receiving life-saving treatment, leading to fewer deaths from AIDS-related illnesses around the world....Peter Ghys of UNAIDS said: "We estimate that if the funding is there and coverage targets are... achieved by the 2020, that will lead to ending the HIV epidemic by 2030. If the money is not there, then it is almost impossible to achieve that end."

A growing number of people in Sweden now live with HIV, yet ignorance about what this means can lead to discrimination. This is why we need to increase public awareness....“I view HIV as any other chronic illness like diabetes or high blood pressure,” says Anna-Mia Ekström, a specialist in infectious diseases and HIV researcher at Karolinska Institutet, in the promotional film for the hividag.se campaign.

Researchers [at the University of Adelaide] have shown that a combined approach, using a common cold virus to introduce a vaccine into the body, as well as an injection of a DNA-based vaccine, results in the immune system actively protecting against HIV in the gut and bodily cavities. The studies, published in the Nature journal Scientific Reports, represent an important step forward in attempts to introduce a first line of defense against HIV at the site of infection.

Too little has been done to help girls protect themselves and stay well, according to Michel Sidibé, UNAIDS executive director. “Young women are facing a triple threat,” he said. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment."....Girls are particularly vulnerable in southern Africa because of their low status in a strongly patriarchal society.

With the (unsurprising) concession that I too felt that watching the election returns was akin to witnessing an...incomprehensible train wreck, I remind you that the expression of gratitude is well known to make you happier. Plus, it's the season. So here's a brief list of things in our fascinating field to be grateful for as you get the turkey ready.

When Dr. Wanjiru Mukoma began educating at-risk communities about a new preventative HIV treatment in Kenya, interest appeared high. Her company, LVCT Health, reached out to hundreds of members of at-risk communities.... But when LVCT Health began its demonstration study to test the new treatment in three Kenyan communities, many of the same people who appeared enthusiastic didn’t take part....Mukoma suspected multiple factors pushed the numbers down, “But underlying all of that is stigma,” she said.

While African Americans make up 12% of the US population, they made up 44% of new HIV infections in 2014....After reviewing literature on criminal drug policies, researchers from the University of Louisville School of Public Health and Information Sciences developed the Drug War HIV/AIDS Inequities Model [which] led to identification of two main factors which eventually put this population at a greater risk of contracting HIV – disproportionate drug arrests and sentencing of African Americans.

Over the last five years, governments and private companies have made some $7 billion in global health commitments affecting more than 600 million lives and, according to a new report, most have followed through....While global health pledges have seen follow-through overall, the authors raise concerns about the shifting trend in funding...[and] also warn that success stories can make the global community lose sight of the continued need for funding health systems.

Every year since 2010, POZ has honored the POZ 100, a roundup of HIV and AIDS advocates fighting the virus. This year’s list focuses on the American South, where 44 percent of all people diagnosed with HIV live, and where Black women account for 69 percent of women with the virus....Oriol Gutierrez, POZ editor in chief, said: “We can’t end the U.S. HIV/AIDS epidemic without addressing the impact of the virus in the South.”

Dana Hines, Ph.D. M.S.N., didn't want to come to Atlanta on Wednesday, Nov. 9, despite the importance of the annual conference of the Association of Nurses in AIDS Care (ANAC)....Yet, somehow,...she did land in Atlanta. And what she found on the other side, at the annual ANAC event, was an oasis.,...a safe space, she said, to talk and mourn and prepare to fight -- all with people who are also dedicated to the care of those affected by HIV.

The review showed that in those studies which provided incentives, such as free school uniform or small cash payments to young people who stay in school, that while there was no definitive change in the number of HIV, one showed a reduction in other STI infections, and overall there was a significant reduction in adolescent pregnancies, although more high quality evidence is needed to confirm this.

Cochrane researchers conducted a review of the effects of school-based interventions for reducing HIV, sexually transmitted infections (STIs), and pregnancy in adolescents. After searching for relevant trials up to 7 April 2016, they included eight trials that had enrolled 55,157 adolescents.

In this review, we focus on PrEP as a new prevention tool for MSM at high risk in Europe, including its evidence for effectiveness, challenges for implementation, ongoing European demonstration studies; as well as how PrEP relates to other existing prevention tools. In light of European Medicines Agency's recent recommendation for approval of PrEP we briefly review the potential implications.

People who inject drugs are a key population being left behind in the global HIV prevention programmes; they comprised 51% of people with new HIV infections in eastern Europe and central Asia and 13% in Asia and the Pacific in 2014, according to...UNAIDS. Despite abundant evidence that HIV infection rates decline when PWID have access to harm reduction and other evidence-based interventions, only 80 of 192 reporting countries have opiate substitution therapy programmes, and 90 offer needle and syringe programmes.

In an extension to the [Bangkok Tenoforvir Study, participants were offered 1 year of open-label tenofovir....More than 60% of returning, eligible participants started PrEP, which indicates that a substantial proportion of PWID knowledgeable about PrEP might be interested in taking it. Participants who had injected heroin or been in prison were more likely to choose to take PrEP, suggesting that participants based their decision to take PrEP, at least in part, on their perceived risk of incident HIV infection.

No statistically significant differences were observed between TDF and comparison non-TDF regimens in pregnancy incidence, stillbirth/pregnancy loss, preterm delivery, small for gestational age, birth defects, infant or maternal mortality. Given available safety data, there does not appear to be a safety-related rationale for prohibiting PrEP during pregnancy/lactation or for discontinuing PrEP in HIV-uninfected women who become pregnant and are at continuing risk of HIV acquisition.

We find compelling evidence for a real-world benefit of 4vHPV vaccination in sexually-active minority, inner-city adolescent and young adult women against cervical and anal HPV infection with vaccine targeted types, as well as for HPV31 and 45....Nevertheless, we see that delayed completion of the 3-dose vaccine schedule among women immunized at 15 years and older is associated with increased risk of incident infection or re-infection with anogenital HPV6/11/16/18 and risk of associated cytological abnormalities.