24 APRIL 2015 VOLUME 16 ISSUE 17

“Strengthening and expanding community-based approaches to delivering HIV treatment is vital to the long-term success of the AIDS response," according to a new report by Médecins sans Frontières (MSF) and UNAIDS. The report highlights MSF’s innovative approaches to the critical challenge of how to scale up treatment to ensure that people living with HIV have access to antiretroviral therapy through ways that fit in with their daily lives"....

Let us now praise Newt Gingrich....There he was, the scourge of Big Government, on the op-ed page of the New York Times Wednesday calling for doubling the National Institutes of Health budget. “It’s irresponsible and shortsighted to let financing for basic research dwindle,” he wrote, noting that government investments in preventing and curing disease could save the government money in direct health care costs....But his argument raises a larger issue....

The Zulu king blamed for sparking the violence against foreigners which has seen South Africa's streets turn into battlefields...over the past two weeks is no stranger to scandal. Just a couple of years ago King Goodwill Zwelithini...labelled homosexuals as 'rotten'. The dyed-in-the-wool traditionalist has also courted the wrath of women's rights and HIV/AIDS campaigners for his hard line stance on controversial traditional virginity testing.

This week the Swaziland media contained several articles about the damage caused by relatives of gender-based violence victims who do not report the crimes for fear of ‘airing dirty family laundry’ in public (tibi tendlu or ‘house rubbish.’) Gender-based violence has many causes and many consequences, including injuries and deaths and the social and economic damage caused by the loss of Swazi women....Specifically, the need to overcome gender-based violence is essential if Swaziland is to conquer AIDS.

Zambia National Women Lobby Board Chairperson Beauty Katebe said it is wrong for the some former commercial sex workers to abandon the skills which they were being empowered with and get back into immoral activities. Speaking in an interview with ZANIS, in Lusaka today, Ms. Katebe said it was unfortunate and irresponsible that a woman can think of getting quick money through prostitution instead of engaging in tangible business ventures to earn a living.

The government on Tuesday officially repealed a controversial legal provision issued three years ago “to curb the spread of infectious diseases” but was widely condemned for stigmatizing women with HIV, particularly prostitutes, as it allowed their details to be made public. The decision was published in the Government Gazette after a committee of health experts deemed that the provision unfairly stigmatized members of vulnerable social groups.

A new analysis by Population Council researcher Nicole Haberland provides powerful evidence that sexuality and HIV education programs addressing gender and power in intimate relationships are far more likely to be effective than programs that do not. The research appears in International Perspectives on Sexual and Reproductive Health....Haberland studied the common characteristics of the effective interventions and offered recommendations for integrating content on gender equality and power dynamics into sexuality and HIV education.

There is a high treatment failure rate among children taking second-line ART, Thai investigators report in the online edition of Clinical Infectious Diseases. Therapy was based on a protease inhibitor and 50% experienced virological failure within five years of switching to second-line treatment. “Treatment failure was independently associated with longer exposure to first-line ART, older age and thinness at second-line initiation as well as undetectable drug levels after second-line investigation,” note the investigators, who suggest these issues should now be addressed.

Fake and substandard drugs are responsible for tens of thousands of deaths each year, and the persistent lack of reliable medicines in poor countries threatens to roll back decades of efforts to combat malaria, tuberculosis, HIV/AIDS and other conditions...."The pandemic of falsified and substandard medicines is pervasive and underestimated, particularly in...countries where drug and regulatory systems are weak or non-existent," said Jim Herrington, University of North Carolina, who co-edited a collection of articles in the American Journal of Tropical Medicine and Hygiene.

The custom in Malawi of sending girls to sexual initiation camps is just as harmful as child marriage and must end if the nation is serious about protecting girls' rights, a teenager who escaped being a child bride said. Memory Banda, 18, said the tradition of early sexual initiation, seen as a way of preparing pubescent girls for marriage, was forcing girls to have sex and exposing them to the risk of HIV infection.

Annual CD4 count monitoring may be sufficient for people taking antiretroviral treatment who have a suppressed viral load and a CD4 count above 250 cells/mm3, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Their study showed that people in this situation had a very low risk of experiencing a drop in their CD4 count below 200 cells/mm3 or of developing a serious HIV-related illness.

We evaluated HIV-1 subtypes in seroincident and seroprevalent HIV-1-infected men enrolled in the Bangkok MSM Cohort Study (BMCS) between 2006 and 2011. A significant increase in the proportion of nontypeable strains was observed among seroincident MSM between 2006 and 2011. The presence of complex recombinants and a significant rise in nontypeable strains suggest ongoing changes in the genetic makeup of the HIV-1 epidemic in Thailand, which may pose challenges for HIV-1 prevention efforts and vaccine development.

There are three fundamental messages...from this paper. First, we have presented a new methodology for calculating the basic reproduction number in the presence of episodic [HIV transmission] risk,...which helps in understanding not only the reasons for the effects of episodic risk itself, but for its interactions with other behavioral or biological phenomena. Second, we have shown how episodic risk can increase prevalence....Third, we have shown how strong these effects can be.

We read with interest the Global Burden of Disease Study by Christopher Murray and colleagues...,, which included an estimate of 35,665 new HIV cases and 12,145 deaths in China in 2013....All estimates are uncertain, and national estimates...based on reported cases are almost always lower than the true value....However, we feel it important to clarify that the reported (not estimated) number of HIV-related deaths in China was a third higher than that estimated by Murray and colleagues' analysis.