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3 March 2017: Volume 18 Issue 9

Media Coverage

  • Can women who are at high-risk of acquiring HIV safely use hormonal contraception?

    What is the new guidance on hormonal contraceptive eligibility for women at high risk of HIV? The new guidance is that women at high risk of acquiring HIV can use progestogen-only injectables but should be advised about concerns that these methods may increase risk of HIV acquisition, about the uncertainty over whether there is a causal relationship, and about how to minimize their risk of acquiring HIV.

    March 2, 2017
    Hormonal Contraceptives and HIV
    WHO Updates

  • East Africa: EALA bill to introduce contraceptives for children

    The East African Legislative Assembly (Eala) has drafted a Bill seeking to introduce contraceptives for children and teenagers aged between 10 and 19. The Bill dubbed the EAC Sexual Reproductive Health and Rights (SRHR), Bill 2017, if passed into law will bind the East African Community member states to provide contraceptives to all EAC citizens including children....The EAC member states include; Uganda, Kenya, Tanzania, Rwanda, Burundi and South Sudan.

    March 2, 2017
    General
    allAfrica.com

  • Zimbabwe's struggling health system leans on unsung heroines

    As Zimbabwe's health service buckles amid low levels of public funding and a government freeze on hiring medical staff, volunteers have stepped in to take the strain. Home-based carers can be found across Bulawayo, Zimbabwe's second largest city, where they work with local clinics to monitor tuberculosis and HIV patients, making sure they take their medication as prescribed. Led by local religious organisations such as the Roman Catholic Church, Seventh Day Adventists and Brethren in Christ, the volunteers - almost all women - work in groups to attend patients who need support.

    March 2, 2017
    General
    allAfrica.com

  • Men Do not Engage in Reckless Sex After the Cut - Kisumu Study

    Recently circumcised men do not necessarily adopt riskier sexual practices because of perceived protection from HIV after the procedure. A study conducted in Kisumu, published in the current edition of the Journal of Acquired Immune Deficiency Syndromes, shows...“no association between circumcision status and sexual behaviours, HIV knowledge, or indicators of risk perception"....The prevalence of male circumcision in Kisumu increased steadily from 32 percent in 2009, to 49 percent in 2011, and to 60 percent in 2013.

    March 2, 2017
    Voluntary Medical Male Circumcision
    The Star (Kenya)

  • As HIV soars in Philippines, conservatives kill school condom plan

    The Philippine Department of Education [has] announced that it would scrap a plan developed by the Health Department to distribute condoms to juniors and seniors in public high schools. The plan would have trained teachers to counsel students on how to prevent pregnancies and sexually transmitted infections, and offer voluntary HIV testing. It would have also provided training to help parents talk to their children about sex. The plan was opposed by a coalition of parents, the Roman Catholic Church and conservative politicians.

    March 2, 2017
    Male and Female Condoms
    Today Online

  • Condom wars in Sudan

    A reference to condom use to prevent HIV/AIDS in Al-Tayar, a Sudanese newspaper, has sparked a feud between secularists and Islamic religious leaders. The article’s author, Shamail Alnour, wrote that the Sudanese government’s investment in an anti-condom campaign rendered Sudanese youth more vulnerable to HIV/AIDS. In response, radical cleric Mohamed Ali Al-Gizoli has called for Alnour to be charged with apostasy—a crime punishable by death in Sudan.

    March 1, 2017
    Male and Female Condoms
    Global Health Now

  • National HIV survey could be compromised by access

    [Said] Professor Geoff Setswe, [a principal] investigator for the Human Sciences Research Council’s HIV survey: “Gated communities don’t want to participate because they don’t have trust. We are trying to make our field-workers visible. There will be workers from all race groups."...This is the fifth National HIV and Health Study, but the first to include sections on drugs and alcohol as well as the relationship between HIV and mental health....[It] will take 9 months and include 60,000 people living in about 22,000 households.

    March 1, 2017
    General
    Medical Brief

  • Better mental health management improves treatment outcomes

    Improved management of depression and other mental health disorders has the potential to improve the outcomes of HIV treatment programmes, Pamela Collins of the National Institute of Mental Health told the Conference on Retroviruses and Opportunistic Infections....Integrating care for mental disorders and HIV is feasible, she said. This means making the screening and treatment of mental disorders a normative part of HIV care.

    March 1, 2017
    General
    Medical Brief

  • Liberia joins global community to stand up for zero discrimination

    The National AIDS Commission of Liberia, in collaboration with civil society and human rights organizations in the West African state, joins the United Nations, partners and the world at large to commemorate "Zero Discrimination Day" on Wednesday March 1, 2017....In Liberia, Dr. Ivan F. Camanor, Chairman of the National AIDS Commission of Liberia, pointed out that..."HIV-related stigma and discrimination is pervasive and exists in almost every part of the world including our Liberia."

    March 1, 2017
    General
    Front Page Africa

  • County campaign aims to stop spread of HIV

    The “PrEP San Diego” campaign aims to raise awareness about Truvada, an existing drug that can be up to 99 percent effective at preventing new HIV infections....San Diegans will see billboards, bus shelters and digital ads throughout the region raising awareness for PrEP [and encouraging] those at the greatest risk...to learn more about the pill and where to get it....As of December 31, 2014, 13,200 people were diagnosed with HIV in San Diego County.

    March 1, 2017
    General
    Military News

  • Trump plan to slash State, foreign aid spending has foes in Congress

    President Donald Trump's proposal to slash funding for the State Department and foreign aid faces stiff opposition in Congress,...not just from Democrats, but from many of his fellow Republicans....Senator Marco Rubio, member of both the Senate foreign relations and intelligence committees, noted:..."Foreign aid is not charity. We must make sure it is well spent, but it is less than 1% of budget & critical to our national security."

    February 28, 2017
    General
    Reuters

  • Why Europe should lead on fight against disease

    The fight against diseases of poverty — HIV and AIDS, tuberculosis, malaria and other neglected diseases — may seem an unlikely battleground in our new era of foreign policy. But this is where the effects of the United States’ emerging isolationism will be most obvious. If Europe fails to fill the power vacuum, we will be abandoning millions of people in the world’s poorest countries.

    February 28, 2017
    General
    Politico

  • Influential health fund reboots its search for a leader

    The Global Fund to Fight AIDS, Tuberculosis and Malaria has announced that it is reopening its search for a new executive director....The fund’s board had expected to conclude the search for a replacement for the current executive director, Dr. Mark Dybul, this week...but “due to issues encountered in the recruitment process,” board members were unable to finish.

    February 28, 2017
    General
    New York Times

  • This epidemic unfortunately remains an epidemic of women

    Since the start of the global HIV epidemic, in many regions women have remained at a much higher risk of HIV infection than men. Young women and adolescent girls in particular account for a disproportionate number of new HIV infections....Moreover, HIV remains the leading cause of death among women of reproductive age, yet access to HIV testing and treatment remains low.

    February 28, 2017
    General
    News Gambia

  • HIV vaccine plus latency reactivator induce sustained HIV remission in proof-of-concept study

    After treatment of primary HIV infection, two doses of a therapeutic HIV vaccine plus three infusions of romidepsin, an HIV latency reactivator, allowed five of 13 trial participants to stay off ART without rebound for up to 28 weeks in a Spanish proof-of-concept study. BCN02-Romi is the first immune intervention trial showing that manipulating cytotoxic T lymphocyte (CTL) immunodominance patterns may allow off-ART viral control in some people.

    February 27, 2017
    HIV Vaccine
    BodyPro

  • After fracas, Global Fund abandons plan to pick new chief and reopens search

    Leaks. Concerns about alienating President Donald Trump. Allegations about conflicts of interest. All of those reasons factored in to a surprise decision today by the board of the Global Fund to Fight AIDS, Tuberculosis and Malaria to restart its search for a new executive director....“Due to issues encountered in the recruitment process, the Board felt they were unable to bring the process to conclusion,” reads a statement issued by the Global Fund.

    February 27, 2017
    General
    Science

  • Trump’s 2018 budget will squeeze civilian science agencies

    White House officials said they will ask Congress to increase discretionary defense spending by $54 billion...in the 2018 fiscal year.....They expect to pay for that increase by cutting an equivalent amount from...the part of the budget that includes major basic research funders. That [includes] a potential squeeze on the $31 billion National Institutes of Health....However, the White House will need to persuade Congress to change [the] 2011...Budget Control Act, designed to maintain a balance between military and civilian spending.

    February 27, 2017
    General
    Science

  • AIDS vaccine may be ‘functional cure’ for some

    [W]hen a field suffers as much failure as the search for an AIDS vaccine has.., researchers sometimes celebrate glimpses of hope. That’s what happened last week when scientists showed that a vaccine may have helped five people already infected with HIV keep the virus in check....The results...suggest the vaccine may boost the immune system enough to allow infected people to drive down HIV levels without taking drugs—although it’s not clear for how long.

    February 22, 2017
    HIV Vaccine
    Science

  • Antibiotic prophylaxis cuts STI rates

    In a randomized trial in France, taking 200 milligrams of doxycycline within 72 hours of unprotected sex sharply reduced the number of syphilis and chlamydia infections, according to Jean-Michel Molina, Saint-Louis Hospital/Paris....Wafaa El-Sadr,...of Columbia University's Mailman School of Public Health, told MedPage Today that if the findings are borne out with longer follow-up and in a larger number of patients, they could have a "huge public health impact."

    February 17, 2017
    General
    MedPage Today

Published Research

  • Time to get serious with HIV-1 resistance in sub-Saharan Africa

    In Lancet Infectious Diseases, John Gregson and colleagues report results of a meta-analysis investigating HIV-1 drug resistance in 20 studies from sub-Saharan Africa....They found a substantial prevalence of thymidine-analogue mutations (TAMs) among patients who had treatment failure (16% of 712 patients), which was a somewhat unexpected finding, and TAMs were significantly associated with the presence of resistance to TDF, NNRTIs, and cytosine analogues.

    March 2, 2017
    Treatment
    Lancet HIV

  • Comment: Criminal law, sex work, HIV: need for multi-level research

    Aaron Reeves and colleagues report an ecological analysis of the association between the differing legal policies regarding sex work of 27 European countries and HIV prevalence among female sex workers. Results suggest that countries where aspects of sex work are fully or partly legalised have a lower burden of HIV among female sex workers than countries that criminalise sex work...[T]his study...should raise caution for governments and policy makers considering criminalised or end-demand models.

    March 2, 2017
    General
    Lancet HIV

  • Population attributable fraction of incident HIV infections associated with alcohol consumption in fishing communities around Lake Victoria, Uganda

    In a community-based cohort study, 1607 HIV sero-negative participants aged 18–49 years were enrolled from 8 fishing communities along Lake Victoria, Uganda. At follow-up 12 months later, 1288 (80.1%) were seen and interviewed....In [those] communities, 64% of new HIV infections can be attributed to drinking alcohol. Interventions to reduce alcohol consumption should be integrated in HIV/AIDS prevention activities for populations in whom both HIV and alcohol consumption are highly prevalent.

    March 2, 2017
    General
    PLoS ONE

  • The changing face of informed consent

    This multipart review provides an overview of innovative approaches to improving and expanding the informed consent process for researchers and participants, along with short essays covering specific areas of innovation.

    March 2, 2017
    General
    NEJM

  • Comment: Improving HIV prevention and care for African GBMSM

    Andrea Wirtz and colleagues report results of a multisite cross-sectional survey of gay, bisexual, and other men who have sex with men (GBMSM) in Malawi....Findings include an HIV prevalence of 18.2...and age-stratified prevalence ratios indicating early onset of risk. A strikingly low proportion of HIV-positive men had been diagnosed and even fewer had initiated ART....The need to address inequities in HIV outcomes of GBMSM as a result of structural and sociocultural influences has become paramount.

    February 27, 2017
    General
    Lancet HIV

  • Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma

    Dried blood spots (DBS) and plasma sample results were highly correlated. However, when compared to plasma, each assay performed somewhat differently in DBS at the lower and higher ends of the dynamic range. DBS samples were more likely to be classified as recently infected by all three assays, which may lead to overestimation of incidence in surveys using performance criteria derived for plasma samples.

    February 23, 2017
    PLoS ONE

  • Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomised controlled trial

    HIV-negative high-risk gay and bisexual men...were recruited at three clinical and two community-based sites in Australia. HIV self-testing resulted in a two times increase in frequency of testing in gay and bisexual men at high risk of infection, and a nearly four times increase in non-recent testers, compared with standard care, without reducing the frequency of facility-based HIV testing.

    February 16, 2017
    Treatment
    Lancet HIV

  • Uptake contexts and perceived impacts of HIV testing and counselling among adults in East and Southern Africa: A meta-ethnographic review

    HIV testing and counselling (HTC) interventions are key to controlling the HIV epidemic in East and Southern Africa where HTC is primarily delivered through voluntary counselling and testing (VCT), provider-initiated testing and counselling (PITC), and home-based counselling and testing (HBVCT)....HBVCT is associated with minimal stigma and should be considered an area of priority. Counselling components in HTC interventions were effective in transmitting information about...risk, but...ineffective in addressing broader personal circumstances.

    February 16, 2017
    Treatment
    PLoS ONE

  • Kazakhstan can achieve ambitious HIV targets despite expected donor withdrawal by combining improved ART procurement mechanisms with allocative and implementation efficiencies

    Kazakhstan can achieve its national HIV targets with the current budget by (1) optimally re-allocating resources across programs and (2) either securing a 35% reduction in antiretroviral treatment drug costs or reducing management costs by 44% of 2014 levels. Alternatively, a combination of antiretroviral treatment and management cost-reductions could be sufficient....The key changes recommended were considered realistic by Kazakhstan country representatives.

    February 16, 2017
    General
    PLoS ONE

  • Factors influencing antiretroviral treatment suboptimal adherence among perinatally HIV-infected adolescents in Thailand

    We analyzed data from 568 pairs of perinatally infected adolescents (aged 12–19) and their primary caregivers....Younger age, having grandparents or extended family members as primary caregiver, caregiver-assessed poor intellectual ability, having a boy/girlfriend, frequent online chatting, self-reported unhappiness and uneasiness in asking doctors questions were significantly associated with suboptimal adherence....Social and emotional support and counseling from peer group was consistently reported as a strong adherence-promoting factor.

    February 16, 2017
    PLoS ONE

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