8 January 2016 VOLUME 17 ISSUE 1

But a survey of 600 doctors found that more than one-third don't actually recommend it, according to the Associated Press. The reason? They don't want to talk about sex.

How far the field of microbicides has progressed...is a pipeline half-full, half-empty situation....Only one trial of a topical vaginal microbicide to date showed any efficacy and follow-up studies have failed to confirm the candidate's protective effect....Yet the microbicide pipeline remains quite robust with attention now focused on new formulations that are less user-dependent.

Gilead Sciences said its once-daily experimental hepatitis B drug was found to be as effective as its approved drug, Viread, in two late-stage studies. The drug, tenofovir alafenamide, or TAF, also showed improved renal and bone safety compared with Viread. Gilead plans to submit regulatory applications for TAF in the United States and the European Union in the first quarter of 2016.

New infections in the country have skyrocketed...but HIV prevention is a difficult undertaking in Cebu City, which has plenty of places to go shoot up on Nubain or “milkshake” (an injectable combination of Nubain and crack cocaine) but few places to access a clean needle....The city’s drug problem is creating a sort of ripple effect, increasing the risk of infection for non-IV-drug users as well.

The state of the epidemic is improving. It is not really one epidemic, however, but a loose collection of smaller epidemics among various risk groups, including MSM and in particular black MSM, injection drug users (IDUs), and women of color.

Nucleoside reverse transcriptase inhibitors can be safely omitted from HIV salvage therapy, investigators from the United States report in the Annals of Internal Medicine. The findings come from a randomised study conducted between 2008 and 2011....The study may not be applicable to resource-limited settings because of the high cost of resistance and tropism testing.

A pivotal clinical trial of a novel HIV vaccine regimen is expected to get underway in South Africa during 2016. Some 252 HIV-free South Africans between ages 18 and 40 are to get the HVTN 100 experimental regimen....Pre-clinical trials suggest that it may confer at least 50% protection against the acquisition of HIV. The...findings generated from the trial will help determine whether this vaccine regimen will be tested in a larger study.

The Texas state health department has elected not to renew a nearly 30-year contract providing HIV prevention funds to Planned Parenthood Gulf Coast....The contract — which totaled $618,227 in 2015 — is provided by the CDC to the state health department.....Since Planned Parenthood Gulf Coast’s HIV program was established in 1988, it has conducted 138,000 HIV tests and identified 1,182 people with infection in several affected counties.

Margaret Thatcher attempted to block explicit, public health warnings about AIDS because she feared the proposed descriptions of “risky sex” would do immense harm to young teenagers. Objections raised by the prime minister and older cabinet colleagues in the 1980s may appear inappropriate now but reflect public reluctance at the time to acknowledge that the UK was facing a major epidemic.

1. The fight against HIV and AIDS took a huge step forward in 2015 when researchers at the Scripps Research Institute developed a vaccine that was incredibly effective against HIV-1, HIV-2 and simian immunodeficiency virus. The key difference here is the new HIV vaccine actually alters DNA to fight off the virus....The research is still in early stages, but results thus far are extremely promising.

The Chief Medical Officer of England has warned of an antibiotic resistant strain of gonorrhea reemerging in the industrial city of Leeds...Other cases of the superbug have cropped up internationally, with Australia, Japan, and Canada all reporting cases within the last three years....Peter Leone, an epidemiology professor at the University of North Carolina in Chapel Hill,...dismisses the more apocalyptic assessments.

Targeted, multilevel strategies are needed to reduce risk behaviors among young MSM living with HIV, particularly among those with a detectable viral load, according to a study in JAMA Pediatrics.

Immunogeneticists specializing in immunoglobulin GM genes monitored for immune responses that could limit the effectiveness of the broadly neutralizing antibody VRC01 in HIV-infected individuals in a phase 1 trial of that antibody in HIV-infected individuals led by a team at the National Institute of Allergy and Infectious Diseases....The trial...showed that a single infusion of the VRC01 antibody could suppress the blood plasma level of HIV in infected individuals not taking antiretroviral therapy.

In one of the most tightly controlled trials ever conducted of drugs used to treat sexually transmitted infections, University of Alabama researchers...compared the two most commonly used medications for urogenital chlamydia -- a single dose of azithromycin versus doxycycline twice daily for seven days.....[The] study confirmed that azithromycin should be considered a front-line therapy, especially when drug adherence is a factor.

As the...UN Millennium Development Goals...[are] replaced by the Sustainable Development Goals, deeper analysis...is necessary....The case of South Africa...suggests that success is partly determined by how the goal was formulated. In South Africa, under-five mortality was already low in 1990, but increased as the HIV epidemic emerged. Thus, despite considerable mortality reduction in the last 10 years, South Africa saw no appreciable change between 2015 and the beginning of the MDG period.

Some AIDS organizations don’t promote use of the drug, partly out of concern it could encourage more risky sexual behavior. “We are having an explosion of other sexually transmitted diseases impacting the gay community and PrEP offers no protection whatsoever for any other disease,” said Ged Kenslea, communications director for AIDS Healthcare Foundation, a Los Angeles-based global AIDS organization.

The US Department of Health and Human Services (HHS) released their annual report—Advancing LGBT Health & Well-being—which highlights substantial advances in health initiatives for LGBTQ people and their families, as well as outlining HHS objectives in LGBTQ health care for 2016.

Scientifically feasible vaccines against major diseases are stalled for lack of funds. Science names 10 top candidates that need a boost.

Cross-continent collaboration in the sciences has become the norm. We must ensure that disadvantaged regions are not left out....There must also be broader awareness that, just as there is more to research than papers, there is more provided to a partnership than conventional resources such as cash and equipment.

The Investment Framework Enhanced (IFE) proposed in 2013 by UNAIDS explored how maximizing existing interventions and adding emerging prevention options, including a vaccine, could further reduce new HIV infections and AIDS-related deaths in low- and middle-income countries (LMICs).

Increased anal and penile high-risk HPV (hrHPV) incidence rates and decreased anal hrHPV clearance rates were found in HIV-infected compared with HIV-negative MSM, after adjusting for sexual behavior. Our findings suggest an independent effect of HIV infection on anal high-risk HPV infections.

The Lancet (Oct 10) stated that the new WHO antiretroviral therapy guidelines are based on trials that “showed promising, but modest, benefits for affected individuals, and for reducing HIV transmission following early treatment initiation”. The benefits are not modest....The Lancet also labelled the guidelines “ambitious” and questioned whether ART as a prevention means can be done at scale....The accompanying editorial in The Lancet HIV similarly missed the potential benefits and listed the challenges instead.

We examined outcomes of ART patients decentralized to community-based adherence clubs (CACs) in Cape Town, South Africa and compared these to patients managed in the community health center. CAC participation was associated with a 67% reduction in the risk of LTFU compared with community health centre, and this association persisted when stratified by patient demographic and clinic characteristics. Community-based models represent an important development to facilitate ART delivery and possibly improve patient outcomes.

The HVTN 907 study identified a high-risk cohort of women with excellent retention for all 3 sites, despite major challenges, especially in Haiti. These results show that a bridging study of a vaccine shown to be efficacious in other clade settings would be possible among FSWs in the region, particularly in Haiti.

A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for young adults living with HIV (YLWH) was more effective in achieving and sustaining remission from depression than treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics to successfully treat YLWH, who are at particular risk for depression.

Most respondents were nurses and female, from public clinics, and had received formal STI training. Most correctly identified all common STI syndromes....However, almost none correctly identified the most common etiologies for all 3 of these syndromes...and very few correctly answered the 14 basic STI knowledge questions. Providers reporting formal STI training were more likely to...answer correctly... compared with those not reporting STI training. Several providers reported negative attitudes about patients with STI.

Although I share the impatience of Kuhn and colleagues to accelerate implementation of new HIV prevention methods, particularly for young women,...their criticism of the importance of replicating results from randomised controlled trials is misplaced. Their argument concerns studies of tenofovir gel....Rather than considering these trials as “disastrous, because their results now cast inappropriate doubt on the preventive effects of tenofovir”,...we have learnt a great deal....There are grave dangers in using a product of uncertain efficacy to prevent HIV infection.

In the wake of reports of an HIV cure for Timothy Brown (the Berlin patient) after two haemopoietic stem cell transplantations from a donor homozygous for the CCR5Δ32 mutation, at least four other individuals have had antiretroviral therapy (ART) stopped as analytical treatment interruptions after similar procedures....The clinical outcome after each of these interruptions has been disappointing, with pronounced viral rebound and associated morbidity.

Tenofovir disoproxil fumarate [TDF] is generally well tolerated clinically but is associated with effects on the kidney and bone. Tenofovir alafenamide [TAF] more efficiently delivers tenofovir to target cells resulting in lower plasma and kidney exposures. Clinical studies have shown tenofovir alafenamide has reduced impact on markers of renal function and bone mineralization.

We tested participants’ oral fluid for HIV using OraQuick monthly and blood using a nucleic-acid amplification test (NAAT) every 3 months. The oral fluid HIV test performed well at screening, suggesting it can be used when rapid results and non-invasive tools are preferred. However, participants receiving tenofovir took longer to develop a reactive oral fluid test result than those receiving placebo. Thus, among people using pre-exposure prophylaxis, a blood-based HIV test may be an appropriate choice.

For media members and public communicators of many kinds it is imperative to do more than just read study abstracts; understanding the methods and concepts that underpin academic studies is essential to being able to judge the merits of a particular piece of research...Knowing the basic language can help in formulating better, more critical questions for experts, and foster deeper thinking, and skepticism, about findings.

Many HIV patients on cART exhibit HIV-associated neurocognitive disorders because the brain becomes a viral reservoir. There is a need for therapeutics that can enter the CNS and eradicate the virus....We demonstrated that [radiolabeled human] Bi-2556 mAb crossed an in vitro human BBB [blood brain barrier] and specifically killed transmigrated HIV-infected PBMCs and monocytes without overt damage to the barrier.