Recent study compares standard antiretroviral combinations
Female hormone may protect men against HIV infection, researchers say
Utah AIDS Foundation rejects federal prevention dollars
Proposal put forth requiring HIV testing for marriage licenses in the capitol
Recent study compares standard antiretroviral combinations
A recent study published in the New England Journal of Medicine found that a HAART regimen which includes Sustiva (efavirenz) as one of its components is more effective than two other commonly used anti-HIV regimens at suppressing viral loads for those beginning treatment for the first time.
Headed by Sharon Riddler, associate professor of medicine at the University of Pittsburg School of Medicine, the study compared the efficacy of three different antiretroviral combinations among 753 people enrolled in the National Institutes of Health (NIH) AIDS Clinical Trials Group. Three different combinations were studied: one containing Sustiva and two NRTIs, another containing Kaletra (lopinavir/ritonavir) and two NRTIs, and yet another containing Sustiva and Kaletra only (referred to as NRTI-sparing therapy).
At week 96 of the study, Ridder and colleagues found that 89% of the participants taking the Sustiva/two-NRTI regimen had a viral load of less than 50 copies per milliliter of blood, compared to 77% in the Kaletra/two-NRTI arm, and 83% in the NRTI sparing group.
At 112 weeks, the time to virologic failure was significantly longer in the Sustiva group than in the Kaletra group, but not significantly different from that of the NRTI-sparing group. Though it was found to be nearly as effective as treatment with Sustiva/two-NRTIs, NRTI-sparing treatment was also found to be more likely to be associated with drug resistance.
“This is a critically important study,” said Joel Gallant of the Johns Hopkins University School of Medicine (not directly involved in this study) in the Pittsburgh Tribune Review. “[It] really compares what have been considered gold standards [of treatment].”
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Female hormone may protect men against HIV infection, researchers say
Australian researchers Dr. Andrew Pask and Professor Roger Short believe that they may have solved the mystery to blocking HIV infection in men.
By applying estrogen, a female hormone, to the inner foreskin of the penis, these researchers have created what they believe to be a “living condom” for men, providing protection against HIV. They believe their discovery has the potential to cut the global spread of HIV in half.
Estrogen was applied in the form of an estriol cream and works by quadrupling the thin layer of keratin (a protective protein) in the skin.
“By using keratin we can increase the body’s natural defence…and then the virus can’t physically inject itself through that barrier to infect the cells underneath,” said Dr. Pask. He noted that circumcision can provide up to 80% protection form HIV and that estrogen has the potential to fill that gap.
“It’s not a contraceptive,” Professor Short said, “but it is a living condom and a perfect protection against HIV.”
Pask noted that this new discovery could be particularly useful in resource limited places around the world, where circumcision and safe sex are not always feasible. So far, it has proven effective in laboratory tests and will soon move into clinical trials in Africa, the epicenter of the disease. It is the hope of the researchers that it could eventually have application in condoms and in lubricants as well.
Note: Don’t try this at home – estrogen in men has effects such as breast development and shrinkage of the testicles.
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Utah AIDS Foundation rejects federal prevention dollars
According to the Salt Lake Tribune, the Utah AIDS Foundation recently turned down $87,000 in federal prevention funding due to controversy surrounding its prevention ads.
In the past, the organization’s messages have been heavily focused on condom usage to prevent HIV and other STIs. Currently, however, as regulated by the U.S. Centers for Disease Control and Prevention (CDC) by way of the Utah Department of Health, their prevention messages have been labeled as “blander” and focused more on testing, which is considered an effective prevention method by the feds.
“We weren’t talking about using condoms,” said Executive Director Stan Penfold. “We weren’t being blunt [about] what behaviors put you at risk for HIV. It just felt like we were compromising our mission and compromising the population we are trying to serve.”
The HIV infection rate is up 32% already this year in Salt Lake County, compared with the same time last year. The foundation believes that there is a connection between the “blander” approach and the rising infection rate and, according to Penfold, their proposal of an edgier, more in-your-face campaign has been rejected by health department officials. For this reason, they have decided to reject the current funding offer.
Instead, they will seek funding from other sources to support their new prevention programs and campaign, which feature the slogan: “Unleash the Power of the ‘C’” (which stands for condoms).
“The prevention messages we’re using in our nation in general, they’re not working,” Penfold continued. “If we can make [condoms] less of a stigma by making it more fun or more easy to talk about, it will do a great deal in reducing the spread of this [disease].”
An official from the state’s health department, however, denied that the state would reject ads simply for using the word “condom,” unless the content “detracts” from the prevention message.
“Condoms, when combined with testing, are an efficient public health tool,” said public information officer Tom Hudachko. “It’d be pretty silly on our part to have a policy that would restrict anyone from using the word ‘condom.’”
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Proposal put forth requiring HIV testing for marriage licenses in the capitol
Legislation was recently proposed in Washington, D.C. that would mandate couples applying for marriage licenses to be tested for HIV, in addition to already required syphilis testing.
Labeled the Safe Marriage Amendment Act, the proposal is the subject of much debate in the general assembly’s Committee on Public Safety and the Judiciary. Citing issues related to “privacy and liberty,” committee chair Phil Mendelson (D) has recommended that the provision be eliminated, along with the syphilis requirements and a section of the current law which prohibits the “marriage of an idiot or of a person adjudged to be a lunatic.”
Mendelson’s recommendations were included in a report from the committee which has been accepted by The Committee of the Whole, however, this does not guarantee that the amendment will be accepted.
An HIV/AIDS test could save lives, said Yvette Alexander (D), who is an original sponsor of the bill. “You may still marry that person. I think it is for both of you to take…Especially with the epidemic in the District, we would set a precedent.”
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