UNITED STATES: Washington to Host International AIDS Forum in 2012
Agence France Presse (11.30.09) - Tuesday, December 01, 2009
Ahead of World AIDS Day, the Obama administration announced on Monday that the United States will host the
International AIDS Society's 2012 conference in Washington, D.C. The conference has not been held in the United States for decades because of
the US policy barring entry by HIV-positive visitors and immigrants. In October, President Barack Obama announced that the 1987 ban would be
overturned, effective early next year.
"Today, I'm pleased to announce that, with the repeal of the ban, the International AIDS Society will hold the
2012 International AIDS Conference in Washington, D.C.," Secretary of State Hillary Rodham Clinton said. "This conference will draw together an
estimated 30,000 researchers, scientists, policymakers, health care providers, activists, and others from around the world."
"On World AIDS Day, let us renew our commitment to ensuring that those infected and affected by HIV - the woman
on treatment who is supporting her family, the child who dropped out of school to care for sick parents, the doctors and nurses without
adequate resources - that all those who have joined together to fight this pandemic will someday live in a world where HIV/AIDS can be
prevented and treated as a disease of the past," Clinton said.
Next year's International AIDS Conference will be held in Vienna, followed by Rome in 2011.
INTERNATIONAL NEWS
GLOBAL: WHO: Treat HIV Patients Sooner
Maria Cheng
Associated Press (11.30.09) - Tuesday, December 01, 2009
People with HIV should initiate antiretroviral (ARV) therapy earlier rather than later in order to reduce the
risk of death and disease, the World Health Organization said on Monday.
ARV therapy should begin when a patient has a CD4 threshold of 350 cells/cubic millimeter, regardless of
symptoms, WHO said. In 2006, WHO had recommended that patients begin therapy at 200 cells/cubic millimeter. Since that time, several studies
have shown earlier ARV treatment reduces rates of death and disease, WHO said.
About 4 million people with HIV/AIDS worldwide are receiving ARVs, and 5 million more people are in need of them.
Under the new higher treatment threshold, an additional 3 million to 5 million patients will need the drugs.
HIV-positive pregnant women should also begin earlier treatment to prevent mother-to-child infection, WHO said.
Pregnant women should begin ARVs at the 14th week and continue through the breastfeeding period, WHO said. WHO's 2006 guidelines had
recommended ARVs at the 28th week, or third trimester, and evidence that ARVs could reduce HIV risk during breastfeeding was still insufficient
at that time.
Adopting WHO's treatment guidelines will allow "many more people in high-burden areas to live longer and
healthier lives," said Hiroki Nakatani, WHO's assistant director general for HIV/AIDS, TB, malaria and neglected tropical diseases.
Boosting ARV access in poor countries - especially those with weak infrastructure, limited human and financial
resources, and poor integration of HIV interventions within maternal and child health services - is fraught with challenges, WHO acknowledged.
Even under current guidelines, some African clinics are turning away new patients. Experts say the earlier treatment recommendations could add
billions of dollars to global AIDS-control costs.
In addition, convincing HIV-positive people to begin treatment before they are symptomatic could be
difficult.
GLOBAL: New WHO Guidelines Urge Phase-Out of Major HIV Drug
Stephanie Nebehay
Reuters (11.29.09) - Tuesday, December 01, 2009
New HIV/AIDS treatment guidelines announced on Monday by the World Health Organization (WHO) include phasing out
the use of stavudine (d4T) due to its side effects.
Stavudine has long-term, cumulative and irreversible side effects such as peripheral neuropathy (nerve disorder
characterized by numbness, weakness and burning pain of hands and feet), and lipoatrophy (loss of fat from specific parts of the body). While
its use has declined globally from about 80 percent of people taking ARVs in 2006, about half of patients still are using a d4T-containing
regimen, WHO said.
Marketed by Bristol-Myers Squibb Co. as Zerit in the United States, d4T is manufactured in generic forms by
Indian firms Cipla Ltd., Aurobindo Pharma Ltd., and Strides Arcolab Ltd. Because it is relatively cheap and easy to use, d4T is a widely
prescribed first-line AIDS drug in low- and medium-income countries.
WHO's new guidelines propose that countries "progressively phase out the use of stavudine as a preferred first-
line therapy option and move to less toxic alternatives such as zidovudine (AZT) and tenofovir (TDF)," which are comparable in terms of
efficacy. However, while safer than d4T, AZT and TDF are currently more expensive first-line therapies, WHO acknowledged.
WHO called on countries using d4T to draw up plans to move toward AZT- or TDF-based first-line regimens, based on
the assessment of cost and feasibility. WHO also said it would assist countries in creating phase-out plans that would not jeopardize treatment
access or sustainability.
"[D4T] is the most widely used," said Dr. Siobhan Crowley of WHO's HIV/AIDS department. "There is a trend moving
away from it. We think it will take some time."
SOUTH AFRICA: South Africa Struggles to Provide Medications to All AIDS Patients
Darren Taylor
Voice of America News (11.23.09) - Tuesday, December 01, 2009
Thousands of HIV-positive South Africans have been unable to access free antiretroviral (ARV) therapy because of
inadequate supply, with the worst shortages in Free State province, advocates say.
Lekgotla Nkopane has been taking ARVs for four years, but four months ago nurses told him they had run out of
treatment. He has since been "very sick," he told Treatment Action Campaign (TAC) fieldworkers outside the Manguang Community Health Center.
"This is the first time in four months that the nurses have given me my medicine. But I don't know for how long. I am afraid they will tell me
again, 'Sorry, we have no drugs for you.'"
The story is familiar for TAC's Sello Mokhalipi and Thabo Nkwe, whose cell phones constantly ring with reports of
people falling ill and dying because state facilities are not supplying ARVs. Some provincial health ministries, including Free State's
ministry, deny there are treatment access problems, activists say.
"[But] in our office we have affidavits [by people] who have been neglected, due to the fact of not getting
medication in time," Nkwe said. Provincial authorities "have hated us, because they say we made them look bad," Mokhalipi said.
The national government has allocated an additional 900 million rand (US $120 million) to prevent clinics from
running out of ARVs before April next year. However, TAC says the funds are not enough to prevent deaths, and bureaucracy is slowing their
delivery.
"The damage [caused by] these shutdowns is absolutely phenomenal," said Francois Venter, president of the South
African Clinicians Society. "People die."
"When people don't get drugs and they die, other HIV-infected people say, 'Why should we test ourselves for HIV
if we are going to die anyway?'" said Nkwe. "And so the disease spreads and spreads."
MEDICAL NEWS
UNITED STATES: Stressful or Traumatic Life Events, Post-Traumatic Stress Disorder (PTSD) Symptoms, and HIV
Sexual Risk Taking Among Men Who Have Sex with Men
Sari L. Reisner; Matthew J. Mimiaga; Steven A. Safren; Kenneth H. Mayer
AIDS Care Vol. 21; No. 12: P. 1481-1489 (12..09) - Tuesday, December 01, 2009
The researchers designed the current study to assess "the presence of post-traumatic stress disorder (PTSD)
symptoms in response to stressful or traumatic life events and their impact on HIV risk behaviors and associated psychosocial variables among
men who have sex with men (MSM)."
Notices posted in a community health clinic and a modified respondent-driven sampling technique were used to
recruit participants. A total of 189 MSM signed up, of whom 60 percent were HIV-positive, and completed a behavioral assessment survey. In
assessments using the startle, psychosocial arousal, anger and numbness screening instrument, 60 percent of the men were positive for PTSD
symptoms.
After the researchers controlled for race, sexual self-identification, and HIV status, multivariable logistic
regression analyses "revealed that screening in for having PTSD symptoms was significantly associated with having engaged in unprotected anal
(insertive or receptive) sex in the past 12 months, over and above any effects of whether or not a traumatic/stressful event occurred during
the year (adjusted odds ratio [AOR]=2.72; p<0.02; 95 percent confidence interval [CI]=1.19-6.20)."
Further, MSM with PTSD symptoms were more likely to have clinically significant depressive symptoms (AOR=3.50;
p<0.001) and/or symptoms of social anxiety (AOR=2.87; p<0.01; 95 percent CI=1.48-5.62).
"The current study, in the context of other research documenting the high rates of co-occurring psychosocial
issues facing MSM, points to the importance of incorporating coping with these issues in HIV and [STD] prevention and care interventions," the
authors concluded.
EDITORIALS AND COMMENTARY
UNITED STATES: AIDS Epidemic Is Far from Being Over
Phill Wilson
The Afro-American (Baltimore) (11.24.09) - Tuesday, December 01, 2009
"When I sit down for Thanksgiving dinner with my family, as a person having lived with HIV for 29 years now, I'm
thankful for a lot of things. I'm thankful that I have had the love and support of family and friends, and access to proper medical care that
have kept me alive all these years. I'm thankful that HIV today is diagnosable, preventable, and treatable.
"Today, knowing your HIV status has never been easier. An HIV test today is free, painless, easy, quick, and you
get information that might save your life. I'm thankful about that.
"HIV is completely preventable. The primary mode of HIV transmission in the United States is unprotected sexual
contact. If we all commit to protecting ourselves all the time, we would break the back of the epidemic. So, what does that mean? It means
delaying sexual contact until you are ready, you really know your partner, and you've had a conversation about your hopes and dreams, and about
HIV/AIDS.
"It means, once you know you are both negative, protecting the sanctity of your relationship by being faithful.
And it means being responsible for your own health by using a condom when you engage in sexual contact. While there is no cure for HIV, it is
no longer the automatic death sentence it once was. There are treatments available that can control the virus and help people with HIV live
healthy lives. And the treatments are getting easier to take and less toxic all the time. I'm thankful for that.
"But let's not get it twisted: The AIDS epidemic is far from being over, especially in black communities. So, on
my Christmas list this year, in addition to a cure for AIDS, I'm adding that black America take ownership of the AIDS epidemic. When we are
around 50 percent of people living with HIV/AIDS in America, 50 percent of new HIV cases, and 50 percent of the annual AIDS-related deaths,
AIDS is about our people. It is our problem and we have to be in the leadership in the development of any solution to the issue.
"Black people have been greater than any challenge we've confronted in the past. We were greater than the Middle
Passage. We were greater than slavery. We were greater than the Reconstruction and Jim Crow. We were greater than racism, and we are greater
than AIDS as well."
The author is founder and executive director of the Black AIDS Institute.
NEWS BRIEFS
SWEDEN: Swedish Agency Revises Guidelines for Blood Donors
Deutsche Presse-Agentur (12.01.09) - Tuesday, December 01, 2009
On World AIDS Day, Sweden's National Board of Health and Welfare announced new guidelines that lift the lifetime
ban on blood donations by men who have sex with men (MSM). Effective in March, a waiting period will be introduced that involves only sexual
risks, not sexual orientation. People who have engaged in sexual risk behaviors, including male-male sex and sex with prostitutes, will be
suspended as blood donors for a year. In addition, employees at blood donation centers will be tasked with educating potential donors about the
guidelines and ensuring that they are able to answer health questions.
INDONESIA: Indonesian Islamists Protest Condom Use for Preventing AIDS
Agence France Presse (12.01.09) - Tuesday, December 01, 2009
About 700 members of the Muslim Women of Hizbut Tahrir political party rallied today in Surabaya in East Java,
marking World AIDS Day with calls to prevent HIV/AIDS through the establishment of sharia law. "We have to admit that using condoms is equal to
legalizing free sex," said Febrianti Abassuni, a spokesperson. "We hope that the government stops the program and returns to the application of
sharia," the strict Islamic legal code. The party rally also rejected harm-reduction interventions among drug users. "It has been proved that
harm reduction cannot stop the behavior of drug users and cannot guarantee that they won't share the needles," said Nurul Izzati, another
Hizbut spokesperson. "We also urge the government to close down brothels." Hundreds of Hizbut Tahrir members rallied on Sunday in Jakarta,
Solo, Yogyakarta, and Makassar. Some 270,000 Indonesians have HIV, and the nation has lost about 8,700 people to AIDS, according to
UNAIDS.
FRANCE: Red Ribbons at the Elysee for World AIDS Day
Agence France Presse (12.01.09) - Tuesday, December 01, 2009
Today for the first time, Elysee Palace - the office and residence of President Nicolas Sarkozy - was draped with
red ribbons to mark World AIDS Day. Sarokzy's wife, Carla Bruni-Sarkozy, lost a brother to AIDS and last year became an ambassador for the
Global Fund to Fight AIDS, TB and Malaria. As part of the "Light for Rights" campaign for antiretroviral access, the lights of the Eiffel Tower
will be switched off for five minutes at 1730 GMT - the same moment at which New York's Empire State Building and Brooklyn Bridge will also go
dark.
CALIFORNIA: Bay Area Events Honor World AIDS Day
Seth Hemmelgarn
Bay Area Reporter (San Francisco) (11.26.09) - Tuesday, December 01, 2009
Many events are planned across the Bay Area to commemorate the 21st annual observance of World AIDS Day. On
Tuesday from 2 to 5 p.m., a symposium will mark the 25th anniversary of the University of California-San Francisco's AIDS Health Project. Ilan
H. Meyer of Columbia University's Mailman School of Public Health will give the keynote address at the event in Cole Hall, 513 Parnassus St.;
visit www.ari.ucsf.edu. An ecumenical service of remembrance will be held at 6 p.m. at St. Mark's Lutheran Church, 1111 O'Farrell St. From noon
to 7 p.m., the AIDS Healthcare Foundation will offer free HIV testing at its five Out of the Closet thrift stores in San Francisco, Oakland,
and Berkeley. On Sunday, Dec. 6, the Metropolitan Community Church-San Francisco will welcome guest speaker John Hassell, UNAIDS' Washington
director. The church is located at 150 Eureka St.; visit www.mccsf.org.
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