Behavioral interventions aimed at reducing sexual risk behaviors, such as unprotected sex, are effective at both promoting condom use and reducing sexually transmitted infections (STIs) long after the initial intervention, according to a new report in the Journal of Acquired Immune Deficiency Syndromes. …
…Researchers found that behavioral interventions – which included HIV education, motivation and skills-based training aimed at negotiating safer sex behaviors – were successful at improving condom use and reducing incident STIs, including HIV, for up to four years. This meta-analysis is believed to be the first to examine the incidence of HIV in a wide range of at-risk populations.
Scott-Sheldon says that while it may seem intuitive that behavioral changes, such as increased condom use, will result in fewer STIs, previous studies have been unable to support that assertion.
“The association between behavioral and biological outcomes is complex, since transmission of STIs depends on a number of factors, including partner type, characteristics, and perceptions of partner safety,” she says. “Examining both outcomes, and factors associated with sexual risk behaviors, should be important in determining the efficacy of behavioral interventions.” …
- Behavioral interventions can increase condom use, reduce sexually transmitted infections (medicalxpress.com)
- Behavioral interventions can increase condom use, reduce sexually transmitted infections (eurekalert.org)
- Unsafe Sex More Likely After Drinking, Study Confirms (livescience.com)
- Average man has 9 sexual partners in lifetime, women have 4 (telegraph.co.uk)
- Protecting adolescent girls from unwanted unprotected sex (scienceblog.com)
- The Custom-Sized Condoms Are Now Legally Available [Sex] (gizmodo.com)
- 1 in 4 girls have sex under age (suncda-w8.wpng.newsint.co.uk)
Only One Quarter of Americans with HIV Have Virus Under Control
Nearly 3 out of 4 Americans living with HIV do not have their infection under control, according to a Vital Signs report by the Centers for Disease Control and Prevention.
The Press Release
CDC launches campaign to increase HIV testing so more can access needed care
Nearly 3 out of 4 Americans living with HIV do not have their infection under control, according to a Vital Signs report by the Centers for Disease Control and Prevention, released today in advance of World AIDS Day, December 1. The authors say the low percentage is because 1 in 5 people with HIV do not realize they are infected and, of those who are aware, only 51 percent receive ongoing medical care and treatment.
Of the nearly 1.2 million people living with HIV in the United States, only an estimated 28 percent have a suppressed viral load (defined as viral load less than 200 copies of the blood-borne virus per milliliter of blood) – meaning that the virus is under control and at a level that helps keep them healthy and reduces the risk of transmitting the virus to others.
However, of those living with HIV who are in ongoing care and on antiretroviral treatment, 77 percent have suppressed levels of the virus. Effective HIV treatment and care benefit infected individuals by improving their health, and are also important for HIV prevention. Results from a recent study of heterosexual couples from the National Institutes of Health showed that consistently taking antiretroviral therapy, in combination with safer behaviors, can reduce the risk of spreading HIV by approximately 96 percent.
“While we have known that viral suppression can be achieved with proper HIV treatment and care, today’s new Vital Signs data highlight the challenges our country faces in keeping HIV-positive Americans in the care they need to control the virus,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “By improving testing, linkage to care and treatment services, we can help people living with HIV feel better and live longer, and can reduce the spread of HIV dramatically. This is not just an individual responsibility, but a responsibility for families, partners, communities and health care providers.”
Men who have sex with men (MSM), the population most severely affected by HIV in the United States, are least likely to know they are infected and less likely to receive prevention counseling (39 percent, compared with 50 percent of men who have sex with women and women who have sex with men).
Study authors underscore that improvements are needed at each stage in the overall process of treatment and care. That means increasing the number of infected Americans who are tested, linked to care, remain in care, receive prevention counseling and are successfully treated – all to achieve viral suppression.
“Closing the gaps in testing, access to care and treatment will all be essential to slowing the U.S. HIV epidemic,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention. “HIV testing is the most important first step toward breaking the cycle of transmission. Combined with effective prevention services, linkage to care and ongoing effective treatment, testing provides a gateway to the most effective prevention tools at our disposal.”
New campaign encourages black gay and bisexual men to get tested for HIV
To increase HIV testing rates among one of the populations most affected by HIV, black gay and bisexual men, CDC also launched a new national awareness campaign, Testing Makes Us Stronger. CDC collaborated with gay and bisexual community leaders, physicians and other experts to develop the campaign, which strives to raise awareness, improve access and increase the number of black gay and bisexual men who are aware of their HIV status: the first step to care, treatment and prevention services.
Testing Makes Us Stronger encourages men to “stay strong and informed.” The ads depict a diverse range of black gay men, including individuals and couples. The campaign includes national print and online advertising; a dedicated website and Facebook page; promotion at black gay pride events; and outdoor and transit advertising in gay and African-American neighborhoods in six cities where black gay and bisexual men are heavily affected by HIV – Atlanta, Baltimore, Houston, New York City, Oakland, Calif., and Washington, D.C.
“Black gay and bisexual men across the country are already doing many of the right things to protect themselves – but more need to make HIV testing a regular part of their lives,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention. “Testing Makes Us Stronger was designed by black gay men for black gay men and strives to communicate the power of knowing your HIV status as a first step toward staying healthy.”
Research shows that black gay and bisexual men do not engage in riskier behaviors than other gay men, but are at higher risk for HIV due to the high prevalence of HIV that already exists in many black and gay communities, increasing the likelihood of becoming infected with each sexual encounter.
In addition to increasing testing and ensuring that people with HIV remain in care, CDC scientists stress that proven approaches to risk reduction – such as consistent condom use and reducing the number of sexual partners – among uninfected individuals will also remain critical. In part, because of the substantial amount of HIV transmission that occurs during the early stages of HIV infection, well before diagnosis and treatment can occur.
Testing Makes Us Stronger is the latest campaign of Act Against AIDS, CDC’s umbrella campaign to fight complacency about HIV nationwide. Other Act Against AIDS campaigns include those which focus on African-American women, African-American youth, health care providers and the general public.
More information about the new statistics on viral suppression and Testing Makes Us Stronger is available at www.cdc.gov/nchhstp/newsroom.
CDC works 24/7 saving lives, protecting people from health threats and saving money to have a more secure nation. Whether these threats are chronic or acute, manmade or natural, human error or deliberate attack, global or domestic, CDC is the U.S. health protection agency.
Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journalMorbidity and Mortality Weekly Report, or MMWR. The report provides the latest data and information on key health indicators, such as cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care–associated infections, cardiovascular health, teen pregnancy, asthma and food safety.
- Few Americans with HIV have virus under control – msnbc.com (today.msnbc.msn.com)
- Few Americans with HIV have virus under control (msnbc.msn.com)
- Few Americans with HIV have virus under control (msnbc.msn.com)
- Few in U.S. with HIV have virus under control: CDC (vancouversun.com)
- CDC launches campaigns for increased HIV testing – GoErie.com (goerie.com)
- An update from the Centers for Disease Control and Prevention (CDC) (untiltheresacure.wordpress.com)
- CDC: 240000 Americans have HIV and don’t know it – CBS News (cbsnews.com)
- Most Americans With HIV Don’t Have Infection Under Control (webmd.com)
World AIDS Day was December 1.
However AIDS prevention and treatment goes on each day.
Thirty years of an infectious pandemic, drug research, public health education, and counseling have brought us to the point where we boldly announce the goal of an HIV-free generation in the next three years. This may seem attainable as HIV is a preventable disease. Personal behavior changes will determine the rate of infection. Assuming we will curb behaviors of all people who engage in IV drug use and unprotected sex, especially at a time when economies are struggling, is delusional.
Greece’s troubled economy has seen new infections rise by 52% in 2011, and that rate is expected to increase to 60% by the end of the year. (The US rate of increase is about 7%.) The rate of injected drug use is increasing because people can no longer afford other methods, and there have been heavy cuts to prevention in the form of free needles. …
A new study by investigators from the University of North Carolina at Chapel Hill School of Medicine has confirmed the existence of a “trial effect” in clinical trials for treatment ofHIV.
Trial effect is an umbrella term for the benefit experienced by study participants simply by virtue of their participating in the trial. It includes the benefit of newer and more effective treatments, the way those treatments are delivered, increased care and follow-up, and the patient’s own behavior change as a result of being under observation. …
ScienceDaily (Mar. 18, 2011) — A new study [Abstract***], conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University, is one of the first to explore and demonstrate the impact of electronic record systems on quality of medical care in a developing country….
…This work is particularly significant because of the many medical errors that occur in settings where too few skilled health-care providers deal with a large patient population with critical illnesses. In developed countries, patients with HIV are often seen by infectious disease specialists for their HIV care. In contrast, a large number of HIV-positive patients in resource-limited countries like Kenya are taken care of by clinical officers whose level of training is similar to that of nurse practitioners. The combination of overworked staff with limited training, increasingly busy clinics, the challenges of providing chronic disease management, and the difficulty of keeping up-to-date often results in suboptimal patient care.
Towards electronic healthcare centred on the patient (Science Daily)
A vast computer based glossary of healthcare terms culled from so-called e-health tools, medical news sites, telemedicine applications, home care-management systems, internet-based public health records, and even health-oriented and medical blogs could help improve the relationship between patients and healthcare workers, according to new research.
Rice University scientists refine process at heart of diagnostic bio-nano-chip
Microsponges derived from seaweed may help diagnose heart disease, cancers, HIV and other diseases quickly and at far lower cost than current clinical methods. The microsponges are an essential component of Rice University’s Programmable Bio-Nano-Chip (PBNC) and the focus of a new paper in the journal Small.
The paper by John McDevitt, the Brown-Wiess Professor in Bioengineering and Chemistry, and his colleagues at Rice’s BioScience Research Collaborative views the inner workings of PBNCs, which McDevitt envisions as a mainstream medical diagnostic tool.
PBNCs to diagnose a variety of diseases are currently the focus of six human clinical trials. McDevitt will discuss their development at the annual meeting of the American Association for the Advancement of Science (AAAS) in Washington, D.C., Feb. 17-21.
PBNCs capture biomarkers — molecules that offer information about a person’s health — found in blood, saliva and other bodily fluids. The biomarkers are sequestered in tiny sponges set into an array of inverted pyramid-shaped funnels in the microprocessor heart of the credit card-sized PBNC.
When a fluid sample is put into the disposable device, microfluidic channels direct it to the sponges, which are infused with antibodies that detect and capture specific biomarkers. Once captured, they can be analyzed within minutes with a sophisticated microscope and computer built into a portable, toaster-sized reader.
The biomarker capture process is the subject of the Small paper. The microsponges are 280-micrometer beads of agarose, a cheap, common, lab-friendly material derived from seaweed and often used as a matrix for growing live cells or capturing proteins.
The beauty of agarose is its ability to capture a wide range of targets from relatively huge protein biomarkers to tiny drug metabolites. In the lab, agarose starts as a powder, like Jell-O. When mixed with hot water, it can be formed into gels or solids of any size. The size of the pores and channels in agarose can be tuned down to the nanoscale.
The challenge, McDevitt said, was defining a new concept to quickly and efficiently capture and detect biomarkers within a microfluidic circuit. The solution developed at Rice is a network of microsponges with tailored pore sizes and nano-nets of agarose fibers. The sponge-like quality allows a lot of fluid to be processed quickly, while the nano-net provides a huge surface area that can be used to generate optical signals 1,000 times greater than conventional refrigerator-sized devices. The mini-sensor ensembles, he said, pack maximum punch.
The team found that agarose beads with a diameter of about 280 micrometers are ideal for real-world applications and can be mass-produced in a cost-effective way. These agarose beads retain their efficiency at capturing biomarkers, are easy to handle and don’t require specialized optics to see.
McDevitt and his colleagues tested beads with pores up to 620 nanometers and down to 45 nanometers wide. (A sheet of paper is about 100,000 nanometers thick.) Pores near 140 nanometers proved best at letting proteins infuse the beads’ internal nano-nets quickly, a characteristic that enables PBNCs to test for disease in less than 15 minutes…….
Co-authors of the paper included first author Jesse Jokerst, a National Institutes of Health postdoctoral fellow at Stanford University; postdoctoral students James Camp, Jorge Wong, Alexis Lennart, Amanda Pollard and Yanjie Zhou, all of the departments of Chemistry and Biochemistry at the University of Texas at Austin; Mehnaaz Ali, an assistant professor of chemistry at Xavier University; and from the McDevitt Lab at Rice, Pierre Floriano, director of microfluidics and image and data analysis; Nicolaos Christodoulides, director of assay development; research scientist Glennon Simmons and graduate student Jie Chou.
The National Institutes of Health, through the National Institute of Dental and Craniofacial Research, funded the research.
Read the abstract at http://onlinelibrary.wiley.com/doi/10.1002/smll.201002089/abstract***
The AIDS Education and Training Centers (AETC) Program of the Ryan White CARE Act currently supports a network of 11 regional centers (and more than 130 local performance sites) that conduct targeted, multi-disciplinary education and training programs for healthcare providers treating persons with HIV/AIDS.
The AETCs serve all 50 States, the District of Columbia, the Virgin Islands, Puerto Rico, and the six U.S.-affiliated Pacific Jurisdictions.
The mission of the AETCs is to improve the quality of life of patients living with HIV/AIDS through the provision of high quality professional education and training. The AETC Program is administered by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau.
A few of the Web site’s features
- Trainer Resources with self-study modules, adult learning training designs, teaching methods (including clinical, group, mentoring based) and training materials (as curricula and slide sets)
- Clinician Resources with a manual, support tools (as pocket guide, charts, posters, and patient information)
- Reference Materials with fact sheets, articles, and Web links.
- Approved and investigational HIV/AIDS related drugs
- Three versions of each fact sheet: patient, health professional, and Spanish.
One may search by drug name, drug class, or select drug names from an alphabetical list.
Study highlights urgent HIV prevention needs for men who have sex with men, especially young men and men of color
Excerpts from the US Centers for Disease Control (CDC) news release
“This study’s message is clear: HIV exacts a devastating toll on men who have sex with men in America’s major cities, and yet far too many of those who are infected don’t know it,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “We need to increase access to HIV testing so that more MSM know their status, and we all must bring new energy, new approaches, and new champions to the fight against HIV among men who have sex with men.”
The study’s results bolster key themes in the President’s National HIV/AIDS Strategy for the United States. The recently released strategy states that “the United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men,” and MSM are listed among a few priority populations to focus HIV prevention efforts. The President’s strategy also sets targets for reducing the number of individuals living with HIV who are unaware of their HIV status.
Low awareness of HIV infection a major concern, particularly for younger men
The study provided additional insight into the populations of MSM most in need of HIV testing and prevention:
- Among racial/ethnic groups, black MSM with HIV were least likely to be aware of their infection (59 percent unaware, vs. 46 percent for Hispanic MSM and 26 percent for white MSM).
- While young MSM (under age 30) had lower HIV prevalence than older men, they were far more likely to be unaware of their HIV infection. Among MSM aged 18-29 who had HIV, nearly two-thirds (63 percent) were unaware, versus 37 percent for men age 30 and older.
- Among young MSM, young MSM of color were less likely than whites to know they were HIV-infected. Among HIV-infected black MSM under age 30, 71 percent were unaware of their infection; among HIV-infected Hispanic MSM under age 30, 63 percent were unaware. This compares to 40 percent of HIV-infected white MSM under age 30.
Scientists Make Immune Cells in Mice That Fight Off HIV, but it will be years until this gene therapy is tested in humans.
“According to the scientists, the genetically engineered stem cells went on to create mature immune system cells, such as T-cells, in the humanized mice. After a couple of weeks, these new immune cells appeared to provide protection against HIV. The cells grew greatly in number, offering fewer targets for the virus to attack.”
The study was released online July 2 in Nature Biotechnology.
An abstract of the article may be found here.
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