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World AIDS Day marks 30th anniversary

VALDOSTA – World AIDS Day is a global health event held annually Dec. 1.

The event offers an opportunity for people worldwide to unite in the fight against HIV, show support for those living with HIV/AIDS and to commemorate those who have died, according to area health officials.

Althea Daniels, HIV prevention manager, said World AIDS Day was the first ever global health day and the first one was held in 1988. This year marks the 30th anniversary and South Health District officials hope the infectious disease program will increase awareness and participation to mark the date.

In collaboration with Valdosta State University, the ID program will host a World AIDS Day event 11:30 a.m.-1 p.m. Friday, Nov. 30, VSU in the University Center, Cypress Room.

Cass Marie Downing, HIV activist and advocate, will be the guest speaker, sharing her past struggle with drug addiction and HIV diagnosis.

Downing was diagnosed with HIV during a time when deaths from AIDS had reached an all-time high, health officials said.

“Stigma, discrimination and fear did not stop Cass from living,” Daniels said. “She chose to fight back by becoming an advocate for HIV/AIDS through community work and HIV/AIDS resource centers. We are thrilled to have her as our guest speaker during the 30th anniversary event.”

The Centers for Disease Control and Prevention estimate more than 1.1 million people in the United States are living with HIV today, and only one in seven know it, health officials said. Young people are the most likely to be unaware of their infection. Among people ages 13-24 with HIV, an estimated 51 percent don’t know it, they said.

To empower more people of knowing their HIV status, all county health departments in South Georgia (Ben Hill, Berrien, Brooks, Cook, Echols, Irwin, Lanier, Lowndes, Tift and Turner) will provide free HIV testing, 8 a.m.-5 p.m. Thursday, Nov. 29. No appointment is needed.

Free HIV testing will also be held following the Nov. 30 event at Valdosta State University, 1-2 p.m. in the University Center, Rose Room.

Lunch will be provided during the event; however, people interested in attending must register by calling (229) 245-8711, ext. 288 or 303. Online registration is also available at www.southhealthdistrict.com.

Source: https://www.valdostadailytimes.com/news/local_news/world-aids-day-marks-th-anniversary/article_782df0c5-6f61-533e-967e-2a5c010d5643.html

These Porn Actors Are Working to Destigmatize HIV

With services under threat and effective sex ed still a myth, HIV+ performers like Jason Domino and Hans Berlin are using their platforms to educate and advocate.

Photo courtesy of Jason Domino

The 1st of December marks World AIDs Day, which means the coming weeks will bring an influx of red ribbons and articles commemorating those who died at the height of the HIV/AIDS crisis. Understanding the devastating impact AIDS had on LGBTQ communities in the 1980s is crucial, but there is a tendency to talk about HIV as a thing of the past. It isn’t: around 36.9 million people worldwide were living with HIV/AIDs last year, and there were around 5,000 new infections every day, although mortality rates are thankfully much lower. East and Southern Africa is by far the hardest-hit region (with some countries in the region imposing age restrictions on buying contraception, for example), whereas black, trans and gay male (MSM) people are still disproportionately likely to contract the virus overall. And so HIV education for those vulnerable groups in particular is even more important. But the virus can affect anyone – a fact largely obscured by the homophobic panic of mainstream media, which used the AIDS epidemic to demonise gay men. As a result, HIV+ women in particular are all too often rendered invisible.

In the UK, treatment has advanced astronomically over the last few decades – contraceptive drug PrEP is currently being trialled by the NHS, while ART (antiretroviral treatment) suppresses the viral load of HIV positive people on medication to ‘undetectable’ levels, meaning they can’t transmit the virus even through unprotected sex (you should always rubber up regardless, folks!). However, reports of over-subscription and limited access to those in need are trickling out about the NHS PrEP trial, and it’s not surprising that, while awareness of HIV may be high, understanding is low.

England still doesn’t delivereffective, mandatory sex ed in schools, although Wales and Scotland recently introduced LGBTQ-inclusive lessons. Meanwhile, mainstream media and entertainment treats HIV as either a historical footnote or glosses over the subject entirely – a fact proven once again by the recent Freddie Mercury biopic Bohemian Rhapsody, which arguably neuters his radical legacy by creating a pleasant, ‘safe’ narrative that won’t piss off Middle England – or, of course, hinder its box-office numbers. So, if we can’t trust sex education or a supposedly faithful biopic of an HIV+ icon to tackle the subject, what can we trust? The answer, perhaps surprisingly, is gay porn.

For starters, a handful of HIV+ porn stars have sex on-screen to demonstrate in extreme detail that treatment works. But in addition, performers like Jason Domino build initiatives like The Good Porn Project, which goes a step further by also tackling issues like transphobia and sexual racism. His first porn scene was with an HIV+ partner, Tony Parker, although he wasn’t told beforehand. (“Tony thought I had been told – that’s what had always happened in the past”). Domino admittedly “freaked out,” (“My HIV knowledge was really rubbish back then”) but quickly realised that Parker was undetectable. In other words, Domino needn’t have worried.

Years later, as part of The Good Porn Project, he recreated his original scene with Parker as a kind of educational tool, but Parker had since become detectable again. “I was on PrEP so we knew it would be fine,” recalls Domino, but little did he know the scene was to become somewhat of a landmark. “That actually became the first recorded evidence of PrEP preventing transmission from a detectable partner. We could show right there on-screen that PrEP works.”

This isn’t the first time that Domino has used on-screen fucking to concisely communicate PrEP’s efficacy. A few years ago he founded Porn4PrEP, which fuses sexual health advice and activist toolkits with sex scenes starring HIV+ performers, and continues to advocate for treatment. This wasn’t always the case: when Domino first discovered the treatment he kept quiet until a close friend contracted HIV. Then he realised the devastating consequences of silence. “I knew I wasn’t protecting anybody by keeping it quiet. The guilt that you feel when someone catches HIV and you haven’t been talking about PrEP is so extreme,” he says, his voice stricken with sadness.

There’s no shortage of HIV+ porn performers in the gay porn industry in particular, but lingering stigma and a lack of education means some actors choose not to disclose their status. Hans Berlin, who last year came out during a Grabby awards acceptance speech, puts it this way: “There are still some dumb people in the industry – and that shouldn’t be an insult. There are places in the world, even countries like the United States, which don’t have much sex education, so there are people who are still fearful of HIV+ performers.”

His own entry into porn was unconventional; he came into the industry in his mid-30s after years of pursuing an acting career. “I’m literally that story of the unsuccessful actor ending up in porn,” he laughs. Since coming out he uses his platform to educate and to raise awareness of the fact that HIV+ performers pose no risk if they’re ‘undetectable’. Even if detectable, PrEP can protect: “In the porn industry you can’t really make anyone take PrEP, but if you’re negative and taking it then the HIV status of your partner shouldn’t matter any more.”

Berlin does say he was initially afraid of disclosing his status, but the hate messages he expected never came. Instead, both the industry and the media more broadly welcomed him, warmly. Unfortunately the same can’t be said of his personal life. “I still get it on dating apps,” he laments. “Someone recently asked if I was drug and disease-free, so I told him to read my bio – all the information is in there. He blocked me soon after.”

Terrence Higgins Trust, the leading UK HIV prevention charity, concurs that unconventional approaches to activism work. “We definitely need to be creative in how we get this message out there,” says Marc Thompson, the organisation’s health improvement lead. “We’ve found that the most powerful way of amplifying the message is sharing the stories of couples who know for themselves that HIV can’t be passed on because one of them is HIV+ and on effective treatment, and the other is negative. [Porn activism] is another example of that; if it draws attention to this important message, then great.”

We’re in the middle of a crucial time to keep that activism going. National HIV Testing Week is currently underway, and it’s easier than ever to get home testing kits. It’s important to show that PrEP works, as the reports of NHS trial oversubscription are threatening to undermine progress. Women are also often lacking from these discussions, but organisations like Sophia Forum are aiming to counter this narrative. It may have seemed unthinkable a few decades ago, but HIV is no longer a death sentence; complacency could always change that.

Berlin is hard at work on a musical love story set in the world of gay porn, whereas Domino is a renowned sexual health advocate consistently using his platform – and his experience – to fight stigma. “Education is so fear-led, and that scares people out of being tested,” he says. “Information and empowerment is so much more important and sex workers are doing the work, but sex worker activists don’t get invited to activism awards. We’re the first to disappear from the list. Companies are worried about funding and respectability, they think we inherently damage that. At the end of the day, it’s just discrimination.”

But these are people with lived experience, and their voices matter. HIV+ performers and activists are crucial to the discussion, as are allies with real knowledge of the industry like Domino. Both the media and the government seem reluctant to listen, writing a narrative that’s both dangerously out-of-touch and rooted in a fear of openly discussing sex. “There are so many cultural factors that make it difficult for some people to talk about sex,” admits Domino. “You can listen to your doctor, but that’s really clinical advice. Ultimately it’s about listening to us, because people are talking about sex work without listening to sex workers. There’s something seriously wrong there.”

Source: https://www.vice.com/en_us/article/nepend/hiv-aids-porn-jason-domino-hans-berlin-activism

New UBC pot professor to research potential of cannabis in treating opioid addiction

The $3 million professorship is funded, in large part, by cannabis producer Canopy Growth

M-J Milloy was named inaugural professor of cannabis science at UBC on Friday. (Rafferty Baker/CBC)

The University of British Columbia is getting a new pot professor, thanks to a $2.5 million gift from a major cannabis producer and $500,000 from the B.C. government.

M-J Milloy has been named the inaugural Canopy Growth Professor of Cannabis Science, a position that will carry the branding of the main benefactor but will remain arms-length and independent from the company, according to officials at the university.

It’s a research position intended to lead clinical trials into the potential of using cannabis to help people getting treatment for opioid use disorder.

“I am thrilled. It is sort of a dream that hasn’t sunk in yet,” said Milloy on Friday.

“To have the resources and the security and the freedom to investigate this idea — and hopefully produce evidence to help address the overdose crisis — it’s why I became a scientist,” he said.

Milloy’s office will remain at the B.C. Centre on Substance Use, where he already works as a substance use epidemiologist. His previous research has focused on the connection between illicit drug use and HIV.

‘A renaissance in cannabis science’

According to Milloy, the type of work he plans to carry out has been made immeasurably easier by the legalization of recreational cannabis.

“Legalization has really touched off, I think, what will be known as a renaissance in cannabis science,” he said, adding that ending prohibition has helped make it possible for corporations like Canopy Growth — but also the government — to support the research.

For Canopy’s director of patient education and advocacy, Hilary Black, the death of a close friend to an opioid overdose inspired the contribution.

“This project was actually sparked out of the death of my best friend’s daughter,” said Black. “Right now, this health crisis is screaming for leadership and for investment. And so we decided collectively to step up.”

Hilary Black is director of patient education and advocacy at Canopy Growth — a cannabis producer that donated $2.5 million to research the potential of treating opioid use disorder with cannabis. (Rafferty Baker/CBC)

“With the dawning of legalization, we have much more freedom to actually do the research and Canopy Growth has the economic capacity to make significant contributions like this to Canada,” she said. “That’s exactly what should be happening with the resources from the recreational cannabis industry.”

According to Milloy, if the opioid overdose crises abates, the role of the cannabis science professor can shift to researching how pot can help other substance use disorders, including alcohol and tobacco.

Author: Rafferty Baker

Source: https://www.cbc.ca/news/canada/british-columbia/ubc-cannabis-professor-to-research-opioid-treatment-1.4919245

Grant to put mobile HIV testing unit on local streets

 

The news that OASIS was chosen to receive an Impact 100 grant of more than $100,00 was great news to staff members. It will be even better news to the folks in Walton County whom the OASIS team hopes to reach with the new mobile unit funded by the grant.

In an era when HIV rates are declining and treatment is available, numbers are on the increase in Walton, Okaloosa and Santa Rosa counties among newly diagnosed heterosexual women, studies have shown.

The two leading causes are heterosexual contact and IV drug use. A big risk factor for straight women is having sex with men who may call themselves straight, but also have had sex with other men.

“They’re living a secret lifestyle,” said Kurt Goodman, director of prevention of OASIS, which has offices in Pensacola and Fort Walton Beach.

The solution is simple, though.

“If we could just get everybody tested, we could get everyone treated and we would eliminate HIV,” he said. “There’s no reason for anybody to die anymore.”

The mission of OASIS is to prevent the spread of HIV and support those affected by HIV/AIDS.

One of the agency’s biggest challenges continues to be overcoming the stigma, which makes people reluctant to be tested. Even though the mobile units are unmarked and discreet, people are fearful of being seen going into one.

About one in seven individuals who are living with HIV don’t know they have the virus. That translates to about 1,000 people walking around undetected in the four county area served by OASIS.

If they are treated, they will not pass the virus along to their sexual partners.

That’s been the experience of one Walton County mother and grandmother, who contracted HIV after being raped 14 years ago. It took her four years to go to OASIS for help.

Now, she credits staff there with saving her life, both physically and emotionally.

“OASIS, they go above and beyond,” she said. “They help with rent, the electricity, things that take the stress off your body so the medications can work.”

The mother of a young son, she is also raising her three grandchildren.

“It was very frightening to me when I contracted it 14 years ago,” she said. “It was a deadly disease. It was a life sentence.

“With my medication, I’m undetectable,” she added. “I have as much chance of giving someone HIV as you do.”

The new mobile unit, which will target the needs of Walton County, is being purchased and outfitted. It should be in use early next year.

Author: 

Only 50% of people with HIV seek treatment and here’s why, says AIDS council

AFP pic

KUALA LUMPUR: Approximately 100,000 Malaysians are affected by HIV/AIDS but almost half of them fail to seek treatment due to shame and fear of social stigma despite government initiatives to provide free medication, according to an AIDS body under the health ministry.

The Malaysian AIDS Council (MAC) said some were also in denial or resigned to what they believed to be fate.

“A lot of them probably think they’re going to die anyway, so they don’t bother. Many of them are drug users who might not have stable jobs, and some of them are homeless.

“When you put all the factors together, that’s where you get the 50% of those who don’t get treatment,” MAC president Bakhtiar Talhah told FMT.

Although frontline treatment for HIV, which costs about RM400 a month, is given for free at government hospitals, Bakhtiar said MAC often came across people who refused to seek treatment at the closest medical centre. Instead, he said, they preferred to travel to hospitals further away to avoid running into people they knew.

“There’s still a lot of stigma and discrimination that people with HIV in Malaysia face.”

There are currently some 3,300 reported cases of HIV infections a year, down from 6,000 to 7,000 a decade ago.

The majority of the 3,300 cases were sexually transmitted, although Bakhtiar said the spread of HIV in Malaysia was initially driven by drug use.

“Sex was never the main factor in Malaysia,” he said. “We had a very unique case of the HIV pandemic.”

With initiatives such as needle exchange programmes, which provide drug addicts with clean needles, the number of cases involving HIV infection through needle-sharing dropped by 90%, he said.

Bakhtiar said through MAC’s work on the ground, it had discovered that the urban population was generally more open to HIV/AIDS-related issues than those in rural areas.

“But at the same time, we have been surprised by the acceptance of certain initiatives by those in rural areas,” he added.

“For example, drug use is probably more rampant in rural areas, plantations and fishing communities. But we found that because the family or community lanes are very strong in those areas, they actually support our initiatives.”

Asean deputy secretary-general for the Asean Socio-Cultural Community Kung Phoak meanwhile told FMT he was optimistic about the overall HIV rates in the region.

He said there had been great progress in the area and a drop in the number of people affected by HIV/AIDS.

Bakhtiar, however, was less confident.

“If you’re looking at absolute numbers, we have been able to get the number of infections down,” he said.

“But compared to what other regions have done and how they have performed, we are way behind.”

He told FMT that Asia was in fact the worst performing region in this matter, below Latin America and Africa.

“We have to ask why. What is it that they are doing which we are not? In that sense, there’s still so much for us to do.”

Author: Ainaa Aiman

Source: https://www.freemalaysiatoday.com/category/nation/2018/11/22/only-50-of-people-with-hiv-seek-treatment-and-heres-why-says-aids-council/

Transgender women with HIV struggle to get competent healthcare in South Florida

Arianna Lint, left, is the executive director of a namesake organization that aids transgender people. She and Sophia Kass, an advocate with the Transgender Law Center, were part of a panel in South Beach discussing the Human Rights Watch report released Tuesday.
Arianna Lint, left, is the executive director of a namesake organization that aids transgender people. She and Sophia Kass, an advocate with the Transgender Law Center, were part of a panel in South Beach discussing the Human Rights Watch report released Tuesday. Joey Flechas jflechas@miamiherald.com

Imagine being identified by the wrong gender in the lobby of your own doctor’s office, or having trouble finding a job, or being rejected by your own family, because you are a transgender person.

Doctors should be recommending HIV preventive pills, experts say

Experts believe doctors should take extra steps to help patients avoid HIV, according to a new report.

The U.S. Preventive Services Task Force recently drafted a new set of recommendations that would for the first time urge doctors to offer a daily prophylactic pill to patients at risk of contracting human immunodeficiency virus.

They propose a drug called pre-exposure prophylaxis or PrEP, which can help stop the spread of HIV. It can reduce the risk of catching HIV by up to 92 percent if used consistently, according to the Centers for Disease Control and Prevention.

“The evidence is clear: when taken as prescribed, PrEP is highly effective at preventing H.I.V.,” Seth Landefeld, a USPSTF member, said in a statement. “To make a difference in the lives of people at high risk for HIV, clinicians need to identify patients who would benefit and offer them PrEP.”

The USPSTF also said doctors should be screening all patients, aged 15 to 65, for H.I.V., a recommendation first announced in 2013.

“About 40,000 people are diagnosed with H.I.V. each year. This is why the Task Force, once again, calls for universal screening for H.I.V. in adolescents and adults ages 15 to 65 years and in all pregnant women,” USPSTF member John Epling added. “People deserve to know their HIV status so, if needed, they can start treatment early and live long, healthy lives.”

Here are the patients at high risk of developing HIV, who should be prescribed PrEP, according to the panel:

  • Anyone without H.I.V. who has an H.I.V.-positive sex partner
  • Gay, bisexual or transgender men who have had any recent sexually transmitted infection
  • Gay and bisexual men who do not use condoms consistently
  • Heterosexual or transgender women who do not consistently use condoms with a high-risk sex partner, such as a bisexual man or someone who injects drugs
  • Women who have had a recent STI
  • Injecting drug users who share equipment

They acknowledged PrEP does have side effects, such as kidney problems and nausea, but they said the benefits of the drug outweigh the harms.

The experts also noted that PrEP helps prevent HIV but not other sexually transmitted infections. They said people who take PrEP should still use condoms and practice healthy habits that reduce the risk of other sexually transmitted infections.

Want to know more? Take a look at the full assessment here.

Author: Najja Parker

Source: https://www.ajc.com/news/world/doctors-should-recommending-hiv-preventative-pills-experts-say/UKO0igkv1VLz6Xydgl36rM/

New Research Suggests Optimism for HIV/AIDS

A new model shows a possible end to the HIV/AIDS pandemic in parts of Africa. How can models help lead to eradication — and what are the limits?

FOR A SCIENTIST who studies the spread of HIV/AIDS — one of the worst pandemics on record — Brian Williams is surprisingly optimistic. To date, AIDS, the immunodeficiency syndrome caused by the virus HIV, has killed more than 35 million people worldwide. But Williams, co-founder of the South African Center for Epidemiological Modelling and Analysis (SACEMA), thinks we are close to effectively wiping out AIDS in eastern and southern Africa. This is despite the fact that there are more people living with HIV there than anywhere else in the world.

“We can certainly end AIDS,” he adds. “It is a perfectly controllable disease, let me say.”

In August, Williams and Reuben Granich, an independent public health consultant who has worked on HIV control for more than two decades, published preliminary work that projects the continuing decline of HIV cases in many African countries over the coming years. By 2030, if trends in the use of HIV/AIDS treatments hold, the rate of infection might fall to a key threshold of one in 1,000 people in some of the worst-affected nations. That threshold would, in theory, stop the disease’s spread, Williams says.

“We can certainly end AIDS,” he adds. “It is a perfectly controllable disease, let me say.”

That’s a bold statement, and it’s based on the projections of computer models that look at the interplay between HIV infections and treatments. The models give researchers a target to hit, which is “a great thing to do because it causes us to think, ‘How do we reduce infections?’” says Anna Bershteyn, a senior research manager at the Institute for Disease Modeling. But Bershteyn and other experts are not convinced a one-in-1000 threshold means the epidemic will fade away.



That’s the thing about models: Each offers a slightly different view of the world and none can perfectly predict the future. But for HIV/AIDS, two factors may prove Williams and Granich right. First, access to antiretroviral therapy (ART), a treatment for HIV/AIDS, has greatly improved in parts of Africa. Second, while epidemiological models are nothing new, they are increasingly guiding strategies to curb HIV/AIDS and helping to steer future research and policy.

By looking at disease prevalence and ART availability, the new modeling analysis gives a broad picture of how close we might be to tackling the pandemic. And the models point to optimism.


AIDS REMAINS A troubling pandemic. Last year alone, UNAIDS, the United Nations-sponsored organization which tracks global HIV prevalence and treatment coverage, tallied roughly one million deaths. UNAIDS also says that nearly 37 million people live with HIV worldwide, mostly in developing countries where accurate information about HIV, testing facilities, and treatment may not be readily available. And in some regions — including Eastern Europe, Central Asia, and parts of the U.S. — HIV is on the rise.

That’s the thing about models: Each offers a slightly different view of the world and none can perfectly predict the future.

Despite these numbers, the global rate of new infections each year has been falling — down 16 percent among adults and 35 percent among children since 2010. In particular, HIV infection rates are decreasing in much of Africa, Western Europe, and the Asia Pacific region. More people also have access to ART than ever before.

Models can use all these data to help show possible outcomes for the disease, says Kate Mitchell, an epidemiologist at Imperial College London. To build a specific HIV model, for example, researchers could look at regional data on how often people have unprotected sex, the uptake of testing and treatment, and the current number of known infections.

“What we’re often trying to do is predict into the future,” Mitchell says, by asking: “What would happen if we keep doing pretty much what we’re doing now? What would happen if we increase testing or treatment? What would happen if people’s behavior changed in a particular way?”

The new modeling by Williams and Granich zooms in on a few key African regions, pulling data on the current prevalence of HIV as well as local policies. Specifically, they look at the availability of ART and whether the drug can help end AIDS in the regions (fully eradicating HIV is another matter, as the virus can persist for many years in someone who has it). While ART isn’t a cure, it can stave off AIDS. The drugs can also make HIV undetectablein an infected person and prevent them from transmitting the virus to others.

In nations with solid access to ART, such as Kenya, Tanzania, and Uganda, Williams and Granich think HIV infections can be brought to that key threshold — one case in every 1,000 people — by 2020. Southern African countries that have had lower ART access might expect to reach the same point by 2030. This means fewer people would die from AIDS in Africa and HIV would not be transmitted so easily, so long as people with infections continue taking the drugs. And if southern African countries increase access to ART, there will be tangible benefits: Many thousands, if not millions, of lives might be saved.

In an earlier model, published in 2009, Williams, Granich, and others projected an outcome that never happened: meeting the one-in-1000 threshold by 2016. In this model, they looked at the same parameters — HIV prevalence and ART availability — but expanded it across the world, rather than focusing on smaller regions. They also assumed a hypothetical strategy with wider distribution of ART than actually happened. Other researchers called the work “blue skies thinking,” and while the “precise predictions were very optimistic,” says Mitchell, the model helped change “people’s opinions about what we could do going forward.”

The new analysis is “carefully grounded in data,” adds Mitchell, who was not part of the research team. What’s new about the latest effort is that it focuses on key nations in Africa where the availability of ART has improved and where the cost has come down. The researchers also compared the model projections to the actual rate of new infections and found they were largely in agreement.

But the new model still relies on an optimistic assumption: the expanding provision of ART. For some regions, this will be possible. In eastern Africa, many countries are already at the one-in-1000 mark or on track to meet it. South Africa has offered ART to all people with HIV since 2016 and now has more patients on ART than any other country. But such interventions cost money, and other southern African nations, such as Swaziland, have limited budgets and have been relatively slow in tackling HIV/AIDS.

Still, as with the 2009 paper, the new model could push policy in a positive direction. According to Williams and Granich, the global annual cost of HIV/AIDS treatment is approximately $40 billion. If public health officials can get more people on ART, keep the remaining 35 million HIV-positive individuals on the drugs, and get the cost of those drugs to $100 per person per year worldwide, that cost would drop to $3.5 billion.

That’s all very well, says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) in the U.S., but he points out that models can only ever be as good as the assumptions or data one puts into them. While models can inform decision-making, Fauci adds, public health agencies must also take a pragmatic approach — and pull even more data from the ground.


DESPITE THE LIMITATIONS, some models do reflect reality — and influence policy. Models have, for instance, helped improve guidelines on ART distribution — policies that will be key in realizing the projections made by Williams and Granich. In 2014, Mitchell co-authored a major study that looked at what might happen if a broader group of HIV patients in South Africa, Zambia, India, and Vietnam had access to ART as a result of relaxing guidelines for initiating treatment.

As their disease progresses, people with HIV have lower numbers of certain types of white blood cells that are essential to the human immune system and the exact count can help gauge the severity of their infection. Previously, guidelines from the World Health Organization (WHO) said only people with HIV who had a white blood cell count of 350 or lower should have access to ART. Mitchell and her colleagues modeled the effects of raising the threshold to 500 or removing it altogether. They found that the shifts were both cost-effective and provided significant health benefits. The WHO now recommends that countries offer ART to all people with HIV, regardless of their white blood cell count.

Nearly 37 million people live with HIV worldwide, mostly in developing countries.

Andrew Phillips, an epidemiologist at University College London, says the paper influenced the policy. “It would certainly not be right to suggest that modeling has been the only reason for introduction of these policies,” he says. “But I think it has been one essential element.”

In some cases, data can provide unexpected insights into a new strategy. Bershteyn, of the Institute for Disease Modeling, and her colleagues, modeled the policy of offering ART to everyone who is HIV positive, regardless of their white blood cell count. The model showed that even if you discount the direct medical benefit of ART, which raises white blood cell counts, it was still better to offer the drugs to everyone because it meant more people would come to take HIV tests and engage with health clinics. That alone changed behavior so that more people got treatment, says Bershteyn, which “was the crucial thing.”

Insights like that can drive policymakers to take models seriously and may even help convince politicians to address epidemics such as HIV, says Rachel Baggaley, coordinator of HIV testing and prevention at the WHO.

Modeling can also allow recommendations to be neatly targeted to specific places. Take Russia, where the HIV epidemic is growing. The rate of new infections rises between 10 and 15 percent every year. Starting in 2010, a main route for transmission — injection drug use — got worse after the number of needle exchanges in the country fell from 80 to just 10 due to funding cuts. A study published in The Lancetin July used a model to explore the dynamics of HIV in Omsk, Russia. The authors found that by scaling up needle exchange programs and ART recruitment, among other things, the rate of new HIV infections in the city could be halved within a decade.

Not all of the insights gleaned by modelers get to influence policy. Baggaley points out that governments are not always willing to engage with the problem regardless of well-researched predictions. Even when the will is there, it takes a long time, and often millions of dollars, to put new recommendations into practice. Still, modeling analyses like the new one from Williams and Granich may show a way to end one of the most persistent pandemics in history.

New Research Suggests Optimism for HIV/AIDS

Aspirin could reduce HIV infections in women

With nearly two million new infections and one million associated deaths each year, the HIV (human immunodeficiency virus) pandemic is alive and well.

Thirty-seven million people are now living with HIV, more than half of whom are women.

Today, most HIV transmission occurs through sex.

 Fortunately, you can protect yourself and others by keeping HIV away (abstinence, condom use, circumcision) or by inactivating HIV (microbicide gels or a combination of prophylactic anti-HIV drugs such as PrEP).

However, these methods are not always feasible for many and can come with stigma.

Imagine though, if instead of targeting the virus, we could make people less susceptible to HIV and address the needs of communities by using a relatively safe, affordable and globally accessible drug with no associated stigma.

This is where Aspirin comes in.

It may sound like a fairy tale, but results from our lab’s pilot study published last month suggest it may be true. Plus, there’s good science behind the explanation.

Aspirin reduced HIV ‘target cells’

The idea comes from a partnership with a community of women in Nairobi, Kenya over more than 30 years.

This relationship has led to establishment of a clinic which provides almost 50,000 sex workers with disease prevention and treatment resources, and is often referred to by the WHO and UNAIDS as a model of best practices.

Remarkably, many of these women are naturally resistant to HIV, at least in part because they have very little inflammation in their blood and genital tract.

This is important because inflammation can increase HIV infection by 1) recruiting immune cells to the site of inflammation, including the cells that HIV loves to infect—so-called HIV “target cells” and 2) activating these HIV target cells, which increases their susceptibility to viral infection and enhances HIV’s ability to replicate within them.

The major question posed by our study was this: as an anti-inflammatory drug, could Aspirin reduce the number of HIV target cells and make them less activated?

To answer this question, our lab quantified HIV target cells in the blood and vagina of 37 Kenyan women before and after taking Aspirin for up to six weeks.

The results, published in the Journal of the International AIDS Society, show that aspirin reduced the frequency of vaginal HIV target cells by approximately 35 per cent and made them less activated.

As a bonus, Aspirin seemed to increase the structural integrity of the skin in the vagina, which could also prevent HIV infection by further restricting HIV’s access to more target cells in the blood.

We also tried another anti-inflammatory drug called hydroxychloroquine (HCQ).

HCQ is less well known than Aspirin, but used to be a popular treatment for malaria and is now used to treat autoimmune diseases such as rheumatoid arthritis.

HCQ also seemed to reduce inflammation in the vagina, but in a slightly different manner.

First drug to target the host

PrEP (a daily treatment of anti-HIV drugs used for prevention) is often used in the form of a vaginal gel, but does not work for women who have genital inflammation.

The next step will be a clinical trial testing whether Aspirin can reduce inflammation in women using PrEP and thereby reduce the number of HIV infections in women at high risk for HIV, such as female sex workers.

This population has been asking about future research plans focusing on using Aspirin to prevent HIV.

If we can demonstrate this, Aspirin would be the first drug that targets the host, rather than the virus, to prevent HIV.

By acting on the host rather than the virus, Aspirin is not prone to generate HIV resistance, since there is no selective pressure for HIV to evolve around.

We are not yet at the stage where Aspirin can be recommended for preventing HIV, but the potential for another tool in our belt against a virus that has killed 35 million people (almost the population of Canada), can only be good news.

Especially one as safe, affordable, accessible and non-stigmatizing as Aspirin.

Written by Colin Graydon PhD Candidate in Medical Microbiology, University of Manitoba; Monika Kowatsch PhD Student in Medical Microbiology, University of Manitoba

Source: The Conversation.

Aspirin could reduce HIV infections in women

Thousands of Canadians are living with HIV, and they don’t even know it

More testing, and better access to it, are keys to fighting Canada’s hidden HIV epidemic

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More than 9,000 Canadians are estimated to be living with undiagnosed HIV, and this is where most new infections originate, writes Laurie Edmiston. – ake1150sb , Getty Images/iStockphoto

Earlier this year, I witnessed a profound historic moment at the International AIDS Conference in Amsterdam. Dr. Alison Rodger, a leading HIV researcher in the United Kingdom, presented the final results from a study of couples with one HIV-positive and one HIV-negative partner. After eight years of the study, she reported, there were zero cases of HIV transmission from one partner to the other — thanks to the prevention benefits of modern HIV medications.

The evidence has been mounting for years. Several large clinical trials have confirmed that HIV treatment can suppress the virus so successfully that sexual transmission doesn’t occur. Three-quarters of Canadians diagnosed with HIV have already achieved this level of viral suppression, and this number could grow even further by linking people to treatment and care. The reality is that most Canadians who are living with HIV today can’t pass the virus on to their sexual partners.

So if most Canadians living with HIV can’t pass it on, why are there still more than 2,000 new infections in our country every year? Research tells us that most HIV transmissions originate from people who think they are HIV-negative but have recently contracted the virus — the undiagnosed. There are a few reasons for this.

First, when someone acquires HIV the virus is circulating through the body at its highest levels, making them more likely to pass it on. Second, a person who has been diagnosed is more likely to take measures to prevent passing it on to their partners. And finally, we now know that an HIV-positive person on effective treatment does not transmit the virus sexually.

More than 9,000 Canadians are estimated to be living with undiagnosed HIV, and this is where most new infections originate. To effectively respond to this hidden HIV epidemic, we must focus our efforts on expanding access to testing.

Yet across the country, barriers remain. Many people have never been tested for HIV, or don’t test as often as they should. Sometimes this is because they don’t perceive themselves to be at risk, sometimes it is because of the stigma around HIV, and sometimes it is because testing clinics are difficult to access.

Some places in Canada and abroad have shown us how we can do better. In British Columbia, an online service allows people to order routine HIV tests online and submit samples directly to a lab, bypassing clinic lineups. In Saskatchewan, routine HIV testing is offered for all teenagers and adults every five years through both primary and emergency health care. Dried blood spot testing has been introduced in some First Nations to overcome some of the barriers to drawing blood and transporting samples from rural and remote locations. In the United Kingdom, free HIV self-testing kits can be delivered to your mailbox, and many regions and countries have employed community educators to offer HIV tests to their peers, free of stigma and judgment. These initiatives have only been possible with the support and funding of governments committed to ending their respective HIV epidemics.

We have seen shining examples from communities across the country and around the world making great strides to reach the undiagnosed. Yet at a national level, Canada is falling behind other countries in the adoption of these approaches, and this has meant slow progress in reaching the undiagnosed — and a greater likelihood of new infections continuing unabated.

This World AIDS Day, I urge governments and leaders to take their calls for awareness one step further and turn them into action. Let’s do more than encourage testing. Let’s make it possible.

Laurie Edmiston is executive director of CATIE, Canada’s source for HIV and hepatitis C information.

Author: Laurie Edmiston

Source: https://www.thespec.com/opinion-story/9046236-thousands-of-canadians-are-living-with-hiv-and-they-don-t-even-know-it/