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HEADLINES

NATIONAL NEWS

UNITED STATES: "US Rate of HIV Testing Still 40 Percent" UNITED STATES: "Efforts to Stem AIDS Increase Get Failing Grade from Activists"

INTERNATIONAL NEWS

GLOBAL: "Wider Treatment of HIV Could Reduce Risk of New Infections" MEXICO: "Vulnerable to HIV, Resistant to Labels" FORMER SOVIET UNION: "Former Soviet States at AIDS Tipping Point: Experts"

MEDICAL NEWS

KENYA; SOUTH AFRICA: "Male Circumcision Could Be Even Greater Boon than Thought" UNITED STATES: "Among Gays, Young Partiers Spread HIV: Study"

NEWS BRIEFS

CARIBBEAN: "Homosexuality Must Be Legal to Beat Caribbean AIDS: Activists" IRAN: "EU Presidency Calls on Iran to Free AIDS Doctors"

NATIONAL NEWS

UNITED STATES:

"US Rate of HIV Testing Still 40 Percent" Los Angeles Times (08.08.08)::Thomas H. Maugh II

CDC researchers reported on Thursday that slightly more than 40 percent of US adults have been tested for HIV. Meanwhile, an estimated 250,000 Americans are believed to be infected but do not know it. "These findings help confirm that new strategies are warranted to increase HIV testing, particularly among persons who are disproportionately affected by HIV infection," the researchers wrote. The data were derived from the National Health Interview Survey, which periodically polls a broad range of persons ages 18 to 64. According to the results, in 1987 only 6 percent of the US population had ever been tested for HIV. By the 1990s, up to 15 percent of Americans tested each year, and the total who had ever tested reached 38 percent by 2000. The total has since remained stable at about 40 percent of the population. The report noted that in 2005, 38 percent of persons newly diagnosed with HIV progressed to an AIDS diagnosis within one year. Late diagnosis both increases the likelihood of the patient spreading the virus and decreases the chance of controlling the infection once drug therapy is initiated. CDC last year allocated additional funds to 23 locales toward the goal of testing an additional 1 million people - primarily African Americans, who are disproportionately infected - and identifying 20,000 more persons with the virus. The report, "Persons Tested for HIV - United States, 2006," was published in Morbidity and Mortality Weekly Report (2008;57(31)::845-849).

UNITED STATES:

"Efforts to Stem AIDS Increase Get Failing Grade from Activists" Palm Beach Post (08.07.08)::Antigone Barton

AIDS activists are mulling the ramifications of CDC's revised estimates of HIV incidence in the United States, which found that 40 percent more people were newly infected each year than was previously believed. Though the report showed a roughly stable US epidemic since the late 1990s, men who have sex with men (MSM) represented a significantly greater proportion of estimated new infections, CDC said. When CDC released the report in Mexico City at the 17th International AIDS Conference, some attendees staged a protest, holding aloft large "F" banners and posters, the grade they said the United States deserves for failing to slow its epidemic. Dr. Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, noted that incidence among MSM had steadily increased since the early 1990s. "It doesn't have to be this way," Fenton said. Among the more than 1 million Americans with HIV, one-quarter are unaware of their infection, representing a "tremendous unmet need," he said. Based on the more accurate data, CDC estimated there were 56,300 new HIV infections in 2006. In response, Fenton said CDC will expand HIV testing; work to engage people in communities at risk; develop a "strategic road map"; and create a national plan to fight the epidemic. A national plan, activists said, should include ending abstinence-only sex education in favor of comprehensive school-based programs; lifting the federal funding ban on needle exchange programs; and ending the ban on HIV-positive immigrants and visitors.

INTERNATIONAL NEWS

GLOBAL:

"Wider Treatment of HIV Could Reduce Risk of New Infections" Business Day (South Africa) (08.07.08)::Tamar Kahn

Some experts this week at the 17th International AIDS Conference in Mexico City spoke of "treatment for prevention," stressing that treating more people with HIV would not only prolong their lives but also reduce their risk of transmitting the virus. "No one is talking about treating our way out of the epidemic, but by treating people you reach two objectives: You save lives and prevent further infections," said Julio Montaner, president-elect of the International AIDS Society. "Modeling suggests expanding antiretroviral therapy by 50 percent would lead to a 30 percent drop in new infections," Montaner said. Last year in the Journal of Infectious Diseases, Montaner and colleagues published a study predicting that universal treatment access in British Columbia, Canada, would cut new HIV infections by 60 percent. "We've known for some time that the expansion of coverage with highly active antiretroviral therapy could help reduce the number of new infections," Montaner said. "However, we were amazed at the actual number of new infections that can be potentially averted by expanding access to treatment." Stephen Lewis, the former UN special envoy for AIDS in Africa, hopes the research will encourage national leaders to do more to promote treatment access. "I spent years begging [African] governments to treat people to save lives," he said. "If I had been able to say not only are you going to be able to keep people alive but you will reduce infection over the long run, there would have been a huge inducement to roll-out treatment more widely." The Community HIV/AIDS Mobilization Project raised doubts about the hypothesis. "The strongest argument for skepticism is the experience of [parts of the United States and Europe] where treatment is relatively widely available, yet HIV incidence remains stubbornly high or even rising," CHAMP said.

MEXICO:

"Vulnerable to HIV, Resistant to Labels" New York Times (08.07.08)::Marc Lacey; Elisabeth Malkin; Lawrence K. Altman

AIDS experts say the challenge of preventing AIDS in Latin American countries such as Mexico, where the 17th International AIDS Conference is taking place, is made far more difficult by machismo and negative attitudes toward homosexuality. HIV/AIDS is concentrated in Mexico among men, particularly those who have sex with other men, "hombres que tienen sexo con hombres," or HSH. HIV prevalence in the general Mexican population is 0.3 percent, while among HSH it approaches 15 percent. Experts say some men live lives of denial and frequently engage in high-risk behavior. Such men are particularly hard to reach in prevention campaigns because they do not listen if they sense the message is geared toward gay men. Dr. Jorge Saavedra, who directs Mexico's AIDS program, said, "I'd say most of the men in Mexico who have sex with men will never recognize that they are gay or bisexual." He added, "It makes our job all the harder since there is so much shame involved." According to Saavedra, Mexico has promoted condom use but not stressed fidelity in its AIDS campaigns because if only the woman is faithful, the man could still become infected by secretly having sex with men. Experts call this the "bisexual bridge." Acceptance of gay relationships in Mexico has increased significantly, as evidenced by the recent law in Mexico City allowing civil unions for gay couples. All the same, prejudice still exists and many gay people live secret lives. Martin Marquez Chagoya, an HIV-positive gay man in Mexico, counsels other men to use condoms and often hears from them that they are not gay and are therefore not at risk. They say they are merely having sex with gays.

FORMER SOVIET UNION:

"Former Soviet States at AIDS Tipping Point: Experts" Agence France Presse (08.06.08)::Richard Ingham

Experts at the 17th International AIDS Conference in Mexico City this week voiced fears that the HIV epidemic could be poised to leap from high-risk groups to the general populations of the nations of the former Soviet Union. While some progress has been made toward providing antiretrovirals to infected persons in the region, prevention efforts face formidable roadblocks. Widespread stigma and homophobia reinforce secrecy about the epidemic. Nearly half the nations in question have official policies or laws that act as impediments to anti-HIV efforts. Needle exchanges, a proven way to fight HIV's spread, are only now getting off the ground. "Some of the work we do can be incompatible with the laws and practices of our countries, " said Farida Tishkova of the Tajik Scientific and Research Institute for Prevention Medicine. UNAIDS reports about 110,000 people acquired HIV last year in Eastern and Central Europe. Of the 1.5 million people with HIV in the region, 69 percent live in Russia, and 29 percent live in Ukraine. In Ukraine, some 8,000 HIV patients are now receiving treatment. But Anna Koshikova, of the All-Ukrainian Network of People Living with HIV/AIDS, said some of the drugs provided are of poor quality. "There's a very high level of corruption in government and non-transparency in [drug] procurement," she said. "It's a huge problem." Stigma and intolerance, Koshikova said, drive many infected Ukrainians from their rural homes into big cities. "When a village finds out that a person has HIV, life becomes very difficult, almost impossible," she said. "Many decide to move."

MEDICAL NEWS

KENYA; SOUTH AFRICA:

"Male Circumcision Could Be Even Greater Boon than Thought" Agence France Presse (08.08.08)::Richard Ingham

Circumcision may offer even more protection against female-to-male HIV transmission than previously revealed, as well as partial protection against human papillomavirus (HPV), researchers said Thursday at the 17th International AIDS Conference. Among 2,784 men who were randomly circumcised or not in a study in Kisumu, Kenya, those circumcised were 60 percent less likely to have acquired HIV than uncircumcised men at 24 months. The intervention was so successful that all uncircumcised men in the trial were offered the procedure. And at 42 months, among the 1,739 participants remaining in the trial, protection was 65 percent, Robert Bailey of the University of Illinois-Chicago told the conference. "These results further support the addition of male circumcision to our limited armamentarium of HIV prevention," Bailey said. In another presentation, researcher Dirk Taljaard reported findings indicating that males in the randomized circumcision trial in Orange Farm, South Africa, were 36 percent less likely to acquire HPV than uncircumcised participants. In addition, circumcision conferred "borderline" protection from the parasitic organism trichomonas vaginalis. It offered no protection against gonorrhea, however.

UNITED STATES:

"Among Gays, Young Partiers Spread HIV: Study" Reuters (08.07.08)::Tan Ee Lyn

Young gay and bisexual men who binge drink and abuse drugs are more likely to transmit HIV to others, partly explaining HIV's growth in that population, US researchers told the 17th International AIDS Conference in Mexico City Thursday. Men who have sex with men (MSM) accounted for 53 percent of new HIV infections in the United States in 2006, according to CDC. Among 200 HIV-positive gay and bisexual US men in the study, 57 percent were receiving treatment for the virus, and half reported unprotected anal sex that classified them as "high-risk HIV transmitters." Three-quarters of the men were white, and more than half were college-educated. In the previous three months, 65 percent had used drugs such as methamphetamine, and a quarter had consumed five or more alcoholic drinks in one day. About 12 percent had been diagnosed with an STD in the past year. "When one drinks or uses other substances, inhibitions are lowered, making people more likely to engage in risky behavior like unprotected sex," said Dr. Kenneth Mayer, an infectious-disease specialist at Brown University. "This is particularly true for young people, who often take risks without thinking about the consequences." "What it shows is the task of prevention is a permanent one. Every generation has to start [learning] again," said Mukesh Kapila of the International Federation of Red Cross and Red Crescent Societies. "Within the community of [MSM], the new generation would not have been through the 1980s and 1990s, and they wouldn't have the high levels of awareness that the previous generations have," he said. "And [they have] the feeling perhaps that treatment is available, that maybe it's not such a fatal condition anymore."

NEWS BRIEFS

CARIBBEAN:

"Homosexuality Must Be Legal to Beat Caribbean AIDS: Activists" Agence France Presse (08.08.08)

The Caribbean, whose HIV/AIDS epidemic is second only to that in sub-Saharan Africa, must decriminalize sex between men to thwart the spread of the virus, experts said Thursday at the 17th International AIDS Conference in Mexico City. Psychologists from Jamaica and Trinidad and Tobago said research shows that half the men in the region have had multiple sexual contacts with other men, while 80 to 90 percent have had same-sex relations at least once. Many are also married with children. "It will not be possible to have effective HIV/AIDS prevention in the Caribbean if we don't decriminalize [sexual] relations between men," said Michael Kleinmoedig, a West Indian journalist and activist. "Human rights are limited for those who have relations with men. They are not recognized as a valid group by law, and many countries silence them and deny them their rights."

IRAN:

"EU Presidency Calls on Iran to Free AIDS Doctors" Agence France Presse (08.06.08)

On Wednesday, the French European Union presidency called on Iran to release two physicians - brothers who are known for their pioneering work in HIV/AIDS. "The presidency of the European Union Council calls on the Iranian authorities to free Arash and Kamiar Alaei and drop all charges against them," said the EU statement, which maintains the men were "arbitrarily arrested." "The Iranian authorities accused the Alaei brothers in a serious manner of activities to destabilize the Islamic Republic," the statement continued. "They are internationally known for their work in the prevention and treatment of AIDS in Iran."

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