Meet 4 of IRMA's new Steering Committee Members - Latifa Boyce, Dr. Jorge Sanchez, Cindra Feuer and Dr. Alex Carballo-Dieguez - Friendly Rectal Microbicide Advocates all. Click here to read their bios. They are part of IRMA's 23-member Steering Committee, many of whom just joined in February 2009.
Read more about HPV on the IRMA blog.
Also of interest:
Anal cancer prevention: how we are failing men who have sex with men
via Washington Post, by Rob Stein
When a vaccine designed to protect girls against a sexually transmitted virus arrived three years ago, the debate centered on one question: Would the shots make young girls more likely to have sex?
Now the vaccine's maker is trying to get approval to sell the vaccine for boys, and the debate is focusing on something else entirely: Is it worth the money, and is it safe and effective enough?
"We are still more worried about the promiscuity of girls than the promiscuity of boys," said Susan M. Reverby, a professor of women's studies and medical history at Wellesley College. "There's still that double standard."
by A. Carballo-Diéguez, A. Ventuneac, J. Bauermeister, G. W. Dowsett, C. Dolezal, R. H. Remien I. and Balan M. Rowe, January 2009,Culture, Health & Sexuality.
The terms bareback and bareback identity are increasingly being used in academic discourse on HIV/AIDS without clear operationalisation. Using in depth,face-to-face interviews with an ethnically diverse sample of 120 HIVinfected and -uninfected men, mainly gay-identifying and recruited online in New York City, this study explored respondents’ definitions of bareback sex, the role that intentionality and risk played in those definitions, and whether respondents identified as ‘barebackers’. Results showed overall agreement with a basic definition of bareback sex as condomless anal intercourse, but considerable variation on other elements. Any identification as barebacker appeared too loose to be of use from a public health prevention perspective. To help focus HIV prevention efforts, we propose a re-conceptualisation that contextualises risky condomless anal intercourse and distinguishes between behaviours that are intentional and may result in HIV-primary transmission from those that are not.
Read the full article here (housed on the IRMA website.)
Beep beep, heyyyy, TWEET TWEET.
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through March 31, 2009. We have received a lot of great submissions already - is yours among them?Beep beep, heyyyy, TWEET TWEET.
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There is also a "recurrent" myth that there is one "silver-bullet" solution to HIV prevention; however, "no approach will be enough on its own, and the promotion of one solution is ... irresponsible," the authors write. They continue that another "prevailing" myth is that there is little heterosexual transmission of HIV outside Africa and note that HIV transmission among women is rising worldwide, with "[m]ethods of transmission and affected groups" being "many and varied."
"Nearly 30 years into the AIDS epidemic, we are able to access our progress in tackling the disease with both increased knowledge and the benefit of hindsight," former UNAIDS Executive Director Peter Piot of Imperial College London, who also serves as an adviser on global health strategy to the Bill & Melinda Gates Foundation; Michel Kazatchkine, executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria; Mark Dybul of the O'Neill Institute for National and Global Health Law at Georgetown University and former U.S. Global AIDS Coordinator; and Julian Lob-Levyt of the GAVI Alliance write in a Lancet opinion piece. They add that the piece aims to examine "what we -- the international community -- got right, what we got wrong, and why we need to urgently dispel several emerging myths about the epidemic and the global response to it."
According to the authors, when "HIV was emerging in the early 1980s, we clearly underestimated the global effect that the disease would have, and that in only a few decades, tens of millions of people worldwide would become infected." They add, "The epidemic nowadays is the result of what 30 years ago was an unpredictable -- but tremendously potent -- combination of intimate personal behaviors ... and socioeconomic factors ... that have affected nearly every country worldwide." In addition, the international community underestimated "the extent to which stigma and discrimination -- against people living with HIV/AIDS and those most vulnerable to it -- would remain formidable obstacles to tackling AIDS," the authors write, adding that the "sense of urgency and solidarity that would eventually develop in the global AIDS epidemic, leading to an unusual convergence of political will, money and science" also was underestimated.
Other aspects of the HIV/AIDS pandemic were overestimated, the authors write. They add that despite innovations and successes regarding antiretroviral treatment, "we have also overestimated our capacity to devise technological solutions to prevent HIV," and "continued investments in new prevention technology remain a crucial part of the AIDS research agenda."
The author's point to the common myth that HIV prevention has not been successful overall -- which they say is contradicted by evidence it has been effective in several countries, adding that prevention is about behavior in addition to technology. They add that sustaining changes in sexual behavior "remains a major challenge," citing the possible "complacency about AIDS and the sense that a treatable disease is somehow less threatening than are other diseases."
There is also a "recurrent" myth that there is one "silver-bullet" solution to HIV prevention; however, "no approach will be enough on its own, and the promotion of one solution is ... irresponsible," the authors write. They continue that another "prevailing" myth is that there is little heterosexual transmission of HIV outside Africa and note that HIV transmission among women is rising worldwide, with "[m]ethods of transmission and affected groups" being "many and varied."
The authors write, "Alarmingly, a myth has begun to emerge that too much money is spent on AIDS," as countries face new financial difficulties while "competing for the attention of political leaders and donors." The myth that investments in AIDS efforts have been at the expense of underfunded health systems also needs to be dispelled, the authors write, adding that funds for HIV/AIDS efforts "are making a major contribution to the strengthening of health systems." The authors also address the myth that HIV/AIDS "has somehow been solved, writing, "We need to recognize that AIDS is a long-term event. Tackling it is complex, but our successes so far indicate what is possible." Increased efforts to examine epidemiological trends, "develop long lasting links with broader efforts to strengthen health systems and health workforces," continue investment in research, and make a "serious, concerted effort" to address stigma and discrimination are needed to "be anywhere close to the point at which we can truthfully say the fight against AIDS is being won" (Piot et. al, Lancet, 3/20).
While IRMA is right on time when it comes to rectal microbicide research and advocacy, if we must say so ourselves, we have been a little late to arrive at the Facebook party. Well, dilly dally no more. Thanks to IRMA member extraordinaire Bill O'Brien of Boston, we now have a Group listing on Facebook. YEAH!! Thanks Bill for bringing us into 2009!
Online on subject of the Pope and Condoms in Africa. I introduce it with a few comments on the Catholic Church. While I never address personal attacks and this is not the real reason for this reply -- I have to address the prejudice inherent in the blog as indicative of the failure adopt a nuanced and moral approach to sexuality and HIV by some people in the Catholic Church.]
The comments of Pope Benedict in this context were deeply regrettable and dangerous to life. Few people in Africa or for that matter Europe will have basic HIV prevention literacy that uses scientific evidence to explain that the smallest sexually transmitted virus Hepatitis B cannot find its way through a latex condom.
Excellent piece from on Change.org
Original item, by Alanna Shaikh
I'm not going to write about the pope again. I just can't face it. But I'll offer you a related topic - things to know about condoms.
1) When used properly and every time, the male condom has a 3% failure rate. In typical use - not always worn right, and not every single time - the failure rate is 10-14%. reference
2) The female condom has a failure rate of 21% during typical use. reference
3) When a condom breaks, it generally happens because no space was left at the tip of the condom for ejaculate. A properly worn condom has a small reservoir at the end. reference
4) There are condoms especially designed for anal sex. They're stronger and less prone to breakage. The female condom can also be used. reference reference
5) You can put at least 625 condoms on a single dildo. Also, you can fit a condom on your head. reference reference
Such outrageous comments are not appropriate coming from the highest office in the hierarchy of the Catholic Church.
WASHINGTON (AP) — The Obama administration on Wednesday formally endorsed a U.N. declaration calling for the worldwide decriminalization of homosexuality, a measure that former President George W. Bush had refused to sign.
The move was the administration's latest in reversing Bush-era decisions that have been heavily criticized by human rights and other groups. The United States was the only western nation not to sign onto the declaration when it came up at the U.N. General Assembly in December.
"The United States supports the U.N.'s statement on human rights, sexual orientation and gender identity and is pleased to join the other 66 U.N. member states who have declared their support of the statement," said State Department spokesman Robert Wood.
"The United States is an outspoken defender of human rights and critic of human rights abuses around the world," Wood told reporters. "As such, we join with other supporters of this statement, and we will continue to remind countries of the importance of respecting the human rights of all people in all appropriate international fora."
The Associated Press reported on Tuesday that the administration would endorse the declaration.
Gay rights and other groups had criticized the Bush administration when it refused to sign the declaration when it was presented at the United Nations on Dec. 19. U.S. officials said then that the U.S. opposed discrimination on the basis of sexual orientation but that parts of the declaration raised legal questions that needed further review.
According to negotiators, the Bush team had concerns that those sections could commit the federal government on matters that fall under state jurisdiction. In some states, landlords and private employers are allowed to discriminate on the basis of sexual orientation; on the federal level, gays are not allowed to serve openly in the military.
But Wood said a "careful interagency review" by the Obama administration had concluded that "supporting this statement commits us to no legal obligations."
When it was voted on in December, 66 of the U.N.'s 192 member countries signed the nonbinding declaration, which backers called an historic step to push the General Assembly to deal more forthrightly with anti-gay discrimination. It was endorsed by all 27 European Union members as well as Japan, Australia and Mexico.
But 70 U.N. members outlaw homosexuality — and in several, homosexual acts can be punished by execution. More than 50 nations, including members of the Organization of the Islamic Conference, opposed the declaration.
Some Islamic countries said at the time that protecting sexual orientation could lead to "the social normalization and possibly the legalization of deplorable acts" such as pedophilia and incest. The declaration was also opposed by the Vatican.
Copyright © 2009 The Associated Press. All rights reserved.NEW YORK (Reuters Health) - Human papillomavirus or HPV, which can cause cervical cancer, may also infect the anus -- but the infection appears to resolve relatively quickly, researchers report.
"This fact may help explain why anal cancer among women is so much rarer than cervical cancer," Dr. Yurii B. Shvetsov told Reuters Health.
Dr. Shvetsov of the Cancer Research Center of Hawaii, Honolulu and colleagues examined the factors associated with anal HPV infection and its clearance in 431 women.
During an average follow-up period of 1.2 years, 50 percent of the women incurred a total of 414 anal HPV infections. Of these, 58 percent cleared during follow-up, the team reports in the medical journal Clinical Infectious Diseases.
The average duration of infection of the types of HPV considered high risk was 150 days, although this varied from type to type.
Delayed clearance was linked to douching, long-term smoking, and having anal sex.
Testing for cervical HPV is a way to screen for possible cervical cancer. However, the fact that anal infections are relatively short-lived "raise the possibility that anal HPV testing might be a less effective cancer screening tool, as compared to cervical HPV testing," continued Dr. Shvetsov.
"Whether or not anal HPV testing should become a generally accepted cancer screening tool," he concluded, "is an important question that should be addressed in future studies."
SOURCE: Clinical Infectious Diseases, March 1, 2009.
Friends,
My colleagues and I are urgently trying to raise $3,000 to get a young gay Mexican man released from detention, where he's being beaten and abused by other inmates. More details follow:
Jose is a 21 year old gay Mexican who is currently detained by U.S. immigration authorities in Chicago. When Jose was 15, a close relative abducted him and forced him into sexual slavery in a brothel in Mexico. For two years, Jose's abusers drugged him and forced him to perform sexual acts with an average of five "clients" per day. Jose escaped when a friend visited the brothel and took pity on him. Jose lived in hiding in various locations throughout Mexico for the next couple years, and was eventually able to flee to the United States in 2007.
Jose was recently apprehended by the immigration authorities and he is now detained in the gym of an over-crowded prison, sharing a space with 50 other men, most of whom come from Latin American countries. Recently, Jose has been threatened by other inmates because of his sexuality. This morning, Jose was attacked by another inmate without provocation. Jose is traumatized and he is now living in fear of further attacks while he is in detention.
Jose is now applying for asylum. U.S. law recognizes sexual orientation as a grounds for asylum, and Jose's lawyers at Heartland Alliance's National Immigrant Justice Center believe he has a strong chance of success. Unfortunately, the law mandates the continued detention of asylum-seekers like Jose, and requires a bond to secure their release. Jose's bond has been set at $3,000, an amount he is unable to pay. Jose has no family in the U.S., and his family in Mexico has rejected him for being gay. Heartland Alliance is seeking donations for a revolving loan fund (to be repaid by Jose) to secure Jose's release from detention. Donations are tax-deductible, and will contribute to a fund for especially vulnerable asylum seekers. Any funds contributed for Jose release will, in the future, be used to obtain the release of other individuals fleeing persecution on account of their sexual orientation.
Checks made out to Heartland Alliance can be sent to my attention (memo: Urgent Asylum Seeker Release Fund) at the address below. Please forward this appeal to others who might be able to help, as well. We hope to raise these funds by the end of this week to move Jose to safety as quickly as possible.
Many thanks,
Sean
--------------------------------------------
Sean Casey
Coordinator, Global Equality Network
Director, Global HIV Initiatives
208 S. LaSalle Street
Suite 1818
Chicago, IL 60604
www.heartlandalliance.org
non-discriminatory Nigeria society through empowerment education and advocacy over the last 5 years. In 2006 the federal government sponsored a bill banning the same sex marriage and all association of same-sex-loving people in Nigeria. Through the bill did not pass into law, it violates the right to freedom of LGBT life choices and heath. TIP envisions a Nigeria society that respects the right of all it citizens ensuring that everyone can fully attain their fundamental human right for a stronger and healthier nation.
society that may not be directly to the organization but it affects the organization. TIP as an LGBT organization is not acceptable in the community and the Nigeria government does not recognize it as an organization that is approved, which make us have less support from government and the society in terms of moral and physical support that totally make us stand. But with the support of other organizations like Heartland Alliance, American Jewish World Service, to mention a few, we have been able to have our leg standing on the floor, which means that with their support some changes have taken place.
Heartland Alliance for Human Needs & Human Rights established the Global Equality Network to help LGBT organizations working in dangerous environments. The Global Equality Network strengthens the capacity of these organizations to advocate and work for LGBT rights and protections in their regions. Last year HA receive a grant from the John D. and Catherine T. MacArthur Foundation to train all activists under the Global Equality Network in Chicago for a period of one month on leadership development through which each person will get more knowledge and experience during different placements with other organizations in Chicago that work on HIV/AIDS and LGBTI people.
AS DEBATE stirs over the Jamaican Government's insistence on retaining legislation against buggery, homosexual men continue to suffer from discriminatory acts which make it difficult for them to seek health care in the country, a study has indicated.
have sex with men in Laos (Lao People’s Democratic Republic) than any other group in the country, according to a study published in the January 28th edition of AIDS.
via Morning Edition, March 10, 2009For years now, scientists have tried to find a product that would give women in developing countries more control in protecting themselves against sexually transmitted HIV. They have yet to find a universally effective and safe method.
A recent study presented at the Conference on Retroviruses and 
Opportunistic Infections in Montreal highlighted the dilemmas in this field — a gel to prevent HIV worked in 30 percent of the women who tried it. Many scientists have dismissed those results because there was a 1-in-10 chance that the effect was due to chance. Others who had great expectations riding on the findings were encouraged.
Still, Tachi Yamada (pictured), director of global health policy for the Bill and Melinda Gates Foundation, was concerned that the results were presented as promising.
"To me, it was very unfortunate," says Yamada. "In fact, there should be a little bit of concern that this is now the fifth or sixth trial that came out statistically insignificant."
Listen Now [4 min 50 sec]
IRMA's next Global Teleconference
Thursday, March 19, 2009
Featuring presentations by Medical Research Council’s Dr. Sheena McCormack (UK - on left), UCLA’s Dr. Peter Anton (center) and Dr. Ian McGowan, University of Pittsburgh (right). Be among the first to know about upcoming rectal microbicide trials - including rectal safety studies of tenofovir and Pro2000 - from the scientists leading the efforts.
Materials will be available here in advance of the call.
Send an email here to RSVP. Call-in details will be sent to all who RSVP.
Special thanks to AVAC for hosting the call!
[NOTE - the times below were edited on March 12 - a number have changed due to daylight savings time. Please look carefully.]
by Whitney Welshimer, Akimbo via AlterNet.
Male circumcision is not full-proof. And it gives many men an excuse to avoid condoms, which puts their female partners at more risk.
About a year ago, my colleague was visiting IWHC partners in Cameroun and drove by this billboard promoting adult circumcision. Driving too quickly to do a double-take, she returned to the site later to confirm that she had read the the billboard correctly.
Three African studies in 2006 showed that male circumcision could significantly reduce a man's risk of contracting HIV from vaginal intercourse. "Significantly" in health study-speak might not mean what you think it means though. The studies, which examined nearly 8,000 men ages 18-24 in Kisumu, Kenya and Rakai, Uganda, found that male circumcision reduced men's risk of contracting HIV from vaginal intercourse by as much as 53 percent. These studies corroborated findings from an earlier study in South Africa, which reported reductions as high as 60 percent. A 50-60% reduction is not 100%. Not by a long shot.
But since these studies were published, sliced foreskins have replaced sliced bread as the next best thing. Bad puns and gory images aside, the avid support for male circumcision among public health professionals, funders, and the public alike has often failed to ask the simple question: What does this mean for women?
Read the rest. And be sure to check out the comments section.
One grim lesson the reports teach is that the sun never sets on anti-gay laws stemming from the British colonial era. Countries from Brunei to Zambia continue to criminalize acts "against the order of nature," despite England having decriminalized homosexual acts in 1967.
via Bay Windows, by by Richard J. RosendallFrom the Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94105, USA. lbutler@psg.ucsf.edu
OBJECTIVES:
Compared with other sexually active adults, men who have sex with men (MSM) are more frequently infected with several pathogens including cytomegalovirus, hepatitis B virus, and Kaposi sarcoma-associated herpesvirus. Because one common element between these organisms is their presence in saliva, we evaluated saliva exposure among MSM in a heretofore relatively unrecognized route-via use of saliva as a lubricant in anal sex.
METHODS:
MSM in a San Francisco population-based cohort were interviewed regarding use of saliva by the insertive partner as a lubricant in various anal sexual practices.
RESULTS:
Among 283 MSM, 87% used saliva as a lubricant in insertive or receptive penile-anal intercourse or fingering/fisting at some point during their lifetime; 31%-47% did so, depending upon the act, in the prior 6 months. Saliva use as a lubricant was more common among younger men and among HIV-infected men when with HIV-infected partners. Even among MSM following safe sex guidelines by avoiding unprotected penile-anal intercourse, 26% had anal exposure to saliva via use as a lubricant.
CONCLUSIONS:
Among MSM, use of saliva as a lubricant is a common, but not ubiquitous, practice in anal sex. The findings provide the rationale for formal investigation of whether saliva use in this way contributes to transmission of saliva-borne pathogens in MSM.
The IRMA website offers a host of informational resources.
Check out reports and materials published by IRMA here.
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Check out presentations done in the community and conferences here.
An experimental microbicide containing a naturally occurring compound provides protection in monkeys against the simian version of HIV by diminishing immune responses to the virus, according to a study published Wednesday in the journal Nature, the Los Angeles Times reports. HIV typically spreads in the body by entering CD4+ T cells, which the immune system sends out to attack the virus after exposure. The compound -- called glycerol monolaurate, or GML -- works by inhibiting immune signals that dispatch the T cells to attack the infection. It is those T cells that HIV infects and uses to proliferate throughout the body (Engel, Los Angeles Times, 3/5). GML occurs naturally in the human body and already is approved for use as an antimicrobial and anti-inflammatory ingredient in cosmetics and toiletries, as well as an emulsifier in foods. In addition, each dose of GML used in the study costs less than one cent. According to the researchers, the study's findings have promising implications for the development of effective microbicides to prevent HIV (AFP/Google.com, 3/4).
Willie T. Ong, MD, writing in the column "Mind Your Body" (Philipine Star), seems to think so...Q. Is there a problem with anal sex or gay sex?
A. Yes, according to urologist Dr. Eduardo Gatchalian. Anal sex is not advisable because the anus, including the rectum inside, is a “dirty” organ meant for the body’s waste. It’s like putting feces on the male organ. Studies show that those who engage in anal sex are prone to serious infections like HIV-AIDS, genital warts, anal warts, and HPV virus. These diseases are very easily transmitted because of the breaks in the skin of the anus. The anus is tight and wasn’t meant for sex. However, if you can’t avoid anal sex, use a condom for protection.
Anyone care to correct Dr. Ong?
"Talking about disease and fear haven't worked very well. People believe they are in a safe relationship and that disease does not apply to them," said Arushi Singh, a resource officer for the International Planned Parenthood Federation, which trains health educators in South Asia. "But pleasure," she said, "applies to everybody."
NEW DELHI -- A recent youth festival aimed at raising awareness about health issues and HIV in 
India did something unique to draw visitors. Amid all the sobering talk of at-risk communities, safe sex and health care, the festival invited bashful attendees to talk about pleasure.
At one booth, visitors were urged to leave tips in a drop box under a sign that asked, "Can safe sex be sexy?" In another booth nearby, the use of the female condom was demonstrated to curious onlookers.
But talking about sex can be an uphill task in India's traditional and patriarchal society. Even though India gave the world the "Kama Sutra," the ancient Sanskrit text about sexual behavior, open conversations about sex remain taboo in the country.
1Départements de Microbiologie et Infectiologie, Médecine Familiale, Médecine et Pathologie, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, 2Départements de Médecine Familiale, Microbiologie et Immunologie, Pathologie et Médecine, Faculté de Médecine, Université de Montréal, 3Division of Cancer Epidemiology and 4Department of Medicine, McGill University, 5Department of Medicine and Immunodeficiency Clinic, McGill University Health Center, 6Clinique Médicale l'Actuel, and 7Clinique Médicale du Quartier-Latin, Montreal, Quebec, Canada.
Background.
Human immunodeficiency virus (HIV)-seropositive men who have sex with men (MSM) are at higher risk of human papillomavirus (HPV) infection. This study was conducted to better understand the natural history of type-specific HPV infection in the anus.
Methods.
A cohort study was conducted among HIV-seropositive MSM in Montreal to investigate acquisition and loss of anal HPV infection. Participants were followed up every 6 months for 3 years for risk behaviors, HIV-related parameters, and HPV testing.
Results.
HPV DNA was detected in 97.9% of the 247 participants at baseline (median, 5 HPV types). The most common types were HPV-16 (38.2%) and HPV-6 (35.3%). Prevalent HPV-16 infections had the lowest clearance rate (12.2 cleared episodes per 1000 person-months [95% confidence interval {CI}, 8.5-17.7]) and a mean retention time of 36 months (95% CI, 32.7-38.8). The highest incidence rates were found for HPV-16 (10.8 new cases per 1000 person-months [95% CI, 8.0-14.7]), HPV-52 (10.8 new cases per 1000 person-months [95% CI, 8.2-14.1]), and HPV-53 (9.8 new cases per 1000 person-months [95% CI, 7.4-13.0]), with cumulative incidences at 36 months of approximately 30%.
Conclusions.
Multiple HPV types were common in the anal canals of HIV-seropositive MSM. Incidence and clearance rates were not similar among HPV types. Ongoing surveillance of this cohort will help our understanding of the determinants of HPV persistence and progression to lesions.
other hand, optimistic quotations have been liberally used, from Shakespeare's Henry V's "Once more unto the breach, dear friends" to Winston Churchill's definition of success as "going from one failure to another with no loss of enthusiasm". I will forgo optimistic quotations for the phrase "Sang Froid", which translates literally from the French as "cold blood"; what it really means is to avoid panic when things look bad, to step back and coolly evaluate the situation. This is not to counsel easy optimism or to fly in face of the facts, but I believe that while the situation is serious, it is not desperate."Science appears calm and triumphant when it is completed; but science in the process of being done is only contradiction and torment, hope and disappointment." - Emile Roux
