PRESS RELEASE: Researchers Reformulate Tenofovir Vaginal Gel for Rectal Use

via Microbicide Trials Network

[The abstract, Tenofovir Gel Reformulation Results in Improved Product Safety for Rectal Application, was presented at a poster session from 2-4 p.m., Monday, Feb. 28. The results of RMP-02/MTN-006 were discussed at a CROI press conference from 7:30-8:30 a.m., Monday, Feb. 28]

‘New’ gel safe in laboratory studies




BOSTON, Feb. 28, 2011 – A change in the formulation of tenofovir gel, an anti-HIV gel developed for vaginal use, may make it safer to use in the rectum, suggests research presented today at the 18th Conference on Retroviruses and Opportunistic Infections (CROI). In laboratory tests of rectal tissue, researchers from the Microbicide Trials Network (MTN) found the reformulated gel was less harmful to the lining of the rectum than the original vaginal formulation, and just as effective in protecting cells against HIV.

Researchers are now testing the reformulated gel in an early-phase clinical trial with men and women. Results from these and future studies will have important implications for the development of a rectal microbicide that could help protect against HIV or other sexually transmitted infections during anal sex.

Tenofovir gel has shown significant promise in reducing HIV risk in women through vaginal sex. But because the rectal epithelium – the lining of the rectum that serves as the first line of defense against HIV – is much thinner than the vaginal lining, the gel may not be safe or effective to use rectally. By its nature, tenofovir gel is hyperosmolar – contains a higher concentration of sugars and salts relative to cells. This quality could have a harmful effect on the rectal lining by causing epithelial cells to shrink as they purge water to achieve balance. Weakened in this manner, the rectal epithelium may be less able to protect against HIV.

To make tenofovir gel safe and more amenable to rectal use, researchers from CONRAD, a research organization which holds the rights to develop the gel, reformulated it with a reduced amount of glycerin, a common additive found in many gel-like products. In laboratory tests conducted by MTN researchers, the reformulated gel was three times less likely to cause cells in rectal tissue to release water, and equally effective against HIV as the vaginal formulation.

“The lining of the rectum is much more fragile than the vaginal epithelium, so we can’t be certain a product like tenofovir gel that is safe for vaginal use will be completely safe to use in the rectum,” said Charlene Dezzutti, Ph.D., associate professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine and principal investigator of the MTN Network Laboratory. “We are very encouraged by our laboratory data that suggest the reformulated gel could be safer for rectal use. These results provide an important bridge to clinical studies, and we have already begun testing it with men and women.”

The new formulation of tenofovir gel is being tested for safety and acceptability in a clinical trial called MTN-007, currently underway at three MTN-affiliated sites at the University of Pittsburgh,

RMP-02/MTN-006, the first-ever clinical study to test the safety of vaginal tenofovir gel in the rectum. These results, which were also presented at CROI, found the gel significantly inhibited HIV in tissue samples, but that men and women in the study did not particularly like it and some experienced uncomfortable gastrointestinal side effects. Researchers are hopeful the reformulated gel now being tested in MTN-007 will address these concerns.

In addition to Dr. Dezzutti, other authors of the study are Lisa Rohan, Ph.D., University of Pittsburgh; J.D. Lynam, Magee-Womens Research Institute; Lin Wang, M.D., Ph.D., Magee-Womens Research Institute; and David Friend, Ph.D., CONRAD, Arlington, Va.

Tenofovir gel contains the antiretroviral tenofovir, which is commonly used in the treatment of HIV. Both the oral and vaginal formulations of tenofovir were developed by Gilead Sciences, Inc., of Foster City, Calif. In 2006, Gilead Sciences assigned the rights for tenofovir gel to the International Partnership for Microbicides of Silver Spring, Md., and CONRAD, of Arlington, Va.

The study was conducted through the MTN, which is funded by the National Institute of Allergy and Infectious Diseases Division of AIDS with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

# # #

The abstract, Tenofovir Gel Reformulation Results in Improved Product Safety for Rectal Application, was presented at a poster session from 2-4 p.m., Monday, Feb. 28. The results of RMP-02/MTN-006 were discussed at a CROI press conference from 7:30-8:30 a.m., Monday, Feb. 28.

About the Microbicide Trials Network

The Microbicide Trials Network (MTN) is an HIV/AIDS clinical trials network established in 2006 by the National Institute of Allergy and Infectious Diseases with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the U.S. National Institutes of Health. Based at Magee-Womens Research Institute and the University of Pittsburgh, the MTN brings together international investigators and community and industry partners who are devoted to preventing or reducing the sexual transmission of HIV through the development and evaluation of products applied topically to mucosal surfaces or administered orally.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

PRESS RELEASE: Tenofovir Gel Provides High Level of Protection Against HIV in Rectal Tissue

via Microbicide Trials Network

[The abstract, RMP-02/MTN-006: A Phase I Placebo Controlled Trial of Rectally Applied 1% Vaginal Tenofovir Gel with Comparison to Oral Tenofovir Disoproxil Fumarate, is being presented at a scientific session at CROI 2011 TODAY from 10 a.m. - 12:15 p.m. ET.]



Strongest effect seen in tissue taken from participants after one week of use

BOSTON, Feb. 28, 2011 – A gel developed to protect against HIV during vaginal sex produced a strong antiviral effect when used in the rectum, according to an early-phase study presented today at the 18th Conference on Retroviruses and Opportunistic Infections (CROI). The results, based on rectal tissue biopsies sampled from HIV-negative men and women who used the product daily for one week, provide the first-ever evidence that tenofovir gel could help reduce the risk of HIV from anal sex, even though the vaginal gel formulation may not be optimal for rectal use.

Tenofovir gel was not especially well-liked by a majority of men and women in the study, yet most reported they would be likely to use the gel if it became available in the future as a method for preventing HIV. Although the study found use of the gel generally safe, side effects were problematic to a few study participants. In hopes of making tenofovir gel more acceptable for rectal use, researchers have since modified the gel and are now testing it in another study.

“We are very encouraged about these findings that indicate applying tenofovir gel topically to the rectum could be a promising approach to HIV prevention,” said Peter Anton, M.D., professor of medicine and director of the Center for Prevention Research at the University of California, Los Angeles (UCLA), who led the study with Ian McGowan, M.D., Ph.D., co-principal investigator of the Microbicide Trials Network (MTN) and professor of medicine at the University of Pittsburgh.

“These are early results, but help set the stage for current and future trials of rectal microbicides and the development of a rectal-specific formulation of tenofovir gel,” added Dr. McGowan, who is leading the second study of the new gel formulation.

Microbicides, products applied on the inside of the rectum or vagina, are being designed and tested to help prevent or reduce the sexual transmission of HIV or other sexually transmitted infections. The majority of microbicide research thus far has focused on products to prevent HIV during vaginal sex. Yet, the risk of becoming infected with HIV from unprotected anal sex may be at least 20 times greater than unprotected vaginal sex, in part because the rectal lining is only one-cell thick compared to the vagina’s multiple layers, making it easier for the virus to reach cells to infect.

The study, known as RMP-02/MTN-006, is the first clinical trial of tenofovir gel for rectal use. Last year, tenofovir gel was shown in a trial called CAPRISA 004 to reduce the risk of HIV infection in women who used it before and after vaginal sex.

Conducted at UCLA and the University of Pittsburgh, RMP-02/MTN-006 tested two products – tenofovir gel and oral tenofovir – in 18 sexually abstinent, HIV-negative men and women. Oral tenofovir, an antiretroviral (ARV) tablet commonly used to treat people with HIV in combination with other ARVs, is being explored as a means to prevent infection in people who are HIV-negative through an approach called pre-exposure prophylaxis, or PrEP.

The trial directly compared the anti-HIV activity of a single dose of oral tenofovir to a single dose of rectally-applied tenofovir gel. This was followed by six days of at-home dosing of tenofovir gel or a placebo gel, with the last and seventh dose given in the clinic. A novel approach was used to determine whether any actual protection was provided by the drug given in the different regimens – single oral, single gel and seven-day gel (or placebo) – in which small biopsies were taken from the rectal lining of the participants using a standard clinical procedure called sigmoidoscopy. The tissue samples were then sent directly to the laboratory where they were exposed to HIV to determine how well study products protected the tissue from infection.

The researchers found that HIV was significantly inhibited in tissue samples from participants who used tenofovir gel daily for one week compared to tissue from participants who used the placebo gel. While a slight anti-viral effect was noted in tissue from participants who received a single dose of tenofovir gel, the finding was not statistically significant. The single dose of oral tenofovir did not provide any protection against HIV in rectal tissue samples.

“These kinds of efforts early in the development phase of rectal microbicides can give us insight into a particular product’s potential efficacy, which enables us to better design and hasten the pace of future clinical trials,” said Dr. Anton.

According to self-reports, only 25 percent of men and women who had used the tenofovir gel said they liked it. However, when asked whether they would consider using the product in the future, 75 percent of these participants reported a high likelihood of future use. Two of the 12 participants who received tenofovir gel reported severe gastrointestinal side effects, including diarrhea and lower abdominal cramps.

“These results tell us that tenofovir gel was relatively safe to use in the rectum for most participants, but we need to address side effects to make it more acceptable to use,” said Dr. Anton, who reported the findings at CROI. “Even though three-quarters of the participants reported they didn’t like the gel, we are very encouraged that the majority would consider using such a product in the future.”

Another study, MTN-007, now underway is using a formulation of tenofovir gel with less glycerin, a common additive found in many gel-like products, in the hope that this will make it better tolerated when used in the rectum. Laboratory tests of the reformulated gel suggest it is just as effective as the original formulation but less irritating to the epithelium – the layer of cells that serves as a protective barrier inside the rectum. The study began in October 2010 and is enrolling 60 men and women at three sites – University of Pittsburgh, University of Alabama at Birmingham and Fenway Health in Boston.

In addition to Drs. Anton and McGowan, other authors of RMP-02/MTN-006 are Ross Cranston, M.D., University of Pittsburgh; Alex Carballo-Dieguez, Ph.D., Columbia University; Angela Kashuba, PharmD, University of North Carolina; Elena Khanukhova, UCLA; Julie Elliott, UCLA; Laura Janocko, Ph.D., MTN and Magee-Womens Research Institute; William Cumberland, Ph.D., UCLA; and Christine Mauck, M.D., M.P.H., CONRAD.

RMP-02/MTN-006 was a collaboration between the Microbicide Development Program at UCLA and the MTN. UCLA’s Microbicide Development Program is funded by the Division of AIDS Integrated Preclinical/Clinical Program for HIV Topical Microbicides at the National Institute of Allergy and Infectious Diseases. The study products were developed by Gilead Sciences, Inc., of Foster City, Calif., which assigned the rights for tenofovir gel to the International Partnership for Microbicides of Silver Spring, Md., and CONRAD, of Arlington, Va., in December 2006. Gilead Sciences and CONRAD provided the study products free of charge.

# # #

Additional information about the study and rectal microbicides is available here.

The Microbicide Trials Network (MTN) is an HIV/AIDS clinical trials network established in 2006 by the National Institute of Allergy and Infectious Diseases with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health, all components of the U.S. National Institutes of Health. Based at Magee-Womens Research Institute and the University of Pittsburgh, the MTN brings together international investigators and community and industry partners who are devoted to preventing or reducing the sexual transmission of HIV through the development and evaluation of products applied topically to mucosal surfaces or administered orally.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Study finds most lubricants damage rectal cells and some increase HIV activity

via Aidsmap, by Gus Cairns

A study by the Population Council (Begay 2011) has found that every one of a panel of 41 commercially-available sexual lubricants for sale in the USA damaged human rectal and colonic cells in the test tube and compromised the integrity of the single-cell layer that forms the surface of the rectum.

In contrast Carraguard, a gel formerly tried as an experimental microbicide, did not damage cells

Unexpectedly, the investigators found that four of the lubricants not only damaged the rectal lining cells but appeared actively to increase HIV replication in the cell cultures.

Read the rest.

Click here for all of our blog posts regarding lubricants and lube safety.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

HPV and Anal Cancer in Older Women: Risk and Prevention

via Women's Voices for Change, by Patricia Yarberry Allen, M.D.

Excerpt:

Although it has not been documented rigorously, there is a reason to believe that anal cancer could develop very much the way cervical cancer does. The change in the cells begins with mild atypica, progresses to more serious abnormal change (mild, moderate and severe dysplasia), before developing into frank anal cancer. Doctors have known about the relationship of HPV and anal cancer from long experience with gay men, who have a high incidence of this cancer due to receptive anal sex practice. We need the expertise of these physicians, now that HPV has been recognized to be a growing concern for women and recognized as a cause of cervical, vaginal, and vulvar cancer and is now publicly discussed as a cause of anal and oral cancer.

It is important that colo-rectal surgeons develop expertise in high-resolution anoscopy and an interest in recognizing abnormal change at an early stage. Gynecologists are specially trained in colposcopy to view and recognized abnormal cellular patterns that can be biopsied, diagnosed, and treated.  It takes time and training to become very good at these procedures.

At the moment, there is no consensus among our specialities about how to monitor for and evaluate the presence of anal HPV. An HPV swab test can be done in the anal area. Pap smears can be done in this area. But there are no national guidelines for primary care doctors about when to do these tests, and no guidelines about what to do with the results. We don’t have a treatment protocol for anal dysplasia that is universally used.

The result is that women with high-risk HPV of the genital area are almost never tested for anal HPV, even if the woman expresses concern about her risk. That means that cells that could be treated earlier, before there is frank malignancy, are not found.

We don’t want women to wait for a diagnosis until they have rectal bleeding or a feeling that there is a constant fullness in the anal area. These are symptoms of many benign diseases but also the symptoms of anal cancer. We have to have a plan based on what is known and what evaluations are available.

Read the rest.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Learn about Project Gel - rectal microbicide research in action

What is Project Gel?
Project Gel is a federally-funded clinical research study that is being conducted at three sites in the United States, including: The University of Pittsburgh (Pittsburgh, PA), Fenway Health (Boston, MA), and the University of Puerto Rico (San Juan, PR).

Why is This Study Being Conducted?
There are three main purposes of this study. In Part 1, the main purpose is to find out more about the sexual health of young men who have sex with men, including how common sexually transmitted infections are among this group of men. In Part 2, the main purpose is to find out how young men feel about using a gel in their rectum prior to anal sex and whether or not they actually use it prior to anal sex. The gel in Part 2 is a placebo gel, meaning it does not have any medicine in it. In Part 3, the main purpose is to find out if a gel with medicine (a microbicide gel) is safe to use and to learn how men feel about using a microbicide gel in their rectum.

Who Can Participate?
Are you 18-30 years old? A man who has sex with men? Willing to be tested for HIV? If you answered yes to all of these questions, then you may be eligible to participate in Project Gel!

Why Should I Participate in Project Gel?
HIV infections are increasing worldwide (5 million/year), with 63% of all HIV/AIDS cases in the U.S. in gay and bisexual men. New strategies are needed to prevent HIV infection. Microbicides are being studied as new ways to prevent HIV infection.

Why Can't People Just Use Condoms?
Condoms are effective, but not always available, not always used, and often break or slip if used incorrectly. Rectal microbicides could be discreetly used by tops and bottoms who don't have access to and/or don't want to use condoms.

What Happens If I Enroll?
If you enroll, you will: Be tested for HIV, complete a physical exam, including an anal exam, and be asked questions about your medical and sexual history.

How Many Visits Are Required?
Project Gel consists of at least one and possibly up to nine visits. Some participants will be asked to return for subsequent visits to participate in Part 2 and Part 3 of the study, while others will only go as far as Part 1, which requires only one visit.

Will I Receive Compensation For My Participation?
Yes!

Who is Sponsoring Project Gel?
The study is being paid for by the National Institute of Child Health and Human Development (NICHD) and National Institute of Mental Health (NIMH), branches of the National Institutes of Health.

Where Do I Sign Up or Get More Information?
Visit the Project Gel website.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

NEW! AIDS and Behavior articles: rectal microbicides, PrEP, community perspectives and gay men's health

New articles of interest from AIDS and Behavior - February 18, 2011

• "Community Perspectives on Developing a Sexual Health Agenda for Gay and Bisexual Men",Stewart Landers, Jim Pickett, Leo Rennie, and Steve Wakefield, AIDS and Behavior, 2011-02-18. DOI 10.1007/s10461-011-9896-z
  
  
• "Pre-Exposure Prophylaxis and the Promise of Combination Prevention Approaches", Susan P. Buchbinder and Albert Liu, AIDS and Behavior, 2011-02-18. DOI 10.1007/s10461-011-9894-1
  
  
• "Rectal Microbicides: Can We Make Them and Will People Use Them?", Ian McGowan, AIDS and Behavior, 2011-02-18. DOI 10.1007/s10461-011-9899-9
  
  
• "Sexual Health, HIV, and Sexually Transmitted Infections among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States", Richard J. Wolitski and Kevin A. Fenton, AIDS and Behavior, 2011-02-18. DOI 10.1007/s10461-011-9901-6

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

CHAARM Program Newsletter - Issue Number 1, 2011

This newsletter contains information about the CHAARM project, main activities executed and results achieved in these 12 months activity as well as researchers’ interviews to give a deeper overview of single laboratories tasks.

CHAARM - Combined Highly Active Anti-Retroviral Microbicides project is large scale collaborative project co-funded by the European Commission under the 7th Framework Programme (FP7). The main objective of this project is to develop combinations of new and existing microbicides that will be designed to be specifically targeted agents, which can be applied topically to reduce transmission of HIV during sexual intercourse.

The content of the newsletter is the result of all CHAARM project partners’ efforts under the coordination of the communication partner together with the project coordinator. This newsletter is published once per year and is sent out via email to a number of interested stakeholders but it is also available on the website.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Study Authors Call for More Testing of Personal Lubricant Safety

via About.com, by Cory Silverberg

Last May two studies were released that got a lot of attention for pointing out the potential role personal lubricants might play in STD transmission during anal intercourse. Specifically, lab studies raised the possibility that lubricant could actually make transmission easier by irritating the rectal lining.

The work was supported by the interdisciplinary group, International Rectal Microbicide Advocates, who have been doing their best to help researchers and health care providers contextualize the findings so they are neither blown out of proportion, nor cast aside as irrelevant.

This week more findings were published in the journal AIDS Research and Human Retroviruses. Researchers studied forty-one brands of lubricants (taken from the IRMA list of most frequently used lubricants), looking for any anti-HIV-1 activity, toxicity, and essentially the salt content of lubricants that could contribute to damage at the cellular level.
Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Vision: How Yoga is Transforming a Kenyan City

via AlterNet, by Anna Clark

In Nairobi, the Africa Yoga Project is training HIV+, poor, and disabled citizens to be yoga instructors, creating jobs and changing lives.


Here is what the Africa Yoga Project wants you to know: it is not religious. Nor is it a collective of devil worshippers. If you come to AYP’s free and rambunctious Saturday morning class in Kenya’s capitol city, you will certainly not be lured into practicing an unfamiliar faith. Also, AYP will not give you money to do a few downward dogs.

Given the missionary tradition of East Africa, these are the not unreasonable suspicions AYP instructors face when they invite Kenyans to practice yoga. But just over three years since its founding by American ex-pat and yogi Paige Elenson, AYP has gathered enormous momentum. Those Saturday classes? About 70 people come each week, many traveling some distance to the studio in Sarakasi Dome on Nairobi’s Ngara Road. Students show off their acrobatics before the opening child’s pose—balancing on each others’ knees, pulling themselves vertical.

Throughout the two-hour yoga class in a sunny room marked by colorful graffiti and gleaming mirrors, students noisily whoop and groan and sigh with relief as they move through a vinyasa flow. There is no meditative music playing; the sounds of this studio are all voices and breath and movement. As the teacher of this class rotates, AYP instructors practice alongside newcomers, children, mothers, teenagers, and a handful of ex-pats. Afterward, sitting up on the dusty black mats, everybody claps.

By training yoga instructors who come from the same Nairobi slums that are the center of the program’s outreach, and by making explicit connections to the acrobatic and dance arts many potential yoga students are already doing on street corners, AYP hosts 200 free classes a week, reaching 3,000 students with 42 local yoga instructors. Most students are aged 16-30, living on about $2 a day, and many live with HIV/AIDS.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Uganda: Closet homosexuals sink further under the radar after Kato’s death

via Daily Monitor, by John K. Abimanyi

He sits at a table with his fingers encircled around the tail of a glass filled with Smirnoff. He is at a Kampala nightspot and has dissolved into the crowd, looking just like any other reveller. What most people at the bar would not know however, is that he, plus a couple of his colleagues at the venue, is homosexual. He demands that his identity is hidden if he is to be quoted in the papers instead; he proposes a pseudonym, Alan Mukasa.

He gives off no signs that he is gay. He’s not dressed in a tight fitting pair of jeans, commonly known as skinnies, his hair is a natural un-treated neatly trimmed black, he has no studs or earrings, wears no make-up or anything that may attract undue attention to him. “It’s a security precaution one has to take,” he says. “The best way to hide is to fit in.

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Lube Alert: Population Council Releases New Lube Safety Data

via AIDSmeds, by David Evans

A forthcoming research report suggests a number of personal lubricants can damage anal tissue cells and increase HIV replication, potentially heightening the risk of contracting HIV, notably if condoms aren’t used.

The “personal lubricant” market is a thriving one. One popular website sells 53 different brands, with many boasting several varieties. If you’d like one that tastes like fruit or chocolate, or adds the sensation of heat, you’ve got multiple options to choose from. The same goes for the degree of slipperiness, the type of sex you want to have, the ease of cleanup and, most important, condom compatibility.

What sexual accoutrement retailers can’t tell you is whether a lube will increase, decrease or have no effect on your chance of becoming infected with HIV if the condom breaks or you decide not to use a condom in the first place. Until recently, it wasn’t a question high on the list of researchers’ or manufacturers’ priorities—lubes are intended to keep condoms from tearing during sex, end of story. But for scientists at the Population Council, a New York City–based research organization at the forefront of HIV microbicide development efforts, the positive or negative effects of lubricants on HIV transmission has been a nagging issue for years.

New research results from the nonprofit organization suggest there may be reasons for concern. According to laboratory studies the group conducted—on schedule to be published in a forthcoming issue of AIDS Research and Human Retroviruses and currently available online—a large number of popular lubes may actually make it easier for HIV to get past the body’s defenses, notably during anal sex without a condom. Even more alarming is the finding that four lubes in particular cause HIV to reproduce up to four times faster than it does in the absence of such products.

Read the rest.

Read the IRMA Q&A on lubricant safety.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

NYC Forum next Weds: WHAT IS THE MESSAGE?! A community discussion on HIV prevention campaigns targeting gay and bisexual men

[check out IRMA's blog post on the controversial and problematic ad campaign released by the NYC department of public health recently]

WEDNESDAY, FEBRUARY 23, 2011
6:30 pm to 8:00 pm
GMHC - The Tisch Building
119 West 24th Street – 12th floor
(between 6th and 7th Avenues NYC)

Guest panelists include:

Oriol R. Gutierrez Jr., Deputy Editor, POZ; Editor-in-Chief, Tu Salud

Jacoby Johnson, Managing Director - Black Men’s Initiative, Harlem United

Les Pappas, President & Creative Director, Better World Advertising

Tokes Osubu, Executive Director, Gay Men of African Descent (GMAD)

Daniel Siconolfi, MPH, Project Director - Center for Health, Identity, Behavior, & Prevention Studies (CHIBPS)

Monica Sweeney, MD, MPH, Assistant Commissioner – HIV/AIDS Prevention and Control, NYC Department of Health and Mental Hygiene


Guest moderator: Sean Cahill, PhD, Managing Director - Public Policy, Research & Community Health, GMHC


Topics to be discussed include:

• What are effective HIV prevention messages that reach gay and bisexual men?
• Do scare tactics work?
• How should AIDS service organizations and government agencies involve community in the development of campaigns
  
  

The discussion is free and open to the general public. Please bring your ideas for future HIV prevention campaigns.

For more information, please call (212) 367-1016 or write to krishnas@gmhc.org.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

PODCAST: Get Your Butt Out of the Sand

via Feast of Fun

Your body is a magical wonderland waiting to be explored, but proceed with caution because risks may be lurking around the backside. You can’t just stick your butt in the sand and pretend there’s nothing behind there to deal with.

Today health advocate (and IRMA chair) Jim Pickett joins us to answer your vital questions about your butt. Yes, your derriere, your bon bon, your gluteus maximus, because overcoming our bashfulness over the booty is key to gay men’s health.(And rectal microbicides too!)

Why do gay men enjoy anal sex? How do I know if my boyfriend is good for me? Are some types of lube safer than others? How do I keep my booty fresh and fabulous?

Plus we take a closer look at the Asset Based Lifestyle- the secret every gay man needs to know about focusing on what works in your life in order to bring about the change you need to shine.

And of all the hot hot hot news... Listen.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

HIV prevalence and risk practices among men who have sex with men in two South African cities

J Acquir Immune Defic Syndr. 2011 Feb 4. [Epub ahead of print]

Abstract

BACKGROUND:

In South Africa information on HIV among men who have sex with men (MSM) is limited and HIV prevention programs for men MSM are not widely available, despite global evidence that MSM are at substantial risk for HIV infection. The Johannesburg/eThekwini Men's Study (JEMS) was conducted during 2008 to provide information on HIV among MSM in Johannesburg and Durban.

METHODS:

MSM aged 18 years or older were recruited using respondent-driven sampling. Participants completed a questionnaire and provided finger-prick blood specimens for anonymous HIV testing in a laboratory.

RESULTS:

From July to December 2008, 285 MSM were recruited in Johannesburg (n=204) and Durban (n=81). Participants had a median age of 22 years and were predominantly black Africans (88.3%). The HIV prevalence was 49.5% (95% confidence interval [CI], 42.5%-56.5% in Johannesburg and 27.5% (95% CI 17.0%-38.1%) in Durban. HIV infection was associated with gay identification (adjusted odds ratio [aOR], 8.4; 95% CI, 3.7-19). Factors in the previous year that were associated with HIV infection included receptive unprotected anal intercourse (aOR 4.3; 95% CI 2.4-7.6); sex with a person known to be HIV positive (aOR 2.3; 95% CI 1.1-4.9); and a sexually transmitted infection diagnosis (aOR 2.4; 95% CI 1.1-5.2).

CONCLUSIONS:

HIV prevalence among MSM in Johannesburg and Durban is considerably higher compared to men in the general population. There is an urgent need to establish national HIV surveillance among MSM and to expand the availability of HIV prevention programs for MSM.

Source

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

LGBT Africans Face Blackmail and Extortion on a Regular Basis

via International Gay and Lesbian Human Rights Commission

Antiquated laws against same-sex sexual activity as well as deeply ingrained social stigma result in the all-too-frequent targeting of lesbian, gay, bisexual and transgender (LGBT) people in Africa for blackmail and extortion, said the International Gay and Lesbian Human Rights Commission (IGLHRC) in a report launched today.

The report, Nowhere to Turn: Blackmail and Extortion of LGBT People in Sub-Saharan Africa, illustrates how LGBT Africans are made doubly vulnerable by the criminalization of homosexuality and the often-violent stigmatization they face if their sexuality is revealed. Based onresearch from 2007 to the present, the volume features articles and research by leading African activists and academics on the prevalence, severity and impact of these human rights violations on LGBT people in Cameroon, Ghana, Malawi, Nigeria, and Zimbabwe.

"The tragic reality is that blackmail and extortion are part of the daily lives of many LGBT Africans who are isolated and made vulnerable by homophobic laws and social stigma," says IGLHRC's Executive Director, Cary Alan Johnson. "The responsibility clearly lies with governments to address these crimes and the underlying social and legal vulnerability of LGBT people."

The report's authors vividly depict the isolation, humiliation and manipulation to which LGBT people are subjected by blackmailers and extortionists and describe the threats of exposure, theft, assault, and rape, that can damage and even destroy the lives of victims. Vulnerability to these crimes is faced on a regular basis and families and communities are not safe havens. For example, according to research conducted in Cameroon and featured in the report, "the bulk of blackmail and extortion attempts were committed by other members of the community - 33.9% by neighbors, 11.8% by family members, 11.5% by classmates, and 14.1% by homosexual friends. Police were often complicit in this - either by ignoring or dismissing it or, in 11.5% of cases, directly perpetrating it."

Nowhere to Turn explores the role the State plays in these crimes by ignoring blackmail and extortion carried out by police and other officials by failing to prosecute blackmailers, and by charging LGBT victims under sodomy laws when they do find the courage to report blackmail to the authorities.

IGLHRC urges States to take concrete steps to reduce the incidence of these crimes by decriminalizing same-sex sexual activity, educating officials and communities about blackmail laws, and ensuring that all people are able to access judicial mechanisms without prejudice.

A PDF version of Nowhere to Turn is available here. To obtain a hard copy of the volume, email iglhrc@iglhrc.org

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Being Gay in Egypt: ‘Some of my best friends do not know me’

via OUT Impact, by Theodora Birch

“Denying who you are leads to acceptance.”

In Egypt, laws on public morality are severe – homosexuality is seldom openly acknowledged. Whilst being gay is not technically illegal it is unacceptable in Egypt, it is frowned upon socially, culturally, religiously and politically. Gay people are vilified by the press and the public, Al Balagh Al Gadid, an independent weekly newspaper, was banned after accusing actors of homosexuality.

The personal struggle of many young gay Egyptians is constant- they must deny who they are to survive. Yet despite hostility, there are many Egyptians out there hoping that society will change its strict laws and accept them for who they are.

“Mohammed” is a good-looking man in his early twenties with a successful career and a very open mind. I met him for the first time in a quiet little coffee shop in central Cairo. In perfect English he tells me that he hides a secret most of the time: he is gay.

Below is a full transcript of our conversation. Mohammed touches on various issues: social perception, acceptance amongst his peers and family, as well as the personal struggle that he faces everyday with his religion and himself:

Theodora Birch, Out Impact: I wanted to start out by asking you, when you first realized that you were gay? 
“Mohammed”: When I was eighteen, I knew.

TB: Did you struggle with this realisation? 
M: Yes. I tried to fight my urges for a couple of months.

TB: Have you come out yet to your family and friends? 
M: No. My family and none of my close friends know, only my friends amongst the gay community. I am seeing a therapist, and she suggested that I don’t tell them. I come from a conservative family, and they would not accept me. There is also a possibility that I might change, therefore it is best to keep quiet.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Africa: Need for systematic HIV drug resistance testing

via IRIN PlusNews

HIV is a tough enough diagnosis, but when one contracts a strain of HIV resistant to some life-prolonging medicines, treatment options are limited. A new study has found that transmitted HIV drug resistance may be on the rise in Africa, and the authors warn that unless resistance surveillance is increased, the continent's treatment programmes could suffer.

The study, led by the International AIDS Vaccine Initiative (IAVI) in five African countries, found that the prevalence of transmitted drug resistance in Rwanda, Uganda and Zambia was considerably higher than previously reported.

Of 408 people studied in Kenya, Rwanda, South Africa, Uganda and Zambia, 19 had transmitted resistance mutations. Resistance prevalence rose considerably during the study in Zambia and remained high throughout the study in Entebbe (Uganda).

"The message to take away from this study is the urgent need for regular drug resistance surveillance, which we currently do not have," said Omu Anzala, head of the Kenya AIDS Vaccine Initiative. "If we can see transmitted resistance in such a small study then there could be much more going around."

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Researchers criticise AIDS spending, stigma

via Mail and Guardian

Nearly three million lives have been saved by HIV/Aids treatment, but scarce resources are being misspent and stigma is still keeping the most vulnerable from seeking help, according to a new book by researchers commissioned by the United Nations.

The failings are particularly worrying at a time when worldwide recession and donor fatigue are hurting spending on Aids, the researchers say.
Among the two dozen people involved in the research was Nelson Mandela Foundation chief executive Achmat Dangor, who hosted a discussion of the research on Thursday.

The book, titled Aids: Taking a Long Term View, was aimed at ensuring that "the response to Aids is systematic and effective in the long term," Dangor said. "We believe it is crucial also to our founder's legacy."

Read the rest. 

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Malawi refuses ‘homosexuality’ aid condition

via NY ASA Times

Malawi government on Wednesday took a strong stand against bilateral donors saying it cannot compromise its sovereignty to legalise homosexuality in order to get aid.

Minister of Justice and Constitutional Affairs, Dr George Chaponda led a team of Presidential spokesperson Hetherwick Ntaba, Information and Civic Education Minister Symon Vuwa Kaunda and Gender, Women and Children Welfare  Minister Tereza Mwale in addressing a news conference in the capital Lilongwe.

During the news conference, the officials were reacting to reports that Germany government has cut aid following Malawi’s failure to repeal laws that criminalize homosexuality and its enactment of laws seen as restricting media freedom.

Ntaba: Immoral to force Malawi to be a homosexual nation just to give us aid

And the United States of America government has delayed to release $350 million grants amid concerns of new laws to curb individual freedoms in the southern African nation.

Justice Minister said although Malawi has strict laws against same sex relationships “the international community should note that since such acts occur in private and that Malawi laws on privacy are enriched in the constitution it is very difficult to prosecute homosexuality.”

“We are not ready to change the laws to satisfy donors. We have to understand that as a country you need to have certain principals for the benefit of the country,” said Chaponda.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

It's not if, it's when: IRMA's Jim Pickett on Rectal Microbicides in Africa

Writing for  the September - December 2010 issue of Echoes, a publication of the Nigerian HIV Vaccine and Microbicide Advocacy Society, IRMA chair Jim Pickett discusses the need for rectal microbicides in Africa.

Excerpt:

Until recently, rectal microbicides have simply not been part of the HIV prevention agenda in Africa, due in part to the denial of anal sex among heterosexuals and pervasive homophobia and criminalization that has denied and vilified the existence of gay men/MSM.

IRMA diligently addresses these issues, leading efforts to put rectal microbicides on the African map. These efforts are now bearing fruit - due in no small part to the significant engagement of hundreds of African advocates across the continent and extraordinary leadership by IRMA Nigeria with Kadiri Audu, IRMA Community Vice Chair, at the helm.

Read the whole thing.

While you are there, be sure to also check out the report on a rectal microbicide training for MSMs in Abuja!

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

The Role of Public-Sector Research in the Discovery of Drugs and Vaccines

via New England Journal of Medicine

Ashley J. Stevens, D.Phil., Jonathan J. Jensen, M.B.A., Katrine Wyller, M.B.E., Patrick C. Kilgore, B.S., Sabarni Chatterjee, M.B.A., Ph.D., and Mark L. Rohrbaugh, Ph.D., J.D.

Historically, there has been a clear distinction between the roles of public-sector research and corporate research in the discovery of new drugs and vaccines to solve unmet medical needs. Public-sector research institutions (PSRIs) have performed the upstream, basic research to elucidate the underlying mechanisms and pathways of disease and identify promising points of intervention, whereas corporate researchers have performed the downstream, applied research to discover drugs that can be used to treat diseases and have then carried out the development activities to bring the drugs to market. The intellectual property that protects the investment in developing these drugs is created in the applied-research phase.

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Saving Lives From Anal Cancer

via New York Times, by Roni Caryn Rabin

Paulette Crowther’s three children were grown and she was plotting a midlife career change when a routine colonoscopy picked up cancer, but not of the colon — of the anus.

The diagnosis was a shock. Ms. Crowther, a 51-year-old mother of three from New York City, had had no symptoms and was feeling just fine. It felt like a bolt from the blue. The cancer had already spread.

But as Ms. Crowther and her children scoured the Internet for information, they couldn’t help but wonder whether the cancer could have been prevented, or caught earlier at least.

Some 80 to 90 percent of anal cancers are caused by the human papillomavirus, or HPV, the same kind of virus that causes cervical cancer. And decades earlier, when Ms. Crowther was in her 20s, she had been treated for cervical dysplasia, a condition that often precedes cervical cancer – and is also caused by an HPV infection.

If only she had known.

“We think Mom could have been saved if she’d been monitored and screened more often,” said Ms. Crowther’s oldest child, Justine Almada, 27. “Studies show that if you have cervical dysplasia, you’re at higher risk. At the very least, she should have been made aware of that.”

She added, “Anal cancer is quite treatable if it’s found early.”

The same types of human papillomavirus implicated in cervical cancer, HPV 16 and 18, are also linked to anal cancer. And in December, the Food and Drug Administration expanded the approved uses of the HPV vaccine Gardasil to include prevention of anal cancer and precancerous lesions.

Ms. Crowther — who was fiercely devoted to the brood she raised in Lower Manhattan, largely on her own after a divorce, and whom the children call their “best friend” — died last April. Within three months, Justine and her siblings, Tristan and Camille Almada, ages 25 and 23, had established the HPV and Anal Cancer Foundation.

The foundation’s aim is to raise awareness about the link between the human papillomavirus, an incredibly common sexually transmitted infection, and a whole list of cancers, each of which affects a relatively small number of people but which, taken together, affect tens of thousands. Besides anal cancer, HPV infections are linked to some gynecological cancers, like vulvar and vaginal cancers, certain penile cancers in men and certain head and neck cancers.

With a robust Web site — analcancerfoundation.org — and an expert scientific advisory board, the organization also aims to increase awareness about preventive screening, provide support to family members and caregivers and raise money for research on treatment, which remains limited for metastatic disease.

“What keeps us going is the thought that if someone had done this already, it could have prevented what happened to Mom,” said Camille, who recently stepped in to run the tax-exempt foundation.

The irony is that while Ms. Crowther was still alive, she never told anyone what kind of cancer she had. Experts say that’s not unusual for people with anal cancer, who often are ashamed of their disease. “The assumption most people make is that if you have anal cancer, you had anal sex,” Camille said. “That’s not true. Heterosexual men also have HPV in their anus, because HPV is so prevalent. But also: who cares if you had anal sex?”

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

VIDEO controversy: "One up the bum and you won't be a mum"

Article via TNT

A safe sex video has attracted criticism for suggesting anal sex as a form of birth control.

The risqué video advises: “one up the bum and you won't be a mum”.

Abortion charity Marie Stopes International teamed up with comedy music band The Midnight Beast to create the video for an online safe sex campaign.

Read the rest.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

US aid deal for Malawi delayed

via Washington Post, by Raphael Tenthani

A planned deal to give Malawi $350 million in U.S. aid will not be signed this week because more talks are needed amid international concerns new laws curb individual freedoms, officials said Monday.

The Millennium Challenge Corporation announced the power projects in January.

U.S. Embassy spokesman Benjamin Canavan said officials from the program - which dates from George W. Bush's United States presidency - and the Malawi government have been working for three years "to develop a much-needed investment for Malawian people in the power sector."

Caravan did not say what was holding up the agreement nor when it would be finalized.

The delay comes after the German government announced it was decreasing aid to Malawi following Malawi's failure to repeal laws that criminalize homosexuality, and its enactment of laws seen as restricting media freedom.

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Microbicide Trials Network Releases Fact Sheet on Rectal Microbicides

The Microbicide Trials Network has just released a handy resource - a brand new fact sheet on our favorite topic, rectal microbicides. Check it out.

Of course, you can find all kinds of other informational resources on the IRMA website, such as fact sheets on rectal microbicides in Spanish, French, Portuguese, Chinese and Arabic, fact sheets on lubricant safety, as well as adaptable PowerPoints and reports.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Versatility and HIV Vulnerability: Investigating the Proportion of Australian Gay Men Having Both Insertive and Receptive Anal Intercourse

Lyons A, Pitts M, Smith G, Grierson J, Smith A, McNally S, Couch M.

J Sex Med. 2011 Jan 26. doi: 10.1111/j.1743-6109.2010.02197.x. [Epub ahead of print]

Source of abstract.


Introduction. 

There is a lack of recent data on the extent to which gay men engage in insertive anal intercourse (IAI) and receptive anal intercourse (RAI). Accurate assessments of the overall risk of infection from HIV and other sexually transmitted infections (STIs) require such data because versatile men who engage in both roles have heightened vulnerability for becoming infected and infecting others.

Aim. 

To investigate the extent to which gay men are versatile with regard to having IAI and RAI.

Main Outcome Measures. 

Percentages of gay men who reported engaging in IAI, RAI, or both during the past 12 months and in their most recent sexual encounter. Methods.  Eight hundred fifty-six Australian gay men completed an online survey to retrospectively report on their sexual practices over the past 12 months. Results.  Of men who had anal intercourse in the past 12 months, 83% had both IAI and RAI, of whom 57% were highly versatile in that they had approximately equal numbers of partners for IAI and RAI. Of men who had anal intercourse in their most recent sexual encounter, as many as one in five (20%) had reciprocal anal intercourse, having both IAI and RAI with the same partner in a single encounter. Condom use was significantly less likely with reciprocal (38%) than nonreciprocal anal intercourse (50%; P = 0.04). While highly versatile men were less likely to know their HIV status, practices at most recent sexual encounter such as reciprocal anal intercourse and condom use were not significantly related to either their HIV status or that of their partner.

Conclusions. 

Engaging in both IAI and RAI appears to be common among gay men. HIV/STI prevention strategies would benefit from paying attention to the implications of high rates of versatile sexual practices, particularly the tendency for condoms to be used less often when having reciprocal anal intercourse.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenya: "Gays here are just outcasts"

via Voice of America, by Darren Taylor

Excerpt:

Denis Nzioka lives in Nairobi and is one of East Africa’s most prominent gay rights activists.  He works for a variety of NGOs, including the Gay and Lesbian Coalition of Kenya and the Gay Activists Alliance of Africa.

Nzioka says opinions like those of Ichuliza, Wathira and Githui have always been popular in Kenya.  But – fueled by some politicians, religious leaders and “cultural bigots” – he says homophobia’s becoming “much more” common in the country.

“We have had (recent) cases of police beating up gay people.  We have had gay parties being raided by police, or any effeminate guy – maybe in a club – being thrown out by bouncers or the police being called to arrest this person,” Nzioka says.  “We also have cases of gay people being blackmailed.  I know of one well-known Kenyan who has paid blackmailers 200,000 Shillings (about US$ 2,500) to prevent him being exposed as a homosexual.”

According to Nzioka, some Kenyan health institutions are also homophobic.  “We’ve had cases of homosexuals being infected with anal and oral gonorrhea and going to the hospital where doctors refused to treat them,” he says.

He says homophobia is very prevalent in Kenya’s schools.  “We often hear of cases of gay students being discriminated against by fellow pupils and even teachers,” he says.

And in Kenya’s streets, the insults persist.  “Homophobes shout at you, ‘You fag! Homo!   You prostitute!  You are evil; you are immoral.  You are worse than pigs; you are just dogs,” says Nzioka.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Today is National Black HIV/AIDS Awareness Day

National Black HIV/AIDS Awareness Day, February 7th of every year, is a national HIV testing and treatment community mobilization initiative targeted at Blacks in the United States and the Diaspora. There are four specific focal points: education, testing, involvement, and treatment. Educationally, the focus is to get Blacks educated about the basics of HIV/AIDS in their local communities. Testing is at the core of this initiative, as it is hoped that Blacks will mark February 7th of every year as their annual or bi-annual day to get tested for HIV. This is vital for those who are sexually active and those at high risk of contracting HIV. When it comes to community and organization leadership, getting Blacks involved to serve is another key focus. We need Black People from all walks of life, economic classes, literacy levels, shades and tones as well as communities (large and small) to get connected to the work happening on the ground in their local areas. And lastly, for those living with HIV or newly testing positive for the virus, getting them connected to treatment and care services becomes paramount.

Learn more.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]