Can HIV Infection Be Prevented with a Once-Daily Pill?

(The following article is included in the World AIDS Day issue of Scientific American, along with articles on circumcision and microbicides.)

Once the bane of global activists and politicians in developing nations, pre-exposure HIV preventatives are being tested in AIDS-stricken Africa

By Nicole Itano
JOHANNESBURG, SOUTH AFRICA—Nearly four years after political pressure shut down two trials that would have tested whether a once-a-day pill could prevent high-risk HIV-negative people from catching the AIDS-causing virus, there’s a surge of renewed interest in the concept, known as Pre-Exposure Prophylaxis, or PrEP.

Western doctors and organizations that funded the halted trials of the anti-HIV drug tenofovir in Cameroon and Cambodia say they've learned their lesson from the debacle in 2004 and 2005, when activist groups questioned the quality of medical care impoverished study participants would receive if they suffered side effects or the became infected by HIV. Today, with at least seven U.S.-funded PrEP trials underway at a cost of $39.5 million, researchers are working with local advocates, who have traditionally been distrustful of Big Pharma, to push the studies forward.

"The whole prevention community really had a wake-up call," says Linda-Gail Bekker, an infectious disease researcher at the University of Cape Town’s Desmond Tutu HIV Center, who is running the South African study site for a new PrEP trial that will eventually involve at least 3,000 gay men in South Africa, Asia, South America and the U.S. The study, which is enrolling trial participants now, is being funded by the U.S. National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation. Its first results are expected in 2010.

Read the rest of this article.

"I'm not a gay person. I just do this for pleasure, like a lot of men."

PHNOM PENH, 11 November 2008 (PlusNews) - At the end of each day, Lux, a construction worker in the Cambodian capital, Phnom Penh, goes home for supper with his wife and young children. But at the weekend he leads a different life, cruising the city's most notorious male brothels, where he regularly has group sex with men while watching pornographic videos.

"I think it's pretty common. A lot of men I know do this in secret without their wives knowing," he told IRIN/PlusNews. When asked about using condoms during sex, he said, "Sometimes, but never with my wife."

After police cracked down on the brothels he visited, Lux turned to the streets, taking nightly strolls through Hun Sen Park, where he pays transsexuals for sex at least once a month.

"Sometimes I get regular women, and sometimes I hire lady-boys," he said. He has never been tested for HIV and does not think it an issue, given Cambodia's falling HIV rate.

HIV prevalence dropped to just 0.9 percent in 2006 from 3.7 percent in 1997. But among men who have sex with men (MSMs), the rate remained an uncomfortably high 5.1 percent nationally, and 8.7 percent in Phnom Penh in 2006, the most recent year for which UNAIDS data is available.

Advocacy groups warn that the lack of outreach programmes to educate MSM about HIV risks could undo the progress that Cambodia as a whole has achieved.

Read the rest on Real Cambodia, Khmer News.

Clearasil condoms?

thanks to IRMA member Sean Philpott for spotting this one!

[via salon.com]
When I was a teenager, my mother had an irritating habit of identifying my zits and then aggressively pointing them out to me. "What's that on your chin?" she would ask, gesturing at the incriminating spot as if, despite the half-hour I had just spent staring at my face in the bathroom, I might have somehow missed it. "It looks like you've got a pimple there. Did you know you have a pimple there?"

"Yes, Mom. I know I've got a pimple there."

"Put some toothpaste on it," she'd say. "Just a dab. It'll clear it right up."

"I already put some other stuff on it."

"Put some toothpaste on it," she'd repeat. "It's amazing."

This routine continued for about four years, and despite many mornings of waking up with blue, peppermint-scented goo on my pillow, I can't really tell you if it worked. (I can, however, assure you that in a pinch, toothpaste makes an excellent silver polish.)

My teenage self would be shocked to learn that when it comes to bizarre pimple treatments, my mother's got nothing on Cambodia. According to Agence France-Presse, there's a new treatment in town: condom lubricant.

Apparently Number One Plus, a water-based lubricant designed for sex workers and gay men, does a great job of clearing up your skin. "It is very effective," said one happy user. "Some people don't believe in it but people who do get a very good result. My younger sister and my aunt use it, too."

Says another: "My friends ... advised me to apply the lubricant from Number One Plus condoms to my face every night. And just within three to four nights, the acne on my face gradually and then totally disappeared."

Someone should sign this woman up for an infomercial. And in countries where there's political opposition to distributing condoms, maybe someone else should play a little fast and loose with labels and switch the terms around, marketing the lubricant as acne cream instead. That way there'd be less controversy around its distribution, teenagers wouldn't have to go to bed with toothpaste on their faces, and eventually people would figure out that the pimple cream was good for smoothing more than just their skin. (Note: The above statement does not apply to Noxema.) Any takers?

In the meantime, though, a question for you all: What are some of the most bizarre beauty treatments family members have recommended to you? Did anyone else out there get the toothpaste thing? Are there American girls who are being urged to smear K-Y jelly on their faces? And have any of these treatments actually worked?

Related: Condom lubricant popular acne cure for Cambodian women

Social stigma in Cambodia keeps gay and MSM from services

Clandestine sexual encounters drive up HIV infections: UN
Original article from the Phnom Penh Post (Aug 18) linked here

Social stigma is keeping same-sex relations among men in the dark, discouraging STD testing and leading to their spiraling HIV rate


The Country Progress Report by the United Nations' General Assembly Special Session (UNGASS), conducted from 2006 to the end of 2007, found 8.7 percent of Phnom Penh's MSM, or "men who have sex with men", are infected with HIV, compared with the national prevalence rate of 1.6 percent amongst adults age 15-49.

Denial and ignorance of same-gender sex have kept many MSM from seeking testing and treatment for sexually-transmitted diseases for fear that their friends and relatives would find out about their sexual activities.

The UN's report said that around 42 percent of MSM have not tested for HIV.

MSM make up about four percent of Cambodian men, according to Tony Lisle, the country coordinator for the Joint United Nations Program in HIV/AIDS (UNAIDS) in Cambodia.

The problem is particularly strong amongst "short-haired" MSM - those who identify themselves as heterosexual and often have wives and families but secretly pursue sex with often multiple male partners each month.

Public health challenge

Cambodia has been able to tackle its HIV/Aids crisis through aggressive public service campaigns targeting mostly sex workers and their male customers.

But so far little has been done to address the risk of infection among MSM, and the UN report cites concerns that these men are spreading HIV to their spouses, threatening the Kingdom's otherwise downward trend in the rate of new infections.

Even MSM who are open about their sexual preferences face sharp discrimination that often discourages them from seeking proper healthcare.

Pech Sokchea, 42, who has been in a relationship with his 25-year-old partner Nay Heng for four years, said that while he has learned to endure insults, the harsh words have taken a toll.

"I think I am just as much a member of society as other people are, and I have the right to love who I want, but I've come to hate myself sometimes," he said.

MSM AND HIV
An estimated 8.7 percent of MSM in Phnom Penh are infected with HIV, while 9.7 percent have some other sexually transmitted disease. Some 66 percent of MSM reported having had an average of three male partners each month. NEW HIV infections among men having often secret sexual relations with other men is five times higher than the national prevalence rate, according to United Nations figures.