ANRS launches first PrEP trial for gay men in Europe

via iPrEx NEws

The ANRS (French National Agency for Research on AIDS and Viral Hepatitis) is about to launch in Europe the first pre-HIV exposure prevention trial in men who have sex with men.

This phase III trial—ANRS IPERGAY—will start at the end of January 2012, in Paris (Hôpital Saint-Louis, Professor Jean-Michel Molina and Hôpital Tenon, Professor Gilles Pialoux) and Lyon (Hôpital de la Croix-Rousse, Dr Laurent Cotte), and later in Montreal in Quebec (CHUM Hôpital Hôtel Dieu, Dr Cécile Tremblay). The trial will include 300 volunteers in the pilot phase and ultimately 1900 in total.

ANRS IPERGAY will involve men who have sex with men and seronegative trans men who have anal sex with men without routine use of condoms, with at least two different sexual partners in the six months prior to trial participation. Participation will last for between 12 (minimum) and 48 (maximum) months.

The trial will compare two groups of participants, one given Truvada®, the other a placebo, taken in both cases during the period of sexual activity, starting before sexual relations and ending afterwards.

All participants, irrespective of group, will be offered various means of prevention: free condoms, regular HIV screening, regular screening for and treatment of sexually transmitted diseases, vaccination against hepatitis A and B. Participants can ask for personalized prevention advice, if they wish.

An important part of the trial will involve a social sciences study of the profiles of participants and analysis of their sexual behavior, in particular regarding condom use, and will determine whether or not they take the medication as intended.

Participants will be invited to the hospital every two months or so for an interview and for clinical examinations, including screening tests.
The ANRS will sponsor and fund the trial, and Gilead will supply the medication.

The HIV community-based association Aides helped draw up the protocol, is a scientific and operations partner in the trial, and is a member of the scientific board. It will coordinate recruitment in the field and provide volunteers with prevention support.

ANRS press contact:
Marie-Christine Simon – Tel : +33 (0) 1 53 94 60 30 marie-christine.simon@anrs.fr



[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.]

Ongoing risk behaviour likely cause of high HIV incidence rate among gay men treated with PEP

via Aidsmap, by Michael Carter

HIV incidence is high among gay men who use post-exposure prophylaxis (PEP), investigators from Amsterdam report in the online edition of AIDS.

Overall, users of PEP were almost four times more likely to become infected with HIV than gay men who did not use the therapy.

There was no evidence that PEP failure was the cause. The investigators believe this is because PEP users continued to put themselves risk of HIV after completing their treatment.

“Our study showed a high incidence of HIV among MSM [men who have sex with men] who used PEP, an indication of ongoing risk behaviour,” write the investigators. “This implies that PEP alone for this group is not sufficient to prevent HIV infection, and a combination of other more comprehensive preventative strategies is needed.”

HIV post-exposure prophylaxis is a four-week course of combination antiretroviral therapy, prescribed after an encounter with body fluids possibly infected with HIV.

It is estimated that the treatment can reduce the risk of infection by up to 81%.

Gay men are the group most likely to request PEP after a possible sexual exposure to HIV. Australian research has shown that gay men who used PEP continued to be at risk of HIV after completing their treatment.

Therefore, Dutch investigators compared HIV incidence among gay men prescribed PEP in Amsterdam between 2000 and 2009, and compared this to the rate of new infections seen over the same period among gay men enrolled in the Amsterdam Cohort Study.

A total of 355 men who received 395 PEP prescriptions were included in study. The majority of individuals took one course of PEP, but approximately 10% of men were provided with multiple prescriptions (two to four).

Adherence rates were high, with 94% of men completing their therapy. HIV status was monitored three and six months after baseline.

Eleven PEP users seroconverted. Two men tested HIV-positive at their three-month follow-up appointment; one individual who did not attend for his three month appointment was diagnosed at month six; and the remaining eight men were HIV-negative at month three, but were HIV-positive at month six.

This provided an HIV incidence of 6.4 per 100 person years among the individuals treatment with PEP.

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.]

MSM living in hostile social environments more likely to have negative feelings about sexuality, less likely to test for HIV

via aidsmap, by Roger Pebody

The largest ever international study of the sexual health of men who have sex with men (MSM), which recruited men from across the European continent, has found clear links between the social environment men live in and their own internal acceptance of their sexuality. Furthermore, men with 'internalised homonegativity' were much less likely to test for HIV.

These European results are to some extent confirmed by a study from the United States, which found that men living in states that are hostile to gay issues were more likely to have internalised homonegativity than men living in more tolerant states. However the American researchers found that the relationship between men's feelings about their sexuality and unprotected sex was quite weak.

Preliminary results from both studies were presented to the Future of European Prevention among MSM (FEMP) conference in Stockholm last week.

While the term 'homophobia' is probably better known than 'homonegativity', a number of researchers prefer the latter as it does not suggest that negative attitudes to homosexuality and homosexuals are fundamentally driven by fear. Public expressions of homonegativity may include discriminatory laws, personal rejection by family and friends, violent attacks in public spaces, disapproval from religious authorities and hostile newspaper articles.

When gay, bisexual and other men who have sex with men have negative or ambivalent feelings about their own sexuality, this is termed 'internalised homonegativity'. It has been defined as "the gay person's direction of negative social attitudes toward the self, leading to a devaluation of the self and poor self-regard".

While it may seem obvious that negative social environments can create negative psychological states, the link between social factors at a country level and men's internalised homonegativity has not been clearly demonstrated before.

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.]

The European MSM Internet Survey (EMIS) - See What They Learned!

via EMIS

This is the second community report written especially for you - members of Europe’s diverse LGBT communities. We hope that you find this information interesting and helpful! The first community report covered testing for HIV, knowledge about testing, being ‘out’, sexual happiness and the ‘sexiest man on the planet’. All EMIS community reports are available in 25 languages at www.emis-project.eu.

In this second report we will focus on a range of topics dealing with sex and the number and type of sexual partners, as well as testing for STIs other than HIV. Please be aware that this information is only preliminary, and that we are in the process of preparing a more detailed report for publication later in 2011. Similar to the previous community report, we have included an overview of the data discussed in this report on page three. When reading the table, if you compare the numbers of EMIS respondents in the left column with the first report, you will notice that they have slightly decreased. This is due to changes in the criteria used to exclude respondents’ data from the study if responses were not consistent. We do our best not to report on data from men who hastily clicked through the survey and who did not provide answers that actually corresponded to their knowledge and experiences.

Who You Had Sex With

In each country a significant number of you, who completed the EMIS questionnaire, did not identify as ‘gay or homosexual’. This means we clearly reached a wide range of men who have sex with men. Indeed, around 15% of all respondents reported having had sex with a woman in the twelve months prior to completing the survey. As the table on page three shows, this went from a low of nearly ‘one in ten’ of you in Belgium (.be), the Netherlands (.nl), Poland (.pl) and France (.fr) to over a quarter of you in Slovenia (.si), Bulgaria (.bg) Romania (.ro) and Bosnia & Herzegovina (.ba).

How Many Men You Had Sex With

In the table on page three you can see in which countries partner numbers were particularly high or low. Many of you (43% to 59%) had between two and ten partners, while having more than ten partners went from 10% to over 25% across the 38 countries. The number of sexual partners tells us a few things, such as, how easy or difficult it is to find partners (because they might not be ‘out’ or there might be no places or venues for you to meet). This may also tell us about how hard it might be for many of you to build steady relationships, particularly in societies where same sex couples are not officially recognised or allowed. Of course many men choose to have multiple sex partners. It is advised that the more partners you have, the more often you need to have a sexual health check-up.

Where You Met Men to Have Sex

We asked you where you met your last non-steady male sex partner (of those who had a non-steady partner in the last twelve months). The most common response was “on the Internet”, followed by various sex venues including gay saunas and backrooms of bars and clubs.

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.]

A Gay Age of Consent?

From Pink News, by Jessica Geen

The Gibraltar Supreme Court is considering whether the age of consent for gay men is discriminatory.

The territory currently allows lesbians and heterosexuals to have sex at 16, but the age of consent for gay men is 18. Anal sex is illegal between men and women.

Chief Minister Peter Caruana and Attorney General Ricky Rhoda have asked the court to declare whether the current law is constitutional.

The Gibraltar government’s arguments against lowering the age of consent for gay men were published in February.

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.]

Catholics and Condoms: Why What the Pope Says Matters

via The Body, by Jon O'Brien

During his 2009 trip to Cameroon, a country with an HIV prevalence rate of over 5%, Pope Benedict XVI made a shocking assertion on condom use to prevent HIV. He told reporters, "You can't resolve it with the distribution of condoms. On the contrary, it increases the problem."

Read the rest.

Tip one back at the Rectum Bar?

Come Inside The Rectum Bar For A Slow Comfortable Screw Up Against The Wall
via Gizmodo, by Kat Hannaford

Here I was, thinking Europeans were meant to be classier than Americans—but have you ever heard of a Rectum Bar outside of Vienna, Austria? Do you even know what a rectum is? The whole digestive system is there—the tongue, stomach, small and large intestines and then the money-shot—the anus. All anatomically correct (apart from the large intestine), all enough to turn you off your G&T.

Source.

Funding for rectal microbicides has DECREASED in two years

According to the latest report just released by the HIV Vaccines and Microbicides Resource Tracking Working Group, funding for rectal microbicides research has decreased significantly in the past 2 years.

When IRMA last tracked resources dedicated to RM research in 2006, we estimated that US$7.2 million was spent globally. According to the report Adapting to Realities: Trends in HIV Prevention Research Funding 2000-2008, released earlier this week, that amount decreased to US$5 million in 2008.

7X more funding needed
In 2006, IRMA called for a five-fold increase in annual funding for rectal microbicide research and development: from about US$7 million to US$35 million per year for the next 10 years. This is what we estimated would be needed – conservatively – to bring at least one effective rectal microbicide through all stages of research.

Now, we need a seven-fold increase from US$5 million to US$35 million.

More diverse funding needed
Nearly 100% of all global investment for rectal microbicides development comes from one source: US public and philanthropic institutions. Most of this US investment comes from the government. While this support is appreciated, a much more diverse funding base is needed.

Where are the governments and research institutions? Where are the foundations?

Australia?
Belgium?
Canada?
Denmark?
France?
Germany?
Ireland?
The Netherlands?
Norway?
Spain?
Sweden?
The UK?
The European Commission?
The Bill & Melinda Gates Foundation?
The Rockefeller Foundation?
UNFPA?
The World Bank?

All of them have contributed to microbicides research, for which we are eternally grateful. But they should also contribute specifically to rectal microbicide research. The entire rectal microbicides field should not be funded solely by the US NIH and amfAR.

Recognised need
It is ironic that in the same time period that saw rectal microbicides become increasingly recognised as an essential component of HIV prevention research, global investment faltered.

Investment in rectal microbicide development MUST INCREASE at this critical time when the HIV prevention field is more willing than ever to acknowledge the need to address the prevention needs of those who engage in anal sex: heterosexual women and men, gay men and other men who have sex with men from around the world – including in Africa, Latin America and the Caribbean, Asia-Pacific, Europe and North America.

Funds needed to move research agenda forward
Exciting research projects are ready to move forward: rectal safety trials, rectal-specific formulation work, lubricant safety, acceptability research, research into incidence, prevalence and context of anal intercourse in various populations around the world. More funding is desperately needed to maintain a robust research agenda.

Read IRMA’s 2006 report: Rectal Microbicides: Investments and Advocacy

Read the HIV Vaccines and Microbicides Resource Tracking Working Group report: Adapting to Realities: Trends in HIV Prevention Research Funding 2000-2008

Read IRMA’s 2008 report: Less Silence, More Science: Advocacy to Make Rectal Microbicides a Reality





Join efforts to advocate for more investment in rectal microbicide development!

EATG calls for more research and funding for prevention

The European AIDS Treatment Group (EATG) has recently released a comprehensive policy paper on HIV and AIDS prevention.

As a pan-European organisation of people living with HIV, EATG has been championing the concept of prevention, especially 'positive prevention' for years. Positive prevention entails the active involvement and leadership of people living with HIV and AIDS in prevention work.

EATG chair, Anna Zakowicz, states: ”Universal access to HIV prevention as well as treatment is necessary if we are to control the HIV epidemic globally and in Europe. No single prevention intervention is ever likely to stop the epidemic by itself and EATG therefore demands a comprehensive response involving social, behavioural, biomedical and structural interventions.”

People therefore need a varied package of prevention interventions which should include access to condoms (male and female) and access to sterile injecting equipment and opiod substitution therapy in all settings including prisons, information on HIV, behavioural support and interventions, and social support. EATG emphasises that it is important not to base HIV prevention and risk decisions on assumptions about the HIV status of partners and recommends continued awareness-raising of this point.

In addition, EATG urges more scientific research, and more funding allocation for research, into behaviour change and support programmes to populations living in Europe, especially marginalised and invisible groups. EATG supports continued research into new biomedical methods of prevention such as microbicides, pre-exposure prophylaxis (PrEP), prophylaxis against other sexually transmitted infections (STIs), and vaccines.

EATG considers that the HIV prevention needs of people already living with the virus have been neglected. Targeting HIV-positive people for prevention help and support is an equitable and cost-effective way of preventing HIV. EATG supports methods and technologies, which help to prevent HIV transmission between serodiscordant partners who have a desire for childbirth.

EATG supports initiatives to increase the proportion of people with HIV who are aware of their status. EATG advocates for counselling for every pregnant woman and encouragement and offer of voluntary HIV testing. It is also important to combat social, legal and cultural barriers against testing and disclosure, in particular the criminal prosecution of HIV transmission and exposure.

Click here for the paper (and note that IRMA is mentioned on page 18!)

HIV rates have DOUBLED among gay men in Europe, TRIPLED among gay men in China

Rates of HIV among gay men have tripled in China in three years, according to the Shanghai Daily.

In Europe, rates have almost doubled since 2000, according to aidsmap.


Article from China: HIV-rate among gay men triples

The prevalence of HIV/AIDS infection among local gay and bisexual men has almost tripled from 1.5 percent three years ago to 4.4 percent, said a survey released yesterday, World AIDS Day.

The incidence of syphilis among gay and bisexual men had risen to 10.3 percent, according to the survey. The latest figures from Shanghai Center for Disease Control and Prevention put the incidence of syphilis in gay and bisexual men even higher, at around 13 percent.

The survey information was collected from 203 gay and bisexual men in Shanghai. All those interviewed underwent blood tests for HIV and syphilis. The hospital has started to give any who tested positive free syphilis treatment. Treatment for HIV/AIDS is also free. Read the full article.



Article from aidsmap: HIV diagnoses in European MSM have almost doubled since 2000, UK tops the list

Data from 23 European countries show that the annual number of HIV diagnoses in men who have sex with men (MSM) has increased by 86% between 2000 and 2006, report epidemiologists in the November 2008 issue of Sexually Transmitted Infections. The United Kingdom is the country with the highest number of new diagnoses in Europe, but dramatic increases were also seen in low prevalence countries in Central and Eastern Europe. Read the full article.

European Request for Proposals Includes Rectal Microbicides

From the Global Campaign for Microbicides' European Secretariat:

We are happy to announce that the European Commission has launched a series of Requests for Proposals (RFPs), including a specific call for microbicides discovery and/or development for 6 to 12 million euros (more information below).

Officials at the European Commission Directorate-General for Research informed us that there had been unanimous support from member states for the idea of a 12 million euro Request for Proposals for microbicides research. Of the several hundred potential RFPs presented to member states, many had selected the microbicides one as being of particular importance and no negative comments were received at all.

Clearly there is a broad level of support among policymakers across the region at the member state level for ongoing EU-led and funded microbicides research, thanks to the efforts of advocates working at both the national and EU level to articulate the value of microbicides research and why it must continue.

We are also happy to note that for the first time in a call, the topic focuses on both vaginal and rectal mucosae.

We strongly urge European researchers to take advantage of this call, and we encourage microbicide advocates to circulate this call among researchers in your country. GCM and their European advocates are in the process of compiling a list of researchers working on microbicides across Europe and can help researchers make the linkages necessary to be eligible to apply.

Deadline for applications: December 3, 2008

Warm regards,

GCM European Secretariat: Rebekah Webb, Arwa Meijer and Marc-André LeBlanc

In order to receive a complete Information Package for this call, you will need to select the following elements:

1. The call fiche (only available in .pdf format) attached

2. The work programme (.pdf format) attached

3. FP7 factsheets in your preferred language - an overview of the basic features of this programme (.pdf format)

4. The Guides for Applicants relevant to the funding schemes used in this call (.pdf format)