IAC 2012: No Progress on Visas for Drug Users or Sex Workers

Via Housing Works.

One year from the International AIDS Conference in Washington, D.C., prospects are looking dim for sex workers and drug users who want to attend.

The International AIDS Society has announced that it will release a document in August that details the U.S. visa process for IAC 2012. That document will describe entry restrictions for sex workers and drug users, and it will provide instructions on how to apply for a waiver if a delegate’s visa is denied. IAS will post that information here.

Still no obvious solutions

Strict U.S. regulations that block entry for people who admit to sex work or drug use could keep hundreds from participating in the world’s largest gathering on HIV/AIDS. Recognizing the key role these individuals play in charting the future of the fight against the disease, the IAS formed a working group to troubleshoot avenues for getting marginalized groups into the country.

The working group, however, has already explored—and discarded—a number of options. In June, it released a document stating that it will not lobby to change U.S. immigration policy before the conference.

The group did meet with U.S. officials to ask the federal government to issue a blanket waiver for all conference delegates who are denied a visa. The U.S. government rejected that proposal, and immigration authorities will have to review each waiver individually—a process that will cost delegates both time and money.

Read the rest here.

[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 Report: World’s Premier AIDS Event Neglects Populations Most at Risk for HIV

 via Global Forum on MSM and HIV

Independent assessment indicates severe underrepresentation of gay men, transgender people, sex workers and people who use drugs at the biennial International AIDS Conference

A new report indicates that the International AIDS Conference (IAC), a biennial event convened by the International AIDS Society (IAS) that has become the world’s premier gathering for people working in the field of HIV, suffers from gross underrepresentation of populations most at risk for HIV infection, including men who have sex with men (MSM), transgender people, sex workers and people who use drugs.  The independent audit, conducted by the Global Forum on MSM & HIV (MSMGF), confirms suspicions long-held by activist groups and calls for a comprehensive review of IAC governing structures.

Produced in response to growing concern among community groups that the IAC has repeatedly neglected these key populations, the report focuses on program content at the most recent IAC, held in Vienna, Austria in July 2010.  The analysis reveals that the percentage of all sessions at the conference exclusively focused on these groups was limited to 2.6% for MSM, 1.1% for transgender people, 3% for sex workers and 4.5% for people who use drugs.

“While the International AIDS Society turns a blind eye, HIV rates among these populations continue to climb around the world,” said Dr. George Ayala, Executive Officer of the MSMGF.  “The IAC is the world’s most important opportunity for international exchange and collaboration on HIV and AIDS.  Such abysmal representation of most-at-risk groups only serves to reinforce the invisibility, discrimination and disregard that drive the epidemic among these communities.”

Research has shown that these four populations are at higher risk for HIV infection than the general population in nearly every country context where reliable data exist.  MSM represent more than a quarter of HIV infections in Latin America and the Caribbean, people who inject drugs account for more than half of HIV infections in Eastern Europe,  and sex workers across Sub-Saharan Africa experience HIV prevalence rates of up to 50%.  Infection rates among transgender people in El Salvador, Indonesia and India are as high as 25%, 35%, and 42% respectively. 

The IAC takes place in a different city every two years, gathering tens of thousands of experts and advocates from around the world to share the field’s most recent developments and engage in strategic collaboration.  The most recent conference hosted an estimated 25,000 people.

“Ostensibly, the IAC offers chances for local healthcare providers to learn ways to improve their services, provides channels for advocates to engage in dialogue with powerful decision-makers, and creates opportunities for community members to shape global funding and research agendas,” said Dr. Mohan Sundararaj, Policy Associate at the MSMGF.  “This really is a phenomenal platform, but how useful can it be when those who need it most are locked out?”

The report recommends a number of steps to bring the IAC’s program coverage of these key populations up to a level proportionate to their epidemiological burden.  Among these recommendations are efforts to ensure transparent processes for abstract review and program design, the development of targeted support to authors developing abstracts focused on key populations, and open representation of civil society on the committees responsible for developing conference programs.

“The International AIDS Conference has unparalleled potential to impact the global AIDS epidemic,” said Dr. Ayala.  “It is incumbent upon the organizers to ensure that the IAC becomes a vehicle for change, shifting the global landscape so that funding, research and programs are directed to those who need them most.  Right now it’s part of the problem.”

[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.]

Straight Talk with Dr Zeda Rosenberg, CEO of the International Partnership for Microbicides

Via PlusNews Global

There were cheers and some tears at the International AIDS Conference in Vienna in July when delegates heard the news that a clinical trial in South Africa, had found a vaginal gel containing the antiretroviral drug, tenofovir, was 39 percent effective at reducing women's risk of contracting HIV during sex.

"There were tears from many people – tears of happiness that finally there is something we can work towards - and a lot of tears of sadness for all of the women whose lives have been lost waiting for a microbicide," Dr Zeda Rosenberg recalled at a recent meeting in Johannesburg, South Africa, hosted by the International Partnership for Microbicides (IPM), a non-profit organization.

IPM is involved in coordinating and funding the long process of developing effective microbicides - products that women can apply vaginally to protect themselves against HIV - and making sure they reach the women in developing countries who most need them. Rosenberg, who has been working in the field of HIV prevention research for more than two decades and is CEO of IPM, talked to IRIN/PlusNews after the meeting.

QUESTION: What do you think is the likelihood that women will use a microbicide any more consistently than men use condoms?

ANSWER: Part of the issue with condoms is that although they're highly effective, many people put a large value on skin-to-skin contact and ... in long-term relationships it just seems that condoms aren't used as often because it's a trust issue, an issue of intimacy; and also, if everyone uses a condom all the time, women can't get pregnant.

So there really does need to be a method that women can use where they and their partners don't feel it reduces intimacy, allows for conception, and is culturally acceptable.

I think microbicides need to be marketed with the message: 'Condoms should be used', because you don't want a less effective microbicide replacing highly effective condoms. At some point there will be all of these partially effective methods that, when used together, will be highly effective.

Adherence was a challenge in the [South African] trial - those women who reported greater adherence had greater efficacy. [The investigators] also saw a drop-off in product use over the course of the study, which means you need something that's sustainable in the long term.

For more click here.

AIDS2010 for Dummies: An Entertaining Review

Via My Fabulous Disease, by Mark S. King

If you require a clinical overview of AIDS2010 in Vienna, or a review of the scientific data presented, boy are you reading the wrong blog. Please check out those articles on The Body, AIDS Map, or the AIDS2010 organization itself.

I’m more of a Charles Kuralt type of correspondent. If he had been gay. And HIV positive. And umm, an addict in recovery. I think you get the idea. The goal of my video blogs from Vienna was to introduce you to the people and programs that energized the conference, and the individual stories of participants from far-flung regions of the world. Beyond the headlines, I wanted you to get a feeling for the sights, sounds, and pure energy of the event.

So here’s a day-by-day breakdown of my video blog episodes, including the stories and interviews included in each. Each synopsis begins with a link to that day’s video blog.

For more click here.

New York Times Examines Questions Left Unanswered By Microbicide Trial

Via Kaiser Daily Global Health Policy Report

The New York Times examines a set of questions raised by news out of the International AIDS Conference-AIDS 2010 last week that a microbicide gel containing the antiretroviral (ARV) tenofovir used by women before and after sex helped reduce their risk of HIV infection by 39 percent.

"After more than a dozen microbicide failures, [the news of the trial] was a huge relief …," the newspaper writes, before noting researchers' questions regarding the amount of testing needed before the drug could win approval from regulators, the cost of the drug for poor countries and the potential for tenofovir-resistance from using the microbicide gel.

According to the newspaper, "The price of a dose could fall below that of a condom because the applicators are just molded plastic and, without patents restrictions, 'the Chinese could make them for half a penny,' [Principal investigator Salim Abdool Karim, professor of epidemiology at the University of KwaZulu-Natal in South Africa and Columbia University] said." Other questions, such as how to improve drug efficacy, would be dependent on what researchers find in future clinical trials. "A complex multination trial of several methods, including microbicide, is due to end in 2013, but a rapid new one may be designed as quickly as possible. … Globally, more than a million women a year die of AIDS, so speed is important," the newspaper writes.

The article explores still more questions raised by the trial – such as the viability of the microbicide gel offering protection against HIV transmission for gay men – and includes comments by Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Kevin Fenton, director of the AIDS division of the CDC; Catherine Hankins, chief scientific adviser for UNAIDS; as well as a microbicide researcher and HIV/AIDS advocate (McNeil, 7/26).

For more click here.

'The business of public health': new research on financing of HIV programmes

Via AIDSMap, by Rebecca Hodes

At the International AIDS Conference in Vienna, a session on the financing of HIV programmes yielded important results about the long-term costs and health impacts of continued Global Fund financing of ART. John Stover, from the Futures Group, presented the findings of a model on the future financing required for Global Fund-supported cohorts of ART patients.

Stover explained: “The Global Fund provides grant funding to 140 countries, costing a total of about $11 billion so far. A large proportion of this money is spent on ART. By the end of 2009, the Global Fund was supporting 2.5 million people on ART. This is going to increase to 3.5 million by the end of 2011.”

The key objective of Stover’s study was to answer the question: “How much funding is required to maintain support for these 2.5 million ART patients for as long as they need treatment? And what is the impact of providing this support?”

For more click here.

Gay Men Don't Engage in Riskier Sex When Taking AIDS Pills, CDC Study Says

Via CDC, by Simeon Bennett
Gay and bisexual men didn’t have riskier sex or suffer serious side effects while using Gilead Sciences Inc.’s Viread in a study of whether taking pills to prevent HIV infection would loosen inhibitions or harm health.

Gay and bisexual men who took a daily pill -- either Viread or a placebo -- were no more likely to take greater sexual risks on the assumption they were protected than those who didn’t take one, researchers from the U.S. Centers for Disease Control and Prevention said at the International AIDS Conference in Vienna today. The study also compared the rate of side effects between those who received Viread and those who got a placebo, and found no significant difference.

The study supports efforts to test whether drugs approved to treat AIDS patients can also be used to prevent infections in the first place. That theory, called pre-exposure prophylaxis, or PrEP, was partially validated this week when a vaginal gel containing Viread was shown to reduce infections by 39 percent among women in South Africa.

Click the full study, click here.

Scientists Say A Gel Can Slow HIV Spread

Via NPR, by Ira Flatow
Scientists and policymakers are packing up their posters and PowerPoint presentations and heading home from the International AIDS Conference in Vienna, Austria.

Today is the last day of the week-long meeting, which featured speeches from Bill Clinton and Bill Gates. Some good news was presented at the meeting. The number of people receiving drugs to treat HIV infections is up. And a promising development for controlling HIV transmission was talked about, a new gel that women can use that can help dramatically slow the spread of the virus.

Scientists also shared some new insight in how HIV infections get started and what happens in the body in just the minutes after exposure to the virus.

For audio and transcript click here.