Many HIV/AIDS Advocates Support the FDA to Approve PrEP for HIV Prevention

via PRNewswire

In public comments submitted this week, a group of 14 leading HIV/AIDS and health organizations stated their support for Food and Drug Administration (FDA) approval of emtricitabine/ tenofovir disoproxil fumarate (TDF/FTC or Truvada®) as pre-exposure prophylaxis (PrEP) to prevent HIV infection in adult men and women. Their comments, submitted in advance of a May 10 FDA Advisory Committee meeting, pointed to compelling evidence on the efficacy of TDF/FTC as PrEP and highlighted the unique potential of this intervention to help slow the HIV epidemic in the U.S.

With PrEP, HIV-negative individuals who are at risk for HIV take anti-HIV medications in order to reduce their chances of becoming infected if exposed to the virus. At the May 10 hearing, the FDA will consider data from clinical trials showing that TDF/FTC reduced the risk of sexual transmission of HIV in populations including men who have sex with men (MSM) and heterosexual women and men.

"The U.S. and international AIDS community overwhelmingly supports FDA's priority review of this potentially game-changing new tool to prevent HIV," said Mitchell Warren, executive director of AVAC. "The evidence is increasingly clear that daily PrEP can help reduce HIV risk in women and men who take it consistently as prescribed. While no single tool will be enough to stop the spread of HIV, PrEP could be a vital part of a comprehensive, global strategy to end the AIDS epidemic."

Despite some progress in reducing HIV incidence using other available methods, approximately 50,000 people become newly infected with HIV every year in the United States, and 2.6 million people were newly infected with HIV worldwide in 2010. Globally, half of all people infected with HIV are women and girls. In the United States, HIV infection continues to take a disproportionate toll on African Americans and Latinos; MSM, including transgender individuals; and the poor. Driving down HIV infection rates is a primary objective of the U.S. National HIV/AIDS Strategy, and is at the core of global efforts to end the AIDS epidemic.

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*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.

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The FDA Evalutes the Decision on PrEP for HIV Prevention

via The New York Times, Denis Grady

An advisory panel to the Food and Drug Administration is expected to vote Thursday on whether a drug already used to treat H.I.V. infection should also be approved to prevent it. Such a recommendation, if made, would mark the first time that government advisers have advocated giving antiviral medicine to healthy people who might be exposed through sexual activity to the virus that causes AIDS.

Studies have shown that people who take the medicine, Truvada, every day have a greatly reduced risk of infection.

The F.D.A. usually accepts the advice of its advisory panels, which are made up of outside experts, mostly from medical schools.

On Thursday morning, the panel evaluated studies of the once-a-day pill and heard scientific presentations about whether Truvada should be prescribed for people at high risk of infection, like gay men who have multiple sex partners, especially those who do not always use condoms, and people in relationships with someone who is H.I.V.-positive. Young black men who have sex with other men are at highest risk.

The drug is meant not to replace condoms and other safe-sex measures, but to be used with them for added protection.

Experts say better methods of prevention are needed because there are 50,000 new H.I.V. infections a year in the United States. Several speakers emphasized on Thursday that that number had not budged in 15 to 20 years. Counseling and condoms are not doing the job, they said, and many of the newly infected are men whose sexual partners do not realize they are H.I.V.-positive.

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------------------- *Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world. *Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content. -------------------

U.S HIV Funding for Gay and Bisexual Men May Cause Concerns

via Funders Concerned About AIDS, by Sean Cahill



Over the past few years we have witnessed a number of advances in science-based HIV prevention and care policy and LGBT health policy in the U.S.

We have a first-ever National HIV/AIDS Strategy that prioritizes reducing the disparity affecting gay and bisexual men—who were 64% of new infections in 2009, although just 2% of the adult population.

We repealed a number of counterproductive policies dating back to the dark days of the 1980s and Senator Jesse Helms, such as ending the HIV entry ban, ending the ban on using federal funds for syringe exchange, and ending funding for abstinence-only-until-marriage education. Unfortunately, the latter two changes were short-lived. And we’ve seen long overdue increases in funding for Ryan White care, the AIDS Drug Assistance Program, HIV prevention through the CDC, and research at NIH, including promising biomedical prevention research.

In LGBT health policy—an overlapping area of concern as about 600,000 people living with HIV in the U.S. are gay and bisexual men and transgender women—we’ve got a public health strategy, Healthy People 2020, that prioritizes for the first time ending LGBT health disparities. President Obama has guaranteed hospital visitation rights for same-sex partners, offered domestic partner health insurance to civilian federal employees, and Secretary Sebelius is adding a sexual orientation question to the National Health Interview Survey. This is all great news, and we are grateful to our allies in government who have worked with community leaders to accomplish these important advances.

However, as the HIV epidemic among gay and bisexual men, and especially Black gay men, rages—with 30,000 gay men newly infected each year, 60% of them Black and Latino—federal government funding targeted toward gay and bisexual men and transgender women is not matching the demographics of the epidemic. Furthermore, critically needed, bold policy initiatives that address key structural drivers of vulnerability among gay men are lacking.


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[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 Impact 'Harm Reduction Strategies' Has on Sex Workers

via The Jurist, by Elizabeth Hand

Shohagi was only fourteen when her father arranged her marriage. Sent away from her home, family and friends to marry an unknown man who was much older, she quickly discovered her partner's violent nature. The abuse sent her fleeing back home to a family that rejected her for disobeying her father, threatening her with death. No longer possessing any support system or income, she was shepherded into a brothel in Calcutta. Western perspectives on sex work require such a tale to be met with horror and sympathy. However, Shohagi describes her experience as a sex worker with hope and empowerment. Working in a brothel gives her the chance to earn an income and support herself. Distanced from the violence of both her husband and family, she prefers her life of autonomy.

Shohagi's story is far from unusual, yet it does not conform to the usual cautionary tale that accompanies debates about sex work. Too often the narrative is one of woe and misfortune that leaves a woman with no choice but to become a prostitute, and her life rapidly decays. Adopting this typical western, feminist criticism of prostitution leaves no room for the possibility that a person chooses sex work, and is also pursuing his or her best interests. While many second-wave academics, like Catharine MacKinnon in her article Prostitution and Civil Rights, draw a distinction between indentured servitude and sex work by making the argument that a condition entered into voluntarily, prostitution, is different than one entered into involuntarily, servitude. However, functionally they are both treated as a type of slavery. This approach fails to validate a person's choice to work as a sex worker. In the name of protecting women, MacKinnon fails to acknowledge the agency of women who choose sex work. A viewpoint like this highlights the shortcomings of western ideologies that tend to equate morality with legality. To the contrary, harm reduction strategies can offer protection to sex workers, who are at a high-risk of contracting HIV or facing sex-related violence. However, rather than focusing on harm reduction, generally criminalization is preferred, which strips sex workers of valuable protections and condemns them as immoral.

While no federal law exists that bans all prostitution across the board, Nevada is the only state that, in a few counties, has legalized some forms of prostitution. Many states enforce punishments exceeding a year in prison for this line of sex work. In essence, with the exception of a few counties in Nevada, prostitution is illegal in the US. The reasons cited for why prostitution should remain illegal range from the argument that it is degrading and base to the idea that it is a form of violence against women, or that banning it deters violence against women. Are these compelling enough reasons to justify the continued criminalization of many forms of sex work? Looking to other countries' approaches to monitoring sex work, the US has a lot to gain from legalizing prostitution as a means to ensure sex workers' safety, health and protection from abuse. If the US were to legalize prostitution, the government could more closely regulate it, implementing harm reduction strategies that could be pivotal in tackling HIV/AIDS, STIs, and violence towards sex workers.

The US has traditionally disfavored the implementation harm reduction strategies, preferring to take the moral high road. From needle exchanges to the regulation of sex work, the US chooses hardline stances against these activities at the cost of abandoning citizens that could be offered partial protection. Needless to say, HIV and AIDS are significant concerns when it comes to sex work, and US policy continually uses HIV/AIDS as a guise for providing a motive for eradicating sex work, specifically prostitution. However, when the government steps in to monitor and regulate commercial sex, as opposed to prohibiting it, HIV incidence is likely to go down. Without the government stepping in to police the sex trade, sex workers will continue to be at high risk of infection, while also lacking access to health care and prophylactic resources. Policies aimed at regulating brothels for public health reasons have had tremendous success in lowering not only the incidence of HIV infections in sex workers, but also the overall incidence in the population by altering behavior when it comes to practicing safer sex methods. A UNAIDS case study evaluated Thailand's 100 percent condom use program and found that the government's mandate of condom use within brothels, a policy aimed at combating rapidly rising HIV at the onset of the global AIDS epidemic, made sex work safer and altered cultural norms surrounding sexual practices for the entire nation.

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[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 Present Data on the Relationship of HIV Knowledge and MSM Internet Users

via PLoS One, by Bradley H. Wagenaar, Patrick S. Sullivan, Rob Stephenson

Introduction

Since the emergence of HIV as a global pandemic in the 1980s, men who have sex with men (MSM) have shared a disproportionately large burden of infection in many high-income countries in Western and Central Europe, Australia, and North America. Due to this recognized high burden, MSM represent a large target population for resources on HIV/AIDS prevention, treatment, and research in these areas. By contrast, Africa's HIV/AIDS epidemic has long been understood primarily as a “heterosexual epidemic”, with an estimated 80% of HIV infections being tied to heterosexual transmission. This focus has led to HIV/AIDS prevention efforts in Africa being targeted primarily to heterosexuals.

Recent epidemiological evidence has shown that MSM in Africa share a disproportionate burden of HIV infection. Prevalence estimates of MSM in Africa range from 1–4% of the general population, but high levels of HIV infection and a high prevalence of MSM also engaging in sex with women has led MSM transmission to be linked to over 20% of all HIV cases in several countries of the Middle East, North Africa, and West Africa. These data are at odds with the fact that most African countries have not dedicated any national HIV/AIDS funds to specifically target HIV/AIDS among MSM.

The 2009 UNAIDS report on universal access for MSM and transgender people highlights the global failure in addressing the needs of MSM regarding HIV/AIDS education, prevention, treatment, research, and care. One of the foci of this report is increasing access to HIV/AIDS prevention materials for MSM and transgender individuals. Although increasing HIV/AIDS knowledge alone is not sufficient to promote sustainable behavior change, accurate knowledge of transmission and prevention of HIV is necessary if MSM are to adopt risk reduction strategies.

Globally, reporting on HIV knowledge among MSM is sparse. Only 33 out of 147 low and middle income countries (LMIC) reported knowledge data through the 2008 United Nations General Assembly Special Session (UNGASS). Only 2 of these 37 countries reporting UNGASS HIV knowledge data were in Africa, with Nigeria and Mauritius reporting that only 44% and 48% of MSM respectively could “correctly identify ways of preventing sexual transmission of HIV and could correctly reject major misconceptions about HIV transmission”. Additionally, across all low and middle-income countries reporting knowledge scores, less than half of MSM held correct HIV knowledge.

Other studies from Sudan and Kenya indicate that MSM in Africa may have low knowledge regarding HIV prevention and transmission. More than half (55%) of a sample of MSM in Sudan and 35% of respondents in Mombasa, Kenya did not understand the link between anal sex and HIV infection. By contrast, over 90% of samples of MSM in Malawi, Botswana, and Namibia understood that HIV can be transmitted through anal sex with a man. However, of these samples, only 57%, 50%, and 85% respectively had ever received educational materials on preventing HIV transmission between men.

Data on levels and correlates of HIV/AIDS knowledge in Africa are essential to develop effective prevention and education strategies. Previous studies of HIV knowledge among MSM have focused on levels of HIV knowledge, but have not systematically examined factors associated with low knowledge. The present study aims to fill this gap by examining factors associated with low HIV/AIDS knowledge among MSM in South Africa and the United States using a validated HIV knowledge scale.

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[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.]

Ugandan Gay Rights Activists Take Action

via New York Times, by Laurie Goodstein

A Ugandan gay rights group filed suit against an American evangelist, Scott Lively, in federal court in Massachusetts on Wednesday, accusing him of violating international law by inciting the persecution of gay men and lesbians in Uganda.

The lawsuit maintains that beginning in 2002, Mr. Lively conspired with religious and political leaders in Uganda to whip up anti-gay hysteria with warnings that gay people would sodomize African children and corrupt their culture.

The Ugandan legislature considered a bill in 2009, proposed by one of Mr. Lively’s Ugandan contacts, that would have imposed the death sentence for the “offense of homosexuality.” That bill languished after an outcry from the United States and European nations that are among major aid donors to Uganda, but was reintroduced last month.

Mr. Lively is being sued by the organization Sexual Minorities Uganda under the alien tort statute, which allows foreigners to sue in American courts in situations asserting the violation of international law. The suit says that Mr. Lively’s actions resulted in the persecution, arrest, torture and murder of gay men and lesbians in Uganda.

Reached by telephone in Springfield, Mass., where he runs Holy Grounds Coffee House, a storefront mission and shop, Mr. Lively said he did not know about the lawsuit. Nevertheless, he said: “That’s about as ridiculous as it gets. I’ve never done anything in Uganda except preach the Gospel and speak my opinion about the homosexual issue.”

Mr. Lively is the founder and president of Abiding Truth Ministries. He is also the author of “The Pink Swastika: Homosexuality in the Nazi Party,” which says that Nazism was a movement inspired by homosexuals, and “Seven Steps to Recruit-Proof Your Child,” a guide to prevent what he calls “pro-homosexual indoctrination.”

He has traveled to Uganda, Latvia and Moldova to warn Christian clergy members to defend their countries against what he says is an onslaught by gay rights advocates based in the West.

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[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/AIDS Treatments Compromised by Budget Cuts

via Nature News, by Erika Check Hayden

Preventing the spread of HIV used to mean testing people for infection and encouraging them to practise safe sex. Increasingly, it also means prescribing drugs, as studies show that giving infected people or their uninfected partners antiretroviral drugs as soon as an infection is diagnosed can help to check the spread of AIDS.

Yet at this week’s annual Conference on Retro­viruses and Opportunistic Infections in Seattle, Washington, there was growing concern that financial austerity in the United States and elsewhere is eating away at the funding needed for a worldwide prevention effort.

Many scientists and advocates agree that there is now an “awesome possibility to prevent the spread of HIV”, says Sharonann Lynch, HIV policy adviser for Médecins Sans Frontières (MSF, also known as Doctors Without Borders) in New York. “If we decrease the money invested in treatment now, we are squandering the best opportunity we’re going to have to get ahead of the wave of new infections.”

Last month, US President Barack Obama’s 2013 budget request proposed a 10.8% cut to direct international aid for HIV programmes under the President’s Emergency Plan for AIDS Relief (PEPFAR) which, together with previous cuts, would slice more than US$1 billion from the fund’s 2010 level (see ‘Sliding support’). And last November, the Global Fund to Fight AIDS, Tuberculosis and Malaria said that it would not hand out any more funds for scaling up AIDS treatments until 2014 because of tightening budgets in donor countries (see Nature 480,159–160; 2011).

The shortfalls come as a slew of results presented this week reinforce a growing consensus about the power of early treatment for HIV infections. The latest data are part of a trend that accelerated last May, when HPTN 052, a clinical trial run by the multinational HIV Prevention Trials Network, showed that giving antiretroviral drugs to people who are HIV-positive can stop them from passing the virus to their uninfected partners (M. S. Cohen et al. N. Engl. J. Med. 365, 493-505; 2011). In light of such results, the World Health Organization is expected to issue new guidelines for managing HIV in couples soon.

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[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.]

CDC awards $55 million for HIV prevention among gay, bisexual and transgender youth of color

via NCHHSTP Newsroom

The Centers for Disease Control and Prevention today awarded $55 million over five years to 34 community-based organizations (CBOs) to expand HIV prevention services for young gay and bisexual men of color, transgender youth of color, and their partners. The awards expand upon a previous program to reach these populations with an increase of $10 million to fund a larger number of community organizations. The average award for each organization is approximately $300,000 per year.

“On this National Gay Men’s HIV/AIDS Awareness Day, we are reminded of the urgency of the HIV epidemic in the United States and the dramatic impact among gay and bisexual men, who account for more than 60 percent of new infections,” said Dr. Jonathan Mermin, director of CDC’s Division of HIV/AIDS Prevention. “We must also recognize that the epidemic cannot be overcome without effectively addressing the severe and rising toll of HIV infections among gay and bisexual men of color, who continue to be hardest hit by this disease.”

Recent data show that young men who have sex with men (MSM) of color are at particularly high and increasing risk of HIV infection. According to CDC estimates released in August, between 2006 and 2009, the annual number of new HIV infections increased 48 percent among young black MSM. Among Latinos, men who have sex with men are by far the most severely impacted, accounting for nearly two-thirds of all new infections. Nearly half of these infections among Latino MSM occurred in the youngest age group (aged 13-29). Transgender people are also severely affected by HIV. It is estimated that 28 percent of transgender people are HIV-infected.

The new CDC awards are designed to enable CBOs with strong links to these populations to meet their specific HIV prevention needs. As part of these awards, each organization will be required to provide specific prevention services. These include providing HIV testing to a total of more than 90,000 young gay and bisexual men and transgender youth of color, with a goal of identifying more than 3,500 previously unrecognized HIV infections (over the five-year funding period) – and linking those who are HIV-infected to care and prevention services. CBOs will also carry out proven behavioral change HIV prevention programs and distribute condoms to young gay and bisexual men and transgender youth of color who are at high risk for HIV or are HIV-infected.

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[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.]

An end to AIDS is within our reach

via The Washington Post, by Desmond Tutu

A study published in the New England Journal of Medicine last month has demonstrated that antiretroviral treatment can prevent the spread of HIV, in addition to saving those infected from sickness and death.

Armed with this new data, President Obama should lead the world in a massive effort to expand access to treatment and rid humanity of AIDS — the most devastating disease of our time.

But just as the end of AIDS has finally come within reach, we are witnessing an unprecedented drop in financial and political support for the cause.

The Joint United Nations Programme on HIV/AIDS and the Kaiser Family Foundation reported in August that donor funding for HIV/AIDS leveled in 2009 and then declined — 10 percent — in 2010 for the first time ever. The United States, which accounts for more than half of global contributions to fight the disease, disbursed $700 million less in 2010 than in 2009. And projected U.S. funding in 2011 is roughly $28 million less than in 2010.

This is a great shame, as millions of people receiving treatment worldwide depend on these funds to stay alive.

Our support should be increasing. AIDS remains the leading cause of orphanhood and of death among women of reproductive age. It is a major driver of opportunistic infections — particularly tuberculosis — and keeps tens of millions of Africans mired in poverty.

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[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.]

'Less education' associated with PrEP and PEP use: only one in five gay men yet aware of PrEP

via aidsmap, by Gus Cairns

A survey (Mansergh) of 454 HIV-negative gay men in four US cities (New York, Los Angeles, Chicago and San Francisco) has found that men with lower educational attainment (high school only) were more likely to use antiretrovirals informally for HIV prevention, either as pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), than men who had had further education.

In a parallel survey of 557 HIV-positive gay men, men with lower educational attainment were, similarly, more likely to share their antiretroviral pills with HIV-negative partners to use as PrEP or PEP.

Taken together, 22% of the men in the two surveys were under 30, 35% in their 30s and 43% 40 or over. A third were black, 38% white and the rest Hispanic or of other ethnicity.

Roughly a third each of the sample had education only to high school level, to some college qualification, or to a university degree.

The survey asked both groups if they had used PrEP or PEP or, in the case of the HIV-positive men, provided it to others, in the last six months.

Informal use of PrEP or PEP was still comparatively uncommon; only a few per cent of those surveyed overall had used ARVs as prevention or provided them in the previous six mnoths.

However men with high-school-only education were two to six times more likely to report using one of these strategies.

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[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.]

Meet Amy Stapleford Jackson - A Friendly Rectal Microbicide Advocate

"IRMA has gathered together people who are doing great work in the fields of sexual health, scientific research, medicine, HIV prevention, and microbicide advocacy and by pooling these resources is making important strides advocating for safe, effective rectal microbicides." - Amy Stapleford Jackson, Chapel Hill, USA

Amy is a many-talented and busy advocate. Among several projects, she works with a scientist to develop novel formulations for user-friendly, safe sexual lubricants which could someday also deliver microbicides. She also serves as the Sexuality Education Coordinator at the Sinclair Institute.

Her current pet project is an informative venture: "the creation of a table of information about common lubricant ingredients…so that there's an easy resource from which folks can learn what scientists know and don't know about the ingredients in their lubes." She became interested in IRMA's work after she shared her lube findings with some rectal microbicide advocates, and was excited to be asked to join IRMA's Lubricant Safety Working Group and IRMA.

Amy feels IRMA's work is especially important because of the dialogue it encourages and nurtures between people of disparate fields with a common interest. "Microbicides are a natural extension of what people already do: use lubrication during sex," she says: "If a microbicide could be found which would be safe and non-toxic for the user and would also reduce transmission rates for HIV (and hopefully other STIs), people will have an amazing tool for reducing sexual risk while also increasing sexual health and pleasure."

In her advocacy work Amy hopes to spread her knowledge and enthusiasm with sexual health professionals and consumers, with the goal of making lubes safer, more pleasurable, and someday a vessel for microbicides.

Much of Amy's free time is spent invested in her projects, but when she isn't working Amy enjoys Sudoku, audio books, and savoring good food and wine.

Read about other friendly rectal microbicides advocates. Newly featured advocates include Daniel Nuñez, Luis Fernando Galarza, Maheswar Satpathy, Vanessa Marquez, and Mark Hubbard.

Want to join the best e-mail discussion list on new prevention technologies on the planet? Send a note to IRMA here - rectalmicro@gmail.com - and we will get you signed up.Joining the list makes you an automatic IRMA member too!

[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.]

Meet Vanessa Marquez - A Friendly Rectal Microbicide Advocate

"Thank the universe for organizations such as IRMA and individuals who are willing to inform and educate the population at large about the heavily stigmatized topic of anal sex. Without their efforts the possibility of rectal microbicides being readily accepted as a prevention method may not be possible. We must continue to lay the foundation for such important work that could save the lives of millions." - Vanessa Marquez, Boston, USA

Vanessa Marquez, a Clinical Research Nurse at The Fenway Institute in Boston is a proud advocate for rectal microbicides among many other HIV prevention methods. She was born in New York to parents who emigrated from Latin America and was raised in New Orleans, Louisiana.

Vanessa became interested in HIV prevention after volunteering as a massage therapist at an HIV alternative therapies clinic in San Francisco, CA. She got involved with IRMA through her work with the Microbicide Trials Network. She feels very fortunate to have found her dream job immediately after graduating nursing school, and is excited about the possibilities of continuing to advocate for important prevention methods like rectal microbicides.

She believes that rectal microbicides provide a very important other option for HIV prevention. Her work on the iPrEx study has led her to understand that "the more options individuals have, the more likely it is that they will use these prevention technologies".

In her advocacy work she meets with clients each week for microbicide study visits, presents information on anal sex through a skit of her creation called "The Shameless Plug." Vanessa feels that the destigmatization of anal sex and health will lead to more conversations with medical providers, which will hopefully lead to more options like rectal microbicides.

Vanessa, who speaks fluent Spanish, enjoys reading, attending classical music concerts, learning new languages, volunteering in community events, traveling, and being with her family in her free time.

Read about other friendly rectal microbicides advocates. Newly featured advocates include Daniel Nuñez, Amy Stapleford Jackson, Maheswar Satpathy, Luis Fernando Galarza, and Mark Hubbard.

Want to join the best e-mail discussion list on new prevention technologies on the planet? Send a note to IRMA here - rectalmicro@gmail.com - and we will get you signed up.Joining the list makes you an automatic IRMA member too!

[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.]

Meet Mark Hubbard - A Friendly Rectal Microbicide Advocate

"The work we do is difficult, complex, challenging, and nuanced. If we recognize that upfront, we do better at avoiding frustration and conflict." - Mark Hubbard, Nashville, USA

Mark Hubbard is an independent community organizer, advocate, educator and activist. He was introduced to IRMA when he produced a community forum on microbicides that featured Jim Pickett.

Mark is excited to be a part of rectal microbicide advocacy. He believes IRMA serves the community in a number of ways: It educates the community about HIV/AIDS prevention broadly and new prevention technologies research more specifically, it highlights the disparity between vaginal and rectal microbicide research, and it provides context for rectal microbicide advocacy work. "Our best efforts at developing biomedical or behavioral interventions will be futile if we fail to work within a framework of understanding regarding affected communities' cultural contexts and legacies," he says.

The role of rectal transmission in the pandemic is profoundly clear, and for this reason Mark hopes to bring rectal microbicide research to the forefront of HIV prevention technologies. He has produced educational events that attracted a broad, diverse audience in a format that encourages real dialogue. Even in his personal life he "just never stops talking about the issues."

Mark loves to watch movies in his free time – particularly classics and independent films. He also loves being outdoors; taking walks in nature keeps him happy and healthy. He "definitely got the 'gay Broadway' gene" and enjoys musical theater culture as well.

Read about other friendly rectal microbicides advocates. Newly featured advocates include Daniel Nuñez, Amy Stapleford Jackson, Maheswar Satpathy, Vanessa Marquez, and Luis Fernando Galarza.

Want to join the best e-mail discussion list on new prevention technologies on the planet? Send a note to IRMA here - rectalmicro@gmail.com - and we will get you signed up.Joining the list makes you an automatic IRMA member too!

[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.]

U.S. to Take Another Look at Gay Blood Donation Ban

Via the National Journal, by Maggie Fox.

A policy that bars gay men from donating blood for life is “suboptimal,” advisers to the Health and Human Services Department said on Tuesday, and needs another look.

HHS asked a committee of experts on blood and tissue donations to reexamine the policy and see if there is a way to let at least some gays donate blood.

“If the data indicate that a change is possible while protecting the blood supply, we will consider a change to the policy,” HHS said in a statement.

The U.S. Food and Drug Administration, an HHS agency, has banned blood donation by any man who has had homosexual sex because of the risk of the AIDS virus. Soon after the AIDS pandemic began in the 1980s, people such as hemophiliacs who received frequent blood transfusions or blood products began to become infected with the deadly and incurable virus.

Men who have sex with other men, including gay and bisexual men, have an HIV infection rate 60 times higher than that of the general population, the FDA says. They have an infection rate 800 times higher than first-time blood donors and 8,000 times higher than the rate of repeat blood donors. Tests cannot pick up a new HIV infection in the blood with 100 percent accuracy; because blood is often pooled, many people may be at risk from a single infected donor.

But the Red Cross, always struggling with blood shortages, and other groups such as gay-rights organizations oppose the blanket policy. They say that there are other ways to screen out donors at high risk of HIV infection. Sen. John Kerry, D–Mass., has also been pushing for a change in policy.

“We’ve been working on this a long time in a serious way, and I’m glad Secretary [Kathleen] Sebelius responded with concrete steps to finally remove this policy from the books,” Kerry said in a statement. “HHS is doing their due diligence, and we plan to stay focused on the endgame – a safe blood supply and an end to this discriminatory ban.”

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.]

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.]

The death of sex?

Via Salon, by Tracy Clark-Flory.

 In case you've missed these dispatches, allow me to fill you in on what you've been missing (aside from sex, apparently): First, the New York Observer ran an article proclaiming, "Young New Yorkers no longer care about having sex." Meg Wolitzer, author of "The Uncoupling," a magical realist novel about a sex-strike, followed up with a commentary in the New York Times about whispers in her friend circle of 40-plus women about growing "sexual disengagement." That brings us to this past weekend, which saw the publication of a Times Op-Ed by Erica Jong lamenting the sexlessness of young women today.

This concern isn't new, it's just the latest in a long history of arguments about how sex is being corrupted or destroyed. Previously, cultural commentators put the blame on the pervasiveness of pornography and sexually aggressive girls who scare boys out of their boners; and let's not forget the ever-present argument that sex before marriage is sinful and perverse. It seems that no matter the state of the current sexual union, someone somewhere is gravely concerned that everyone else is doing it wrong. More often than not, though, concerns about what other people are doing behind closed doors are really just our own projected anxieties about sex -- whether it's about what goes on in our own bedrooms, or our ability to maintain some semblance of control over the driving force of desire.

Beyond this customary nosiness, these recent reports specifically reflect current anxieties. What all three pieces have in common is that they link this alleged sexual malaise to technology. The Observer piece claims that young New Yorkers are more enamored with the smooth body of their iPhones than actual human flesh, more invested in upping their number of Twitter followers than notches on their bedposts. These caricatured young professionals get off on onanistic maintenance of their Facebook profiles, not on real-life human interaction. It strikes me that this is really just a way of expressing the depth of despair over the fact that, as I've written in the past, we feel "more connected, and yet more isolated, than ever."

Sex often stands in as a marker of personal and relationship health. As Wolitzer, who also gave a nod to the "seductions" of Facebook, Wikipedia and pornography, wrote in the Times, "[I]t's as if we still believe sex equals strength, health and life; and therefore, not-sex equals weakness, illness and death." Maybe it isn't as simple as that, but the connections are certainly there. Pointing the finger at technology -- whether it's addictive social media or the abundance of online pornography -- is a way to escape the uncomfortable self-examination that follows from asking whether we're intentionally avoiding something and, if so, what. It's no surprise that Jong pinpoints it: "We want to keep the chaos of sex trapped in a device we think we can control."

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.]

30 Years: Epidemic to Pandemic

by Aldona Martinka

This Sunday was the thirtieth anniversary of the CDC report that would become the first mention of HIV/AIDS. IRMA is commemorating this with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part three of five.

Today everyone realizes that AIDS is a global issue, from the First World to the Third World. In 1999, AIDS became the fourth most common cause of death in the world. To the average American, however, AIDS as a global issue did not seem so important until the turn of the century. The United Nations began to hold increasingly frequent meetings to discuss HIV/AIDS-related issues, and American politicians and activists began to turn their gaze outward.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) was launched in 1996, and by 2000 the UN was a vital player in the global fight against the disease. In that year alone the UN, the WHO, and UNAIDS worked to negotiate pharmaceutical prices for HIV/AIDS drugs in the developing world, the UN Security Council met regarding AIDS and its effects on peace/security in Africa, and the UN announced its Millennium Development Goals. The same year the G8 met and announced a need for more resources to battle the pandemic. The UN would, in the next few years, hold its first Special Session on AIDS (reviewed in 2005), launch the Global Coalition on Women and AIDS, and continue to reinforce its commitment to providing prevention and treatment options for HIV/AIDS worldwide.

The United States also began fighting AIDS on a global scale during this time. In 200 President Clinton announced his administration’s Millennium Vaccine Initiative, declared HIV a national security threat, and issued an executive order to aid developing countries in producing and importing generic treatments for HIV/AIDS. He and his legacy would continue to work to provide these drugs at a low cost to developing countries worldwide for years to come. In 2001, the Bush administration vowed to continue a commitment to fighting AIDS both nationally and globally. The CDC created a plan to halve US infections within five years. Early in 2003, President Bush announced the creation of the President’s Emergency Plan For AIDS Relief (PEPFAR), a five year plan devoting $15 billion dollars to fight AIDS internationally. This was, and continues to be, the largest commitment by any country to combat HIV/AIDS. The first $350 million was authorized the next year.

The US, the UN, the G8, international projects such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, countless other organizations, have continued to fight for HIV/AIDS prevention and treatment, and as the 31st year of AIDS begins there is a renewed energy to this battle.

[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.]

Countdown to 30 Years: Up in Arms

by Aldona Martinka, IRMA intern

As the thirtieth anniversary of the very beginning of the AIDS crisis draws near, IRMA will be counting down the last five days with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part two of five.

When the eighties came to a close the world was still reeling from the devastation of a new, terrible disease. In the past few years strides had been made to de-stigmatize HIV and its victims, but they were still misunderstood and underrepresented in the media and in the government. This really began to change in the nineties as the government, technology, and pop culture finally took up arms on a large scale.

Ryan White died in April of 1990, and four months later the first Ryan White CARE (Comprehensive AIDS Resources Emergency) Act was enacted, marking the largest piece of AIDS-related legislation to date, allocating $220.5 million in federal funds for HIV care and treatment. Since then it has been reauthorized three times. In the next years, congress would pass several more pieces of legislation that would give funds, housing, and (most importantly) legitimacy and support to AIDS victims and advocates. In 1991 the ubiquitous symbol of AIDS support and awareness, the red ribbon, is launched. Right after AIDS became the number one cause of death for males 25-44, the FDA approved a 10-minute HIV test which would change testing for and diagnosis of HIV in the United States. The female condom is approved in 1993. AIDS is the number one cause of death for women 25-44 as well in 1994. Months later AZT is approved to help prevent vertical transmission of the virus. Clinton’s Conference on HIV/AIDS in 1995 comes the year that the number of US HIV cases crosses the 500,000 line.

The nineties were not just a decade of political advocacy and technological advances; celebrities began to follow in the footsteps of Elizabeth Taylor and others supporting the fight against AIDS. “Magic” Johnson announced his HIV-positive status in 1991. Rock and roll fans everywhere mourned when icon Freddie Mercury of Queen died from AIDS-related pneumonia. Tom Hanks starred in the film “Philadelphia” as a lawyer with AIDS, bringing his repute and acting talent to the first major Hollywood film about AIDS. Athletes, artists, and other celebrities come forward throughout the decade, each one helping to reduce stigma just a little.

Finally, in 1996, the United States collectively heaves a sigh when the number of new diagnoses of AIDS drops for the first time since the start of the epidemic due mostly to the advent of Highly Active Anti-Retrorviral Therapy (HAART.) Really for the first time there are drugs that can suppress the virus.  AIDS is no longer the cause for most 25-44 year olds, but remains so for African-Americans. The next year the CDC reports a 47% decline in AIDS deaths from the last year. With such significant improvements, even though AIDS continues to be a vicious disease in the US (especially among minorities), eyes turn to AIDS in the rest of the world as the crisis becomes a global issue. In the new millennium the United States continues to battle HIV at home, but also sends support overseas where victims of the disease in the third world are ravaged by its effects.

[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.]

Annual HIV Testing May Not Suffice for MSM

Via CDC Morbidity and Mortality Weekly Report.

The findings from this analysis suggest that adherence to annual HIV testing recommendations for MSM is low and that even among MSM who reported being tested during the past 12 months, a substantial proportion were newly infected. Because persons often reduce their risk behaviors when they receive a diagnosis of HIV infection and persons who do not know they are infected are estimated to account for more than half of sexually transmitted HIV infections, increasing the frequency of HIV testing for MSM can reduce the time from HIV infection to diagnosis and reduce HIV transmission.

Current CDC guidelines identify MSM who should be tested more frequently according to their risk behaviors. However, among MSM in this analysis, those who had high-risk behaviors were not more likely to be newly infected than those without high-risk behaviors, suggesting that self-reported risk behaviors might not determine which MSM should be tested more frequently. The 7% prevalence of new HIV infection detected through NHBS among MSM who had been tested for HIV during the past year and the similar prevalence of new HIV infection among MSM with and without high-risk behaviors suggests that more frequent testing, perhaps as often as every 3 to 6 months, might be warranted among all sexually active MSM, regardless of their risk behaviors. In considering revising guidelines regarding frequency of testing among MSM, public health officials also should weigh other factors, including the acceptability and cost effectiveness of testing MSM more frequently and the sensitivity of tests in the early stages of infection.

Read the full report 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.]

Countdown to 30 Years: The Eighties and AIDS

By Aldona Martinka, IRMA intern

As the thirtieth anniversary of the very beginning of the AIDS crisis draws near, IRMA will be counting down the last five days with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part one of five. 

In less than a week it will have been 30 years since the first mention of the disease in the CDC’s Morbidity and Mortality Weekly Report that would someday be known as AIDS . This June 5 marks the thirtieth anniversary of the beginning of the global fight against AIDS. No one knew it then, but the disease behind that cluster of cases of rare Pneumonia would shock the world, set people against each other, and eventually bring together politicians, scientists, and humanitarian workers in what has been perhaps the greatest public health battle since Polio.

Struggling to understand this new disease, the first step was to name it. The first proposed name for the illness was Gay-Related Immunodeficiency (GRID), but that was amended to Acquired Immunodeficiency Syndrome (AIDS) in 1982 for the sake of accuracy. Nevertheless, the mindset that it was a “gay problem” persisted for years, causing stigma that would inhibit HIV education and prevention, causing harm to countless victims both gay and not. The virus that causes AIDS was not discovered until 1984. It eventually came to be called the Human Immunodeficiency Virus (HIV) as we know it today. 1984 was also the year that Ryan White, poster child for the AIDS epidemic of the eighties and future namesake for national legislation, was diagnosed with the disease, having contracted it from a contaminated blood transfusion for his hemophilia.

In the next year AIDS became the topic of choice for everyone from scientists to journalists; from doctors to celebrities; from politicians to housewives. Ignorance and misinformation abounded, and many suffering from HIV/AIDS were shunned and discriminated against. Ryan White was not allowed to return to his middle school in Indiana after being diagnosed, and 117 parents and 50 teachers signed a petition to ban him from the school. When he was eventually permitted to attend, the White family had to deal with death threats and property damage, and White himself was ostracized at school. The Ray brothers, the children of a Florida family, were also hemophiliacs, who had contracted HIV through blood transfusions, and their parents also experienced exclusion. After they won a court battle to be allowed to attend school their home was burned down. At this point in history AIDS meant impending death, and caretakers could only try to make their patients and loved ones comfortable as they passed away.

Despite all the fear and the anger there was also hope. The AIDS Coalition to Unleash Power (ACT UP) formed in 1987at the Lesbian and Gay Community Services Center in New York, the same year that arsonists attacked the Ray’s home, and the same year that the first drug for the treatment of AIDS was approved: AZT. ACT UP would be one of the most important HIV/AIDS advocacy organizations ever, and AZT and the antiretrovirals that followed it would lengthen the lives of those afflicted by this horrible disease that had once been a swift death sentence. AIDS patients could even hope for relatively normal lives. Condoms also became a hot topic as they appeared in PSAs and ads across the country, beginning the de-stigmatization of protection methods that could save lives.

[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.]