Sept 10 at #USCA2013 - Everything You Need to Know About #Anal Health

This Tuesday, September 10 at the United States Conference on AIDS in New Orleans join IRMA and friends from 4:30 p.m. to 6 p.m. for this fun workshop on anal health and rectal microbicide research and advocacy.

Session 5: Imperial 9, Level 4. See ya there - show your rectal pride!

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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 1,200 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

 *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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Meet Stefan Baral: Our Newest Friendly Rectal Microbicide Advocate!

“Though linked geographically, there is extreme diversity in the dynamics of transmission of HIV and potential structural interventions to mitigate transmission. Let the local community lead the way in terms of messaging and strategy, and progress will be made while staying on terra firma.”

Stefan Baral is an IRMA advocate from Baltimore, Maryland. He is a physician, epidemiologist and researcher on the faculty of Johns Hopkins Bloomberg School of Public Health focused on creating more community tailored programs, services, and policies for different communities throughout the world.

Stefan first became involved with IRMA while preparing for the Project ARM - Africa for Rectal Microbicides meeting in Addis Ababa this past December, in conjunction with ICASA. He says it was a natural partnership given the communities he works with across Africa, and believes the meeting got a great start on developing a plan for increased advocacy around rectal microbicides and the accessibility of condom-compatible lubricants. He is excited for everything to be moving forward!

He believes rectal microbicides are such a promising new prevention technology due to encouraging evidence from early studies and the likelihood that people would use them. He is hopeful that rectal microbicides will be in the form of a lubricant to increase the chance that people will use them during anal intercourse.

Stefan is also an advocate for other evidence-based prevention strategies. He loves researching them and advocating for those in which he sees potential. Though he believes rectal microbicides will likely be an important prevention strategy moving forward, he says it is crucial to implement services and strategies in the meantime that are already supported by evidence. He also realizes that though advocacy is key in the fight against HIV/AIDS, service provision is just as important to fully serve different communities.
His advice for combatting stigma associated with standing up for rectal microbicides is short, but important: “Focus on the evidence.”

Thanks Stefan, for all that you do!


[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.]

Oral HPV More Common in Men Than Women

via The New York Times, by Anahad O'Connor


About one in 15 Americans is infected with oral human papillomavirus, a sexually transmitted virus that causes throat cancers, and the disease is especially common among men, new research shows.

The research is the first major study to document the nationwide prevalence of oral human papillomavirus, or HPV, a disease that has drawn growing attention from public health experts because it has fueled a rise in oropharyngeal cancers affecting the back of the tongue and the throat. Researchers showed last year that throat cancers caused by a particular strain of the virus, HPV Type 16, have tripled in the last 20 years. But it was unclear exactly how many people over all were carrying HPV, which exists in more than 40 forms.

By looking at thousands of people across the country, the authors of the new report found that 6.9 percent of adults and teenagers are infected with oral HPV of any kind. The virus was about three times as common in men as it was in women. And the scientists identified several behaviors that significantly raised the risk of becoming infected: increasing age, greater sexual activity and smoking cigarettes.

But the study, which was published in The Journal of the American Medical Association, also revealed some reassuring findings, said Dr. Maura L. Gillison, the chairwoman of cancer research at Ohio State University and senior author of the paper. While the overall prevalence of HPV was about 7 percent, only 1 percent, or roughly two million people, were infected with HPV 16, the strain linked to throat cancers and many cases of cervical cancer. Fewer than 10,000 cases of throat cancer caused by HPV 16 are diagnosed every year, indicating that most people with the virus do not develop cancer.

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.]

Concerns about Gilead's Truvada used as HIV Prevention

via Financial Times, by Christine Livoti

Gilead Sciences’ (NASDAQ: GILD) once-daily Truvada pill has seen only tepid interest for adoption in the HIV prevention setting, despite treatment guidelines by the Centers for Disease Control (CDC), experts told Biopharm Insight. This is largely related to issues around feasibility, cost and historical evidence for other prevention strategies, which may not be remedied even with the FDA label Gilead is seeking, infectious disease experts said.

Last December, the company announced a supplemental NDA (sNDA) regulatory application for its currently marketed HIV drug Truvada, a potential therapy to reduce the risk of acquiring HIV, commonly described as pre-exposure prophylaxis (PrEP). Truvada has been approved since 2004 for use in combination with other antiretroviral drugs to treat HIV infection.

Truvada has not been approved yet as a preventative therapy in HIV.

Results from the Phase III iPrEx study reported in the New England Journal Of Medicine in December 2010 showed prophylactic effect from Truvada given orally among men who have sex with men (MSM). In January 2011, the CDC issued interim guidance on the use of PrEP in this population.
While HIV therapy is much more manageable than previously, with fewer pills and side-effects, experts in recent years have begun to initiate therapy in earlier stages of the viral infection, and most recently in uninfected individuals to prevent infection. While multiple PrEP studies have reported encouraging data, multiple hurdles to adoption still remain.

Slow uptake thus far

This news service reported in December 2010 that uptake of Truvada as an HIV prophylaxis therapy would likely be slow, as non-HIV specialists would largely be responsible for prescriptions. Infectious disease specialists reported few, if any, prescriptions in this indication, when interviewed by this news service.

The University of North Carolina division of infectious disease has not been prescribing PrEP, said Dr Christopher Hurt, clinical assistant professor. He added there has been some talk in the medical community that primary care providers and potentially ob-gyns would be responsible for PrEP prescription, similar to how they are responsible for oral contraceptives.

He noted in some urban areas, particularly San Francisco, Boston, New York and Washington, DC, with stronger healthcare settings for MSM, have probably been prescribing PrEP more frequently as they regularly see those individuals at risk of HIV infection. He noted his clinic had some discussion about offering PrEP to partners of current patients, but no decision was finalized. Those partners need to be in care somewhere, where potential side effects can be monitored, he added.

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.]

Age as a Risk "Marker" for MSM

via JAIDS, by Potterat, John J BA; Brewer, Devon D PhD

Hurt and colleagues observed that primary HIV infection (PHI) in men who have sex with men (MSM) was associated with selecting older sex partners. Specifically, MSM with PHI (median age, 24.5 years) tended to choose partners 5 years older (median, 29.8 years) compared with uninfected MSM who were much closer in age (22.5 years; partners, 23.9 years). This result is not surprising, because older MSM are more likely to be infected. In Colorado Springs, for example, rigorously sought, community-wide sexually transmitted disease/HIV surveillance data show that whereas chlamydia is an infection of the late teens and early 20s, and gonorrhea of the early to mid-20s, the average age for HIV seroconversion is late 20s (median, 27 years; mean, 27.8 years), an average age approaching that of older partners of men with PHI in Hurt and colleagues' study.

What is remarkable is Hurt and colleagues' and Coburn and Blower's interpretation of the observed association between partner age disparity and PHI. They mislabel sex with an older man as a risk factor for HIV and correspondingly call for prevention messages to be refocused on this behavior. Sex with an older MSM cannot be a risk factor for HIV infection, although it is a risk marker. The fact that the age of sex partners remained an independent correlate of recent HIV infection in Hurt and colleagues' multivariate model reflects mismeasurement of exposure to HIV. It appears objective data on partners' HIV statuses were unavailable for 90% (18 of 20) of men with PHI and 46% (25 of 54) of uninfected men. It is unclear whether all such partners were classified as “serostatus unknown” (and thus regarded as having exposed participants to HIV) or their serostatuses were estimated from participants' perceptions (the authors did not describe such procedures). In the former scenario, uninfected men's exposure to HIV may be overestimated. In the latter scenario, men with PHI may have incorrectly perceived infected partners as uninfected or not reported partners during the period when they acquired infection because the authors collected data on the three most recent partners only.

Other characteristics of partners can also serve as markers of HIV risk in MSM such as race and injection drug use. The social contexts in which MSM form sexual partnerships may be even better indicators of HIV risk. Although local data on risk markers might inform ancillary prevention messages, the educational focus in MSM should remain on avoiding the most direct risk factors-anal (especially receptive) intercourse without a condom and sex between serodiscordant men-as their own data clearly show.


[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.]

Obama and Clinton Pledge to Protect Gay Rights Throughout the World

via The New York Times, by Stephen Lee Myers

The Obama administration announced on Tuesday that the United States would use all the tools of American diplomacy, including the potent enticement of foreign aid, to promote gay rights around the world.

In a memorandum issued by President Obama in Washington and in a speech by Secretary of State Hillary Rodham Clinton here, the administration vowed to actively combat efforts by other nations that criminalize homosexual conduct, abuse gay men, lesbians, bisexuals or transgendered people, or ignore abuse against them.

“Some have suggested that gay rights and human rights are separate and distinct,” Mrs. Clinton said at the United Nations Human Rights Council in Geneva, “but in fact they are one and the same.”

Neither Mr. Obama nor Mrs. Clinton specified how to give the initiative teeth. Caitlin Hayden, the National Security Council’s deputy spokeswoman, said the administration was “not cutting or tying” foreign aid to changes in other nation’s practices.

Still, raising the issue to such prominence on the administration’s foreign policy agenda is important, symbolically, much like President Jimmy Carter’s emphasis on human rights.

With campaigning already under way in the 2012 presidential contest, Mr. Obama’s announcement could bolster support among gay voters and donors, who have questioned the depth of his commitment. He chose the Rev. Rick Warren, a pastor who opposes same-sex marriage, to deliver the invocation at his inauguration. Mr. Obama himself has not come out officially in favor of same-sex marriage. But he successfully pushed for repeal of the “don’t ask, don’t tell” policy that prevented gays from serving openly in the military. And the Justice Department has said it will no longer defend in court the Defense of Marriage Act, which defines marriage as between a man and a woman.

The initiative also invites attacks from Republicans trying to appeal to a conservative base in the primary and caucus states.
One Republican candidate, Gov. Rick Perry of Texas, said: “President Obama has again mistaken America’s tolerance for different lifestyles with an endorsement of those lifestyles. I will not make that mistake.”
It could also irritate some American allies, including countries like Turkey, where there have been reports of harassment, and Saudi Arabia, where homosexuality is banned and sex between people of the same sex is punishable by death or flogging.

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.]

Off-Label Use of the Female Condom for Anal Intercourse Among Men in NYC

via American Journal of Public Health, by Kelvin EA, Mantell JE, Candelario N, Hoffman S, Exner TM, Stackhouse W, Stein ZA

Abstract

We surveyed 111 male clients of an HIV/AIDS service organization in New York City in 2008 and 2009. Seventeen percent had used the female condom for anal intercourse; of these, 89.3% had used the female condom with male partners, 21.4% with female partners, and 10.7% with both. Users of the female condom for vaginal intercourse were more likely to use it for anal intercourse (odds ratio = 12.7; 95% confidence interval = 2.5, 64.9; P = .002). The safety and efficacy of the female condom for anal intercourse are unknown and should be evaluated.

Read the full study 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.]

MSMGF Provides New Online Resources Detailing the Law's Effect on MSM Health and Human Rights

Global MSM network calls on policy makers, parliamentarians and advocates to address legal and policy barriers undermining Universal Access to HIV services

This World AIDS Day, as the United Nations Global Commission on HIV and the Law draws up its final recommendations, the Global Forum on MSM & HIV (MSMGF) urges national legislators around the world to review and repeal laws that undermine access to HIV services for gay men and other men who have sex with men (MSM). To help illustrate the connection between HIV and the law for this key population, the MSMGF has launched a new collection of resources that features case studies, toolkits and never-before-seen video testimonials from grassroots MSM advocates in Uganda, Zimbabwe and Cameroon.

“From laws criminalizing homosexuality in more than 70 countries to laws punishing non-disclosure of one’s HIV status, punitive legal environments around the world prevent MSM from accessing life-saving services,” said Dr. George Ayala, Executive Officer of the MSMGF. “This is a major problem for the HIV response among MSM around the world, in countries rich and poor alike.”

The content of the archive was selected to make clear the connection between HIV and the law for this highly-impacted population, as well as provide grassroots organizations with tools to aid in legal advocacy for the health and human rights of MSM.

“Civil society has formed the backbone of the response to the HIV epidemic among MSM around the world, with local men rising up to care for their own communities where support from government and society is lacking or absent,” said Krista Lauer, Policy Associate at the MSMGF. “This archive is part of a larger effort to equip grassroots organizations with the information and resources they need to hold governments and multilateral institutions accountable for doing quality HIV work, including addressing harmful laws.”

The website features the MSMGF's Specialist Submission to the Global Commission on HIV and the Law, made public for the first time. Drawing upon focus group interviews, published research and other sources, the report makes five recommendations for law-based action that would have a game-changing impact on the HIV response for MSM:
1. Review and repeal laws that undermine the HIV response among MSM

2. Address the inappropriate enforcement of laws that hinder access to HIV services for MSM, through coordination, education and training with the judiciary and law enforcement officials

3. Establish laws that protect the health and rights of MSM, and bring perpetrators of violence and other human rights abuses against MSM to justice

4. Implement know-your-rights campaigns, and create enabling environments in which individuals can lay claim to their rights

5. Integrate the law as a core pillar in all National AIDS Reponses, and adopt a rights-based approach to the HIV response

“We know that laws and policies that uphold the human rights of gay men and facilitate their access to services are absolutely essential for an effective HIV response,” said Dr. Ayala. “But real action to transform legal environments has been bogged down by fear, stigma, and a lack of political will to take on the tough issues. Courageous activists have continued to raise their voices in this struggle, often at great personal expense to themselves and their families. We call on all Member States of the United Nations to heed the call of civil society, and recognize that the human rights movement is the HIV movement.”

The online archive can be accessed on the MSMGF’s website at http://www.msmgf.org/law.



[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.]

When Condoms Ain't Enuf

via The Body, by Allen Kwabena Frimpong and Michael Terry Everett

"I also want to mention that we are increasingly becoming better at incorporating conversations about 'harm reduction' into the realms of substance use (needle exchanges, safe injection sites, pill testing, etc.), but we often fail to adequately translate this model when speaking of communicating risk reduction in sex (strategic positioning, sero-sorting, viral load suppression, etc.). My question back to the group then is, how do we more effectively communicate to young people the abstract concept of 'harm reduction' for sex within the context of a sex phobic society?"

This was a question posed by Jamie Forrest of Vancouver, Canada in the North America, Western Europe, and Caribbean CrowdOutAIDS Open Forum on Facebook. CrowdOutAIDS is UNAIDS new collaborative online youth-led project. He posed this question to the group after people were discussing what they considered to be the main reasons for HIV infection among young people.

Reading the responses on Facebook gave us one of those jolted reactions. The dominant message about sexual health in relation to HIV prevention has been focusing on condom usage. Jamie's question was one that I saw as challenging; given the propaganda that the HIV/AIDS field has been pushing around what it means to have safer sex. My colleague at the Harm Reduction Coalition, Michael T. Everett, was also raising this same question especially among young men who have sex with men (YMSM) of color given that their rates of infection have been steadily increasing while rates of infection among injection drug users has been on the decline.

The question for us became what (besides the exchange of needles) was accounting for the decrease in transmission of HIV among injection drug users, and how could we use what works in harm reduction messaging and education when it comes to drug use (if anything) for other high-risk populations greatly affected by the epidemic through sexual transmission. We considered this in light of the following:
a. We cannot exchange condoms like we do syringes.

b. We know people are not using condoms all the time, and the possibilities of HIV and other STI's has not scared enough people into doing so, and so ...

c. If people have been harboring condom use as the dominant end all be all harm reduction response- well then something is terribly wrong with this picture.

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.]

Registration for the XIX International AIDS Conference (AIDS 2012) Opens December 1!

Registration, abstract and programme activity submissions for the XIX International AIDS Conference (AIDS 2012), to be held from 22 to 27 July 2012 in Washington, D.C., open December 1 online at www.aids2012.org.

More than 25,000 participants and 2,000 journalists from approximately 200 countries are expected to convene at the conference, which is predicted to be a landmark event in the history of HIV and AIDS both in the United States and globally.

“Turning the Tide Together”, the theme of the conference, emphasises that we have reached a pivotal moment in time and that seizing this potential and actually turning the tide on HIV and AIDS will require commitment and action on many levels. The conference will be an important and high profile opportunity to reflect on the tension between recent scientific advances which could theoretically end the epidemic, and the current global economic crisis which threatens the funding necessary to implement this scientific knowledge.

“In the last couple of years we have seen some incredibly important breakthroughs in science,” said. Elly Katabira, International Chair of AIDS 2012 and President of the International AIDS Society (IAS). “The results of the CAPRISA trial presented at AIDS 2010 and the data from IAS 2011 proving beyond a doubt that treatment is prevention have shown us that we now have the real potential to change the direction of HIV. Science has provided us with the tools, what we need now is a global political and economic commitment to action. A turbulent economic climate must not halt funding for research and implementation”.

The return of the International AIDS Conference to the United States after more than 20 years represents a victory for public health and human rights and it is the result of dedicated advocacy to end the nation’s misguided entry restrictions on people living with HIV.

“Hosting AIDS 2012 in the U.S will be an occasion to highlight the disparities in access to treatment and care which exist in the country.” said Diane Havlir, Local Co-Chair of AIDS 2012. “We hope for a broad and active participation from all of those affected by the HIV epidemic, particularly people living with HIV and AIDS, policy-makers and key affected populations”.

Together with delegate and media registration, 1 December is the opening day for online abstract submissions. Over half of all conference sessions will be abstract-driven and all of the submissions will go through an extensive peer-reviewed process in order to guarantee the highest caliber of state-of-the-art science. The online abstract submission closes on 15 February 2012 and reopens on 19 April 2012 for late breaker abstract submissions.

In addition to the conference sessions, AIDS 2012 will feature a set of workshops open to delegates. Workshops will fall under professional development, community skills and leadership skills. Online submissions for workshops open on 1 December 2011 and close on 15 February 2012.

AIDS 2012 will host a Global Village, open to conference delegates and the general public, aimed at intensifying the involvement of key affected populations and other stakeholders in the conference. The conference also presents a Youth Programme with the goal of strengthening the participation of young people and youth issues in the conference through activities such as youth-driven sessions. From today it is possible to submit applications for both the Global Village and the Youth Programme. Both the submissions close on 15 February 2012.

With over 7,000 square metres of prime exhibition space AIDS 2012 offers both commercial and non-commercial organizations the opportunity to showcase their products and services to a wide public. Exhibitor applications open on December 1 and close on 25 May 2012. Exhibition space is limited so early bookings are strongly encouraged.

Various satellite meetings will take place in the conference centre during AIDS 2012. These satellite meetings are fully organized and coordinated by the organization hosting the satellite. The satellite slots are available for a fee and the applications open on 1 December and close on 31 March 2012.


From 8 December online applications for scholarships will be open. The International and Media Scholarship Programme is open to everyone around the world and is aimed at making the conference accessible to people from resource-limited settings and communities. Priority is given to those whose participation will help enhance their work in their own communities. A limited number of scholarships will be also available for media representatives.

More information on registration process and registration fees is available here: http://www.aids2012.org/Default.aspx?pageId=368


[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.]

First combination ARV vaginal ring for HIV prevention being tested in Phase I safety trial

via EurekAlert

In the first clinical trial of a vaginal ring combining two antiretroviral (ARV) drugs, researchers from the Microbicide Trials Network (MTN) are collaborating with the International Partnership for Microbicides (IPM) to evaluate whether the ring is safe for use in women. If the ring does prove to be safe, it could be considered for further testing, and eventually be evaluated for its effectiveness as a microbicide for protecting women against HIV infection through vaginal sex.

The trial, which is funded by U.S. National Institutes of Health and goes by the name MTN-013/IPM 026, is evaluating a ring that contains the ARVs dapivirine and maraviroc. Each of these drugs works against HIV in a different way. Dapivirine belongs to a class of ARVs called non-nucleoside reverse transcriptase inhibitors (NNRTIs) that prevent HIV from making copies of itself. Maraviroc, on the other hand, is an entry inhibitor that blocks HIV from getting inside target cells.

The dapivirine-maraviroc ring is the first combination microbicide to enter clinical trials. It is also the first vaginal microbicide containing an entry inhibitor.

The ring was developed by IPM, a non-profit product development partnership headquartered in Silver Spring, Maryland, in collaboration with Queens University Belfast (Belfast, Northern Ireland). The belief is that combining the two drugs, which act at different points in the HIV "life cycle," may provide greater protection against HIV than a single drug alone.

Globally, women comprise half of the 34 million people living with HIV. In sub-Saharan Africa, women represent nearly 60 percent of adults with the virus. In most cases women – especially young women – acquire HIV through unprotected heterosexual sex with an infected partner. Because the use of condoms is often not an option, there is an urgent need for effective prevention strategies that women can control themselves. Toward this end, vaginal microbicides in the form of a gel or a ring, for example, are being developed to provide women with new tools to protect themselves against HIV.

Vaginal rings provide slow, continuous delivery of a drug or multiple drugs to cells inside the vagina over a period of weeks or months. Marketed vaginal ring products include those used for contraceptive delivery and hormone replacement. However, vaginal rings can also be used as a vehicle for delivering potent ARV drugs into the vagina to prevent HIV infection. Because they could be used for one month at a time, vaginal rings may offer a long-acting and convenient prevention option for women.

MTN-013/IPM 026, which is now screening potential participants, will enroll 48 healthy, HIV-negative women ages 18-40 at the University of Pittsburgh, Fenway Institute in Boston and the University of Alabama at Birmingham. Researchers will evaluate the ring's safety and how well women like or are willing to use the ring. In addition, different tests will be performed to help determine how much of each drug is taken up by the cells usually targeted by HIV and whether drug levels are sustained throughout the four weeks the ring is worn.

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.]

Key Issues Overlooked in Hillary Clinton's "AIDS Free Generation" Speech

via AIDS Foundation of Chicago, by Gregory Trotter

The "big news" of Secretary of State Hillary Clinton's remarks today at the National Institutes of Health, in Bethesda, Md., might be that she appointed Ellen DeGeneres to be the Special Envoy for Global AIDS Awareness.

We'll get to that in a minute. What's perhaps even more interesting, though, is what was not said in Clinton's remarks, titled "Creating an AIDS-free Generation." Clinton focused on three modes of intervention in her speech: prevention of mother-to-child transmission, voluntary medical male circumcision and treatment as prevention.There was no mention of pre-exposure prophylaxis (PrEP) or rectal microbicides -- two promising new areas of HIV prevention.

"Overall, it was a good speech but it was missing some things we're interested in, like PrEP and rectal microbicides," said Jim Pickett, director of prevention advocacy and gay men's health for the AIDS Foundation of Chicago,who also serves as chair of the International Rectal Microbicide Advocates.

The omissions were disappointing but not surprising, Pickett said. Clinton's audience was a global one, he pointed out, so it made sense that she would shy away from PrEP, which has been shown in multiple trials to be effective for gay/bi men but less successful for heterosexual couples.

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.]

Rectal! Rectal! Read all About It!

via AIDS Foundation of Chicago, by Gregory Trotter

The word elicits a certain reaction from people.

“People say the word ‘rectal’ and they -- ,” said Jim Pickett, going into a simulated full body shudder of disgust.

Pickett, chair of the International Rectal Microbicide Advocates (affectionately dubbed IRMA), would know. He’s an outspoken advocate for more research and funding in the relatively new field searching for an effective rectal microbicide, an antiretroviral gel that could be a valuable tool in saving lives by preventing HIV/AIDS.

Along with his co-panelists, Pickett was at the United States Conference on AIDS on Friday afternoon to talk about microbicides and other promising new prevention tools, such as pre-exposure prophylaxis (PrEP) and female condoms.

“If condoms work, why do even need this?” Pickett, direction of prevention policy and gay men’s health for the AIDS Foundation of Chicago, asked the group of 30 or so people gathered for the discussion.

Mumbled answers from various people essentially spoke the same truth: Often, people do not use condoms because they’re uncomfortable, and because they can inhibit pleasure and intimacy.

A vaginal microbicide is much closer to being a reality than the rectal variety, mostly because research into the latter has been slowed by years of stigma and political heel-dragging, Pickett said in a separate conversation. Whereas a vaginal microbicide is perhaps a few years away, it could be another 10 years before a rectal product is fully vetted and ready for use.

But both are essential for preventing HIV in men and women, Pickett said. Globally, women are seven times more likely to have unprotected anal sex than men, a conservative projection based on the limited data on anal sex among heterosexuals, he said.

And this biological fact speaks to the need for a rectal-specific microbicide: The rectal wall is only one cell layer of protection from viruses, as opposed to the vaginal wall, which is 20-40 cell layers thick.

But perhaps the most controversial new prevention method is PrEP.

Recent trials have proven PrEP to be effective among gay/bi men who adhere to a regimen of Truvada, the drug made by Gilead Sciences, Inc. The results have been more mixed in trials involving heterosexuals.

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.]

Has anal sex gone out of vogue? What does this mean for HIV prevention?

via the HIV MSM blog

So the Advocate recently reported the findings of a large-scale survey on sexual behaviors.  Apparently, only 37.2% of over 24,000 gay and bisexually identified men indicated that their last sexual encounter consisted of anal sex.   The most practiced activities were kissing (almost 75%) and mutual masturbation (73%).

The survey, entitled  ‘The Gay and Bisexual Men’s National Sex Survey’ was sponsored by Manhunt,  its sexual health affiliate Manhunt Cares (see my past post here about them) and  its research partners, present the findings in a cutesy interactive graphical form which can be accessed from clicking on the picture on the left (i.e. I found out that 80.8 % of surveyed men have eaten cum at some point in their lives!) The abstract of the study, which appears in the Journal of Sexual Medicine can be found here.

Now before we give up our lube and condoms and other devices we find makes our anal sex experience more comfortable, there a few things to keep in mind.  For some reason, the majority of respondents in this latest conducted by researchers from Indiana University and George Mason University were Caucasian males.  Perhaps results would be changed if there was some diversity in the subject pool.  Also, one should note that the respondents were “self identified” gay or bisexual.  Perhaps if behaviors of non-identified men who have sex with men, (i.e. heterosexual identifying men) were recorded the results would also show a higher indication of anal sex.  However, I like the point that one of the commentators made:   Anal sex does require a lot of effort (much like vaginal penile sex as well) and perhaps people don’t want to go through such effort simply to get off.

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.]

Don't Delay HIV Prevention for Gay and Bi Men

via The Huffington Post, by David Ernesto Munar

Lives will be saved when the Food and Drug Administration puts its stamp of approval on a groundbreaking preventative approach called pre-exposure prophylaxis, or PrEP, recently found to reduce HIV infections.

With PrEP, people who are not infected with HIV take a daily pill, usually used to treat the disease, to help prevent infection -- as part of a broad HIV prevention approach that includes condoms and safer-sex counseling.

But the longer the FDA waits before beginning its review of the HIV medication Truvada for prevention, the more lives will be unnecessarily lost. This is particularly true for those at greatest risk: gay and bisexual men.

We urge the FDA to immediately begin its review for approval of Truvada for PrEP for gay and bisexual men.

Last year the iPrEX trial, touted as the scientific breakthrough of the year by TIME magazine, found that gay, bi and other men who have sex with men who took Truvada, along with counseling and condoms, had 42 percent fewer HIV infections than with counseling and condoms alone. Among those who used the prevention pill most consistently, the drop in infections was far greater.

And remember the sobering context: between 2006 and 2009, the number of young gay African-American men infected with HIV in the United States increased by 48 percent, according to the U.S. Centers for Disease Control.

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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.]

Panel Endorses HPV Vaccine for Boys of 11

via The New York Times, by Gardiner Harris

Boys and young men should be vaccinated against human papillomavirus, or HPV, to protect against anal and throat cancers that can result from sexual activity, a federal advisory committee said Tuesday.

The recommendation by the panel, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, is likely to transform the use of the HPV vaccine, since most private insurers pay for vaccines once the committee recommends them for routine use. The HPV vaccine is unusually expensive. Its three doses cost pediatricians more than $300, and pediatricians often charge patients hundreds more.

The committee recommended that boys ages 11 and 12 should be vaccinated. It also recommended vaccination of males ages 13 through 21 who had not already had all three shots. Vaccinations may be given to boys as young as 9 and to men between the ages of 22 and 26.

The committee recommended in 2006 that girls and young women ages 11 to 26 should be vaccinated, but vaccination rates in the United States have so far been disappointing.

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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 Gary Wolnitzek: The Last (But Not Least) of Our New Friendly Rectal Microbicide Advocates!

“First and foremost, as a gay man, and one who works at an organization focused on the LGBT community, it is extremely important to me that we develop ways that gay and bisexual men can protect themselves from HIV (and other STIs). Secondly, as an HIV advocate I feel it is important to create a robust and full toolbox that helps to prevent HIV infection and helps those living with HIV. Rectal Microbicides need to be one of the tools at our disposal.”

Gary is an IRMA advocate from Baltimore, Maryland. He is currently the Director of Gay, Lesbian, Bisexual, and Transgender Community Center of Baltimore (GLCCB). He loves conducting trainings in the community on a range of topics including advocacy planning, providing culturally competent care to the GLBT population and on topics related to new prevention technologies (NPT). He also enjoys spending time with friends at the pub, reading David Sedaris, watching “well-made” horror movies, and his cat, Aureliano.

Gary first became involved with IRMA while working at the Global Campaign for Microbicides (GCM). At this time he was well versed in preventative vaccine research and the research and trials surrounding vaginal microbicides, but he wasn’t as familiar with rectal microbicides. Shortly after starting at GCM he was introduced to people like Anna Forbes and Jim Pickett. He remembers a GCM meeting being co-hosted by the International Partnership for Microbicides (IPM) where this man kept chiming in with “What about rectal microbicides?!” Of course it was Jim, and Gary became inspired from that point on to learn more about rectal microbicides and involve himself with IRMA.

Gary tries to include vaginal and rectal microbicides in any talks he gives about HIV to the community. He believes knowledge is key, and a well informed base is necessary to move any work forward. He advises others doing HIV work to include microbicides in their agenda and points them to the IRMA website and blog for more information about them if needed. He also encourages IRMA members to become more involved on the listserv. He says that “by becoming more engaged in the conversations happening in this space then the more opportunities we have to gain new perspectives, find common ground on diverse issues, and develop new ideas.”

His advice for IRMA advocates combating stigma for their beliefs and work is to approach the individuals or organizations perpetuating the stigma with an open mind, listen to their arguments and opinions, and be prepared to create an informed and fact-based response. He hopes that this will bring about “some sort of common ground.” If this doesn’t work and the individual or organization is not willing to listen, he suggests reaching out to others that may be able to influence them- a method he calls “taking it to the streets!”

Read more bios on the IRMA website.


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

Meet Yaa Simpson: Another New Friendly Rectal Microbicide Advocate!

“Stigma is only dispelled by shining a brighter light on it! We have to speak life and light with our words and actions. There is enough doom and gloom to impact everyone - and that is where stigma resides. But letting people know they have options, biomedical techniques for prevention, medications, possible vaccines, gathering more evidence, integrating creative research designs, etc. are all steps in the right direction. We must expect the impossible and believe in miracles!”

Yaa Simpson is an IRMA advocate from Chicago, Illinois. She is an epidemiologist for the Chicago Department of Health and a Community Epidemiologist for TACTS (The Association of Clinical Trial Services). She loves to contribute to ideas and discussion about better research in the community, specifically HIV/STI prevention trials. She is also working towards her doctoral degree and hopes to one day conduct HIV prevention trails in Chicago.

Yaa first learned of IRMA when she was invited to a presentation on microbicides several years ago. Here she was introduced to Jim Pickett and his work with IRMA. She remembers Jim saying, “We all have opinions, like we all have booties!” She now is an active member on the listserv and enjoys IRMA’s blog and educational teleconferences.

She believes rectal microbicides are an important tool to add to the prevention technology toolbox, and acknowledges that we must develop technologies to prevent HIV spreading through any avenue, including rectally.

Her advice for IRMA is to continue to be involved with people who want to see change! “Talk to those who don’t want to hear about it and strategize with those who are looking for answers. Be diligent and be patient. And if you ever feel discouraged or overwhelmed by the stigma associated with standing up for rectal microbicides, remember what Mark Twain once said: 'Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great.'”

Read more bios from Friendly Rectal Microbicide Advocates.



[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.]

Chimp to Man to History Books: The Path of AIDS

via The New York Times, by Donald G. McNeil, Jr.

Our story begins sometime close to 1921, somewhere between the Sanaga River in Cameroon and the Congo River in the former Belgian Congo. It involves chimps and monkeys, hunters and butchers, “free women” and prostitutes, syringes and plasma-sellers, evil colonial lawmakers and decent colonial doctors with the best of intentions. And a virus that, against all odds, appears to have made it from one ape in the central African jungle to one Haitian bureaucrat leaving Zaire for home and then to a few dozen men in California gay bars before it was even noticed — about 60 years after its journey began.

Most books about AIDS begin in 1981, when gay American men began dying of a rare pneumonia. In “The Origins of AIDS,” published last week by Cambridge University Press, Dr. Jacques Pépin, an infectious disease specialist at the University of Sherbrooke in Quebec, performs a remarkable feat.

Dr. Pépin sifts the blizzard of scientific papers written about AIDS, adds his own training in epidemiology, his own observations from treating patients in a bush hospital, his studies of the blood of elderly Africans, and years of digging in the archives of the European colonial powers, and works out the most likely path the virus took during the years it left almost no tracks.

Working slowly forward from 1900, he explains how Belgian and French colonial policies led to an incredibly unlikely event: a fragile virus infecting a small minority of chimpanzees slipped into the blood of a handful of hunters, one of whom must have sent it down a chain of “amplifiers” — disease eradication campaigns, red-light districts, a Haitian plasma center and gay sex tourism. Without those amplifiers, the virus would not be what it now is: a grim pilgrim atop a mountain of 62 million victims, living and dead.

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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.]