Don't Upset This Rectal Microbicide Advocate!

by Mike Peters
IRMA Intern

A couple of weeks ago, I returned to Ohio for a weekend excursion.  The director of the Women's Studies program at my university informed me that I was named Graduate Student of the Year for Women's Studies and that there was a short awards ceremony that I should attend.  In preparation for this ceremony I was asked to dress nice, write a short bio of myself for the Dean of Liberal Arts to read, and to briefly say a few grateful words at the ceremony.

As excited and grateful as I was about this honor, I could not help but wonder what my interaction with the Dean of Liberal Arts would be like.  Perhaps some background information is necessary here.  My university is in Ohio, and Ohio, like so many other states, is facing a lot of economic issues in education.  During my last year on campus extreme budget cutbacks were made to Liberal Arts (while the basketball stadium and the Student Union were remodeled, and the basketball team was taking a trip to Italy).  Not only were these budget cuts devastating, but they were disturbing.  Six program directors, all women, were informed that they were being forced out of their directorships and required to teach additional classes.  These women, from fields that happened to focus on minority issues (Women's Studies, African and African-American Studies, International Studies, and so on), were to also be replaced  by a new dean of interdisciplinary studies that happened to be a white, heterosexual male as a cost-saving measure and way to increase course enrollment revenue.

Now, perhaps the male that would be replacing them had a strong background in interdisciplinary studies and could discuss minority issues with some level authority and expertise.  It was still utterly disturbing that these women were being removed from their leadership roles when they were all six some of the most respected educators on campus.  I suppose this is where my relationship with the Dean gets a little tricky.  In response to these budget cuts, I worked with three other graduate students as we led multiple protests and demonstrations of civil disobedience on campus – including flooding the Dean's office and taking over an intercom system to read The Vagina Monologues to the entire campus.  So my worry about standing with the Dean and listening to him comment on me was well-founded.

Excitedly, I wrote up a short bio of my educational background and my work new work with IRMA and sent it off to my program director.  On the trip there I worked tirelessly to remind myself to be respectful, not to worry, and to make sure I remembered to thank my various professors for their impact on my work.

On the day of the event my fiancé and I arrived at the auditorium and I was immediately informed that my bio had been edited, because it did not seem family-friendly enough as it used words like "anal", "rectal", and "sex".  Horrified by this reality, I was shuffled on stage and to my seat.  Given that I was being honored for Women's Studies I would be the last person receiving my award, since starting with a "W" the program always was at the end for liberal arts ceremonies, which gave me time to either get my visually-angered self calmed down or to let my anger at this injustice grow.  I chose the latter.

From my standpoint, and from my program director's viewpoint I might add, ignoring research and discussion because the word "anal" appears is not only ignorant, but is downright dangerous, as any member of IRMA certainly knows.  Besides, this is the work that I am doing with my degree, it ought to be celebrated.

So I sat… and sat… and sat.  And then the dean called me up to receive my award.  He read my censored bio as I smiled for the crowd.  Then he asked me to come to the podium to say a few grateful things:

"I'm really happy and thankful to be here today.  I'm also really happy that the Dean has given me a chance to talk about my work.  Right now I am working for IRMA, International Rectal Microbicide Advocates, to advocate for the development of rectal and vaginal microbicides in the global fight against HIV.  I'm very thankful that the education I received here has given me the ability to not be silent, and to actively advocate for proper sexual education as well as access to condoms and safe lubricants for vaginal and anal sex.  I mean let's be honest, HIV is still around and unprotected anal sex is major driver of this epidemic because we don't talk about it as actively as we should.  Thanks for hearing me out today."

Nobody freaked out.  The Dean shook my hand and I received my award.  No one walked out or ridiculed me; in fact a few folks told me that they admired my passion.  And in all seriousness, I was incredibly thankful to have the opportunity to speak about IRMA to people that likely had not heard of it before.  Though to be fair, I had better not ask the Dean for a recommendation letter any time soon.

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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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Rectal microbicide research takes giant leap forward with groundbreaking educational video

HIV prevention organizations debut The Rectal Revolution Is Here: An Introduction to Rectal Microbicide Clinical Trials in advance of first-ever Phase II rectal microbicide trial

 

[Press Release]

International Rectal Microbicide Advocates (IRMA), the Population Council, and the Microbicide Trials Network (MTN) today released a collaborative video project called The Rectal Revolution Is Here: An Introduction to Rectal Microbicide Clinical Trials. The jointly produced video, the first of its kind, is designed to educate communities affected by HIV about rectal microbicide development and the importance of participating in clinical trials to help speed the search for new HIV prevention options.

"The Rectal Revolution will be an excellent tool for education and recruitment for MTN-017, the first-ever Phase II safety trial of a rectal microbicide planned to launch soon. The video will be particularly useful because it's not protocol-specific and can be used in future rectal microbicide trials as well," said Clare Collins, MTN associate director of communications and external relations and video co-producer.

"There is an engaging mixture of animation and live action with beautiful footage from Thailand, South Africa, Peru, and the United States," Collins continued, "and we showcase interviews with scientists, advocates, and an exceptional rectal microbicide trial participant, Rig Rush, who is both eloquent and entertaining as he shares his personal experience as a study volunteer."

Produced by Paw Print Productions of Cape Town, South Africa, the video is available for viewing now on YouTube in English, Spanish, and Thai.

"This educational video is a groundbreaking tool to recruit volunteers and educate public health leaders for what may be one of the most promising new methods to fight HIV," said co-producer Barbara Friedland, associate in the HIV and AIDS program at the Population Council. "It was developed through an intense consultative process to ensure accuracy and relevance to the communities where this video will be shown," she said.

"We wanted the video to be educational and engaging, and to encourage audiences to get involved in efforts to prevent HIV," Friedland continued."So we worked with an advisory committee comprising staff at rectal microbicide trial sites, scientists, advocates, and other community experts to develop the script. We screened 'rough cuts' of the video with 80 professionals in the field and pre-tested it in 13 focus group discussions with over 100 gay men and transgender women in Thailand, South Africa, Peru, and the United States," she said.

"The insights and wisdom these individuals shared with us were absolutely critical to shaping the final version of the video," said Friedland.

Major funding and support for the project was generously provided by the MAC AIDS Fund, the MTN, and the Population Council, through a grant from the Swedish Ministry of Foreign Affairs.

The video debut precedes the soon-to-be launched landmark study being conducted by MTN to test a reduced-glycerin formulation of tenofovir gel among gay men, other men who have sex with men, and transgender women for safety and acceptability. MTN-017 is not only the first-ever Phase II study of a rectal microbicide, it is also the first time rectal microbicide research is expanding outside the United States and going global, with sites in Thailand, South Africa, Peru, and Puerto Rico.

"IRMA and the Population Council enthusiastically support the start of MTN-017," said Jim Pickett, IRMA chair. "The 186 individuals who will volunteer for the trial will more than double the total number of people who have participated in rectal microbicide clinical trials to date. The study will mark a giant leap forward for the field of rectal microbicides and will set the stage for future large-scale efficacy trials," he said.

Pickett continued, "the day we have a safe, effective, and acceptable rectal microbicide as a much-needed HIV prevention option for people who engage in anal intercourse is within our sights—these are truly revolutionary times and we couldn't be more energized."

Learn more about the MTN-017 trial here.

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IRMA, the Population Council, and MTN encourage HIV prevention advocates and community educators to screen The Rectal Revolution Is Here in their own workshops and sensitization sessions and to share it widely. To receive a copy of the video in English, Spanish, or Thai, please contact IRMA at rectalmicro@gmail.com.

Editorial notes:

Currently in development, microbicides are products (gels, lubricants, films) that could be applied in the rectum or the vagina to reduce the risk of HIV infection.

Unprotected anal intercourse is 10 to 20 times more likely to result in HIV infection compared to unprotected vaginal intercourse. Unprotected anal intercourse—a common human behavior—is a significant driver in the global HIV epidemic among gay men and transgender women as well as among heterosexuals.

IRMA, based at AIDS Foundation of Chicago, is a global network of more than 1,100 advocates, scientists, policy makers, and funders from six continents working together to advance a robust rectal microbicide research and development agenda. The "bottom line in HIV prevention," IRMA addresses the institutional, socio-cultural, and political stigma around the public health need for rectal microbicide research, and advocates to increase funding and commitment within this field of inquiry.

The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees.

 

The Microbicide Trials Network is a U.S. National Institutes of Health-funded worldwide collaborative clinical trials network focused on preventing the sexual transmission of HIV. Recognizing the importance of microbicides research to HIV/AIDS prevention, the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health (NIH), established the Microbicide Trials Network (MTN) in 2006, with co-funding from the NIH’s National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The MTN brings together international investigators and community and industry partners devoted to reducing the sexual transmission of HIV through the development and evaluation of products used orally or applied topically.

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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.

*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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AVAC Presents A Research Literacy Database as a Resource for HIV Prevention

AVAC is pleased today to launch the Research Literacy Database at www.avac.org/researchliteracy, an important new resource for the biomedical HIV prevention field.

The Research Literacy Database is the first central portal for educational resources on biomedical HIV prevention including:

• Global and country-specific materials;

• Resources specific to given prevention interventions including AIDS vaccines, ARV-based prevention and voluntary medical male circumcision; and

• General information on clinical trials and the research process.

The tools featured in the database were developed by a range of stakeholders worldwide to meet specific needs. We will continue to expand the database and encourage our users to share their favorite materials on an ongoing basis. The database focuses on materials that won’t necessarily change substantially over time; for trial updates, timelines, recent results and their implications and current issues, please see other areas of the AVAC website.

Using an innovative design, the database allows users to search for what they need based on key criteria. For example, a journalist in South Africa who wants to learn more about the basics of microbicide research can use the database to find relevant fact sheets, e-learning courses and other helpful tools. Research organization staff members who need tools for training and outreach to wider audiences can use the database to get a tailored toolkit according to location, audience and specific content.

We all know that the science behind HIV prevention research is challenging. AVAC believes that building
basic research literacy among key stakeholders is fundamental to effective advocacy, to moving research forward as quickly and ethically as possible, and ultimately to getting new prevention options to people who need them. Whether you are a researcher, advocate, journalist, policy maker or someone interested in learning more about clinical trials and new ways to prevent HIV, we hope this database will make learning and outreach efforts easier and more effective.

The database is an iterative tool, and will be constantly updated with new materials and other user input. We need your help in ensuring that useful materials are available and used! Please contact us at researchliteracy@avac.org with any and all feedback you have as you use the database—and we are especially keen to receive additional relevant resources to be shared with the field.



[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.

Read the Rest of the Study.



[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.

Read the rest.


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

The crazy things they say: politicians and HIV

Via PlusNews.

Political commitment is key to the success of HIV programmes and African leaders have been at the forefront of the fight against HIV on the continent, but politicians also have the power to harm HIV/AIDS campaigns.

Uganda's recently appointed health minister, Christine Ondoa, has been berated by AIDS activists for comments she allegedly made in an interview with a local newspaper on 1 August. According to The Observer, Ondoa claimed to know three people who had been cured of HIV through prayer.

"I am sure and I have evidence that someone who was [HIV] positive turned negative after prayers," she said.

Activists described her comments as "careless and misleading". Ondoa joins a long list of African leaders who have been criticized for comments deemed detrimental to the fight against HIV; here are some of the more controversial statements made by politicians:

Thabo Mbeki - In 1999, the then South African president said the ARV zidovudine - also known as AZT - had toxic side-effects and was dangerous to health, and as such, the government would not provide it free of charge to HIV-positive pregnant women.

Mbeki stirred controversy when he questioned the causal link between HIV and AIDS; in 2000 he set up a Presidential AIDS Advisory Panel, largely comprising AIDS denialists, to discuss how South Africa should deal with the crisis.

Mbeki also evoked conspiracy theories by alleging that the US Central Intelligence Agency, working with large pharmaceutical companies, was part of a conspiracy to promote the view that HIV caused AIDS.

In 2001, the NGO Treatment Action Campaign (TAC) filed a lawsuit against the government aimed at giving HIV-positive pregnant women access to the ARV, nevirapine, used to reduce the risk of HIV transmission from mother to child. TAC won the case, and the government was forced to provide the drug through the public health system.

According to the authors of a 2008 Harvard study, more than 330,000 lives were lost as a result of the delays in implementing a feasible and timely ARV treatment programme in South Africa.

Manto Tshabalala-Msimang - South Africa's health minister from 1999 to 2008 under Mbeki, her years in office were characterized by controversy, largely due to her reluctance to develop public sector policies involving the use of ARVs to fight AIDS.

Even after ARVs became available, Tshabalala-Msimang continued to cast doubt on their safety and efficacy, actively endorsing alternative therapists who promoted scientifically untested alternatives to ARVs.

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.]

Namibia: HIV Keeps Locals Out of Foreign Universities

Via allAfrica.com, by Jana-Mari Smith

Banning HIV-positive Namibians from obtaining overseas scholarships is discriminatory, unconstitutional and a human rights violation. These, and other concerns, were raised by the AIDS Law Unit at the Legal Assistance Centre (LAC) in a press statement yesterday.

The statement referred to recent newspaper advertisements by the Ministry of Education offering international scholarships, which stipulated that Namibians who are HIV positive do not qualify for the opportunity. The ban on HIV-positive applicants from taking up the education opportunities offered by countries such as China, Cuba and the Slovak Republic, among others, goes against the grain of Namibia's purported stance on equal opportunities for all.

One of the advertisements offers a Cuban medical scholarship to young Namibians from low-income families. The notice specifically requires a health certificate "acknowledging HIV-negative tests". A medical scholarship offered by China asks applicants to "undergo a thorough medical check-up, including HIV-AIDS tests". An official at the Namibia Student Financial Assistance Fund (NSFAF) yesterday told a prospective applicant that neither China nor Cuba will accept HIV-positive applicants.

"These are their policies," he said, adding that these countries do not want foreigners to "go and multiply your HIV there". An official at the Directorate of Scholarships and Awards within the Ministry confirmed that an HIV-positive applicant does not stand a chance. "That is their requirement. You cannot go there if you are HIV positive". The press release from the LAC yesterday condemned the condition attached to the scholarship offers. The ostracising of HIV-positive individuals is "discriminatory and unconstitutional".

The LAC argues that the exclusion of HIV-positive students from educational opportunities "unreasonably discriminates against young people living with HIV-AIDS and excludes them from having the same kind of opportunities".

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.]