Category Archives: AIDS
New NIH Study to Look at House-to-House HIV Testing, Other Measures, to Reduce HIV Burden in Africa
A study in South Africa and Zambia is assessing whether house-to-house voluntary HIV testing and prompt treatment of HIV infection, along with other proven HIV prevention measures, can substantially reduce the number of new HIV infections across communities. The trial is funded primarily by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), administered by the Office of the Global AIDS Coordinator. “Through this new study, we aim to learn whether the treatment of HIV-infected individuals as a form of HIV prevention, an approach previously tested in roughly 1,800 heterosexual couples where one partner was infected, will be just as effective when implemented across an entire adult population,” said NIAID Director Anthony S. Fauci, MD. “The study also will tell us whether this method of delivering population-wide HIV treatment as prevention is feasible and cost-effective.” The trial is being conducted in South Africa and Zambia because the HIV prevalence in those countries is among the highest in the world. An estimated 12.5 percent of adults in Zambia and 17.3 percent of adults in South Africa are infected. The study team will measure the impact of the two HIV prevention packages by determining the number of new HIV infections among a representative sample of 52,500 adults drawn from the 21 study communities and followed for three years. The study is expected to end in 2019. Read more on AIDS.
Study: Better Awareness Likely Reason for Increase in ER Visits for Youth Concussions
Improved awareness of the signs and symptoms of traumatic brain injuries (TMI)—such as concussions—is likely the cause of a noticeable increase in TMI-related emergency department visits by children, according to a new study from doctors at the Cincinnati Children's Hospital Medical Center. The study appeared in the journal pediatrics. Visits for these types of injuries climbed about 92 percent from 2002 to 2011, while the overall severity of the injuries decreased and the hospitalization rate remained at around 10 percent. "We are doing a better job at educating ourselves and educating the public about concussion," said Dr. Holly Hanson, lead study author and an emergency medicine fellow. "People and doctors are recognizing sports-related concussions more. People are recognizing the signs and symptoms. People are more aware of the complications. So people are coming in more." According to the U.S. Centers for Disease Control and Prevent, each year TMI accounts for about 630,000 emergency department visits, 67,000 hospitalizations and 6,100 deaths in children and teens annually. Read more on injury prevention.
HHS Developing New Burn Treatments to Improve Disaster Response, Daily Care
Through its Biomedical Advanced Research and Development Authority (BARDA), the U.S. Department of Health and Human Services (HUD) is working to develop five new types of burn treatments for disaster response and daily emergency medical care. The thermal burn medical countermeasures—which could take the form of drugs, vaccines or medical products—will be for chemical, radiological or nuclear incidents. Developing new measures is critical, because with only 127 burn centers in the country, a mass casualty event could quickly overwhelm the public health response. “Sustainability of these medical countermeasures for thermal burns is critical for their availability when they are needed most,” said BARDA Director Robin Robinson, PhD. “Our repurposing and multi-purpose strategy facilitates development, ensures availability, and reduces overall costs for thermal burn medical countermeasures.” Read more on disasters.
UN: Improved Access to HIV/AIDS Treatment Reduces Number of AIDS-related Deaths
The United Nations’ annual report on HIV infections and AIDS related-deaths around the world concluded that increased access to treatment in poorer and middle-income countries has led to positive health outcomes. “AIDS-related deaths in 2012 fell to 1.6 million, down from 1.7 million in 2011 and a peak of 2.3 million in 2005. And the number of people newly infected with the disease dropped to 2.3 million in 2012 down from 2.5 million in 2011.” The executive director of UNAIDS, Michel Sidibé, said that the international community is well on its way to surpass the 2015 goals of expanding access to treatment. Read more on the public health impact of AIDS.
Racism Leads to Negative Effects on Mental Health of Children and Teens
A new report published in the journal Social Science & Medicine examines the link between the mental health and well-being of youth ages 12-18 and racism. The review shows that being a victim of racial discrimination can lead to low self-esteem, reduced resilience, and increased behavior problems. There was also evidence of increased risk of poorer birth outcomes for children when mother experienced racism while pregnant. These types of detriments to children and teen’s mental health and well-being can lead to larger problems in terms of engagement in education and employment later in life, according to study authors. Read more on health disparities.
Positive Relationships May Help Break the Cycle of Maltreatment
In a special supplement released by the Journal of Adolescent Health, investigations on the effects of safe, stable, nurturing relationships found that these types of relationships could help break the cycle of child maltreatment that is often passed along from parents to children. Findings also showed that supportive and nurturing relationships between adults can help protect children as well. This study can provide helpful prevention strategies for breaking the cycle of maltreatment and promoting improved health in the long term. Read more on violence prevention.
The United Nations Foundation believes that, for the biggest public health obstacles facing the world, it will take all nations and all sectors working toward solutions to succeed. So the Foundation works to make that a reality, bringing together partnerships, growing constituencies, mobilizing resources and advocating policies that can help everyone—in both the developing and developed world.
NewPublicHealth recently spoke with Kathy Calvin, President and Chief Executive Officer of the United Nations Foundation, about the organization’s many efforts to improve health both globally and locally—and how these two goals can support each other.
NewPublicHealth: What changes have you seen in global health during your time in the field?
Kathy Calvin: The number of nonprofits dedicated to health issues has quadrupled it seems, and real progress has been made, which is the most important point—that we’re actually seeing a reduction in maternal deaths and newborn deaths and preventable diseases such as measles and diarrhea and pneumonia. I mean, there’s just been enormous progress, with still much more to happen. But it’s been an exciting time after what I think has been a pretty discouraging period where no amounts of foreign aid seemed to be making a difference. I attribute that partly to some innovations in research and financing, but also to the fact that a lot of governments in Africa actually have prioritized women and prioritized health in some pretty significant ways. And I think we’ve had a very enlightened government in the last five years here, too, in terms of what we’re doing overseas.
So, it’s been exciting to see it. Health is not my background. I’ve really been privileged to see both how serious and significant the challenges are, but also how much good can be done with just a little bit of organized effort.
NPH: When you talk about enlightened government, what are some examples? What is making the difference now?
Calvin: Well ironically it isn’t all that political. In fact, some of the biggest shifts took place under President George W. Bush’s administration with his creation of the President’s Malaria Initiative—until then, there had been zero real depth of interest and progress on malaria—as well as PEPFAR, which some people criticized because it was so bilateral, but it had a huge impact in allowing the current administration to really set some ambitious goals for reducing and eliminating parent-to-child transmission and setting that audacious goal of an AIDS-free generation.
Mammography Rates Remained Steady After Change in Guidelines
The proportion of women undergoing screening for breast cancer every year did not change after U.S. Preventive Services Task Force released recommendations saying there wasn't enough evidence to support routine mammograms for women in their 40s, according to a new study published in the journal Cancer. In 2009, the Task Force changed their recommendations to state that women aged 50 to 74 should have a mammogram every other year, and screenings for women under age 50 should be evaluated by each woman with her doctor, according to individual risk factors. "When there are conflicting versions of guidelines, providers may err on the side of screening," said David Howard, a health policy researcher from Emory University in Atlanta, in an interview with Reuters. Read more on cancer.
Latest HIV Vaccine Study Halted
The National Institutes of Health halted a study testing an experimental HIV vaccine after an independent review board found the vaccine did not prevent HIV infection and did not reduce the amount of HIV in the blood. The trial, started in 2009, is the latest in a series of failed HIV vaccine trials, according to Reuters. The halted study included more than 2,500 volunteers in 19 U.S. cities. Study populations included men who have sex with men and transgender people who have sex with men. Read more on HIV.
CDC's Food Safety Report Card: Some Foodborne Illnesses Spiked in 2012
The Centers for Disease Control and Prevention (CDC) recently released the "nation’s annual food safety report card," and it shows that 2012 rates of infections from two types of foodborne bacteria—campylobacter and Vibrio—have increased significantly when compared to a baseline period of 2006-2008, while rates of most others have not changed during the same period. The data are part of the Foodborne Diseases Active Surveillance Network report. Campylobacter infections have been linked to tranmission in many foods, including poultry, raw milk and produce. These infections were at their highest level since 2000, up 14 percent since 2006-2008. Vibrio infections, often associated with raw shellfish, were up 43 percent.
“The U.S. food supply remains one of the safest in the world,” said CDC Director Tom Frieden, MD, MPH. “However, some foodborne diseases continue to pose a challenge. We have the ability, through investments in emerging technologies, to identify outbreaks even more quickly and implement interventions even faster to protect people from the dangers posed by contaminated food.” Read more on food safety.
Kaiser Family Foundation Report Highlights U.S. Engagement in Global Health: A NewPublicHealth Q&A with Josh Michaud
The increasing globalization of the world circles back to health as well. That’s a key tenet in a new report, The U.S. Government Engagement in Global Health: A Primer, from the Kaiser Family Foundation. The report describes the U.S. agencies and programs involved in global health and the federal budget supporting these efforts. Following the release of the primer, NewPublicHealth spoke with Josh Michaud, a Principal Policy Analyst at the Kaiser Family Foundation focused on the U.S. government’s role in global health.
NewPublicHealth: Why did the Kaiser Family Foundation create the global health primer?
Josh Michaud: The Kaiser Family Foundation has produced primers for other health issues on which we work, including Medicare and Medicaid. We felt that global health was an area in which we’ve built up some good data and analysis and we wanted to put it together in a format accessible to as wide an audience as possible. There has also been a growing interest at universities among young people in global issues, in particular global health issues.
Another critical reason to produce the primer is to set out a baseline for discussions, whether it is for different sides of a policy debate, student’s writing papers or people just getting started in the field. We don’t come at this with a particular recommendation, it really is meant to be a portrait of all the different parts of the U.S. government that are involved in global health. In the final section of the primer, we pulled together some policy issues that are of particular importance right now.
NPH: What trends or changes does the report note?
Michaud: The major trends have been increased levels of funding and an engagement by many different parts of the U.S. government in global health. The budget has increased significantly. In fiscal year 2001 the global health budget was about $1.5 billion. In fiscal year 2012 it was $8.8 billion. And while the United States is the most important and largest donor to global health, contributions from other governments have also grown significantly.
Much of the increased funding has been driven by increases for HIV/AIDS programs worldwide, and in particular, the PEPFAR program that the United States funds, as well as U.S. funding in support of Malaria. Earlier in the decade, there were significant increases year by year. That’s now leveled off and we don’t know what will happen in the future.
Eleven Public Health Departments First to Achieve National Accreditation Status
The Public Health Accreditation Board (PHAB) has awarded 5-year accreditation to eleven public health departments. The national program, which is jointly supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention, aims to improve and protect the health of the public by advancing the quality and performance of the nation’s state, tribal, local and territorial public health departments. The newly accredited agencies are the first of hundreds currently preparing to seek national accreditation through PHAB, an independent organization that administers the national accreditation program. “With accreditation, we now have national standards that promote continuous quality improvement for public health and a mechanism for recognizing high performing public health departments,” said PHAB President and CEO Kaye Bender, PhD, RN, FAAN. “These are the first of many health departments that we look forward to being able to recognize for achieving national standards that foster efficiency and effectiveness, and promote continuous quality improvement.”Read more on accreditation.
Report: HIV Cured in Baby
Researchers from the Johns Hopkins Children’s Center will report today that a baby in rural Mississippi has been cured of HIV through aggressive use of anti-retroviral drugs following birth. The finding will be presented at the Conference on Retroviruses and Opportunistic Infections in Atlanta. The findings have not been yet been published in a peer review journal and the researchers say the findings may not apply to adults. Read more on HIV/AIDS.
Public Health and Sequestration
Several public health organizations has issued statements on the potential impact of sequestration, across the board budget cuts to the federal budget, including the Association of State and Territorial Health Officers (ASTHO), the National Association of County and City Health Officials (NACCHO) and the American Public Health Association (APHA). Read more on budgets.
On World AIDS Day, Saturday, December 1, I’m Positive, a new documentary produced by the Kaiser Family Foundation and MTV, will introduce three young adults living with HIV. The documentary is part of a project called GYT: Get Yourself Tested, a campaign to encourage testing for STDs, including HIV. GYT is a sexual health public information partnership between the Kaiser Family Foundation and MTV.
NewPublicHealth spoke with cast member Otis Harris, who is an HIV/AIDS peer advocate who lives in Chicago.
NewPublicHealth: How old are you and how old were you when you found out that you were HIV positive?
Otis Harris Jr.: I am 25 years old and I was 22 [when I found out I was HIV positive].
NPH: What do you wish you had known then that you know now?
Otis Harris Jr.: I wish that I could have been a little more educated about the virus and what to look for and how to protect myself. And if I would have known what I know now then I probably wouldn’t have been infected.
NPH: People have been working on HIV/AIDS education efforts for so many years now, but clearly they weren’t getting through. What are the ways in which they didn’t communicate well and how can they communicate better?
>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.
Mandisa Madikane, a 20-year old, HIV-positive, newly minted journalist from Soweto, South Africa, was the star at a high-wattage Washington D.C. event Wednesday night hosted by the U.S. President’s Emergency Plan for Aids Relief in conjunction with the 2012 AIDS International Conference meeting this week. Her co-panelists, who spoke about empowering women to protect them from rape, poverty, discrimination and humiliation included Tom Frieden, MD, director of the Centers for Disease Control; Rajiv Shah, Administrator of the U.S. Agency for International Development; and Melanne Verveer, U.S. Ambassador at Large for Global Women’s Issues. Discussion was helped by a video, “Mandisa’s Story,” aired at the event. Directed by the young journalist, it tells the story of her rape by a neighbor at age six, which is how Mandisa contracted HIV.
Mandisa is one of three HIV-positive young women from South Africa covering the AIDS conference who received their journalism training through GlobalGirl Media (GGM), a non-profit that teaches teenage girls from disadvantaged communities around the world, including the U.S., to become citizen-journalists. Launched in 2010 by a group of women broadcasters and journalists, GGM teaches girls to use print, video and electronic media to tell their stories in order to build their self-esteem and champion the role of girls throughout the world. The project currently has bureaus in South Africa, Morocco, Los Angeles and one opened just this month in Chicago. “The girls who train with GGM are a family, and we all have important stories to tell,” said Evelyn Mokele, one of the South Africa journalists in Washington this week. “When I found out I was HIV positive, I almost gave up on everything. But instead of letting my status be a death-sentence, I used it as a tool to find my voice.”
NIH Will Test Vaginal Ring for HIV Prevention in Women
U.S. researchers announced at the 2012 International AIDS Conference yesterday that they will begin a multinational clinical trial this month to test the effectiveness and extended safety of a vaginal ring containing an experimental antiretroviral drug to prevent HIV infection in women. Results are expected in early 2015.
“Developing scientifically proven forms of HIV prevention that women can control is essential,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases. “Because the vaginal ring is a long-acting intervention, it has a potential added benefit in that women may find it relatively easy to use.”
Most women who acquire HIV do so through unprotected sex, according to the National Institutes of Health. Because many women cannot negotiate male condom use with their sexual partners, women need forms of HIV prevention that they can use independently and regularly. The clinical trial will be conducted in Malawi, South Africa, Uganda, Zambia and Zimbabwe. Read more on AIDS.
Ground Beef, Strollers Recalled
Cargill Meat Solutions is recalling 29,339 pounds of fresh ground beef products that may be contaminated with Salmonella Enteritidis, according to the Department of Agriculture’s Food Safety and Inspection Service. Although the “use by date” has passed, the USDA is concerned that consumers may have packages of the meat, which is stamped EST. 9400, in their freezers. So far, 33 people in seven states have become ill. The states are Massachusetts, Maine, New Hampshire, New York, Rhode Island, Virginia and Vermont.
Baby stroller firm Peg-Perego is recalling more than 200,000 strollers sold between 2004 and 2007 because of a baby death caused by a Peg-Perego stroller eight years ago. A baby’s head and neck can become trapped between the stroller tray and the seat bottom. Read more on food safety.
Study: Tanning Beds Vastly Increase Skin Cancer Risk in Young People
Using a tanning bed increases the risk of skin cancer by 20 percent, according to a new study in the British Medical Journal. However, starting to use tanning beds before age 35 can raise that risk by 87 percent, according to the study. The results are based on an analysis of 27 studies published between 1981 and 2012 that looked at 11,000 cases of skin cancer. Read more on cancer.
The choice of Washington, D.C. as the site of the 2012 International AIDS Conference is an important one – about 3 percent of the adult and teen residents of the city are HIV positive. That exceeds the definition of an AIDS epidemic by UNAIDS – 1 percent of a population.
A new report from the Kaiser Family Foundation says that, “In many ways, the D.C. epidemic is a microcosm for what is happening nationally”: D.C. is a small, densely populated community with overlapping sexual networks that can fuel transmission, and also faces significant health care access challenges, poverty, drug use, high rates of other sexually transmitted infections, stigma and lack of knowledge about HIV status.
Blacks in D.C. have the highest HIV prevalence rates per 100,000 adults and adolescents (4,264.6)—more than twice the rate among Latinos (1,836.4) and three times the rate among whites (1,226.3). One difference is that in D.C., there is a higher prevalence of HIV among Black women (2.6%) compared with white men (2.4%).
Importantly, though, the report finds gains in HIV awareness and testing in the city. Over 100,000 HIV tests were done in DC last year, triple the number in 2007. And, according to the Kaiser Family Foundation, D.C. was the first jurisdiction to adopt CDC recommendations for routine HIV testing in health care settings and actively works with providers to expand testing. More than four in 10 D.C. residents, ages 18-64, report being tested for HIV within the past year, the highest share of any state.
>>Bonus Link: The Washington Post has been live blogging the AIDS conference this week and the site also has some notable features including an important story on the stigma of AIDS in the South and obstacles in the U.S. to successful treatment for HIV/AIDS.