Category Archives: HIV
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.
The International AIDS Conference is taking place in Washington, D.C., this week, and the Kaiser Family Foundation recently released a quiz to test your knowledge of the disease. Some answers may surprise you, and quiz creators hope that increasing awareness will help reduce the burden of the disease in the United States and around the world. Stats revealed include:
- Nearly 1 in 5 people with HIV don’t know they’re infected.
- Blacks account for the greatest number of new HIV infections in the U.S. (And although Blacks make up 12 percent of the U.S. population, they accounted for 44 percent of new HIV infections in 2009.)
- Since 2006, the CDC has recommended voluntary, routine HIV testing in health care settings for all people ages 13 to 64. In addition, CDC recommends more frequent testing for certain groups at higher risk for HIV infection or transmission.
>>Bonus Link: The AIDS Memorial Quilt will be on display in Washington, D.C., during the conference, but online viewers can see the quilt, and learn its history online.
Study Finds Alarming HIV Rates Among Many Young Black Men
A key study conducted in six cities and released yesterday at the International AIDS Conference in Washington, D.C. by the HIV Prevention Trials Network finds alarming rates of new HIV infections occurring among gay and bisexual black men in the United States (who are also known as men who have sex with men, or MSM), especially among young black MSM. The rate of new HIV infections among U.S. black MSM in the study was 2.8 percent per year, nearly fifty percent higher than white MSM. And the infection rate of young black MSM age 30 years and younger was 5.9 percent, which is three times the rate among U.S. white MSM. According to the researchers, the overall infection rate among black MSM in the study is comparable to the rate seen in the general populations of countries in sub-Saharan Africa hardest hit by the HIV epidemic. Read more on AIDS.
Coordinated Campus Strategies to Address Student Drinking to Reduce Self Harm and Injuries to Others
Strategies that address alcohol availability, alcohol policy enforcement and drinking norms can help colleges and their communities protect students from the harms of high-risk drinking, according to a new study funded in part by the National Institutes of Health. The study was published in Alcoholism: Clinical and Experimental Research. The researchers compared five campuses with coordinated approaches to five campuses without the program, finding that on campuses with dedicated efforts to control student drinking the percentage of students reporting severe consequences fell from 18 percent to 16 percent, but stayed the same on the campuses that had not initiated drinking controls. Reports of injuring another person while drinking decreased from 4 percent to 2 percent on dedicated campuses, with only a tiny change at the control colleges. The researchers estimate that on a campus with 11,000 students, drinking control efforts would result in 228 fewer students experiencing at least one severe consequence of drinking over the course of a month and 107 fewer students injuring others due to alcohol use during the year.
“This is the basic principle of public health — small changes at the population level can translate into significant improvements in the health of a population,” says Mark Wolfson, Ph.D., professor in the Department of Social Sciences and Health Policy at Wake Forest Baptist Medical Center, and the lead author of the study. Read more on alcohol.
DOT Announces Nearly $800M in Grants Help Fix the Aging U.S. Transit Infrastructure
The Department of Transportation has announced grants of almost $800 million to modernize and replace aging transit facilities and vehicles in 48 states, the District of Columbia and Puerto Rico.
- New Jersey Transit: $76 million to upgrade the bus fleet, which will help improve commuting times and air quality for state residents.
- Los Angeles County Metropolitan Transportation Authority: $15 million to replace aging buses with new buses that use compressed natural gas. The new buses are expected to improve reliability for riders, leave a smaller environmental footprint and reduce fuel costs.
- Capital Area Transportation Authority in East Lansing, Michigan: $6.3 million to redevelop a former Amtrak station near Michigan State University, which will improve bicycle and pedestrian access and connections to local bus and rail service.
Read more on transportation.
The XIX International AIDS Conference is taking place in Washington, D.C., this week at a pivotal point in the prevention and treatment of the disease. The World Health Organization on Friday recommended using antiretroviral medicines to try to prevent the infection in people who do not have HIV but are at high risk of transmission. The recommendation is based on recent research that found the drugs effective for many people. And, the International Antiviral Society has recommended treating all patients diagnosed with HIV with antiretroviral drugs, rather than waiting for levels of the virus to reach a certain point. Earlier treatment may help prevent certain diseases associated with HIV, including cancer, heart and kidney disease.
In advance of the meeting, Conference Co-Chair Diane Havlir, MD, chief of the HIV/AIDS division at San Francisco General Hospital and professor of medicine at the University of California, San Francisco, sat down with UCSF science writer Jason Bardi to talk about the pivotal research and global commitments being discussed in meeting sessions and hallway conversations in Washington, D.C., this week. Here are some key excerpts from that conversation, which originally ran on the UCSF News Center website.
Jason Bardi: What can we expect at the AIDS 2012 conference?
Dr. Havlir: Over the last couple of years, we’ve had breakthroughs in AIDS, mostly in the prevention area which include treatment as prevention, adult male circumcision having sustained benefits, pre-exposure prophylaxis, and data showing that early treatment benefits the individual. So, the big theme at AIDS 2012 is about how we begin to end the AIDS epidemic. The conference theme is “Turning the Tide Together,” and there is going to be emphasis on the how: how are we going to start to begin the end the AIDS epidemic? And there’s going to be emphasis on the together: who’s going to finance this, and what partners do we need to bring to the table? The way I like to explain it is that we need to think about the short- and medium-term strategies and the long-term strategies.
Jason Bardi: Your research group at UCSF is presenting quite a lot of research at the conference. Can you talk about some of the highlights?
The Food and Drug Administration (FDA) has approved the first in-home HIV Test. The test, called OraQuick, does not require a prescription and can detect the presence of antibodies to human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2). HIV is the virus that causes acquired immune deficiency syndrome (AIDS).
Consumers use the test by swabbing the upper and lower gums inside of their mouths, then placing the fluid sample collected in a vial that comes with the kit. Results are available within 20 to 40 minutes. The FDA says a positive result does not mean that an individual is definitely infected with HIV, but that additional testing should be done in a medical setting. And a negative test result does not mean that an individual is definitely not infected with HIV, especially if exposure to the virus was within the past three months.
Clinical studies have found that one false negative result would be expected out of every 12 test results in HIV-infected individuals and one false positive would be expected out of every 5,000 test results in uninfected individuals.
OraSure Technologies, which makes the test, will have a consumer support center open 24/7 to help consumers conduct the test and to make referrals for information on prevention and treatment once the test is completed.
“Knowing your status is an important factor in the effort to prevent the spread of HIV,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research. “The availability of a home-use HIV test kit provides another option for individuals to get tested so that they can seek medical care, if appropriate.” According to the FDA, the test will be targeted to people who would not otherwise be tested. “There’s a large group of people who are infected, and don’t know it,” says Midthun. “And even if they are engaged in behaviors that would put them at risk of getting HIV, they may be reluctant to visit their doctor or a health care facility to be tested.”
The Centers for Disease Control and Prevention estimates that 1.2 million people in the United States are living with HIV infection. About one in five are not aware they are infected. There are about 50,000 new HIV infections every year. Many of these new infections are transmitted from people who are unaware of their HIV status.
In observance of National HIV Testing Day, the Centers for Disease Control and Prevention (CDC) has announced a pilot project to train pharmacists and retail store clinic staff at 24 rural and urban sites to deliver confidential rapid HIV testing. The goal of the pilot, according to CDC, is to extend HIV testing and counseling into the everyday services offered by pharmacies and retail clinics. The project is part of CDC’s efforts to support its 2006 testing recommendations, which call for all adults and adolescents to be tested for HIV at least once in their lives.
“We know that getting people tested, diagnosed and linked to care are critical steps in reducing new HIV infections,” said Kevin Fenton, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “By bringing HIV testing into pharmacies, we believe we can reach more people by making testing more accessible…”
CDC estimates that 1.1 million people are living with HIV in the United States, yet nearly one in five remains unaware of the infection. In addition, one-third of those with HIV are diagnosed so late in the course of their infection that they develop AIDS within one year. That can delay treatment and increase potential transmission of the virus to partners.
Why community pharmacies? According to the CDC, millions of Americans shop at pharmacies every week and about 30 percent of Americans live within a 10-minute drive of a retail clinic. The pilot will last for two years, and the training will focus on rapid HIV testing and counseling and linking people diagnosed with the virus to treatment and support. Based on lessons learned, CDC plans to develop a comprehensive toolkit for that pharmacists and retail clinic staff.
More on HIV/AIDS testing:
- Today, HHS revamped and relaunched AIDS.gov to make it more user-friendly and accessible on any kind of device, from cell phones to tablets.
- Testing Makes Us Stronger encourages African-American gay and bisexual men to get tested for HIV.
- Take Charge. Take the Test. Encourages African-American women to get tested for HIV.
- HIV Screening. Standard Care. Gives primary care providers new tools to help ensure all patients are tested for HIV at least once in their life.
- Prevention IS Care encourages providers who treat patients with HIV to screen them for risky transmission behaviors, and remind them about the importance of protecting themselves and others by reducing risky behaviors.
- One Test. Two Lives. gives health care providers information and resources to encourage testing of pregnant women for HIV/AIDS.
- To find a test location goes to www.hivtest.org, call 1-800-CDC-INFO or text your zip code to “KNOW IT” (566948).
- AIDS.gov lists numerous resources to support National HIV Testing Day.
>>Weigh In: What other initiatives do you think might be good opportunities for collaboration between public health and retail clinics?
>>Follow the National HIV Testing Day conversation on Twitter using the hashtag #NHTD.
The timing of the current Washington, DC, revival of The Normal Heart, a period piece about the very earliest days of the AIDS epidemic in America, is no accident. The play (reviewed in the Washington Post) is set in New York City in the early 80s, at the very start of the epidemic—when the disease had no name, no effective treatment and no prevention strategy. The revival will still be playing in the nation’s capital during the International AIDS Conference, the first time the conference has been held in the United States since 1990. Conference organizers boycotted the U.S. as a meeting site because of travel restrictions for HIV-positive travelers, which were lifted in 2010.
But theatre goers who think they’re seeing a historical account of a bygone disease are dangerously mistaken. According to the Centers for Disease Control and Prevention(CDC), 1.2 million people in the United States are living with HIV/AIDS and one in five is unaware of their infection. HIV experts say late detection of the infection can mean that drugs may be insufficiently effective.
To help increase the numbers of Americans who get tested for HIV/AIDS, this week, Greater Than AIDS, a national public information advocacy group, released outdoor media messages, including billboards and bus and rail posters, aimed at connecting people with free and low-cost testing in their communities by promoting hotlines and web-based resources provided by CDC, state and local health departments and AIDS service organizations.
The new campaign includes the first Spanish language messages in the lead up to National HIV Testing Day on June 27. “This campaign is about helping to reduce the stigma surrounding HIV testing and connect people with services in their communities,” says Tina Hoff, Senior Vice President and Director of Health Communication and Media Partnerships at the Kaiser Family Foundation, a co-founding partner of Greater Than AIDS.
Learn more about HIV testing and prevention:
- Use your zip code to find an HIV testing site.
- Participate in a webinar on Thursday, June 21, at 12 p.m. EST from the HHS Healthy People initiative, featuring The Bronx Knows, an initiative that successfully identifies un-diagnosed HIV-positive individuals and connects them to much-needed care. The Assistant Secretary for Health, Dr. Howard Koh, will also announce brand new data on the national percentage of people living with HIV who are aware of their status. Dr. Koh will also be answering questions during a live Twitter chat today (June 19) from 1 to1:30 p.m. EST using the hashtag #NHTD. Follow@gohealthypeople for more information.
Reuters is reporting that an FDA advisory committee has recommended that the HIV drug Truvada be approved for the prevention of HIV for people at highest risk of contracting the infection, such as men who have sex with other men. The agency is expected to rule on the recommendation next month. While the drug has been effective in preventing transmission of the infection in clinical trials, drawbacks include the high cost of the drug and a risk for serious kidney problems when the drug is used long term. Read more on HIV.
This week the governor of Washington State, Chris Gregoire, made emergency funds available to the state Department of Health to help curb the outbreak of whooping cough (pertussis) underway in Washington. The state’s Health Secretary declared a whooping cough epidemic last month. Gregoire also urged health care professionals to get vaccinated and vaccinate their patients, and announced federal approval for health officials to re-direct some funds to buy several thousand doses of pertussis vaccine for adults.
“I’m especially concerned about the vulnerable babies in our communities that are too young to be fully immunized,” said Gregoire. “These actions will help state and local health leaders get vaccine into people’s arms so we can stem the tide.” According to the Department of Health 1,132 cases of whooping cough have been reported in the state through April 28—that’s compared to 117 over the same time last year. There were 965 cases reported in all of 2011. Read more on vaccine-preventable illnesses.
In cooperation with the U.S. Consumer Product Safety Commission (CPSC), Wal-Mart Stores Inc., and Toys R Us Inc., are announcing the recall of about 21,000 inflatable Banzai in-ground pool water slides. During use, the slide can deflate, allowing the user to hit the ground underneath the slide and become injured. The slide is also unstable and can topple over in both still and windy conditions and carries inadequate warnings and instructions. The CPSC says it is aware of one death, a paralyzing injury and a neck fracture linked to use of the slides.
CPSC urges consumers to immediately stop using the product and return it to the nearest Wal-Mart or Toys R Us for a full refund. Consumers can also cut the two safety warning notices out of the slide and just return that portion.
The CPSC has also recently published a roundup of recalls this past year of products most likely to be used in the spring and summer, such as playground sets, gas grills and kiddy bikes. Read more on injury prevention.
A review of 27 observational studies published between January 1950 and August 2011 finds that exercise may help improve survival for people with breast and colon cancer. The study was published in the Journal of the National Cancer Institute.
Read more on cancer.
The Occupational Safety and Health Administration (OSHA) has kicked off a national outreach initiative to educate workers and employers about the dangers of working outdoors in hot weather. The outreach effort builds on last year's campaign to raise awareness about the dangers of too much sun and heat.
Workers at risk include those on farms, construction workers, utility workers, baggage handlers, roofers, landscapers and anyone else who works outside. OSHA has developed heat illness educational materials in English and Spanish; a curriculum for workplace training; a dedicated website; and a free app that lets workers and supervisors monitor the heat index for a worksite. The app displays a risk level for workers based on the heat index, and worker safety information from National Oceanic and Atmospheric Administration heat alerts.
Read more on worker safety.
Johns Hopkins University has been awarded $15 million over the next five years from the National Institutes of Health to establish a new Center for AIDS Research. A major priority for the new center will be to address Baltimore’s HIV epidemic. A report by the Baltimore City Health Department released last year found that despite national advances in HIV prevention and treatment, Baltimore continues to be among the top 10 urban areas in the country in HIV incidence rates.
At the end of 2009, there were 13,048 people in Baltimore living with HIV/AIDS and HIV infections were being diagnosed at a rate of almost one and a half per day. A 2006 study showed that the lifetime expense of treating each new case of HIV in Baltimore costs about $355,000. That expense, according to the Health Department’s report, “puts a significant strain on evolving health care systems, especially in a city like Baltimore with a high poverty rate.”
Read more on HIV/AIDS.
The Weight of the Nation Conference, sponsored by the Centers for Disease Control and Prevention, begins today. The goal of the conference is to provide a forum to highlight progress in the prevention and control of obesity through policy and environmental strategies, and is framed around five intervention settings: early care and education; states, tribes and communities; medical care; schools; and workplaces. Several key resources on obesity are being released in connection with the conference:
- A new book, The Weight of the Nation: To Win We Have to Lose, co-authored by Judith Salerno, Executive Officer of the Institute of Medicine, which looks at the forces driving the obesity epidemic in the U.S. and offers practical tips on weight loss.
- The book is a companion to a new HBO documentary, The Weight of the Nation, on obesity in the US, which debuts May 14 and was produced in association with partners including the Centers for Disease Control and Prevention and the National Institutes of Health.
- On May 8 the IOM will release a report, Accelerating Progress in Obesity Prevention, at the Weight of the Nation conference, which will recommend ways society can support individuals by making healthy choices easier.
A study published in the Annals of Emergency Medicine found that 80 percent of people using bike share programs in Boston and Washington, DC, did not use helmets. According to the researchers, from Beth Israel Deaconess Medical Center in Boston, helmet use is associated with decreased rates of head injury and mortality and decreases the risk of head and brain injury by 65 to 88 percent. Helmet use in the two bike share programs studied, as well as others, is not required in order to rent the bikes.
Blacks with HIV are much less likely to adhere to drug therapy than others with the disease, according to a University of Michigan study. Additionally, untreated depression may interfere with HIV/AIDS treatment for all low-income, HIV-infected patients, regardless of race. The one year study found that less than 30 percent of African-American HIV patients in the one-year study had optimal compliance with their drug therapy, compared with 40 percent of other HIV patients.
More than 66 percent of the 7,034 HIV-infected patients in the study were African-American and nearly half of them reported depression. However, the study also found that antidepressant treatment nearly doubled the odds of drug compliance among HIV patients of all races who reported depression. The study appeared in the Journal of General Internal Medicine.