The CDC HIV/Hepatitis/STD/TB Prevention News Update

UNITED STATES: "Genital Herpes Virus Infects One in Six Americans"

CANADA: "Hepatitis C Sufferers Endangering Health to Get Treatment"

AFRICA: "Cell Phones Latest Tool to Beat HIV/AIDS in Africa"

SINGAPORE: "Nobel Winner Slams Singapore over HIV Treatment Costs"

UNITED STATES: "Smoking Tied to Lung Cancer in Women with HIV"

LOUISIANA: "Baton Rouge HIV/AIDS Nonprofit Groups Seek Funds"

CALIFORNIA: "Women Report Gaps in Health Services"

NEW YORK: "Power Button Wins Condom Wrapper Design Contest"

GEORGIA: "Program Targets Teen Dating Abuse"

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UNITED STATES:
"Genital Herpes Virus Infects One in Six Americans"   back to top
BusinessWeek , (03.09.2010)   Tom Randall, Bloomberg News

A new CDC study finding the US genital herpes infection rate has remained relatively level over a decade “serves as a stark reminder that herpes remains a common and serious health threat,” said Dr. Kevin Fenton, director of the agency’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

The report was presented Tuesday at the 2010 National STD Prevention Conference in Atlanta. The 2005-2008 data were from the National Health and Nutrition Examination Survey, a federal report that draws from medical records and blood tests. Herpes simplex virus type 2 (HSV-2) infection rates in people ages 14-49 were examined.

HSV-2 prevalence in the United States declined from 17 percent in 1999-2004 to 16.2 percent in 2005-2008 - a decrease so small as to be “not statistically significant,” CDC said.

Genital herpes, which can produce painful blisters near the genitals and raise the risk for HIV transmission, infects one in six Americans, CDC said. Women and African Americans are most likely to be infected.

The study found that blacks had a 39.2 percent infection rate, more than three times that of whites. Almost half (48 percent) of African-American women were infected with genital herpes. “We are particularly concerned about persistent high rates of herpes among African-Americans, which is likely contributing to disproportionate rates of HIV in the black community,” Fenton noted. Blacks have higher poverty rates and more limited access to health care, including STD treatment, the agency said.

CDC estimates that more than 80 percent of people with HSV-2 are unaware they are infected. Those with the virus can transmit it to sex partners even when they do not show symptoms. People who have herpes symptoms should seek testing, CDC said. Patients should avoid sex during an outbreak and use condoms on a consistent and correct basis with all sex partners. HSV-2 is an incurable infection, though medications can help manage its symptoms and control outbreaks.

To view CDC’s media release on the study, visit http://www.cdc.gov/NCHHSTP/newsroom/hsv2pressrelease.html

CANADA:
"Hepatitis C Sufferers Endangering Health to Get Treatment"   back to top
CBC.ca , (03.03.2010)   CBC News

Strict criteria for treatment eligibility in British Columbia and Ontario are driving some patients infected with hepatitis C virus to inflame their livers deliberately, experts say. Drug plans in these provinces will only provide antiviral treatment if patients submit documentation of significant liver damage. In contrast, Alberta provides treatment for HCV if a doctor prescribes it.

“The binge drinking is huge,” said Fran Falconer, an HCV support nurse on Vancouver Island. “For the liver, drinking [alcohol] is like putting grease on a flame. It’s like fertilizer to the hepatitis C virus.”

“I see patients that are willing to do anything to get rid of the virus,” Falconer said. “Patients shouldn’t have to stoop to those levels in order to access care and treatment.”

About 50,000 people in British Columbia have HCV, more than in any other province, according to the B.C. Center for Disease Control.

Dr. Brian Conway, an infectious-disease specialist who runs an HCV clinic in downtown Vancouver, said patients are asking on a daily basis how best to inflame their liver in order to raise their enzyme levels to qualify for treatment. Conway advises patients against harming the liver.

Of Conway’s patients, 200 are on antivirals, including some through clinical trials funded by pharmaceutical companies. Another 250 are waiting for treatment, and probably 50-75 will be rejected by the provincial drug plan, he estimated.

“The rules need to change so we don’t have to argue for coverage, case by case,” Conway said.

The approval process is unique to HCV, said Dr. Morris Sherman, head of the Canadian Liver Foundation’s board. “There is no restriction on HIV drugs, or TB drugs, but for hepatitis B and C, the approach is different,” he said.

Kevin Falcon, the B.C. health minister, said the significant side effects associated with HCV treatment are the reason the decision to treat is left to an approval committee, not to an individual patient’s physician.

AFRICA:
"Cell Phones Latest Tool to Beat HIV/AIDS in Africa"   back to top
Agence France Presse , (03.08.2010)   

Cell phones should play an increasing role in delivering HIV/AIDS-related health services in Africa, UNAIDS chief Michel Sidibe said during a recent trip to Nigeria.

The continent’s numerous economic, political, and social challenges demand creative approaches to dealing with HIV/AIDS, said Sidibe. Despite the resources that have flowed to sub-Saharan Africa to combat the epidemic, the region continues to account for 67 percent of global HIV infections, UNAIDS data show.

“I don’t think in any of our African countries we will be able to wait to have professionals, or to have enough of those people” in place in health infrastructures to adequately address HIV/AIDS, said Sidibe. “You can talk about different policies, about capacity building, but you can’t beat this kind of epidemic with facility-based approaches only,” he said. “It is time to reinforce our capacity to use the modern technology differently.”

Africa has some of the highest numbers for cell phone access and should take advantage of that technology, Sidibe noted. For example, Nigeria has more than 70 million cell phone subscribers, roughly one phone for every two people. A pilot project underway in the country’s northern Kaduna and southwestern Ondo states has trained village workers to identify symptoms of illness. They then use their mobile phones to call medical workers at a major center to get diagnoses and prescriptions dictated over the phone.

“Using all these types of approaches can help us improve information systems and expand delivery by reaching the poor in the community,” said Sidibe.

SINGAPORE:
"Nobel Winner Slams Singapore over HIV Treatment Costs"   back to top
BusinessWeek , (03.05.2010)   Simeon Bennett, Bloomberg News

Singapore’s reliance on charging for HIV testing and treatment are counter-productive to prevention efforts, the co-discoverer of the virus said Thursday during a visit to the city-state. New HIV diagnoses in Singapore rose to 456 in 2008, up from 242 in 2003, according to the health ministry.

“The stigma, the fact that they have to pay for everything, it’s the worst conditions for stimulating people to be tested and treated,” said Francoise Barre-Sinoussi. “The numbers they announce are probably much lower than the numbers they have.”

Most insurers do not cover the cost of HIV/AIDS treatments, which can be up to $1,500 (US $1,073) a month, said Stuart Koe, CEO of Fridae.com, Asia’s largest gay Web site. Generic regimens are not on the market there, so doctors often advise patients to purchase them in Malaysia or Thailand, he said.

“It’s a shame, because Singapore is considered by many to be a developed country,” Koe said. “The HIV/AIDS community here is way behind most of the neighboring countries as a result.”

In January, the government announced it would subsidize treatments for poor patients. Still, an anonymous HIV test costs $30 (US $21), according to Action for AIDS, Singapore’s largest provider of anonymous screening.

“The situation is even worse than in developing countries not far from here,” Barre-Sinoussi said. “In Cambodia, everything is free.”

UNITED STATES:
"Smoking Tied to Lung Cancer in Women with HIV"   back to top
Reuters Health , (03.05.2010)   

A new study finds HIV-positive women and those at risk of acquiring the virus are more likely to develop lung cancer compared to women in the general population.

While people with HIV have a much higher risk for many cancers, it is not clear whether the virus plays a role in the development of lung cancer, explained Dr. Alexandra M. Levine, of the Duarte, Calif.-based City of Hope National Medical Center, and colleagues. They compared lung cancer cases in 2,651 HIV-infected and 898 at-risk but uninfected women, with an average age of 35, with those estimated to occur among similarly aged women in the general population.

Compared with population-based expectations, the researchers found a “substantially increased risk of lung cancer among both HIV-infected and at-risk uninfected women.” Population estimates suggested they would find four to five lung cancer cases; instead, 14 cases were seen over a five-year period: 12 among HIV-positive women and two among women at risk for HIV.

Approximately two-thirds of women in the HIV group were smokers. All the women who developed lung cancer were smokers; over their lifetimes, they smoked double the number of cigarettes as their peers without lung cancer. No lung cancer cases were found among the women who were lifetime non-smokers.

Further analysis found that only smoking history and duration “were significantly associated with lung cancer” among women with HIV or at risk for infection, said the researchers. “As such, the development and implementation of smoking cessation programs aimed at HIV-infected persons will be of increasing importance.”

The study, “HIV as a Risk Factor for Lung Cancer in Women: Data from the Women’s Interagency HIV Study,” was published online ahead of print in the Journal of Clinical Oncology (2010; doi:10.1200/JCO.2009.25.6149).

LOUISIANA:
"Baton Rouge HIV/AIDS Nonprofit Groups Seek Funds"   back to top
The Advocate (Baton Rouge) , (03.08.2010)   Steven Ward

Nonprofit HIV/AIDS groups in the Baton Rouge area are struggling to find alternate funding sources in the wake of state and federal budget cuts.

The Baton Rouge AIDS Society recently saw its $158,000 CDC allocation for prevention and outreach slashed by $98,000, said Arnold “A.J.” Johnson, the society’s founder.

“This is more than devastating,” Johnson said. “I’m calling legislators and doing whatever I can do. People get infected every day and the problem is escalating.”

Before the reduction, Johnson explained, the group’s HIV testing van went into communities twice each week. The service now will have to be scaled back to once or twice every other month.

“If people get infected and they don’t get tested, the disease spreads,” said Johnson. “This will cost lives.”

Midway through fiscal 2009-10, Family Services of Greater Baton Rouge lost $34,500 in state funding for HIV/AIDS prevention, according to Rene Milligan, spokesperson for the Louisiana Department of Health and Hospitals. The group provides counseling and testing services, said Mary Helen Borck, its director of HIV/AIDS programs.

CALIFORNIA:
"Women Report Gaps in Health Services"   back to top
Los Angeles Times , (03.07.2010)   Molly Hennessy-Fiske

According to “Health Indicators for Women in Los Angeles County,” a report released last week by the county Department of Public Health, minority and low-income women are less likely to have adequate access to health care and more likely to suffer with chronic diseases. The survey found that African-American women were much more likely to have STDs, including HIV/AIDS, and to die from chronic conditions. Latinas reported the poorest health status of all ethnic groups. Asians were the least likely of any ethnic group to have had a Pap test in the previous three years. Compared to white and Latina women, black women were almost twice as likely to report having had sex without a condom in the preceding year. Dr. Rita Singhal, a report co-author, said researchers suspect that minority women may suffer racial inequality, discrimination, and stress in trying to access health care and maintain healthy diets. “We need to work collectively to improve women’s health and reduce disparities not just for African Americans but for all women,” said Dr. Jonathan E. Fielding, the county’s public health director.

NEW YORK:
"Power Button Wins Condom Wrapper Design Contest"   back to top
New York Times , (03.09.2010)   Natasha Lennard

A design suggesting a computer’s power button has been chosen from among almost 600 entries as the new package art for the New York City condom. The city has distributed more than 40 million of the male condoms since Valentine’s Day 2007, when it became the first municipality to brand its own prophylactic. “I hope my package design reminds people that they’re in control,” said Luis Acosta, the Queens graphic designer whose condom package won with 23 percent of the votes cast. “It’s about empowering people and giving a positive message, while staying subtle.” Other finalist entries included a top hat, a city manhole cover, and a train entering a tunnel. “We’re keeping condoms and the conversation about them fresh,” said Dr. Monica Sweeney, the city’s assistant health commissioner. “We want everybody to think and talk about condoms all the time.”

GEORGIA:
"Program Targets Teen Dating Abuse"   back to top
Atlanta Journal-Constitution , (03.09.2010)   Gracie Bonds Staples

CDC says one teen in four reports verbal, physical, emotional or sexual abuse in dating relationships - a problem that will be addressed at a meeting this Saturday in Atlanta. “Spotlight on Teen Dating Violence: What’s Your Role?” will be presented by the Partnership Against Domestic Violence’s Teen Scene. Local radio personality Beyonce of Hot 107.9, herself a survivor of dating abuse, will host the gathering and facilitate a panel discussion. Participants must preregister for the event, which takes place from 9:30 a.m. to 2 p.m. at Clark Atlanta University’s Carl and Mary Ware Academic Center. For more information, contact the partnership at 404-870-9603 or www.padv.org. To reach Georgia’s statewide abuse crisis line, telephone 800-33-HAVEN.