UNITED STATES: "AIDS Fight Enters New Phase with Prevention Pill"back to top Associated Press , (05.11.2012) Lindsey Tanner
With a Food and Drug Administration (FDA) panel’s endorsement of the use of the drug Truvada to prevent HIV infection, the 30-year battle against the AIDS epidemic is advancing to a new phase, advocates say.
“With this recommendation, we’re nearing a watershed moment in our fight against HIV,” said James Loduca, a spokesperson for the San Francisco AIDS Foundation. “We know this isn’t a magic bullet, and it’s not going to be the right prevention strategy for everyone, but it could save thousands of lives in the United States and potentially millions around the world.”
Truvada has been on the US market as an HIV treatment since 2004. It is already being prescribed off-label by some doctors for preventing HIV infection in certain patients who are healthy but at risk. If FDA expands approval to formally sanction this use, insurance companies could likely cover the cost. And widening the market could prompt Truvada’s maker, Gilead Sciences Inc., to lower its price - currently around $11,000 to $14,000 a year.
Truvada is available in poor countries for as little as $9 per month, said a Gilead spokesperson, but generic versions will not be available in the United States until after the US patent expires in 2021.
Truvada can cause kidney and liver problems. But for some people, the risk of kidney problems “10 years down the line may be less than the risk for acquiring HIV, which is significantly more problematic and can be fatal,” said Jim Pickett, prevention advocacy director at AIDS Foundation of Chicago.
The Ohio House Ways and Means Committee recently approved a bill that would create an option to allow income tax filers to donate money to a state fund that supports cervical and breast cancer testing and treatment. The bill is expected to advance to the full House soon.
The state Department of Health’s Ohio Breast and Cervical Cancer Project provided services to 73,547 women between March 1994 and May last year. Women age 40 or older who earn less than twice the federal poverty limit are eligible for the program, and those needing treatment are eligible to apply for Medicaid coverage, said Sarah Gudz, OBCCP’s director.
OBCCP received about $4.2 million in the past year, much of it from CDC. The program also received a one-time $1.3 million payment from tobacco settlement funds and $832,000 from Ohio’s general-revenue fund.
“There’s never a guarantee when it comes to funding,” said Gudz. The additional resources help OBCCP serve more women, she added.
Many state lawmakers know women who have had breast or cervical cancer, said Peter Beck (R-Mason), chair of the House Ways and Means Committee. “It’s important to protect those women,” he said.
International News
GLOBAL: "Maternal Deaths Plunged over 2 Decades, to About 287,000 in 2010, UN Reports"back to top New York Times , (05.16.2012) Donald G. McNeil Jr.
Increases in contraceptive use, health care provider-assisted births, and treatment for HIV-positive mothers have helped cut the maternal death rate by 47 percent since 1990, according to UN agencies.
In 2010, maternal deaths declined to roughly 287,000, from the UN’s estimate of 543,000 in 1990. Deaths are falling rapidly in East Asia but slowly in Africa, according to the report compiled by the World Health Organization (WHO), UNICEF, the UN Population Fund, the UN Population Division, the World Bank, and a team from the University of California-Berkeley. Countries in southern Africa are witnessing the start of a reversal as more HIV-positive women there receive antiretroviral treatment.
UN maternal death estimates have been challenged in the past. Two years ago, the Institute for Health Metrics and Evaluation, which was created by the Bill & Melinda Gates Foundation as a way to validate WHO figures, disputed the UN’s 2008 tally using three times as much data. In response, the UN “revised and improved” its count for that year. The institute estimated maternal deaths at 274,000 in 2011, meaning the new UN number is within the same statistical boundaries, said Dr. Rafael Lozano, epidemiologist for IHME.
A Queensland judge who last year ordered that a newborn be vaccinated against hepatitis B virus (HBV) despite the objections of its parents released the reasons for her order on Friday.
The child’s mother has HBV. Doctors had filed an urgent application to the court urging that the child, who was just 40 hours old, receive two shots to prevent HBV infection. The Brisbane Supreme Court heard that the newborn had a 20 percent chance of contracting HBV, which almost certainly would lead to chronic infection.
The parents opposed the vaccination, citing religious reasons; the father also expressed concerns about the financial interests of pharmaceutical companies.
Justice Jean Dalton said the immediate welfare of the child trumped the parents’ qualms and ordered the child’s vaccination at once. However, she refused to rule on any future vaccinations against HBV, suggesting the parents seek legal counsel should they wish to continue their dispute against treatment.
The court acted appropriately in its order and by not ruling on treatments other than the initial injections immediately required, said Terry O’Gorman, an attorney and civil libertarian.
“I believe this is starting down a very dangerous path and hopefully one that will stop right here,” said Meryl Dorey, president of the Australian Vaccination Network, which campaigns about vaccine risks.
Medical News
UNITED STATES: "Many Pregnant Women May Not Get STD Tests"back to top Reuters , (05.17.2012) Amy Norton
Many pregnant women are not following recommendations that they undergo testing for certain STDs, according to a new study.
CDC and the American College of Obstetricians and Gynecologists (ACOG) say all pregnant women should be tested for chlamydia at their first prenatal visit. CDC and other groups also recommend gonorrhea screening for pregnant women at increased risk, including those younger than 25 and residents of areas of the country where the STD is common.
The new study showed that of almost 1.3 million US women who had blood tests done during pregnancy, only 59 percent were tested for chlamydia. Fifty-seven percent were screened for gonorrhea.
Because not all pregnant women are counseled to be tested for gonorrhea, it is difficult to determine whether the 57 percent rate is appropriate, according to Dr. Jay M. Lieberman, who worked on the study. Lieberman is infectious-diseases medical director at Quest Diagnostics Inc., which financed the research. But he noted the results found that some women for whom guidelines indicated screening did not get tested: Of pregnant women ages 16-24, only 69 percent were tested for gonorrhea. Left untreated, both STDs can endanger the health of a mother and her baby.
One limitation of the study is that it is based on tests conducted between 2005 and 2008, when screening guidelines were in transition. ACOG issued its guidelines in 2007.
Despite acknowledging that the situation is evolving, Lieberman said, “there’s also no evidence that screening rates have improved.” In 2009, a CDC study found that only a minority of all US women for whom chlamydia screening was indicated had undergone the test.
Lieberman said the current study’s data do not indicate why women were not taking the recommended tests. While access to care is a challenge for some, all the participants were receiving prenatal care. Pregnant women should consult their doctors if they have not been tested for STDs or do not know if they have been tested.
[PNU editor’s note: The study, “Chlamydial and Gonococcal Testing During Pregnancy in the United States,” was published in the American Journal of Obstetrics & Gynecology (2012;doi:10.1016/j.ajog.2012.04.027).
Local and Community News
GEORGIA: "Shuttering Teen Center Will Leave Void for Bibb Youths"back to top Macon Telegraph , (05.12.2012) Phillip Ramati
Open for five years, Bibb County’s Teen Scene Youth Center (TSYC) will close in June due to state and federal budget cuts. Director Valerie Hicks worries the move will leave at-risk area youths without the resources they need to avoid pregnancy, drugs and other concerns.
“We can’t improve those [teen pregnancy] numbers if we can’t get the kids and educate them,” said Hicks, who runs adolescent health and youth development programs for the 13-county North Central Health District, which includes Bibb County. Hundreds of teens have been helped by TSYC since 2007, and during that time just one became pregnant, she noted.
Hicks said teens and their parents have benefitted from TSYC. “We expose kids to the possibilities they can have in academics - what they say ‘yes’ to, not just what they say ‘no’ to. We do tutoring every day. There’s a health component, and we [address the areas] they’re at risk for - obesity, tobacco, drugs, and alcohol.” Parents have had to take part in regular sessions as a condition of enrolling their children in TSYC. “[What is taught] had to be supported and taught at home,” she said.
The idea for the teen centers was introduced in 1997, when Georgia’s teen pregnancy rate was among the highest in the nation. Since the program launched, Georgia has made “tremendous progress” against teen pregnancy, Hicks said. Due to federal budget cuts, Georgia is closing all 30 of its teen centers and half of its 18 adolescent health and youth development programs, though not the one in Bibb.
This Saturday, LOGO TV will air “Positive Youth,” a documentary that looks at HIV/AIDS through the experiences of four young people in four US localities. The individuals - a woman, 18, in a poor farm town; a man, 25, in a major city; an African American, 23; and a performer, 27 - were selected to represent four different situations of people living with HIV. “We made this documentary to educate those who know little of HIV, shed light on the risk of HIV infection among today’s youth, give hope to people living with HIV, and let them know that they are not alone,” said Charles David, a TV personality known for his work on E! and the Travel Channel. The film airs at 8 p.m. on LOGO TV.
TEXAS: "29th Anniversary AIDS Candlelight Memorial to Be Held in South Oak Cliff on Sunday"back to top Dallas Voice , (05.16.2012) David Taffet
“Promoting Health and Dignity Together” is the theme of the 2012 International AIDS Candlelight Memorial, which this year marks its 29th anniversary. Auntjuan Wiley, who is organizing the observance in Dallas, said more than 1,200 cities and towns in 115 countries are expected to take part. Dallas Mayor Mike Rawlings and City Council member Carolyn R. Davis are among those expected to participate in the local commemoration, which is scheduled for 4 p.m. Sunday at Abundant Life Church of God in Christ, 7310 S. Hampton Rd.
San Francisco will mark the 29th anniversary of the International AIDS Candlelight Memorial on Sunday with an 8 p.m. observance at Harvey Milk Plaza in the Castro district. The invited speakers include Mike Shriver, who served as AIDS czar to former Mayor Willie Brown and currently sits on the board of the National AIDS Memorial Grove.
The AIDS Emergency Fund’s “Every Penny Counts” campaign this weekend is kicking off its “Empty Your Drawers” effort, which asks people to collect their loose change and donate it to the cause. EPC Coordinator Lance Brittain said the “penny posse” will be working the corner of Castro and Market streets, at the top of the Castro Muni station’s main entrances, from noon to 4 p.m. Saturday and Sunday. Since 1987, EPC has raised more than $2.7 million, all of which is used to help AEF clients pay basic living expenses. More penny posse members are needed; to volunteer, contact Brittain at 415-558-6999, ext. 232 or lance.brittain@aef-sf.org.
The Hope and Help Center’s 17th annual AIDS Walk Orlando will take a different route when it steps off Saturday, May 19. Rather than walk around Lake Eola, participants will stroll a 2.4-mile path through downtown. A post-walk concert by Sisaundra Lewis will be staged at the lake’s amphitheater. “We outgrew Lake Eola with the number of walkers we have,” said Linda Santiago, events manager. “It just makes sense, and we also want to gain more exposure.” For more information, visit www.AIDSWalkOrlando.org.
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