Monday, 30 November 2009

IUD is an Effective, Underutilized Contraceptive Device

Around the globe, there are several methods for men and women to pick in order to prevent unintended pregnancy. From condoms (both male and female) to intrauterine contraceptives to birth control pills, men and women alike have their choice on whether they want to worry about birth control on a daily, monthly, quarterly or even yearly basis. A recent study emerging from Europe that focused on long-acting contraceptives such as IUDs showed that approximately 10% of European women utilized this type of contraceptive and that most were over the age of 30. This study was recently awarded the National Congress of Gynecology award.

Sergio Haimovich, the author of the study and a researcher at the Hospital del Mar in Barcelona, Spain states, “Long-acting contraceptives (the IUD, contraceptive injection or contraceptive implant) are still not widely used.” Condoms are the most widely used choice of contraceptive, with birth control pills coming in second amongst European women. In terms of long-term birth control options, intrauterine contraceptives like IUDs are the most popular. Over 11,000 women participated in the study that spanned 14 countries in Europe. Of these participants, nearly 10% of the women utilized the long-lasting methods.

Haimovich states that these longer-term methods are used by “women over the age of 30 who do not want more children and who are looking for a long-term solution." In contrast, younger girls decide to use alternate methods. Hamovich’s research was done as a subset of a larger study that researched the various contraceptive methods chosen by women in Europe. Haimovich goes on to explain that this type of research is necessary and that “the answers to these questions can help us to formulate contraceptive advice that is better adapted to the needs of the users."

The data from the study displays each country’s preferred method of contraception. For example, in Spain, the condom reigns triumphant amongst all age ranges. However, the study also shows that different hormonal birth control methods including the birth control pill are being utilized more frequently. These results “help to explain what users want and enable a more appropriate contraceptive check to be created," states Haimovich. "That is why we must always adapt our discourse to the demands of the users, and work such as this makes us aware of these requirements."

Wednesday, 14 October 2009

Cheap Condoms are just as good as Fancy Condoms

I found this article in the Daily Titan very interesting. Usually college papers are not that exciting, but this article is something that I think is really topical for college students and passes on a lesson.

Everything is expensive for a college student. You don't have a lot of money, and you have to spend wisely. For that reason, sadly, a lot of people don't spring for condoms all that often. If a deal were to come by in order to save you money on such an important investment in your health - in this example, a dozen condoms at a dollar store - a lot of students initially may question the quality of said condoms and pass the offer up.

The main lesson of the article is that condoms are not expensive. At least, they don't have to be. They are not hard to make - it'll cost a manufacturer maybe 2 or 3 cents per condom to make. The fact that they end up in Walgreens or Rite-aid for a buck each is not due to the inherent expense or a mark of quality - it's because those retail stores want to make some money and they have a lot of overhead costs to cover.

So if you don't have the money to spend, going for the dollar store condoms is not only better than none at all, it's as safe as any other brand of condom. And it's cheaper in the long run, when you think about how much an STI might cost you.

Tuesday, 8 September 2009

Hitler : The Latest Safe Sex Spokesperson?

There are AIDS and HIV awareness ads running right now in Germany featuring an unlikely star : Hitler. From TIME magazine :

The controversial ad ... shows a couple having steamy sex in a dimly lit room with menacing music playing in the background. The viewer sees only the back of the man's head until the very end, when the camera pans to his face — to reveal that he's Adolf Hitler. Then the slogan flashes across the screen: "AIDS is a mass murderer."

While the obvious attempt of the ad is to demonize AIDS and mobilize AIDS awareness and action - to try and scare people into being safe and proactive - some worry that instead of demonizing HIV, they're demonizing people who have HIV. HIV counseling groups and organizations contend that the ads suggest that people who have AIDS are mass murderers.

Surely there's a better way to open people's eyes to the important topic of safe sex. Though, the ads did accomplish one thing - people are talking about safe sex - though I think everyone would rather have the focus on the safe-sex message of the commercials, instead of the controversy of the commercials themselves.

Tuesday, 7 July 2009

Sex Education: Does it Work?

It is one of those memorable moments in our middle school lives. Almost like cattle, we get ushered out of class by an administrator as if on some top secret mission. Nobody talks in the line that slowly crawls down the hall; eyes are wide and confused. Teenage boys have their hands shoved down into their pockets and shuffle along with their heads hung low. The girls grip onto their purses tightly smacking their gum nervously. Everyone has heard about it, and now the time has come. It is time for the school to educate the youth about sex. Of course, this was the scenes eons ago when I was in middle school and we still laughed when we heard the word "penis." Nowadays, I am sure the youth would be at a much better place in educating the administration about teenage sexual matters.

So, does sex education still work? According to a new study, the resounding answer is yes. In fact, according to this study, teenagers are more likely to wait a little longer before having their first sexual experience if they have had school-taught sex education. The numbers were a little higher in males, with a powerful 71%, compared to the female 59% in terms of being less likely to have sexual intercourse before the age of fifteen. In addition, young adult men who participated in sex education through school were over two and a half times more likely to use some form of protection the first time they had sex. Unfortunately, participating in sex education for young adult females did not increase or decrease the chances of them using protection for their first sexual encounter.

According to lead researcher Tricia Mueller, "Sex education seems to be working. It seems to be especially effective for populations that are usually at high risk." In fact, for African-American females, participating in a sex education course at school made it 91% less likely that they would participate in a sexual activity before the age of 15. Many sex education studies that determined it to be ineffective relied heavily on data garnered from various studies that took place between the 1970s and 1990s. Mueller's study, on the other hand, is much more recent (2002) and boasted over 2,000 participants between the ages of 15 and 19. Different variables, including the household income where those teenagers resided, were also taken into consideration.

The interim director of the Philip R. Lee Institute for Health Policy Studies, Claire Brindis, states that incorporating sex education into a school's curriculum is vital since many teenagers fall prey to strange sexual myths. "Some still believe you can't get pregnant if you're standing up or doing it for the first time or if your boyfriend is drinking a lot of Mountain Dew." She further states that much of the current sex education curriculum focuses on the physical aspect of sex, including how to buy condoms and how to put on a condom. While that is important, she feels it is imperative that sex education also focus on what to do in various settings including when a teenager is feeling pressured into having sex.

Wednesday, 24 June 2009

As Economy Suffers, Sex Industry Continues to Thrive

With the economy seemingly out of control across the globe, there is one industry that has continued to thrive: the sex industry. Unfortunately, as the industry thrives, so does the transmission of HIV. With that in mind, groups of researchers hailing from the University of California at San Diego School of Medicine, the University of California at Davis, Northeastern University and several teams across Mexico joined forces to perform a study on female sex workers living in Ciudad Juarez and Tijuana, Mexico. With the desired outcome of slowing down the rapidly rising HIV and sexually transmitted diseases rates in the border towns between Mexico and the United States, this research team has determined that in order to reduce HIV and STD rates and increase condoms use, female sex workers should receive a short, personal counseling session geared towards impacting their current and future behaviors.

After beginning these 30 minute private sessions, researchers noted an almost 40 percent decline in the rates of new sexually transmitted diseases, including Chlamydia, HIV, gonorrhea and syphilis. This was in direct comparison to a session that involved distributing educational material only to the sex workers. The study's lead author, Thomas L. Patterson, states, "An advantage to the counseling approach is that - instead of simply listening to a lecture - women are taught and can practice skills that are tailored to their personal situations. By working with the counselor, women identify for themselves the barriers to safer sex and discuss potential solutions as part of their goal setting." The study had close to 1000 participants and was geared to those female sex workers over the age of 18 who were not currently infected with HIV but who admitted to having sex with clients without using contraceptives, like condoms. The women were split into two groups with one half participating in the Healthy Woman (Mujer Segura) personalized counseling session and the other half participating in the sessions where educational material was distributed.

According to Patterson, "The major difference in the two approaches is that the Mujer Segura sessions focused on the participants assessing their personal risk factors, such as having unprotected sex with clients, and developing strategies for reducing that risk." Of those who participated in the Healthy Woman sessions, there were no cases of new HIV infections and there was a significant decrease in risky behavior. Those participants in this session were given positive feedback and taught to set and work towards small goals in their quest to practice safe sex. Patterson continues, "In the absence of an effective HIV vaccine in the near future, the urgent need continues for effective, culturally appropriate interventions that can be used as stand-alone programs, or to support existing approaches. Our brief intervention, which counselors can be easily trained to deliver in a variety of settings, is an inexpensive and effective approach to reducing the risk of HIV and other STIs. These are diseases that recognize no borders, and it is critical that we work alongside health providers in Mexico to stem this disturbing trend."

Friday, 29 May 2009

HIV and AIDS: What's the difference?

Many of us, me included, use the terms AIDS and HIV interchangeably, not fully realizing how very different the two are. HIV (human immunodeficiency virus) is the virus that can evolve into AIDS (acquired immunodeficiency syndrome), while AIDS is the syndrome in which the sufferer’s immune system stops working which often proves fatal to the carrier. Without any type of medication, the average time for HIV to develop into AIDS is approximately nine or ten years. Once a patient is diagnosed with AIDS, the average survival span is just over nine months. So, at what point does HIV spiral into AIDS?

Research from an August 2007 study done by UC Irvine demonstrates how HIV transitions into AIDS and offers a way to perhaps halt this transition in HIV patients. One breakthrough involves how HIV evolves within a patient. Most scientists subscribe to the belief that AIDS develops as the HIV virus begins to evolve and starts spreading at the cellular level in a more efficient manner; however the UC Irvine suggests the opposite is true. Their research indicates that once the virus has evolved into a state where it is spreading less efficiently at a cellular level, then AIDS has the chance to truly develop. In addition, a process called co-infection must occur. What this means is that several HIV units must infect singular cells to turn HIV into AIDS. If only one HIV unit infected a singular cell, more than likely, AIDS will not be able to evolve. What this suggests is if researchers are able to stop more than one HIV unit from infecting a singular cell, AIDS could be stopped dead in its tracks. Dominic Wodarz, a UC Irvine biologist working on this study explains, “If this is true, a new approach to therapy could be used to block the process of co-infection in cells. This would prevent deadly HIV strains from emerging and the patient would remain healthy, despite carrying the virus.”

When a person contracts HIV, there are three phases that occur. The first phase takes place in the initial weeks of infection. At this point, the level of the virus within the infected person’s system spikes and symptoms very much like the flu begin to appear. The second phase is called the asymptomatic phase. During this second phase which lasts anywhere from eight to ten years, the level of the virus in the system begins to diminish. In the third and final phase, the transition to AIDS begins and the infected person’s immune system begins to disintegrate. With no immune system, a person is susceptible to many types of infections and death usually occurs.

Research studies to this point had not definitively determined at what point the asymptomatic state progresses into the final phase of AIDS. As mentioned earlier, many scientists believed that as in evolution, the virus grew stronger and was better able to grow, thereby causing HIV to transition. The model developed by Wodarz, however, counteracts this belief. His model which demonstrates the virus spreading and the speed at which it destroys cells suggests that when HIV turns deadly, the strains that kills are not the ones that are the fastest spreading, but rather the slower spreading ones. Wodarz proposes that with further positive testing of this theory, AIDS researchers may be able to devise a drug that prohibits more than one HIV unit from infecting a cell. Thus, the transition to AIDS would not occur.

Tuesday, 7 April 2009

HIV Antiretroviral Treatment Improving, with Fewer Side Effects

Antiretroviral drugs have helped those infected with HIV live longer and fuller lives, helping its patients maintain their infection and releasing AIDS of its death sentence status; however, the drugs that comprise the antiretroviral treatment are extremely strong and often carry intimidating side effects, which had some researchers wondering if perhaps newly infected patients should hold off on starting a drug treatment so soon after diagnosis. The debate has gone back and forth, but there may be some hope on the horizon. The pharmaceutical company that has recently had two new HIV drugs approved is reporting that they have fewer serious side effects than the drugs currently on the market.

These two new drugs were approved for those infected patients who were beginning to develop a resistance to their normal drug cocktails and also for any newly infected patients. These claims were made at a conference held in Washington, D.C. for specialists in the field of infectious diseases. Dr. Robin Isaacs, an executive director at Merck & Co, the company that funded the studies, stated, “There was a desperate unmet medical need for those patients who had failed other therapies.” The drugs that were studied were Isentress (developed by Merck & Co) and Selzentry (developed by Pfizer Inc.); they join three other drugs that might be more easily tolerated by patients, including Aptivus (developed by Boehringer Ingelheim), Prezista and Intelence (both developed by Johnson & Johnson). Isaacs went on to say, “They have all these different options now, which they didn’t before, to build new successful regimens.”

Merck & Co are hoping that Isentress will be granted first-line approval very soon; being an integrase inhibitor, it is the only one of its kind currently being offered. The drug works by stopping the integrase enzyme; this enzyme is responsible for putting HIV’s DNA within a patient’s cells and multiplying the virus. The study sponsored by Merck & Co surveyed over 550 patients. One half of these patients were given Sustiva (developed by Bristol-Myers Squibb Co) and the other half was given Isentress. Both sets of patients also took the Truvada drug as part of their treatment. While both sets of patients had similar levels of the virus after 48 weeks, only 44 percent of those patients that took Isentress reported serious side effects compared to 77 percent of those patients taking Sustiva.

Pfizer Inc had its own study done for its drug Selzentry. In this similar study surveying over 400 patients over 48 weeks, half of the patients received Selzentry and Combivir and the other half of the patients received Sustiva and Combivir. Again, the virus levels were similar, but of those patients receiving Selzentry, only 4 percent reported side effects serious enough to stop the drug treatment compared to 14.2 percent of those taking Sustiva. The Selzentry drug helps patients protect their immune system from the virus by essentially inhibiting or “closing the door” known as the CCR5 co-receptor.