Showing posts with label hiv. Show all posts
Showing posts with label hiv. Show all posts

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.

Monday, 19 January 2009

HIV in Hetrosexual African

As a Hispanic woman, I can say that as a race, we have a culture all our own. Weddings are usually huge with cousins of cousins attending and aunts making brisket and rice and beans in the back kitchen. Gatherings, whether they are for holidays or birthdays or graduation parties are always enormously food-centric, so instead of asking the host what you should get as a gift, you are usually asking what food and how much you should bring. All races have their own cultural norms, so it is not surprising that research studies would focus on race as a factor for behavior. A study published in the journal “AIDS” in June 2008 by researchers at the University of California at San Francisco (UCSF) demonstrates that HIV prevention techniques geared towards changing the behavior of heterosexual African Americans needs to consist of many distinct characteristics in order to be effective.
Lynae Darbes, a professor of medicine at UCSF’s Center for AIDS Prevention Studies and Global Health Sciences and the lead author of the study states, “Peer education, skills training and cultural tailoring were critical factors we found in interventions that increased condoms use, reduced HIV risk behaviors and led to lower rates of sexually transmitted infections. It is important to recognize the diversity that exists within the African American community, and we are not recommending 'one size fits all' types of interventions. Successful interventions honed in on specific aspects of the target populations." The study was comprised of roughly 14,000 participants in a series of 38 controlled trials that were randomized in terms of social norms. Some examples of the norms that were focused on include how one person might perceive their risk factor for contracting AIDS, how to reduce sexual partners, their use of condoms, how to delay the first episode of sex with a new partner or a compilation of these norms. Results from the study point towards members of the African American community educating their peers in order to be more effective.
Darbes goes on to say, “Cultural tailoring was crucial and in effective interventions was derived from activities such as formative research within the target community using a 'ground up' approach as opposed to a top down or 'parachute' approach. Understanding the community was important in developing efficacious interventions." The study analyzed the controlled trials and quantified with measurements of condom use, percentage rates of unsafe or risky sex and the number of sexually transmitted diseases reported. George W. Rutherford, a co-author of the study, states, “This study shows how the technique of meta-analysis can be used to understand an entire literature and to find subtle but important associations that single studies simply can't find."

Saturday, 17 January 2009

Elite AIDS Case

Being elite spurs images of crystal champagne flutes, first-class airline leather recliners, private jets ready to take their passengers to whatever city their whim fancies and five star hotel suites. However, for one woman in Baltimore, being “elite” is quite a different scenario. This woman was diagnosed with HIV ten years ago and yet one would never know it as her body has never displayed one single symptom of the virus.
The Baltimore woman and her husband were both diagnosed with HIV at the same time; however, while it is necessary for her husband to take antiretroviral drug treatments daily, she has never had to take these strong HIV drug cocktails as her body naturally combats the virus. Researchers are studying this woman’s immune system very carefully as she may literally be the key to developing an AIDS vaccine. A team of researchers at John Hopkins University describe this woman as an “elite suppressor.” Joel Blankson who is heading the research team states, “This is the best evidence to date that elite suppressors can have [the] fully pathogenic virus. The feeling was initially that they had [a] defective virus.”
The woman’s immune system is different than that of her husband’s, which is apparent considering they both contracted the same virus strand. Blankson goes on to say, “That’s a good sign in terms of developing a therapeutic vaccine.” While the developed vaccine would not be able to prevent a person from contracting the virus, it would be very helpful in its treatment. With 33 million people suffering from the virus worldwide and 25 million people who have succumbed to the disease, AIDS is still a very dangerous adversary. New studies have estimated that over 55,000 in the United States alone contract the virus; facts show that the disease is usually highest in the gay and bisexual population, and among those who do not use condoms; but it can also be transmitted through drug use, heterosexual sexual encounters without safe sex, from mother to unborn child and through blood transfusions.
Blankson and his colleagues ran tests on the Baltimore woman’s immune system and discovered that her immune cells (CD8 T-cells) were able to stop the virus from replicating by almost 90 percent; meanwhile her husband’s own T-cells were only able to stop the virus from replicating by 30%. In addition, while the virus has grown weaker in her body, her husband’s virus has maintained its strength. Blankson states, “Elite suppression offers clues to vaccine researchers on many fronts: how CD8 killer T-cells can attack HIV and how a stronger immune response can force HIV into a permanent defensive state. We are trying to figure out exactly how the T-cells work in her to inhibit viral replication.” Some researchers in the study have pointed to the fact that the woman has high activity in her HLA (human leukocyte antigen) system. This system is responsible for recognizing harmful foreign bodies, like bacteria and viruses. Only time will tell what more data the researchers can garner from this woman’s case in order to help them in their quest to create an AIDS vaccine.

Friday, 16 January 2009

Is HIV / AIDS Overfunded ?

Just like we all instantly know the pink ribbon is the symbol for the fight against breast cancer, we automatically think of the global fight against AIDS when we see the red ribbon on lapels, hanging from buildings and on the bottom corner of AIDS/HIV campaign posters. Countries and organizations funnel millions upon millions of dollars a year into the fight against the HIV/AIDS epidemic which currently afflicts approximately 33 million people around the globe. In fact, according to data provided by the Global Health Council, about 80% of America’s aid earmarked for population issues and health issues goes towards the fight against AIDS. Now, what some researchers, scientists and politicians are asking is whether too much aid is being provided for this one global disease. Especially when the disease can be prevented 99.9% of the time by simply wearing condoms.
Researchers and critics have begun asking this question as they worry that AIDS is sucking money away from other pressing, but less publicly exposed, health issues around the world. With the exclusion of Africa, AIDS/HIV has become a manageable disease as some experts point out. One critic of the money being spent for AIDS/HIV is Jeremy Shiffman from Syracuse University whose studies focus on health spending, “AIDS is a terrible humanitarian tragedy, but it's just one of many terrible humanitarian tragedies.” Even more vocal on the subject is Roger England from the Health Systems Workshop. England is calling for UNAIDS to be disbanded and states, “The global HIV industry is too big and out of control. We have created a monster with too many vested interests and reputations at stake... too many relatively well paid HIV staff in affected countries, and too many rock stars with AIDS support as a fashion accessory."
Responding to England’s statements is Paul de Lay from UNAIDS, “We have an epidemic that has caused between 55 million and 60 million infections. To suddenly pull the rug out from underneath that would be disastrous." De Lay insists that while it may appear the epidemic has been managed with drugs and multiple HIV campaigns around the world, this line of thinking could not be further from the truth. England feels that the annual budget of $200 million for UNAIDS would be better suited to address more pressing health issues like pneumonia which claims more children’s lives each year than AIDS, measles and malaria altogether. England states, "By putting more money into AIDS, we are implicitly saying it's OK for more kids to die of pneumonia."
Many critics also cite the fact that health and financial resources often get misallocated. One example is demonstrated in the country of Rwanda where, in 2006, close to $50 million was allocated for the fight against HIV/AIDS, $18 million was allocated to the fight against malaria (the number one killer in Rwanda) and only $1 million was allocated to fight various childhood diseases. Activists and researchers for health issues other than AIDS fight to get any financial resources but often have a hard time drawing attention away from the popular AIDS/HIV global battle. John Oldfield from Water Advocates (an agency that campaigns for clean sanitation and water) states, “Diarrhea kills five times as many kids as AIDS. Everybody talks about AIDS at cocktail parties. But nobody wants to hear about diarrhea." With a recession currently in place, the focus of correctly allocating money for various health issues is even more pressing. States Shiffman, “I do not want to see the cause of AIDS harmed. For AIDS to crowd out other issues is ethically unjust." More money should be spent on the prevention of HIV/AIDS through safe sex education and promoting the use of condoms.

Sunday, 21 December 2008

AIDS - Prevention is better than cure

AIDS is one of the most dangerous diseases on the planet. As is the case of any diseases, AIDS prevention also is better than curing it after you gets infected. A major reason which is hampering the AIDS prevention activities around the is the lack of proper sexual education of the people involved and the taboos associated in different cultures around the world regarding condoms usage. Let us take a look at some of the major causes of AIDS infection and how to avoid those situations.
The single most important cause behind the transmission of AIDS is sexual contact. One of the partners has to be HIV positive so as to spread the virus to his/her sexual partner. And the virus spreads only when you have unprotected sex. So the key word is protection here. And condoms can do whole lot of difference here. Studies conducted on HIV positive people and his/her disease free partner who had used condoms during all their sexual activities have shown that the rate of infection is less than 1%. This proves the reliability of condoms. As long as the condoms are used properly, they are very safe. The overall safety of condoms is above 80%. And this rate goes significantly higher when the condom is used properly. The lubricants used with the condom can play a significant role in the effectiveness of the condom. Oil based lubricants can corrode the material of latex condoms and should be avoided. Water based lubricants will work fine with latex condoms and thus helping AIDS prevention.
HIV can be infected to the infant's body from the mother during pregnancy. Again if the mother had safe sex all through her sexual activities, this could be avoided. In the cases where the disease is not transferred to the kid during pregnancy, HIV can be transferred through breast milk and hence breast-feeding should be avoided.
Male circumcision is known to have a positive effect in reducing the rate of AIDS infection. As circumcision has religious as well as cultural angles associated with it, many people would be wary of undergoing the procedure even as a tool for such a worthy cause as AIDS prevention.
Medical personal like doctors and nurses are always at the risk of getting infected from infected patients. This is especially true when surgical operations are performed on the patients. These risks can be reduced to a certain extent by using protective gloves, goggles etc. Washing your hand and face routinely with soap can reduce the chances of getting infected. Extra care need to be given while handling any sharp objects like needles, surgical knives etc.
Blood transfusion is another instance when you could get infected. Only thing you can do for AIDS prevention in this regard is to use tested blood for transfusion. You may use the blood of some one you are familiar with so as to reduce the chances of infection.
Drug addicts get infected with AIDS when they exchange the syringe used to inject them selves. Some governments around the world have created projects where they provide new syringes to drug addicts so as to improve the chances of AIDS prevention.