Posts Tagged ‘hiv’

HIV Positive Kenny Badmus Comes Out As Gay On Facebook

Thursday, January 8th, 2015


Brand expert, Kenny Badmus who took to his Facebook page to reveal he was HIV positive on Dec. 1st, this morning took to his wall again to reveal that he is gay. He wrote about how he got married and led a false life just to satisfy society and how he told his ex-wife before they got married that he’s gay and how she didn’t care hoping he would, with time, stop being gay.He also talked about how she allegedly victimized him when he eventually got fed up and asked for a divorce 6 years after they got married and had a child together. Kenny said he decided to share his experience to mark the one year anniversary of the Anti gay law which was passed on Jan 7th 2014. Read what he wrote after the cut.

When I first told my ex-wife that I was gay, we were far from being married. I wanted her to find other men honorably, who had a thing for women. I never did. I ‘swear down.’ I was only obeying the popular demand of traditions. Now, this was my terrible mistake. No one should live their life based on dogmas and other people’s expectations. As far as I could remember, even though I was always dating girls, I had always preferred being with a man. I had fought it with every fiber of spirituality in me as a Pentecostal preacher boy (find details and journeys in my book ‘THE EXODUS.’) The more I fought my s*xual preference for men, the more I became more miserable. Unfortunately, as erroneously believed, s*x wasn’t the problem. I had been having s*x with women as far back as a twelve-year-old. se*uality is whom we are emotionally present with, not whom we are sleeping with. And oh boy, she really tried to make me a heterosexual. But I’m still not, sadly.

One of those pre-marriage days, while we were with our marriage counseling team, I brought up the issue again – that I had always had a preference for men. I wanted the Ministers to dissuade her from the marriage. I just couldn’t put a ring on a fat big lie. My father taught me one principle: DIE FOR YOUR OWN TRUTH, EVEN IF IT’S UNPOPULAR, BUT DON’T HARM OTHERS WITH IT. She was so happy to tell the ministers, as quickly as she could, that my feelings for men would all be gone, because she believed it was a childhood disorder. I guess she meant she was going to f**k my brains into heterosexuality. This is a mistake a lot of us make. We all want to change people to conform to our preferences. We find it easier to play god in the lives of people we did not make.
After six years together, I knew I was not getting any better. I STILL LOVED MEN. And one day, because I didn’t want to cheat on her, I humbly asked her that we should go our separate ways. That was when all hell broke loose. She suddenly forgot about how it all started. In court, she told the Judge how she suddenly found out that I was gay, and how it’s against the Law of the Federal Republic of Nigeria. In other words, she wanted me sentenced to the new 14 years jail term served by the Nigerian government. Luckily, I was in a civil court. Sadly, that day, I had to duck my face in shame as the crowd jeered at me for being whom I had always been. ‘You faggot’ ‘Oh what a shameful man!’ ‘homo!’ ‘Na wa o ‘ I still don’t know how I walked out of the court premises that day. ( this case is still ongoing) What about my business.? Tell any client in Nigeria that you are gay, and you lose their business. That’s exactly what happened. I lost friends, businesses, sponsorships and family members. I had to start my life all again. Applied for a new job. Get back to school. Although my ex-wife is one of the most faithful and beautiful women in Nigeria, she is a victim of institutionalized homophobia. Just like many people who are reading this.

It will be exactly a year today, when Nigeria instituted a law to jail people like me. What’s our offense? Because we are simply wired differently. There are only about 5 to 10% of homosexuals in every population as cited by popular findings and documents. Why is a 90% dominant population afraid of its 10%? Shouldn’t you care about us? Don’t you think it’s a lot easier to be seen as part of the 90%? And before you throw those religious verses on us for being wired differently, I want to leave you with my favorite Bible verses from Romans 8:Italics mine:
That Nothing Can Separate Us from ( the universal narrative of ) God’s Love
31 What shall we say about such wonderful things as these? If God is for us, who can ever be against us? 32 Since he did not spare even his own Son ( in the popular narratives according to the Christian Faith ) but gave him up for us all, won’t he also give us everything else? 33 Who dares accuse us whom God has chosen for his own? No one—for God himself has given us right standing with himself. 34 Who then will condemn us? No one…

38 And I am convinced that nothing can ever separate us from God’s love. Neither death nor life, neither angels nor demons,[b] neither our fears for today nor our worries about tomorrow—not even the powers of hell can separate us from God’s love. 39 No power in the sky above or in the earth below—indeed, nothing in all creation will ever be able to separate us from the love of God that is revealed in ( in the narrative of ) Christ Jesus our Lord

The question should never be, ‘Are you gay?’

Friday, December 26th, 2014


DW:Do you think a recommendation by the US Food and Drug Administration (FDA) to replace the lifetime ban on blood donations from gay men with a policy barring men who have had sex with men within 12 months is a significant policy shift?

Ivan Scalfarotto: Let’s be very clear: what is at risk is not people, but behaviors. There are behaviors which are clearly risky, but I think all restrictions that have to do with people, and not behavior, are unreasonable. The risk is the exchange of bodily fluids. This can happen between men and women, men and men, and even women and women. So, the only reasonable ban you can impose on blood donation has to do with risky behavior and that has nothing to do with the sexual orientation of the donor.

Three decades on, the spread of HIV is still closely associated with the gay community. Do you think the move by the US could set a precedent for other nations, including Germany, France and Italy, to review restrictions on blood donations from gay men?

Suggesting that sex between two men is, per se, riskier than sex between a man and a woman is unreasonable and still imposes a stigma on gay people. Frankly speaking, it does not touch on the issue that the only discrimination one should consider, the only difference, and the only ban that should be imposed, is on behaviors. Those issues to do with considering some people at more risk than others are irrational – for example, thinking that a celibate gay man is in a riskier position than a sexually active straight person just because of their gay status. This is not reasonable. I think the scientific community is quite clear on this, and I think there is more of a political issue behind the idea that excluding a certain section of the community removes the risk. In recent years, the gay community has done a lot of work in terms of sexual health education, while this did not appear to happen in the heterosexual community, so to speak.

We know the rate of HIV infection between straight people has been on the increase, so I think once again, this does not help because it makes straight people believe they are safe, which is not the case. So, everyone should have protected sex whatever orientation they have. This is the right message to convey.

What are the risks of lifting bans on gay men donating blood, regardless of which country has imposed the restriction?

What you should find on official forms when you are about to donate blood are questions about your behaviors. So, I think there would be no risk at all in just asking people the right questions. What we are interested in regarding blood donation, is if the person who is about to donate went through risky behavior, and was potentially exposed to the virus in the last month.


A US proposal to lift a lifetime ban on gay blood donation still includes certain restrictions. Italy’s Under Secretary of State for Constitutional Reforms, Ivan Scalfarotto, spoke to DW about the implications.

This is all about asking everyone who wants to donate blood whether they recently had unprotected sex. It is up to the health officials to do this. The question should never be, “Are you gay?” The question should be, “Have you had unprotected sex in recent months?” We do not want to know who people are, we want to know what people did. There should be no other question than this.

Ivan Scalfarotto is the Italian Under Secretary of State for Constitutional Reforms and Government Liaison to Parliament. Between 2009 and 2013 he was the Deputy Chairperson of the Italian Democratic Party.



Planting Peace Launches Holiday HIV/AIDS Campaign In Response To Anti-Gay Pastor’s Remarks

Friday, December 5th, 2014

huffington post

An advocacy group is responding to an Arizona pastor’s viral anti-gay rant with aheartfelt holiday campaign.

Organizers of Planting Peace, perhaps best known as the organization that brought you the rainbow-colored Equality House across the street from the Westboro Baptist Church compound, launched the new fundraiser in response to Pastor Steven Anderson’s claims that “executing” gays will help eradicate HIV/AIDS.

The Planting Peace campaign is raising funds that will go toward helping people with HIV/AIDS, and for every donation made, a lump of coal will be sent to Tempe’s Faithful Word Baptist Church, where Anderson is a pastor, in a festive package to be delivered on Christmas Eve.

“Pastor Anderson calling for the execution of gays is a startling reminder of how much hate and bigotry still exists in our society,” Planting Peace President Aaron Jackson told The Huffington Post in an email. “In keeping with Planting Peace’s philosophy of countering messages of hate with compassion, we wanted to provide a positive platform to bring people together to not only help people with HIV, but to do so in a lighthearted way that will raise awareness for a very serious issue.”

Video footage of Anderson’s bizarre rant went viral earlier this week. In it, the pastor argues that members of the gay community are “filled with disease because of the judgement of God,” and that the cure for HIV/AIDS was “right there in the Bible all along.

Citing Leviticus 18:22, he noted, “if you executed the homos like God recommends, you wouldn’t have all this AIDS running rampant.”

Anderson, who “holds no college degree but has well over 140 chapters of the Bible memorized word-for-word” according to his church’s website, has made headlines several times this year for bizarre statements.

Earlier this year, he has argued in favor of keeping women silent in church, and has referred to second marriages as “adultery.”

Court Ruling in the Steeve Biron case: Stunning!!!

Saturday, August 30th, 2014

By Roger-Luc Chayer (Translation by Google)

Steeve Biron sentenced to 6 years in prison
Amazement at the court of Quebec on ​​August 29, that the case Steeve Biron was more than surprising denouement, 6 years in prison for a user to Gay411 who solicited sexual encounters.

Small reminder of the case Steve Biron is a young man from Quebec who, like many gays, solicited sexual encounters mainly through the famous Gay411 site. Biron essentially sought relationships bareback,” his followers knowing that barebacking is a form of Russian roulette that is having unprotected sex and risky, with individuals who may potentially be carriers of HIV or other sexually transmitted. The kick to his followers is to get greater enjoyment because of the voltage generated by the risk-taking. Knowing HIV, Biron did not mention his status to his acquaintances and like most followers of barebacking, “playing the game” until an ex-fuck decides to violate his privacy and to consult his record hospital, that person being a nurse.

The victim nick is then presented to the police to lodge a complaint, the police started looking for other fucks bareback Biron and 15 people have come forward. Following the filing of charges of sexual assault, Gay Globe investigated and managed to get under a false identity via Gay411, multiple appointments with most pseudo-victims, clearly indicating that it was for bareback without condom use THESE SAME PEOPLE WERE SAYING THEY SIGNED COMPLAINTS HAD NEVER GRANTED tO THIS TYPE oF SEX.

The case was in the bag for our survey at least, but now counsel Biron decided initially not to submit our dossier of thousands of pages in evidence at the original trial, and worse, he decided not to mention during argument, saying while the court did not take into account. But now, in the judgment of Judge Marie-Claude Gilbert, it specifically mentions that the informed consent of the victims did not and they were betrayed. FALSE since our record proved otherwise.

Steeve Biron sees therefore sentenced to six years in prison, he will have to serve in a federal prison. The order banning publication remaining, we can not mention the names of victims. The worst part of this whole thing is that from now on, anyone who knows he is infected with HIV can be arrested and sentenced to prison if she fails to mention her status to relationships.

Quebec back 20 years back in campaigning for HIV!
Because of the refusal on the part of counsel for Steeve Biron produce a journalistic record showing that some victims solicited by knowingly bareback relationships even after filing their complaints, contradicting their claims on informed consent and which can Steeve Biron benefit of reasonable doubt required for acquittal, that the people may benefit from HIV testing to quickly process could now refuse these tests since discovering their new status, they become potentially criminal if they do not comply with certain obligations disclosure to all partners BEFORE having only one sex. Go now to convince young people to get tested! Between ignorance and prison, freedom is worth more !!!

The ‘tampon’ that could prevent HIV

Sunday, August 17th, 2014

Washington Post

More than 80 percent of women diagnosed with HIV contract the virus through heterosexual sex. A condom provides the best protection against HIV — but men aren’t always willing to wear them.

The female condom has been on the market since 1993. Unfortunately, it’s less familiar and more expensive than the male condom — and can make a rustling noise, prompting unfortunate comparisons to a wastepaper basket.

But researchers at the University of Washington in Seattle have come up with a new way for women to protect themselves against HIV and other sexually transmitted diseases. The method is not unlike a technology familiar to many women: the tampon.

Here’s how it works: An anti-HIV microbicide — a substance that can kill microbes as well as prevent HIV and other sexually-transmitted infections — is woven into fabric that can be inserted like a tampon before intercourse. Once inserted, the material dissolves, and the microbicide is absorbed into the vagina within six minutes.

It’s a vast improvement over gel and cream microbicides that leak, are messy or take too long to work.

That means women don’t have to apply it far in advance of having sex,” bioengineer Cameron Ball told NPR. “There’s a race between the anti-HIV microbicide to get to the tissue before the virus does. So the more quickly it dissolves, the better.”

Ball and fellow bioengineer Kim Woodrow published a paper about the new delivery mechanism in June in the journal Antimicrobial Agents and Chemotherapy.

Ball and Woodrow told NPR the key innovation is the fabric. Made using nanotechnology, it’s incredibly thin.

“It’s way better than any Egyptian cotton, high-count fabric that you could find,” Ball says. “Each thread is about 200 times smaller than a human hair.”

The fabric has been approved by the FDA, but some microbicides that could be used with it are still in clinical trials. It will be 10 years before the technology is commercially available.

In the meantime, researchers are studying possible shapes for the delivery mechanism. “It’s a matter of giving women enough choices and options of what products are available and how they are used,” Ball told NPR. “So you meet the needs of as many women as possible.”

While tampons are familiar to many women, some studies suggest populations at the highest risk of HIV infection don’t use them.

Twenty-seven percent of all women in the United States are black or Hispanic, but these women account for 79 percent of HIV cases among women. Poverty can also increase risk factors for HIV transmission.

A 2012 study of low-income women aged 18 to 35 published in the journal of Pediatric and Adolescent Gynecology found that black and Latina women were less likely to use tampons than white women. The sample size of the study was small – only 165 women – but the results revealed stark differences. While 71 percent of white women used tampons, only 29 percent of black women, 22 percent of English-speaking Latina women and 5 percent of Spanish-speaking Latina women did.

Experts Say Russia Ill-Equipped for HIV Fight

Sunday, August 17th, 2014

Moscow Times

Olesya asks if her glittery hair clips are in place, if her hot pink lipstick needs reapplication.

It’s all she can do to detract attention from the stump where her arm used to be, the price she paid for injecting drugs even after the site became gangrenous.

People walking past the pharmacy where volunteers chat with Olesya — an intravenous drug user with HIV — glare at the young woman, quickening their pace as they go. Others, many of them also young women, stop to accept the clean syringes, HIV tests and pregnancy tests being handed out as part of an outreach program to do the things that many specialists say authorities are not: acknowledge the fact that a full-blown HIV epidemic is becoming more and more of a reality each day.

Behind the pharmacy in northern Moscow is a field where some drug users go to shoot up. This one, in stark contrast with many others, is mostly free from used syringes.

“There is one other field that is just a carpet of used syringes,” one of the volunteers says.

The same group running the outreach program, the Andrei Rylkov Foundation, a grassroots organization in Moscow that seeks to promote awareness of drug addiction and develop a humane drug policy, conducts periodic cleanup operations in public places to dispose of used syringes. These are often the same parks where families take their children to play, an alarming reminder of how close the epidemic is to spreading to non-drug users.

Olesya pulls up her pants to reveal another festering injection wound.

“Maybe you should go to the hospital,” the volunteers tell her.

“Will they take me?”

“You’re officially registered as a Moscow resident, right? Then they’ll take you.”

“Last time they refused because of my leg. They said gangrene is for drug addicts.”

See No Evil

“It’s obvious that we need to work with drug users; they have always been around and always will be. For more than 1,000 years there has been a culture of drug use. … Neither you nor I, nor [former public health official Gennady] Onishchenko, nor [Health Minister Veronika] Skvortsova, nor [President Vladimir] Putin have a magic cure to stop them being drug addicts. There isn’t one,” says Ilya Lapin, an HIV activist who works with patients on behalf of Esvero, a non-profit partnership that conducts preventative programs among members of the population especially vulnerable to HIV in more than 30 Russian cities.

Last year, there were an estimated 8.5 million drug users in the country, according to the Federal Drug Control Service. That number had skyrocketed from 2.5 million in 2010.

Activists have long warned authorities that the rise in HIV infections in recent years is a direct result of this spike in the number of drug users, but many say the problem is mostly being ignored.

“It’s always the same thing: We say there is a problem, the government says there is not,” Lapin said.

Pavel Aksyonov, the general director of Esvero, said the government had conducted preventative measures across the entire spectrum of the population except for the one group that is most vulnerable to HIV infection: drug users.

“Sure, it’s hard to supervise their treatment, hard to catch them. They are wrongdoers and all that, but they are not martians, they are part of our society … and as long as society ignores their problems, they won’t go away, they just go underground,” Aksyonov told The Moscow Times.

Too Little, Too Late

Even the most zealous activists in Russia’s fight against the spread of HIV agree that, compared to several years ago, there has been progress  — but not enough to stave off the epidemic that they say is undoubtedly coming if the government does not take more drastic measures to confront the problem.

Last year, the country’s health watchdog recorded nearly 78,000 new cases of HIV infection, compared to 69,000 in 2012 and 62,000 in 2011.

As of Jan. 1 of this year, there were 798,122 Russians registered as HIV-positive, more than 7,500 of them children.

“Even if the Russian government wakes up and finally begins to really actively fight the epidemic, the effect of preventative measures will not begin to show until two or three years later, and by that time Russia will need to cure up to 1 million HIV-positive people, which requires huge resources: not only money, but also infrastructure, doctors, etc.,” said Vadim Pokrovsky, director of the Federal AIDS Center.

Andrei Skvortsov, coordinator of the grassroots organization Patients’ Watchdog, which monitors the government’s treatment of HIV-positive people, echoed that sentiment.

“If 18 billion rubles ($500 million) is continued to be allocated each year for the epidemic that keeps growing, rather than the 40 billion called for in the state program, a catastrophe awaits us. … Maybe the ministers will start to actually think about these things when they begin to bury their own children, and not just ours,” Skvortsov said.

Aksyonov of Esvero said that the government had improved its efforts in the fight against HIV in the past several years — setting up a coordination council within the Health Ministry in February 2013 to handle HIV issues, and improving diagnostics and treatment — but the situation has nonetheless deteriorated in the past couple of years, he said.

Both he and Lapin cited the government’s often hostile attitude to NGOs as a factor.

“Unfortunately, in Russia, once again this negative attitude to Western technology, to the Western understanding of the problem is making a comeback. This has a negative effect on both the epidemic and the treatment of patients,” Lapin said.

“With everything we achieved with the help of NGOs in Russia, unfortunately, right now we are moving backwards. Why? Because the government does not support the programs implemented by NGOs that are recognized all over the world: harm-reduction programs, safe-sex programs.”

Lapin said his group had once asked the government for funds that had been promised earlier only to be “told that we are foreign agents, that we promote pedophilia, homosexuality and drug addiction. It all comes back to that.”

“That’s why, unfortunately, these programs that, in my view and in the view of the international community, are effective, are retreating if not to the underground, to the shadows,” Lapin said.

Pascal Dumont / For MT

Activists handing out HIV tests and clean syringes.

Funding Crisis

The warnings voiced by activists and specialists come at a particularly critical time in the country’s fight against the illness: Russia is now classified in the international effort as a donor country, not a recipient, meaning it contributes funds to help other countries fight the disease and as such is not afforded the same privileges from international organizations like the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“The problem is that Russia helps the Global Fund but does not increase funds for the fight against HIV/AIDS within the country,” Pokrovsky said.

Financing from the Global Fund, which has provided the bulk of HIV/AIDS funding to Russia for nearly a decade,  is set to be drastically reduced by 2015 and phased out by 2017 in connection with Russia’s new classification.

Russia’s decision to become a donor country was met with cautious optimism by the international community, but activists say it is not ready.

“Russia has become a developed country in the eyes of the World Bank, and thus we can provide things for ourselves, and more than that we have even become a donor country for various international organizations, so we finance harm-reduction programs in other countries that we forbid here at home,” Lapin said.

“That’s why when we appeal to international organizations, they say ‘Wait, you yourselves are giving us money for this.’ It’s a stupid situation. But the government is nevertheless closing its eyes to that as well.”

Not the Russian Way

Drug substitution therapies are financed by Russia in other countries but outlawed domestically. The same is true for clean needle programs and needle disposal programs.

Clean needle programs are conducted exclusively by nongovernmental organizations like the Andrei Rylkov Foundation, as the official line on such programs is that they promote unhealthy lifestyles and do nothing to curb the rate of infection.

Maria Preobrazhenskaya, one of the activists from the Andrei Rylkov Foundation who distributes syringes, HIV and pregnancy tests and other medications to drug users each week, said police sometimes stop to scold her or other volunteers for what they see as promoting drug use.

Outside the pharmacy in northern Moscow, nearly a dozen people in two hours stopped to accept HIV tests and brochures with information on the disease from Preobrazhenskaya: a dozen people who activists say, at the very least, have more awareness than they did before.

According to Pokrovsky of the Federal AIDS Center, the programs outlawed in Russia have proven to be effective in Europe, U.S. and Canada, and they could work just as well here.

“The problem is that it has not been analyzed in depth in Russia. The bias against methadone in Russia is based entirely on the opinions of certain experts who may have their own motives for being against the drug,” he said.

According to Anya Sarang, president of the Andrei Rylkov Foundation, the use of methadone in treating heroin users would solve more than just the problem of infection.

“You’re hooked on heroin: Switch to methadone. Then you will not need to steal from your grandmother or wife every day. You’ll get methadone for free. Of course it will no solve the problem of addiction, but it will solve a bunch of other problems: crime, health and more. But we don’t even have [this practice], although in Iran, China and India — everywhere else they do this. But with us, this simple solution just evokes idiotic opposition from the government,” Sarang said in comments published on the foundation’s website late last month.

No Access to Medication

Worst of all for Russia’s existing HIV patients, the medication they desperately need to stave off their development of their illness is not always available to them.

Up until mid-2013, the Health Ministry had run a centralized system for medicating HIV-positive people. But last year, the ministry decided to hand over responsibility for the procurement of medications to regional authorities.

As a result, patients in regions including Moscow, Nizhny Novgorod, Ivanovo, Perm, Krasnoyarsk, Novosibirsk, Kazan, Kaliningrad, Murmansk and Rostov-on-Don have complained about a lack of access to life-sustaining medications throughout much of 2014.

The website, which tracks shortages of medications for HIV-positive patients, has been inundated with warnings and complaints of deficits.

“For the third month in a row now, I am unable to get my full set of medications,” wrote one patient from Murmansk in late July.

Activists say the decision to delegate medications procurement to regional authorities only muddied the waters in an already overly bureaucratic system.

“They put all responsibility on the regions. Now there is no one to make demands to,” said Skvortsov of Patients’ Watchdog. “The ministry says they are allocating the money to the regions, and they in turn are supposed to buy everything,” but then the regional bureaucrats respond by “citing resolutions and decrees of the Health Ministry or playing ping-pong with the patients,” he said.

Skvortsov said that even if officials wanted to help patients, the move created so much red tape that it made it virtually impossible.

Although the work of Skvortsov’s group prompted prosecutors in Murmansk to look into these shortages and ensured early supplies of medications in some cities, he said it was a sad but undeniable truth that the patients who survive in today’s Russia are those who are prepared to fight for the state medical care to which they are entitled.

Lack of Political Will

The main method for receiving funding from the Health Ministry for preventative programs — which all specialists agreed is the most crucial part of the fight — is tenders run by the ministry.

But according to Aksyonov of Esvero, there is no mechanism in place to check the effectiveness of the projects implemented by the tender winners: Funding is being funneled into programs that have not been properly vetted, and nobody bothers to check whether these programs have any result at all.

Lapin said such problems were symptomatic of an overall lack of political will to fight the epidemic. “Nothing changes [in the fight against HIV]. … People constantly appear before the government, offering the latest charitable programs that suck up billions of rubles, then no one can find these people. And the government says, ‘You know, we already gave these funds to an NGO.’ But who was that person? Where did they come from? No one knows. But they got the money.”

“If there is no political will, we probably won’t be able to change anything,” he said. “We’ll try, we’ll make temporary changes. But financing will run dry, programs will end. Yeah, we’ll save some lives, which is very, very important, but at some point people will just get tired of running in circles,” he said.

9 factors that increase your risk for HIV

Friday, April 25th, 2014

HIV/ AIDS has killed more than 25 million people in the past 3 decades. But the current statistics are much more frightening. It has been estimated that there are more than 34 million people all around the world living with HIV infection. One of the main reasons why HIV/AIDS is so widespread is the lack the knowledge about risk factors and transmission of HIV. This lack of knowledge is not restricted to people living in remote areas. The highly educated population also seem equally illiterate when it comes to HIV. Maybe in the future we could have a cure for HIV but until then knowing the risk factors is the best way to stay away from HIV.

1. Having unprotected sex: HIV (human immunodeficiency virus) is the causative agent of AIDS, a disease that completely destroys the immune system of the body, making the infected person susceptible to several other diseases. HIV circulates throughout the body via the blood stream. It is also present in sexual fluids (semen and vaginal secretions). Therefore, the primary risk factor for acquiring the infection is having unprotected sex. This includes vaginal, oral as well as anal intercourse. The risk is highest in anal intercourse followed by vaginal and lastly oral intercourse.

2. Multiple sex partners: Having unprotected sex puts you at a risk of HIV but with multiple sex partners the risk almost doubles. Multiple sex partners increase your chances of having intercourse with an infected individual.

3. Other sexually transmitted infections: Not many people know that sexually transmitted diseases (STDs) like syphilis, herpes and gonorrhea increase the risk of contracting HIV. The risk of HIV in individuals earlier infected with an STD is 2-5 times more compared to a person without an STD. Studies suggest that sexually transmitted diseases cause certain changes in the genital tissues, increasing the susceptibility of HIV transmission.

4. Transfusion of contaminated blood and blood products: Whether you were transfused blood during a surgery or are a hemophiliac who needs frequent blood transfusion, your chances of contracting HIV are high if the transfused blood is not tested for HIV. As a standard in medical practice, blood is always tested before a transfusion but recently several cases of HIV due to transfusion of infected blood have been noticed.  

5. Contaminated syringes and needles: Use of unsterilised syringes is still practised in various parts of developing countries, including India. According to a report by the World Health Organisation (WHO) about 5 percent of HIV infections took place due to unsafe injection practices in the year 2002. And, even today the use of unsafe injections is quite rampant. This even includes vaccination given to children. 

6. Drug abuse: If you’re injecting drugs like ketamine, GHB and poppers intravenously, you are more likely to get infected with  HIV. These drugs affect you brain and impair your decision making ability. So you’re more likely to share needles and have unprotected sex.

7. Unsafe piercings: If you’re fond of body piercings and tattooing, you should be aware that you are at a higher risk of HIV. The needles used in these processes could be contaminated or infected with HIV. Ensure that you get piercing and tattooing done from a trained professional. 

8. Negligence in medical practice: All health professionals and health care workers including nurses, doctors, laboratory analysts and pathologists, who have to handle blood samples of patients on a daily basis, are at a risk of HIV if they fail to take necessary precautions and do not follow medical hygienic practices. Handling samples without wearing gloves, improper disinfection and discarding methodology, all can increase your high risk of HIV.

9. Mother-to-child HIV risk: Women with HIV can pass on the virus to their child during pregnancy. Mother-to-child transmission of virus can also take place through breast-feeding because breast milk in an infected mother has high viral load.


  • HIV Risk Factors. National Institute of Allergy and Infectious Diseases (
  • HIV Transmission Risk (

TSRI scientists discover new HIV target

Friday, April 25th, 2014

A team led by scientists at The Scripps Research Institute (TSRI) working with the International AIDS Vaccine Initiative (IAVI) has discovered a new vulnerable site on the HIV virus. The newly identified site can be attacked by human antibodies in a way that neutralizes the infectivity of a wide variety of HIV strains.

“HIV has very few known sites of vulnerability, but in this work we’ve described a new one, and we expect it will be useful in developing a vaccine,” said Dennis R. Burton, professor in TSRI’s Department of Immunology and Microbial Science and scientific director of the IAVI Neutralizing Antibody Center (NAC) and of the National Institutes of Health’s Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery (CHAVI-ID) on TSRI’s La Jolla campus.

“It’s very exciting that we’re still finding new vulnerable sites on this virus,” said Ian A. Wilson, Hansen Professor of Structural Biology, chair of the Department of Integrative Structural and Computational Biology and member of the Skaggs Institute for Chemical Biology at TSRI and member of the NAC and CHAVI-ID.

The findings were reported in two papers—one led by Burton and the second led by TSRI Assistant Professor Andrew B. Ward, also a member of NAC and CHAVI-ID, and Wilson—appearing in the May issue of the journal Immunity.

The discovery is part of a large, IAVI- and NIH-sponsored effort to develop an effective vaccine against HIV. Such a vaccine would work by eliciting a strong and long-lasting immune response against vulnerable conserved sites on the virus—sites that don’t vary much from strain to strain, and that, when grabbed by an antibody, leave the virus unable to infect cells.

Cloaked by Shields

HIV generally conceals these vulnerable conserved sites under a dense layer of difficult-to-grasp sugars and fast-mutating parts of the virus surface. Much of the antibody response to infection is directed against the fast-mutating parts and thus is only transiently effective.

Prior to the new findings, scientists had been able to identify only a few different sets of “broadly neutralizing” antibodies, capable of reaching four conserved vulnerable sites on the virus. All these sites are on HIV’s only exposed surface antigen, the flower-like envelope (Env) protein (gp140) that sprouts from the viral membrane and is designed to grab and penetrate host cells.

The identification of the new vulnerable site on the virus began with tests of blood samples from IAVI Protocol G, in which IAVI and its NAC partnered with clinical research centers in Africa, India, Thailand, Australia, the United Kingdom and the United States to collect blood samples from more than 1,800 healthy, HIV-positive volunteers to look for rare, broadly neutralizing antibodies. The serum from a small set of the samples indeed turned out to block the infectivity, in test cells, of a wide range of HIV isolates, suggesting the presence of broadly neutralizing antibodies. In 2009, scientists from IAVI, TSRI and Theraclone Sciences succeeded in isolating and characterizing the first new broadly neutralizing antibodies to HIV seen in a decade.

Emilia Falkowska, a research associate in the Burton laboratory who was a key author of the first paper, and colleagues soon found a set of eight closely related antibodies that accounted for most of one of the sample’s HIV neutralizing activity. The scientists determined that the two broadest neutralizers among these antibodies, PGT151 and PGT152, could block the infectivity of about two-thirds of a large panel of HIV strains found in patients worldwide.

Curiously, despite their broad neutralizing ability, these antibodies did not bind to any previously described vulnerable sites, or epitopes, on Env—and indeed failed to bind tightly anywhere on purified copies of gp120 or gp41, the two protein subunits of Env. Most previously described broadly neutralizing HIV antibodies bind to one or the other Env subunit. The researchers eventually determined, however, that PGT151 and PGT152 attach not just to gp120 or gp41 but to bits of both.

In fact, gp120 and gp41 assemble into an Env structure not as one gp120-gp41 combination but as three intertwined ones—a trimer, in biologists’ parlance. PGT151 and 152 (which are nearly identical) turned out to have a binding site that occurs only on this mature and properly assembled Env trimer structure.

“These are the first HIV neutralizing antibodies we’ve found that unequivocally distinguish mature Env trimer from all other forms of Env,” said Falkowska. “That’s important because this is the form of Env that the virus uses to infect cells.”

Structure Revealed

The second of the two new studies was an initial structural analysis of the new vulnerable epitope.

Using an integrative approach that combined electron microscopy on the Env trimer complex with PGT151 (led by the Ward lab) with the structure of the PGT151 Fab by x-ray crystallography (led by the Wilson lab), the scientists were able to visualize the location of the PGT151-series binding site on the Env trimer—which includes a spot on one gp41 protein with two associated sugars (glycans), a patch on the gp120 protein and even a piece of the adjacent gp41 within the trimer structure—”a very complex epitope,” said Claudia Blattner, a research associate in the Wilson laboratory at TSRI and member of the IAVI Neutralizing Antibody Center who, along with graduate student Jeong Hyun Lee, was a first author of the second paper.

A surprise finding was that the PGT151-series antibodies bind to the Env trimer in a way that stabilizes its otherwise fragile structure. “Typically when you try to purify the native Env trimer, it falls apart, which has made it very hard to study,” said Ward. “It was a key breakthrough to find an antibody that stabilizes it.”

Although the PGT151 site is valuable in itself as an attack point for an HIV vaccine, its discovery also hints at the existence of other similar complex and vulnerable epitopes on HIV.

Source: The Scripps Research Institute

Bringing the HIV pandemic to zero will require a vaccine, expert says

Saturday, March 29th, 2014


José Esparza to deliver keynote address at upcoming meeting on overcoming vaccine development barriers

WINNIPEG, March 28, 2014 /CNW/ – With 2.3 million new cases of HIV every year globally, including 50,000 in the U.S. alone, internationally renowned vaccine expert José Esparza says the need for an HIV vaccine is imperative to complement other preventive interventions and bring HIV/AIDS under control.

“There has been a sense that we have the tools to bring the pandemic to zero, but that’s not true. We will not be able to do that without a vaccine; how soon one is developed will depend on the decisions we make today,” says Esparza, who will soon retire from his role as Senior Advisor, Vaccines at the Bill & Melinda Gates Foundation.

In May, Esparza will deliver his first post-retirement speech at a Canadian meeting on HIV vaccine research and development. His presentation entitled “Do We Need a New Paradigm for HIV Vaccine Development?” will be the keynote address at the Canadian HIV Vaccine Initiative (CHVI) Research and Development Alliance Coordinating Office (ACO) Annual Meeting, to be held May 1, 2014 in St. John’s, Newfoundland.

Esparza, who is also an adjunct professor at the University of Maryland, has worked for decades in viral diseases and vaccine research. He says more innovative research, efficacy trials, and strong international partnerships will be the keys to successful HIV vaccine discovery.

Esparza and 12 other Canadian and international experts will address barriers to vaccine development and the innovative steps being taken to overcome them at the ACO Annual CHVI R&D Meeting.

The meeting will provide perspectives from research, regulatory affairs, pharma and international organizations – precisely the kind of multidisciplinary dialogue that Esparza has advocated for throughout his career.

“We need voices that maintain the sense of urgency regarding the search for an HIV vaccine,” he says. “Accelerating HIV vaccine discovery and development will require a concerted and collaborative effort that focuses on developing a globally relevant vaccine.”

The ACO annual meeting is being held in tandem with the 23rd Annual Canadian Conference on HIV/AIDS Research (CAHR 2014), where Esparza will also speak on May 2 at the CHVI – Vaccine Research Plenary. The title of his presentation for that session is “An HIV Vaccine Will be Needed to Bring the HIV Pandemic to Zero”.

The CHVI is a five-year collaborative initiative between the Government of Canada and the Bill & Melinda Gates Foundation, and represents a significant Canadian contribution to global efforts to develop a safe, effective, affordable and globally accessible HIV vaccine. The ACO was established by the Government of Canada and the Bill & Melinda Gates Foundation in 2011 at the International Centre for Infectious Diseases (ICID), a not-for-profit, non-governmental organization based in Winnipeg, Manitoba. The ACO is funded by the Public Health Agency of Canada.

DHVI finds lupus antibodies may hold key to HIV cure

Saturday, March 29th, 2014

Researchers at the Duke Human Vaccine Institute recently found that a patient diagnosed with both lupus and HIV produced antibodies that limited the effects of the latter.

The broadly neutralizing antibodies produced by this patient have only been seen in the later stages of a small portion of chronically HIV-infected individuals, when it is already too late to prevent the effects of the virus, said Mattia Bonsignori, a faculty member of DHVI and the lead author of the study that discovered this. This finding, however, provides evidence that inducing these antibodies could limit HIV infection in earlier stages.

“The hypothesis was that auto-reactive broadly neutralizing antibodies weren’t being made in the vast majority of people that contract HIV because the immune system targets them as harmful,” Bonsignori said. “And we’ve got this person with lupus and HIV and bam, out of one person we’ve found broadly neutralizing antibodies.”

Lupus refers to a collection of autoimmune diseases that cause the immune system to go into hyperdrive and attack healthy tissues in the body. In contrast, HIV ultimately inhibits the immune system. The group’s finding that individuals with autoimmune diseases can limit the reproduction of the HIV virus suggests that overriding this control might be the key to engineering a vaccine, said Garnett Kelsoe, a professor of immunology and co-author of the study.

Further research is being conducted on how to safely and feasibly overcome the immune controls that prevent the production of broadly neutralizing antibodies in the general population. Laurent Verkoczy, an assistant professor in medicine and pathology and co-author of the paper, has been able to induce broadly neutralizing antibodies in mice models without autoimmune problems.

“So far, it is encouraging that no clinically adverse effects have been reported in passive transfer studies using 2F5, the broadly neutralizing antibody we have been learning how to induce in mouse models,” Verkoczy said.

The patients dually-diagnosed with HIV and lupus were “extremely important” as they provide evidence that a treatment would work in humans, he added.

“They not only show what might occur under ideal circumstances but something that actually clearly works in human populations,” Kelsoe said.

Although these findings further illustrate the path toward a future vaccine, Bonsignori stressed that this does not mean lupus itself prevents or cures HIV—rather, the effects of lupus simply set the stage for antibodies to develop that strengthen the immune system against HIV.

“The relevance of these kinds of antibodies is for vaccine development, in which you plan to elicit that kind of response before you get in touch with the virus itself,” Bonsignori said. “People with lupus, like all individuals, should protect themselves from contracting the virus in the first place.”

The preventive nature of the DHVI research distinguishes the discovery from previously documented “cures” for HIV, such as the case of Timothy Ray Brown, who received a blood stem cell transplant from a naturally HIV-resistant donor for his leukemia that eradicated his HIV infection in 2008.

“This concentrates in particular on helping us understand how we can make the immune system generate an effective broadly neutralizing antibody response, as part of a preventative vaccine—those are genetic or therapeutic cures,” Verkoczy said.

Tattoo clients urged to get tested for hepatitis and HIV

Saturday, March 29th, 2014


Health officials are warning anyone who received a tattoo at a downtown Edmonton home to be tested for hepatitis and HIV.

tattoosA man works on a tattoo in a picture posted on the Tazzman Tattoos Facebook page. (CBC)

Alberta Health Services is urging anyone who received a tattoo from a home business named Tazzman Tattoo or from the operator Steve Tazz Devilman to get tested.

The business at #301, 10724 – 105 Street, which was never inspected, used unsanitary tattoo procedures, said Dr. Chris Sikora, Edmonton Zone Medical Officer of Health.

“We were able to do a complete inspection and found that the sanitary conditions were unacceptable for current standards and regulations for delivery of tattoos in any situation,” he said.

AHS ordered the business closed on March 21. Clients are advised to get tested for illnesses like Hepatitis and HIV.

Areol Leason, who says she’s the fiance of the tattoo artist, says that he used sterile and there was no reason for AHS to intervene.

“Nobody’s being affected by his hobby,” she told CBC News.

Worried clients can call Health Link Alberta at 1-866-408-5465 (LINK) to arrange for testing.

To confirm that a tattoo operation in the city is inspected, people can call AHS Environmental Public Health at 780-735-1800.

Free, hi-tech HIV vaccine coming soon

Monday, January 27th, 2014

A revolutionary, free and crowd-funded HIV vaccine is in the works. Its creators use a machine learning algorithm to examine the cells of rare individuals naturally immune to the virus to then re-engineer the same biological process in others.

The Immunity Project, as the team is called, is completely crowd-funded. Not only does it promise an effective vaccine this time around, it uses a revolutionary method to achieve its goals and vows to revolutionize how we look at vaccines in general: this one will be a fraction of the cost of development by big pharmaceutical companies, while costing the general population nothing.

An effective cure could be made available to the public in 2016.

The Harvard/Stanford/MIT team behind the vaccine is made up of visionaries and inventors with a few achievements to their names: Dr. Bruce Walker of Harvard University, Dr. David Heckerman, who invented the internet’s spam filter and is an artificial intelligence and machine learning specialist at Microsoft e-Science Research, and Dr. Reid Rubsamen, founder of Flow Pharma and drug delivery system specialist.

And they do not disappoint. Using their combined technological prowess, they have applied a machine learning algorithm which scans the cells of an incredibly rare type of individual – an HIV ‘controller.’ Such people are superheroes in the closest sense of the word, as they are born with a natural immunity to the virus.

“Only one out of 300 people who are living with HIV has this incredible power,” Immunity explains. “The essence of controllers’ immunity is the unique targeting capability contained within their immune systems. Like the finely tuned laser scope on a sniper rifle, the immune systems of controllers have the ability to target the biological markers on the HIV virus that are its Achilles heel. When a controller’s immune system attacks these biological markers, it forces the virus into a dormant state.”

Such immunity can be mimicked in ordinary people, giving their cells the precise abilities of immune cells. And the method of delivery shall be an ordinary nasal spray, which is thought to ease the risks of delivery in HIV hotbed zones like Africa.

Furthermore, the vaccine is apparently much safer than alternatives which incorporate dead or living viruses.

The team has already developed a prototype for the vaccine and the first lab tests are in. The crowd-funding campaign kicked off on Thursday. Their aim is to raise $482,000 over the coming 30 days if they wish to complete the experiment by March.

As The Immunity Project explains, their “macro project is to create a blueprint and set a precedent for how to manufacture and fund vaccines for a multitude of infectious diseases. We believe we can efficiently, economically, and proactively solve some of the biggest virus threats that currently exist.”

There is already something truly special about the project’s use of ‘controller-preferred targets’. These controllers exist for a multitude of illnesses – not just HIV. The team explains that a whopping 13 percent of the US population is controllers for things like hepatitis C, for instance. Research is already underway into harnessing the full potential of this revolutionary targeting system.

Remarkable gains for HIV patients

Saturday, December 28th, 2013

The Province

Longevity: Life expectancy nears that of general population with today’s treatments

By Helen Branswell, The Canadian Press December 27, 2013
Remarkable gains for HIV patients

Audience members watch video images at an international conference focusing on AIDS, a disease that’s seen much-improved treatments over the years. A new study says a 20-year-old HIV-positive person in North America can expect to live into their early 70s.

Photograph by: Canadian Press Files , The Canadian Press

The life expectancy of Canadians and Americans who are HIV positive is closing in on that of the general population, a new study reveals.

It suggests that 20-year-olds diagnosed with HIV today can expect to live into their early 70s.

That is a sharp contrast to the early days of the AIDS epidemic, when a diagnosis of HIV was a death sentence.

People who contracted the disease often died within months or at best a few years, their bodies ravaged by opportunistic infections their demolished immune systems could not quell.

But with the discovery and improvement of antiretroviral drugs, HIV has become a chronic disease for most who have access to and can afford the medication.

The newer generation of drugs also has fewer side-effects, allowing them to be better tolerated and increasing the chances people prescribed the drugs take them as ordered.

They are “simpler and safer and better tolerated, so people are able to take these treatments better and also for a longer period of time,” said Dr. Julio Montaner, a leading HIV researcher.

Montaner is director of the B.C. Centre for Excellence in HIV/AIDS, which led the research collaboration that produced the study.

He said the longevity gains have been remarkable. In 2000, the average 20-year-old newly diagnosed with HIV could expect to live another 36 years. By 2006, that figure had climbed to 51 years.

“I don’t think, in all honesty, that there has been an area of medicine that has undergone (as big a) revolutionary evolution over our lifetime as HIV has,” Montaner says.

The substantial gains haven’t been made across the board.

HIV-positive injection drug users still have lower life expectancies than men who have sex with men. And non-whites have lower life expectancies than HIV-positive people who are white, the study said. Dr. Ann Stewart, medical director of Toronto’s Casey House, said the findings mirror what her staff sees in its patient population. Casey House started 25 years ago as a hospice for dying AIDS patients. As treatment has prolonged the lives of the community it serves, the facility has transitioned into a hospital that offers care for people living with HIV.

Stewart warned, though, that the picture is not an “unclouded” one, noting HIV-positive people often develop the health problems of age faster than those who are not infected.

So heart disease, cancers and the onset of cognitive decline that might be expected in the late 60s, 70s or even 80s in HIV-negative people can show up a decade or two earlier in HIV-positive people, she said.

“We see our folks at 50 feeling a lot older than the average population would feel at that age,” said Stewart, who added that conditions vary depending on how long people have been infected and how religiously they have taken their medication.

Research in HIV therapies

Monday, July 15th, 2013

Over the last 30 years, the face of human immunodeficiency virus (HIV) has changed from one largely associated with homosexuality, drug addicts, prejudice, fear and rejection without much hope of a future, to one involving innocent children born of mothers living with HIV for whom it is hoped the disease will be curable and even eradicated. 

According to the World Health Organization (WHO) and UNAIDS, 34 million people were living with HIV worldwide in 2011. Sub-Saharan Africa was, and still is, the most severely affected area. Approximately 5 per cent of adults in this region live with HIV, representing almost 70 per cent of the global HIV-infected population. On a positive note, the number of newly infected people has declined by approximately 25 per cent over the past ten years and, importantly, over the past two years, half of the reductions in HIV infections has been in children.

Treatment and prevention
The approach to, and success of, HIV treatment and prevention has improved such that the disease may now be considered a manageable, life-long condition.

Currently available therapeutics do not provide a cure, but may prevent infection or attenuate viral load after the fact; for this, the currently available agents are required to be taken daily, and for life. This poses problems relating to compliance and potential for the development of drug resistance. To prevent the latter, it is recommended that therapy includes a combination of drugs from at least two different classes. However, the increased pill burden results in non-adherence to medication. Consequently, suppression of viraemia is compromised and risk of disease transmission increased in non-compliant patients.

The development of future HIV therapies is governed by the need to provide complex drug combinations in the simplest, patient-friendly formulation. The majority of the currently marketed HIV therapeutics are single agents spanning a variety of drug classes; not all are available as once-daily formulations.

There are two main approaches evident in the development of HIV therapeutics that aim to prevent drug resistance and to increase patient compliance: addition of pharmacokinetic enhancers (‘boosting’ agents) to already established drugs, and drug ‘cocktails’ in a single tablet; in some cases these approaches have been combined.

Fixed-dose combinations
There are currently three fixed-dose combination (FDC) products that are available for treatment of HIV – elvitegravir/emtricitabine/tenofovir disoproxil fumarate/cobicistat (Stribild; Gilead Sciences), emtricitabine/rilpivirine/tenofovir disoproxil fumarate (Eviplera, Complera; Gilead, Tibotec) and lopinavir/ritonavir (Kaletra; Abbott Laboratories).

Gilead and Johnson & Johnson (J&J) are developing an oral FDC tablet comprising cobicistat (pharmacoenhancer) and darunavir (HIV protease inhibitor). Phase III trials are underway in the European Union (EU) and US in both treatment-naive and treatment-experienced HIV patients. Darunavir (Prezista; Tibotec) is a protease inhibitor that is already launched as a single agent. Cobicistat does not have antiviral activity against HIV in its own right, but acts as a booster by inhibiting cytochrome P450 3A (CYP3A) and increasing blood drug concentrations of certain therapeutic agents, thus facilitating convenient once-daily dosing.

ViiV Healthcare, in a joint venture with GlaxoSmithKline and Pfizer, is developing a triple-drug cocktail – abacavir/dolutegravir/lamivudine – that combines three distinct mechanisms of action: inhibition of HIV replication, inhibition of HIV integrase and a nucleoside reverse transcriptase inhibitor (NRTI), respectively.

Combining the ‘boosting’ and ‘cocktail’ approaches, Gilead Sciences is developing a quadruple-drug FDC product, cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide (C/E/F/TAF), which entered phase III trials in the US and Puerto Rico in late 2012/early 2013. Two similarly designed studies (Study 104 and Study 111) are being conducted in treatment-naive HIV-1 patients; recruitment will also extend to several countries including the EU, Asia and Latin America. Tenofovir alafenamide (GS 7340) and tenofovir disproxil fumarate (TDF, Viread) are two prodrugs developed by Gilead and designed to have better oral availability and adverse events profiles than tenofovir. TDF is a component of the only quadruple-drug FDC (Stribild) currently launched (US only).

Promising results from a phase II head-to-head study were presented at 20th Conference on Retroviruses and Opportunistic Infections Conference (CROI) in March 2013, which demonstrated that both C/E/F/TAF and Stribild had similar efficacies and overall tolerability profiles, but that C/E/F/TAF had less negative impact on renal function and bone mineral density.

Non-oral prophylactic agents
Despite the downward trend in HIV prevalence over the past few years, according to UNAIDS, the majority of all the people living with AIDS are women, and most of the newly infected patients are children resulting from maternally-transmitted virus. It would therefore seem appropriate to target these particular patient populations with regard to the design of the drug formulation. Appropriately, two vaginally-administered, prophylactic formulations are in phase III development in African regions.

Tenofovir (Gilead, CONRAD) is a NRTI compound in development as a topical vaginal gel in phase III trials in South Africa. Nucleotides are characterised by their ability to form reservoirs of active drug within infected and non-infected (resting) cells; this allows sustained inhibition of viral replication after a single dose, and offers the potential for infrequent dosing and development of resistance, as well as prophylactic use. However, this product requires repeated application, prior to and after sexual intercourse, and is perhaps less user friendly than the slow-release dapivirine intravaginal ring preparation (Janssen, International Partnership for Microbicides) currently in phase III trials in South Africa, Malawi, Uganda, Zambia and Zimbabwe.

Dapivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that entered phase III development in late 2012. The ASPIRE trial is assessing the efficacy of monthly-renewed dapivirine intravaginal rings in approximately 3540 women from Central- East- and South Africa. The preparation is stable and easy to distribute, which is beneficial for use in these developing countries.

A different therapeutic approach to this global epidemic has been adopted by Sanofi Pasteur. Currently, the company has one vaccine in phase III development for both treatment and prevention of HIV. The HIV vaccine vCP1521 comprises a live, attenuated, canarypox viral vector (ALVAC), into which selected HIV-1 genes are inserted. ALVAC-HIV vCP1521 is one of four recombinant vectors in clinical development. This product expresses gp120 of sub-type E (the clade predominant in Thailand).

Most of the newly infected patients are children resulting from maternally-transmitted virus

Results from a proof-of-concept phase III trial (RV144) showed that ALVAC-HIV vCP1521 significantly reduced the rate of HIV infection by 31 per cent, compared with placebo. RV144 was the world’s largest AIDS vaccine study and the first government-sponsored, phase III prime-boost trial involving 16·402 healthy volunteers in Thailand. Participants received ALVAC-HIV vCP1521 as the prime and HIV gp120 vaccine (VaxGen; AIDSVAX B/E) as the boost, over a 6-month period with a 3-year follow-up. The trial data also provided important information regarding the future design of vaccines with respect to a potential target within the HIV genome. Completion of the RV144 trial is expected during the first half of 2013.

Preregistration – the race is on
There are three products currently in preregistration in the EU and/or North America for the management of HIV: two are single-agent oral HIV integrase inhibitors and one is a single-tablet cocktail.

Elvitegravir (Gilead) is awaiting both EU and US approval for treatment-experienced HIV-1 infections. Data from the pivotal 96-week Study 145 were used to support these applications, which showed that elvitegravir was non-inferior to raltegravir (HIV integrase inhibitor; Merck & Co) in treatment-experienced HIV-1 patients who also received a ritonavir-boosted protease inhibitor and another antiviral agent. A decision regarding the US application is imminent.

Following rapidly on the heels of elvitegravir is the other orally administered HIV integrase inhibitor, dolutegravir (ViiV Healthcare), which is awaiting approval in the US, Canada and EU for use in patients aged at least 12 years. Priority review has been granted in the US and a decision is expected in August 2013. This product is a non-boosted, once-daily therapy for use in both treatment-naive and treatment-experienced HIV-1 patients.

Dolutegravir has performed well against its potential market competitors, according to data from the four phase III trials used to support the registrational application. It has been compared with two already marketed therapeutics, raltegravir and Stribild. Dolutegravir demonstrated non-inferiority to raltegravir in treatment-experienced and treatment-naive HIV-1 patients, and showed limited potential for developing integrase resistance. Dolutegravir (combined with abacavir/lamivudine) has also shown a similar 48-week virological suppression rate and a somewhat better tolerability profile than Stribild.

Efavirenz/lamivudine/TDF (Mylan Laboratories) is indicated for use alone, or in combination with other antiretrovirals, as first- or second-line treatment of HIV-1-infected adults. Tentative approval of the NDA has been granted in the US, under the President’s Emergency Plan for AIDS Relief (PEPFAR) initiative that includes an expedited review process and encourages worldwide sponsors to submit US marketing applications for single entity, FDC and co-packaged versions of previously approved antiretrovirals. ‘Tentative’ rather than ‘full’ approval is given to those products that contain agents that still have patent or marketing exclusivity protection in the US.

Striding forward
The global community has made significant strides forward in its mission to eradicate the HIV (and ultimately the deadly AIDS) epidemic. Back in 1996, the advent of potent combination antiretroviral therapy (ART or cART or HAART) served as the impetus for changing the course of the HIV epidemic – resulting in HAART becoming the standard of care for HIV. These ‘cocktails’ of three or more ARTs gave patients and scientists new hope and have significantly improved life expectancy from months, to decades. Development of agents for successful treatment and prevention of HIV is complex, particularly given that combined mechanisms of action are recommended and that exceptional patient compliance is required. Pill burden is often the barrier to therapeutic efficacy in patients with HIV. However, the ‘boosted’ and ‘cocktail’ products in late-stage development appear to be catering for these requirements. Additional hope is offered with the 20+ pipeline compounds in phase II clinical trials, with the majority of these being vaccines, CCR5 receptor antagonists and NNRTIs.

Scientists ‘on brink’ of a cure for HIV

Sunday, April 28th, 2013

The Province

A breakthrough in the search for a cure for HIV will come “within months”, researchers believe.

Danish scientists are expecting results showing that it will be possible to find a cure that is both affordable and can be provided to large numbers of people.

They are running clinical trials to test a “novel strategy” in which the HIV virus, which causes Aids, is stripped from human DNA and destroyed by the immune system.

It has already been found to work in laboratory tests and the scientists are now conducting human trials.

The technique involves releasing the HIV virus from “reservoirs” it forms in DNA cells, bringing it to the surface of the cells. Once it comes to the surface, the body’s immune system can kill the virus through being boosted by a “vaccine”.

In vitro studies — those that use human cells in a laboratory — of the new technique proved so successful that in January, the Danish Research Council awarded the team 12 million Danish kroner (pounds 1.5 million) to pursue clinical trials with human subjects.

Dr Ole Sogaard, a senior researcher at the Aarhus University Hospital in Denmark who is leading the study, said: “I am almost certain that we will be successful in releasing the reservoirs of HIV.

“The challenge will be getting the patient’s immune system to recognize the virus and destroy it. This depends on the strength and sensitivity of individual immune systems.”

Fifteen patients are taking part in the trials, and if they are found to have been cured of HIV, the process will be tested on a wider scale.

The technique uses drugs called HDAC inhibitors, more commonly employed in treating cancer.

It is also being researched in Britain, but studies have not yet moved on to the clinical trial stage.

More than 1 in 270 people in the US are living with HIV and every 9.5 minutes someone is else is infected. The economic cost estimates associated with HIV/AIDS exceed 36 billion dollars a year. The development of effective drug treatments have allowed people with HIV to live longer with federal health officials now predicting that by 2015 one-half of the population with HIV in the US will be older than 50. Efavirenz (tradenames: Sustiva®, Stocrin®) is an antiretroviral (ARV) drug commonly used to treat HIV. Its popularity as a medication, alone or more commonly in combination with other HIV medications (tradename: Atripla®), is due to its superior effectiveness in suppressing replication of the virus that causes AIDS. Though highly effective, a standard dose of efavirenz is known to carry a risk of side effects that include adverse neuropsychiatric complications such as depression, anxiety, sleep disturbances, impaired concentration, aggressive behavior, night terrors, hallucinations, paranoia, psychosis and delusions. However the question remains as to why these side effects occur. Recent anecdotal reports of the recreational use of efavirenz provided some clues. Dr. John A. Schetz at the University of North Texas Health Science Center in Fort Worth, Texas, utilizes a mechanistic approach to solving problems and answering questions of importance to society. As a neuropharmacologist working to discover and develop new drugs for the treatment of neurological and psychiatric disorders, his experience and intuition helped solve the mystery as to why efavirenz, when taken as prescribed, can cause adverse psychiatric events, as well as why there are reports of efavirenz being diverted for recreational use. The later practice could encourage the emergence of ARV-resistant HIV strains by educating the HIV virus. People smoking HIV medicine to get highDr. Schetz’s interest was sparked by a network news report covering the topic of ARV abuse in South Africa. The report described how pills used to treat HIV were being crushed and the powder smoked for its psychoactive effects. Though there were no scientific studies on the topic, Dr. Schetz was aware of studies describing neuropsychiatric side effects in HIV patients taking the medication as prescribed, as well as case reports of sudden onset adverse psychiatric events in patients with no history of mental illness. However, research study results suggested that the later patient population were genetically predisposed because they have less effective variants of the enzyme primarily responsible for metabolizing efavirenz, leading to much slower than expected breakdown of efavirenz, and consequently higher than expected levels of drug in the body. Dr. Schetz initiated his investigation with molecular profiling of the receptor pharmacology of efavirenz which lead to the pinpointing of interactions with multiple established sites of action for other known drugs of abuse. He and a number of his colleagues worked together to achieve a pre-clinical understanding of the psychoactivity induced by efavirenz that may help explain reports both of its adverse neuropsychiatric side effects in HIV patients and of its diversion for recreational use. Dr. Schetz’s work is the first ever study of the mechanisms of efavirenz’s psychopharmacology and these new findings will help stimulate interest to support additional research related to the mechanism of ARV side effects and abuse potential. This would help translate the pre-clinical findings into preventative measures addressing HIV medication-induced adverse side effects in patients living with HIV. Additionally, preventative strategies would improve patient adherence and quality of life, reduce the potential risk for the emergence of HIV drug resistant strains, and could prevent diversion of HIV medication for illicit use.” His findings will be presented April 21, 2012 during Experimental Biology 2013 in Boston, MA.

Monday, April 22nd, 2013

India Times

WASHINGTON: Researchers, including an Indian-origin scientist, have developed a revolutionary new technique to deliver and fully release an anti-HIV drug into the brain.

Scientists from Florida International University’s Herbert Wertheim College of Medicine devised a new nanotechnique that can deliver and release AZTTP into the brain.

Madhavan Nair and Sakhrat Khizroev of the HWCOM’s department of immunology , used magneto-electric nanoparticles (MENs) to cross the blood-brain barrier and send a significantly increased level of AZTTP — up to 97% more — to HIV-infected cells. The blood-brain barrier keeps most medicines from reaching the brain. Most antiretroviral therapies used to treat HIV are deposited in the liver, lungs and other organs before they reach the brain. “This allows HIV to lurk unchecked ,” said Nair.

This new method could help patients suffering from deseases such as Alzheimer’s , Parkinson’s and epilepsy.


Monday, April 22nd, 2013


Human immunodeficiency virus infection / acquired immunodeficiency syndrome (HIV/AIDS) is a disease of the human immune system caused by infection with human immunodeficiency virus (HIV).[1] During the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a prolonged period without symptoms. As the illness progresses, it interferes more and more with the immune system, making the person much more likely to get infections, including opportunistic infections and tumors that do not usually affect people who have working immune systems.

HIV is transmitted primarily via unprotected sexual intercourse (including anal and even oral sex), contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding.[2] Some bodily fluids, such as saliva and tears, do not transmit HIV.[3] Prevention of HIV infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the disease. There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects.

Genetic research indicates that HIV originated in west-central Africa during the early twentieth century.[4] AIDS was first recognized by the Centers for Disease Control and Prevention (CDC) in 1981 and its cause—HIV infection—was identified in the early part of the decade.[5] Since its discovery, AIDS has caused nearly 30 million deaths (as of 2009).[6] As of 2010, approximately 34 million people are living with HIV globally.[7] AIDS is considered a pandemic—a disease outbreak which is present over a large area and is actively spreading.[8]

HIV/AIDS has had a great impact on society, both as an illness and as a source of discrimination. The disease also has significant economic impacts. There are many misconceptions about HIV/AIDS such as the belief that it can be transmitted by casual non-sexual contact. The disease has also become subject to many controversies involving religion.

Signs and symptoms

There are three main stages of HIV infection: acute infection, clinical latency and AIDS.[9][10]

Acute infection

A diagram of a human torso labelled with the most common symptoms of an acute HIV infection

Main symptoms of acute HIV infection

The initial period following the contraction of HIV is called acute HIV, primary HIV or acute retroviral syndrome.[9][11] Many individuals develop an influenza-like illness or a mononucleosis-like illness 2–4 weeks post exposure while others have no significant symptoms.[12][13] Symptoms occur in 40–90% of cases and most commonly include fever, large tender lymph nodes, throat inflammation, a rash, headache, and/or sores of the mouth and genitals.[11][13] The rash, which occurs in 20–50% of cases, presents itself on the trunk and is maculopapular, classically.[14] Some people also develop opportunistic infections at this stage.[11] Gastrointestinal symptoms such as nausea, vomiting or diarrhea may occur, as may neurological symptoms of peripheral neuropathy or Guillain-Barre syndrome.[13] The duration of the symptoms varies, but is usually one or two weeks.[13]

Due to their nonspecific character, these symptoms are not often recognized as signs of HIV infection. Even cases that do get seen by a family doctor or a hospital are often misdiagnosed as one of the many common infectious diseases with overlapping symptoms. Thus, it is recommended that HIV be considered in patients presenting an unexplained fever who may have risk factors for the infection.[13]

Clinical latency

The initial symptoms are followed by a stage called clinical latency, asymptomatic HIV, or chronic HIV.[10] Without treatment, this second stage of the natural history of HIV infection can last from about three years[15] to over 20 years[16] (on average, about eight years).[17] While typically there are few or no symptoms at first, near the end of this stage many people experience fever, weight loss, gastrointestinal problems and muscle pains.[10] Between 50 and 70% of people also develop persistent generalized lymphadenopathy, characterized by unexplained, non-painful enlargement of more than one group of lymph nodes (other than in the groin) for over three to six months.[9]

Although most HIV-1 infected individuals have a detectable viral load and in the absence of treatment will eventually progress to AIDS, a small proportion (about 5%) retain high levels of CD4+ T cells (T helper cells) without antiretroviral therapy for more than 5 years.[13][18] These individuals are classified as HIV controllers or long-term nonprogressors (LTNP).[18] Another group is those who also maintain a low or undetectable viral load without anti-retroviral treatment who are known as “elite controllers” or “elite suppressors”. They represent approximately 1 in 300 infected persons.[19]

Acquired immunodeficiency syndrome

A diagram of a human torso labelled with the most common symptoms of AIDS

Main symptoms of AIDS.

Acquired immunodeficiency syndrome (AIDS) is defined in terms of either a CD4+ T cell count below 200 cells per µL or the occurrence of specific diseases in association with an HIV infection.[13] In the absence of specific treatment, around half of people infected with HIV develop AIDS within ten years.[13] The most common initial conditions that alert to the presence of AIDS are pneumocystis pneumonia (40%), cachexia in the form of HIV wasting syndrome (20%) and esophageal candidiasis.[13] Other common signs include recurring respiratory tract infections.[13]

Opportunistic infections may be caused by bacteria, viruses, fungi and parasites that are normally controlled by the immune system.[20] Which infections occur partly depends on what organisms are common in the person’s environment.[13] These infections may affect nearly every organ system.[21]

People with AIDS have an increased risk of developing various viral induced cancers including: Kaposi’s sarcoma, Burkitt’s lymphoma, primary central nervous system lymphoma, and cervical cancer.[14] Kaposi’s sarcoma is the most common cancer occurring in 10 to 20% of people with HIV.[22] The second most common cancer is lymphoma which is the cause of death of nearly 16% of people with AIDS and is the initial sign of AIDS in 3 to 4%.[22] Both these cancers are associated with human herpesvirus 8.[22] Cervical cancer occurs more frequently in those with AIDS due to its association with human papillomavirus (HPV).[22]

Additionally, people with AIDS frequently have systemic symptoms such as prolonged fevers, sweats (particularly at night), swollen lymph nodes, chills, weakness, and weight loss.[23] Diarrhea is another common symptom present in about 90% of people with AIDS.[24]


Average per act risk of getting HIV
by exposure route to an infected source
Exposure Route Chance of infection
Blood Transfusion 90% [25]
Childbirth (to child) 25%[26]
Needle-sharing injection drug use 0.67%[25]
Percutaneous needle stick 0.30%[27]
Receptive anal intercourse* 0.04–3.0%[28]
Insertive anal intercourse* 0.03%[29]
Receptive penile-vaginal intercourse* 0.05–0.30%[28][30]
Insertive penile-vaginal intercourse* 0.01–0.38% [28][30]
Receptive oral intercourse 0–0.04% [28]
Insertive oral intercourse 0–0.005%[31]
* assuming no condom use
§ source refers to oral intercourse
performed on a man

HIV is transmitted by three main routes: sexual contact, exposure to infected body fluids or tissues, and from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission).[2] There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.[27] It is possible to be co-infected by more than one strain of HIV—a condition known as HIV superinfection.[32]


The most frequent mode of transmission of HIV is through sexual contact with an infected person.[2] The majority of all transmissions occur through heterosexual contacts (i.e. sexual contacts between people of the opposite sex);[2] however, the pattern of transmission varies significantly among countries. In the United States, as of 2009, most sexual transmission occurred in men who had sex with men,[2] with this population accounting for 64% of all new cases.[33]

As regards unprotected heterosexual contacts, estimates of the risk of HIV transmission per sexual act appear to be four to ten times higher in low-income countries than in high-income countries.[34] In low-income countries, the risk of female-to-male transmission is estimated as 0.38% per act, and of male-to-female transmission as 0.30% per act; the equivalent estimates for high-income countries are 0.04% per act for female-to-male transmission, and 0.08% per act for male-to-female transmission.[34] The risk of transmission from anal intercourse is especially high, estimated as 1.4–1.7% per act in both heterosexual and homosexual contacts.[34][35] While the risk of transmission from oral sex is relatively low, it is still present.[36] The risk from receiving oral sex has been described as “nearly nil”[37] however a few cases have been reported.[38] The per-act risk is estimated at 0–0.04% for receptive oral intercourse.[39] In settings involving prostitution in low income countries, risk of female-to-male transmission has been estimated as 2.4% per act and male-to-female transmission as 0.05% per act.[34]

Risk of transmission increases in the presence of many sexually transmitted infections[40] and genital ulcers.[34] Genital ulcers appear to increase the risk approximately fivefold.[34] Other sexually transmitted infections, such as gonorrhea, chlamydia, trichomoniasis, and bacterial vaginosis, are associated with somewhat smaller increases in risk of transmission.[39]

The viral load of an infected person is an important risk factor in both sexual and mother-to-child transmission.[41] During the first 2.5 months of an HIV infection a person’s infectiousness is twelve times higher due to this high viral load.[39] If the person is in the late stages of infection, rates of transmission are approximately eightfold greater.[34]

Rough sex can be a factor associated with an increased risk of transmission.[42] Sexual assault is also believed to carry an increased risk of HIV transmission as condoms are rarely worn, physical trauma to the vagina or rectum is likely, and there may be a greater risk of concurrent sexually transmitted infections.[43]

Body fluids

 A black-and-white poster of a young black man with a towel in his left hand with the words "If you are dabbling with drugs you could be dabbling with your life" above him

CDC poster from 1989 highlighting the threat of AIDS associated with drug use

The second most frequent mode of HIV transmission is via blood and blood products.[2] Blood-borne transmission can be through needle-sharing during intravenous drug use, needle stick injury, transfusion of contaminated blood or blood product, or medical injections with unsterilised equipment. The risk from sharing a needle during drug injection is between 0.63 and 2.4% per act, with an average of 0.8%.[44] The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333) per act and the risk following mucus membrane exposure to infected blood as 0.09% (about 1 in 1000) per act.[27] In the United States intravenous drug users made up 12% of all new cases of HIV in 2009,[33] and in some areas more than 80% of people who inject drugs are HIV positive.[2]

HIV is transmitted in About 93% of blood transfusions involving infected blood .[44] In developed countries the risk of acquiring HIV from a blood transfusion is extremely low (less than one in half a million) where improved donor selection and HIV screening is performed;[2] for example, in the UK the risk is reported at one in five million.[45] In low income countries, only half of transfusions may be appropriately screened (as of 2008),[46] and it is estimated that up to 15% of HIV infections in these areas come from transfusion of infected blood and blood products, representing between 5% and 10% of global infections.[2][47]

Unsafe medical injections play a significant role in HIV spread in sub-Saharan Africa. In 2007, between 12 and 17% of infections in this region were attributed to medical syringe use.[48] The World Health Organisation estimates the risk of transmission as a result of a medical injection in Africa at 1.2%.[48] Significant risks are also associated with invasive procedures, assisted delivery, and dental care in this area of the world.[48]

People giving or receiving tattoos, piercings, and scarification are theoretically at risk of infection but no confirmed cases have been documented.[49] It is not possible for mosquitoes or other insects to transmit HIV.[50]


HIV can be transmitted from mother to child during pregnancy, during delivery, or through breast milk.[51][52] This is the third most common way in which HIV is transmitted globally.[2] In the absence of treatment, the risk of transmission before or during birth is around 20% and in those who also breastfeed 35%.[51] As of 2008, vertical transmission accounted for about 90% of cases of HIV in children.[51] With appropriate treatment the risk of mother-to-child infection can be reduced to about 1%.[51] Preventive treatment involves the mother taking antiretroviral during pregnancy and delivery, an elective caesarean section, avoiding breastfeeding, and administering antiretroviral drugs to the newborn.[53] Many of these measures are however not available in the developing world.[53] If blood contaminates food during pre-chewing it may pose a risk of transmission.[49]


Main article: HIV
A circular structure with purple structures coming out of it and a number of objects inside the circle representing different aspects of the virus

A diagram showing the structure of HIV virus

HIV is the cause of the spectrum of disease known as HIV/AIDS. HIV is a retrovirus that primarily infects components of the human immune system such as CD4+ T cells, macrophages and dendritic cells. It directly and indirectly destroys CD4+ T cells.[54]

HIV is a member of the genus Lentivirus,[55] part of the family of Retroviridae.[56] Lentiviruses share many morphological and biological characteristics. Many species of mammals are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period.[57] Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. Upon entry into the target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded integrase and host co-factors.[58] Once integrated, the virus may become latent, allowing the virus and its host cell to avoid detection by the immune system.[59] Alternatively, the virus may be transcribed, producing new RNA genomes and viral proteins that are packaged and released from the cell as new virus particles that begin the replication cycle anew.[60]

Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was originally discovered (and initially referred to also as LAV or HTLV-III). It is more virulent, more infective,[61] and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2 as compared with HIV-1 implies that fewer people exposed to HIV-2 will be infected per exposure. Because of its relatively poor capacity for transmission, HIV-2 is largely confined to West Africa.[62]


 A large round blue object with a smaller red object attached to it. Multiple small green spots are speckled over both.

Scanning electron micrograph of HIV-1, colored green, budding from a cultured lymphocyte.

After the virus enters the body there is a period of rapid viral replication, leading to an abundance of virus in the peripheral blood. During primary infection, the level of HIV may reach several million virus particles per milliliter of blood.[63] This response is accompanied by a marked drop in the number of circulating CD4+ T cells. The acute viremia is almost invariably associated with activation of CD8+ T cells, which kill HIV-infected cells, and subsequently with antibody production, or seroconversion. The CD8+ T cell response is thought to be important in controlling virus levels, which peak and then decline, as the CD4+ T cell counts recover. A good CD8+ T cell response has been linked to slower disease progression and a better prognosis, though it does not eliminate the virus.[64]

The pathophysiology of AIDS is complex.[65] Ultimately, HIV causes AIDS by depleting CD4+ T cells. This weakens the immune system and allows opportunistic infections. T cells are essential to the immune response and without them, the body cannot fight infections or kill cancerous cells. The mechanism of CD4+ T cell depletion differs in the acute and chronic phases.[66] During the acute phase, HIV-induced cell lysis and killing of infected cells by cytotoxic T cells accounts for CD4+ T cell depletion, although apoptosis may also be a factor. During the chronic phase, the consequences of generalized immune activation coupled with the gradual loss of the ability of the immune system to generate new T cells appear to account for the slow decline in CD4+ T cell numbers.[67]

Although the symptoms of immune deficiency characteristic of AIDS do not appear for years after a person is infected, the bulk of CD4+ T cell loss occurs during the first weeks of infection, especially in the intestinal mucosa, which harbors the majority of the lymphocytes found in the body.[68] The reason for the preferential loss of mucosal CD4+ T cells is that the majority of mucosal CD4+ T cells express the CCR5 protein which HIV uses as a co-receptor to gain access to the cells, whereas only a small fraction of CD4+ T cells in the bloodstream do so.[69]

HIV seeks out and destroys CCR5 expressing CD4+ T cells during acute infection.[70] A vigorous immune response eventually controls the infection and initiates the clinically latent phase. CD4+ T cells in mucosal tissues remain particularly affected.[70] Continuous HIV replication causes a state of generalized immune activation persisting throughout the chronic phase.[71] Immune activation, which is reflected by the increased activation state of immune cells and release of pro-inflammatory cytokines, results from the activity of several HIV gene products and the immune response to ongoing HIV replication. It is also linked to the breakdown of the immune surveillance system of the gastrointestinal mucosal barrier caused by the depletion of mucosal CD4+ T cells during the acute phase of disease.[72]


Main article: Diagnosis of HIV/AIDS
A graph with two lines. One in blue moves from high on the right to low on the left with a brief rise in the middle. The second line in red moves from zero to very high, then drops to low and gradually rises to high again

A generalized graph of the relationship between HIV copies (viral load) and CD4+ T cell counts over the average course of untreated HIV infection.                      CD4+ T Lymphocyte count (cells/mm³)                      HIV RNA copies per mL of plasma

HIV/AIDS is diagnosed via laboratory testing and then staged based on the presence of certain signs or symptoms.[11] HIV testing is recommended for all those at high risk, which includes anyone diagnosed with a sexually transmitted illness.[14] In many areas of the world a third of HIV carriers only discover they are infected at an advanced stage of the disease when AIDS or severe immunodeficiency has become apparent.[14]

HIV testing

Most people infected with HIV develop specific antibodies (i.e. seroconvert) within three to twelve weeks of the initial infection.[13] Diagnosis of primary HIV before seroconversion is done by measuring HIV-RNA or p24 antigen.[13] Positive results obtained by antibody or PCR testing are confirmed either by a different antibody or by PCR.[11]

Antibody tests in children younger than 18 months are typically inaccurate due to the continued presence of maternal antibodies.[73] Thus HIV infection can only be diagnosed by PCR testing for HIV RNA or DNA, or via testing for the p24 antigen.[11] Much of the world lacks access to reliable PCR testing and many places simply wait until either symptoms develop or the child is old enough for accurate antibody testing.[73] In sub-Saharan Africa as of 2007–2009 between 30 and 70% of the population was aware of their HIV status.[74] In 2009, between 3.6 and 42% of men and women in Sub-Saharan countries were tested[74] which represented a significant increase compared to previous years.[74]

Classifications of HIV infection

Two main clinical staging systems are used to classify HIV and HIV-related disease for surveillance purposes: the WHO disease staging system for HIV infection and disease,[11] and the CDC classification system for HIV infection.[75] The CDC‘s classification system is more frequently adopted in developed countries. Since the WHO‘s staging system does not require laboratory tests, it is suited to the resource-restricted conditions encountered in developing countries, where it can also be used to help guide clinical management. Despite their differences, the two systems allow comparison for statistical purposes.[9][11][75]

The World Health Organization first proposed a definition for AIDS in 1986.[11] Since then, the WHO classification has been updated and expanded several times, with the most recent version being published in 2007.[11] The WHO system uses the following categories:

The United States Center for Disease Control and Prevention also created a classification system for HIV, and updated it in 2008.[75] This system classifies HIV infections based on CD4 count and clinical symptoms,[75] and describes the infection in three stages:

  • Stage 1: CD4 count ≥ 500 cells/µl and no AIDS defining conditions
  • Stage 2: CD4 count 200 to 500 cells/µl and no AIDS defining conditions
  • Stage 3: CD4 count ≤ 200 cells/µl or AIDS defining conditions
  • Unknown: if insufficient information is available to make any of the above classifications

For surveillance purposes, the AIDS diagnosis still stands even if, after treatment, the CD4+ T cell count rises to above 200 per µL of blood or other AIDS-defining illnesses are cured.[9]


A run down a two-story building with a number of signs related to AIDS prevention

AIDS Clinic, McLeod Ganj, Himachal Pradesh, India, 2010

Sexual contact

Consistent condom use reduces the risk of HIV transmission by approximately 80% over the long term.[76] When condoms are used consistently by a couple in which one person is infected, the rate of HIV infection is less than 1% per year.[77] There is some evidence to suggest that female condoms may provide an equivalent level of protection.[78] Application of a vaginal gel containing tenofovir (a reverse transcriptase inhibitor) immediately before sex seems to reduce infection rates by approximately 40% among African women.[79] By contrast, use of the spermicide nonoxynol-9 may increase the risk of transmission due to its tendency to cause vaginal and rectal irritation.[80] Circumcision in Sub-Saharan Africa “reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months”.[81] Based on these studies, the World Health Organization and UNAIDS both recommended male circumcision as a method of preventing female-to-male HIV transmission in 2007.[82] Whether it protects against male-to-female transmission is disputed[83][84] and whether it is of benefit in developed countries and among men who have sex with men is undetermined.[85][86][87] Some experts fear that a lower perception of vulnerability among circumcised men may cause more sexual risk-taking behavior, thus negating its preventive effects.[88]

Programs encouraging sexual abstinence do not appear to affect subsequent HIV risk.[89] Evidence for a benefit from peer education is equally poor.[90] Comprehensive sexual education provided at school may decrease high risk behavior.[91] A substantial minority of young people continues to engage in high-risk practices despite knowing about HIV/AIDS, underestimating their own risk of becoming infected with HIV.[92] It is not known whether treating other sexually transmitted infections is effective in preventing HIV.[40]


Treating people with HIV whose CD4 count ≥ 350cells/µL with antiretrovirals protects 96% of their partners from infection.[93] This is about a 10 to 20 fold reduction in transmission risk.[94] Pre-exposure prophylaxis with a daily dose of the medications tenofovir, with or without emtricitabine, is effective in a number of groups including men who have sex with men, couples where one is HIV positive, and young heterosexuals in Africa.[79]

Universal precautions within the health care environment are believed to be effective in decreasing the risk of HIV.[95] Intravenous drug use is an important risk factor and harm reduction strategies such as needle-exchange programmes and opioid substitution therapy appear effective in decreasing this risk.[96][97]


A course of antiretrovirals administered within 48 to 72 hours after exposure to HIV positive blood or genital secretions is referred to as post-exposure prophylaxis.[98] The use of the single agent zidovudine reduces the risk of subsequent HIV infection fivefold following a needle stick injury.[98] Treatment is recommended after sexual assault when the perpetrator is known to be HIV positive but is controversial when their HIV status is unknown.[99] Current treatment regimes typically use lopinavir/ritonavir and lamivudine/zidovudine or emtricitabine/tenofovir and may decrease the risk further.[98] The duration of treatment is usually four weeks[100] and is frequently associated with adverse effects (with zidovudine in about 70% of cases, including nausea in 24%, fatigue in 22%, emotional distress in 13%, and headaches in 9%).[27]


Programs to prevent the vertical transmission of HIV (from mothers to children) can reduce rates of transmission by 92–99%.[51][96] This primarily involves the use of a combination of antiviral medications during pregnancy and after birth in the infant and potentially includes bottle feeding rather than breastfeeding.[51][101] If replacement feeding is acceptable, feasible, affordable, sustainable, and safe, mothers should avoid breastfeeding their infants; however exclusive breastfeeding is recommended during the first months of life if this is not the case.[102] If exclusive breastfeeding is carried out, the provision of extended antiretroviral prophylaxis to the infant decreases the risk of transmission.[103]


As of 2012 there is no effective vaccine for HIV or AIDS.[104] A single trial of the vaccine RV 144 published in 2009 found a partial reduction in the risk of transmission of roughly 30%, stimulating some hope in the research community of developing a truly effective vaccine.[105] Further trials of the RV 144 vaccine are ongoing.[106][107]


There is currently no cure or effective HIV vaccine. Treatment consists of high active antiretroviral therapy (HAART) which slows progression of the disease[108] and as of 2010 more than 6.6 million people were taking them in low and middle income countries.[7] Treatment also includes preventive and active treatment of opportunistic infections.

Antiviral therapy

Two yellow oblong pills on one of which the markings GX623 are visible

Abacavir – a nucleoside analog reverse transcriptase inhibitor (NARTI or NRTI)

Current HAART options are combinations (or “cocktails”) consisting of at least three medications belonging to at least two types, or “classes,” of antiretroviral agents.[109] Initially treatment is typically a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus two nucleoside analogue reverse transcriptase inhibitors (NRTIs).[109] Typical NRTIs include: zidovudine (AZT) or tenofovir (TDF) and lamivudine (3TC) or emtricitabine (FTC).[109] Combinations of agents which include a protease inhibitors (PI) are used if the above regime loses effectiveness.[109]

When to start antiretroviral therapy is subject to debate.[14][110] The World Health Organization, European guidelines and the United States recommends antiretrovirals in all adolescents, adults and pregnant women with a CD4 count less than 350/uL or those with symptoms regardless of CD4 count.[14][109] This is supported by the fact that beginning treatment at this level reduces the risk of death.[111] The United States in addition recommends them for all HIV-infected people regardless of CD4 count or symptoms; however it makes this recommendation with less confidence for those with higher counts.[112] While the WHO also recommends treatment in those who are co-infected with tuberculosis and those with chronic active hepatitis B.[109] Once treatment is begun it is recommended that it is continued without breaks or “holidays”.[14] Many people are diagnosed only after treatment ideally should have begun.[14] The desired outcome of treatment is a long term plasma HIV-RNA count below 50 copies/mL.[14] Levels to determine if treatment is effective are initially recommended after four weeks and once levels fall below 50 copies/mL checks every three to six months are typically adequate.[14] Inadequate control is deemed to be greater than 400 copies/mL.[14] Based on these criteria treatment is effective in more than 95% of people during the first year.[14]

Benefits of treatment include a decreased risk of progression to AIDS and a decreased risk of death.[113] In the developing world treatment also improves physical and mental health.[114] With treatment there is a 70% reduced risk of acquiring tuberculosis.[109] Additional benefits include a decreased risk of transmission of the disease to sexual partners and a decrease in mother-to-child transmission.[109] The effectiveness of treatment depends to a large part on compliance.[14] Reasons for non-adherence include poor access to medical care,[115] inadequate social supports, mental illness and drug abuse.[116] The complexity of treatment regimens (due to pill numbers and dosing frequency) and adverse effects may reduce adherence.[117] Even though cost is an important issue with some medications,[118] 47% of those who needed them were taking them in low and middle income countries as of 2010[7] and the rate of adherence is similar in low-income and high-income countries.[119]

Specific adverse events are related to the agent taken.[120] Some relatively common ones include: lipodystrophy syndrome, dyslipidemia, and diabetes mellitus especially with protease inhibitors.[9] Other common symptoms include diarrhea,[120][121] and an increased risk of cardiovascular disease.[122] Newer recommended treatments are associated with fewer adverse effects.[14] Certain medications may be associated with birth defects and therefore may be unsuitable for women hoping to have children.[14]

Treatment recommendations for children are slightly different from those for adults. In the developing world, as of 2010, 23% of children who were in need of treatment had access.[123] Both the World Health Organization and the United States recommend treatment for all children less than twelve months of age.[124][125] The United States recommends in those between one year and five years of age treatment in those with HIV RNA counts of greater than 100,000 copies/mL, and in those more than five years treatments when CD4 counts are less than 500/ul.[124]

Opportunistic infections

Measures to prevent opportunistic infections are effective in many people with HIV/AIDS. In addition to improving current disease, treatment with antiretrovirals reduces the risk of developing additional opportunistic infections.[120] Vaccination against hepatitis A and B is advised for all people at risk of HIV before they become infected; however it may also be given after infection.[126] Trimethoprim/sulfamethoxazole prophylaxis between four and six weeks of age and ceasing breastfeeding in infants born to HIV positive mothers is recommended in resource limited settings.[123] It is also recommended to prevent PCP when a person’s CD4 count is below 200 cells/uL and in those who have or have previously had PCP.[127] People with substantial immunosuppression are also advised to receive prophylactic therapy for toxoplasmosis and Cryptococcus meningitis.[128] Appropriate preventive measures have reduced the rate of these infections by 50% between 1992 and 1997.[129]

Alternative medicine

In the US, approximately 60% of people with HIV use various forms of complementary or alternative medicine,[130] even though the effectiveness of most of these therapies has not been established.[131] With respect to dietary advice and AIDS some evidence has shown a benefit from micronutrient supplements.[132] Evidence for supplementation with selenium is mixed with some tentative evidence of benefit.[133] There is some evidence that vitamin A supplementation in children reduces mortality and improves growth.[132] In Africa in nutritionally compromised pregnant and lactating women a multivitamin supplementation has improved outcomes for both mothers and children.[132] Dietary intake of micronutrients at RDA levels by HIV-infected adults is recommended by the World Health Organization.[134][135] The WHO further states that several studies indicate that supplementation of vitamin A, zinc, and iron can produce adverse effects in HIV positive adults.[135] There is not enough evidence to support the use of herbal medicines.[136]


Disability-adjusted life yearfor HIV and AIDS per 100,000 inhabitants as of 2004.

  no data
  ≤ 10
  ≥ 50000

HIV/AIDS has become a chronic rather than an acutely fatal disease in many areas of the world.[137] Prognosis varies between people, and both the CD4 count and viral load are useful for predicted outcomes.[13] Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype.[138] After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months.[139][140] HAART and appropriate prevention of opportunistic infections reduces the death rate by 80%, and raises the life expectancy for a newly diagnosed young adult to 20–50 years.[137][141][142] This is between two thirds[141] and nearly that of the general population.[14][143] If treatment is started late in the infection, prognosis is not as good:[14] for example, if treatment is begun following the diagnosis of AIDS, life expectancy is ~10–40 years.[14][137] Half of infants born with HIV die before two years of age without treatment.[123]

The primary causes of death from HIV/AIDS are opportunistic infections and cancer, both of which are frequently the result of the progressive failure of the immune system.[129][144] Risk of cancer appears to increase once the CD4 count is below 500/μL.[14] The rate of clinical disease progression varies widely between individuals and has been shown to be affected by a number of factors such as a person’s susceptibility and immune function;[145] their access to health care, the presence of co-infections;[139][146] and the particular strain (or strains) of the virus involved.[147][148]

Tuberculosis co-infection is one of the leading causes of sickness and death in those with HIV/AIDS being present in a third of all HIV infected people and causing 25% of HIV related deaths.[149] HIV is also one of the most important risk factors for tuberculosis.[150] Hepatitis C is another very common co-infection where each disease increases the progression of the other.[151] The two most common cancers associated with HIV/AIDS are Kaposi’s sarcoma and AIDS-related non-Hodgkin’s lymphoma.[144]

Even with anti-retroviral treatment, over the long term HIV-infected people may experience neurocognitive disorders,[152] osteoporosis,[153] neuropathy,[154] cancers,[155][156] nephropathy,[157] and cardiovascular disease.[121] It is not clear whether these conditions result from the HIV infection itself or are adverse effects of treatment.


 A map of the world where most of the land is colored green or yellow except for sub Saharan Africa which is colored red

Estimated prevalence of HIV among young adults (15–49) per country as of 2011.[158]

HIV/AIDS is a global pandemic.[159] As of 2010, approximately 34 million people have HIV worldwide.[7] Of these approximately 16.8 million are women and 3.4 million are less than 15 years old.[7] It resulted in about 1.8 million deaths in 2010, down from a peak of 2.2 million in 2005.[7]

Sub-Saharan Africa is the region most affected. In 2010, an estimated 68% (22.9 million) of all HIV cases and 66% of all deaths (1.2 million) occurred in this region.[160] This means that about 5% of the adult population is infected[161] and it is believed to be the cause of 10% of all deaths in children.[162] Here in contrast to other regions women compose nearly 60% of cases.[160] South Africa has the largest population of people with HIV of any country in the world at 5.9 million.[160] Life expectancy has fallen in the worst-affected countries due to HIV/AIDS; for example, in 2006 it was estimated that it had dropped from 65 to 35 years in Botswana.[8]

South & South East Asia is the second most affected; in 2010 this region contained an estimated 4 million cases or 12% of all people living with HIV resulting in approximately 250,000 deaths.[161] Approximately 2.4 million of these cases are in India.[160]

In 2008 in the United States approximately 1.2 million people were living with HIV, resulting in about 17,500 deaths. The Centre for Disease Control and Prevention estimated that in 2008 20% of infected Americans were unaware of their infection.[163] In the United Kingdom as of 2009 there where approximately 86,500 cases which resulted in 516 deaths.[164] In Canada as of 2008 there were about 65,000 cases causing 53 deaths.[165] Between the first recognition of AIDS in 1981 and 2009 it has led to nearly 30 million deaths.[6] Prevalence is lowest in Middle East and North Africa at 0.1% or less, East Asia at 0.1% and Western and Central Europe at 0.2%.[161]


Main article: History of HIV/AIDS


The Morbidity and Mortality Weekly Report reported in 1981 on what was later to be called “AIDS”.

AIDS was first clinically observed in 1981 in the United States.[22] The initial cases were a cluster of injecting drug users and homosexual men with no known cause of impaired immunity who showed symptoms of Pneumocystis carinii pneumonia (PCP), a rare opportunistic infection that was known to occur in people with very compromised immune systems.[166] Soon thereafter, an unexpected number of gay men developed a previously rare skin cancer called Kaposi’s sarcoma (KS).[167][168] Many more cases of PCP and KS emerged, alerting U.S. Centers for Disease Control and Prevention (CDC) and a CDC task force was formed to monitor the outbreak.[169]

Robert Gallo, co-discoverer of HIV in the early eighties among (from left to right) Sandra Eva, Sandra Colombini, and Ersell Richardson.

In the early days, the CDC did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy, the disease after which the discoverers of HIV originally named the virus.[170][171] They also used Kaposi’s Sarcoma and Opportunistic Infections, the name by which a task force had been set up in 1981.[172] At one point, the CDC coined the phrase “the 4H disease”, since the syndrome seemed to affect Haitians, homosexuals, hemophiliacs, and heroin users.[173] In the general press, the term “GRID”, which stood for gay-related immune deficiency, had been coined.[174] However, after determining that AIDS was not isolated to the gay community,[172] it was realized that the term GRID was misleading and the term AIDS was introduced at a meeting in July 1982.[175] By September 1982 the CDC started referring to the disease as AIDS.[176]

In 1983, two separate research groups led by Robert Gallo and Luc Montagnier independently declared that a novel retrovirus may have been infecting AIDS patients, and published their findings in the same issue of the journal Science.[177][178] Gallo claimed that a virus his group had isolated from an AIDS patient was strikingly similar in shape to other human T-lymphotropic viruses (HTLVs) his group had been the first to isolate. Gallo’s group called their newly isolated virus HTLV-III. At the same time, Montagnier’s group isolated a virus from a patient presenting with swelling of the lymph nodes of the neck and physical weakness, two characteristic symptoms of AIDS. Contradicting the report from Gallo’s group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier’s group named their isolated virus lymphadenopathy-associated virus (LAV).[169] As these two viruses turned out to be the same, in 1986, LAV and HTLV-III were renamed HIV.[179]


Both HIV-1 and HIV-2 are believed to have originated in non-human primates in West-central Africa and were transferred to humans in the early 20th century.[4] HIV-1 appears to have originated in southern Cameroon through the evolution of SIV(cpz), a simian immunodeficiency virus (SIV) that infects wild chimpanzees (HIV-1 descends from the SIVcpz endemic in the chimpanzee subspecies Pan troglodytes troglodytes).[180][181] The closest relative of HIV-2 is SIV(smm), a virus of the sooty mangabey (Cercocebus atys atys), an Old World monkey living in coastal West Africa (from southern Senegal to western Côte d’Ivoire).[62] New World monkeys such as the owl monkey are resistant to HIV-1 infection, possibly because of a genomic fusion of two viral resistance genes.[182] HIV-1 is thought to have jumped the species barrier on at least three separate occasions, giving rise to the three groups of the virus, M, N, and O.[183]

There is evidence that humans who participate in bushmeat activities, either as hunters or as bushmeat vendors, commonly acquire SIV.[184] However, SIV is a weak virus which is typically suppressed by the human immune system within weeks of infection. It is thought that several transmissions of the virus from individual to individual in quick succession are necessary to allow it enough time to mutate into HIV.[185] Furthermore, due to its relatively low person-to-person transmission rate, SIV can only spread throughout the population in the presence of one or more high-risk transmission channels, which are thought to have been absent in Africa before the 20th century.

Specific proposed high-risk transmission channels, allowing the virus to adapt to humans and spread throughout the society, depend on the proposed timing of the animal-to-human crossing. Genetic studies of the virus suggest that the most recent common ancestor of the HIV-1 M group dates back to circa 1910.[186] Proponents of this dating link the HIV epidemic with the emergence of colonialism and growth of large colonial African cities, leading to social changes, including a higher degree of sexual promiscuity, the spread of prostitution, and the accompanying high frequency of genital ulcer diseases (such as syphilis) in nascent colonial cities.[187] While transmission rates of HIV during vaginal intercourse are low under regular circumstances, they are increased many fold if one of the partners suffers from a sexually transmitted infection causing genital ulcers. Early 1900s colonial cities were notable due to their high prevalence of prostitution and genital ulcers, to the degree that, as of 1928, as many as 45% of female residents of eastern Kinshasa were thought to have been prostitutes, and, as of 1933, around 15% of all residents of the same city had syphilis.[187]

An alternative view holds that unsafe medical practices in Africa after World War II, such as unsterile reuse of single use syringes during mass vaccination, antibiotic and anti-malaria treatment campaigns, were the initial vector that allowed the virus to adapt to humans and spread.[185][188][189]

The earliest well documented case of HIV in a human dates back to 1959 in the Congo.[190] The virus may have been present in the United States as early as 1966,[191] but the vast majority of infections occurring outside sub-Saharan Africa (including the U.S.) can be traced back to a single unknown individual who became infected with HIV in Haiti and then brought the infection to the United States some time around 1969.[192] The epidemic then rapidly spread among high-risk groups (initially, sexually promiscuous men who have sex with men). By 1978, the prevalence of HIV-1 among gay male residents of New York and San Francisco was estimated at 5%, suggesting that several thousand individuals in the country had been infected.[192]

Society and culture


A teenage male with the hand of another resting on his left shoulder smiling for the camera

Ryan White became a poster child for HIV after being expelled from school because he was infected.

AIDS stigma exists around the world in a variety of ways, including ostracism, rejection, discrimination and avoidance of HIV infected people; compulsory HIV testing without prior consent or protection of confidentiality; violence against HIV infected individuals or people who are perceived to be infected with HIV; and the quarantine of HIV infected individuals.[193] Stigma-related violence or the fear of violence prevents many people from seeking HIV testing, returning for their results, or securing treatment, possibly turning what could be a manageable chronic illness into a death sentence and perpetuating the spread of HIV.[194]

AIDS stigma has been further divided into the following three categories:

  • Instrumental AIDS stigma—a reflection of the fear and apprehension that are likely to be associated with any deadly and transmissible illness.[195]
  • Symbolic AIDS stigma—the use of HIV/AIDS to express attitudes toward the social groups or lifestyles perceived to be associated with the disease.[195]
  • Courtesy AIDS stigma—stigmatization of people connected to the issue of HIV/AIDS or HIV-positive people.[196]

Often, AIDS stigma is expressed in conjunction with one or more other stigmas, particularly those associated with homosexuality, bisexuality, promiscuity, prostitution, and intravenous drug use.[197]

In many developed countries, there is an association between AIDS and homosexuality or bisexuality, and this association is correlated with higher levels of sexual prejudice such as anti-homosexual/bisexual attitudes.[198] There is also a perceived association between AIDS and all male-male sexual behavior, including sex between uninfected men.[195] However, the dominant mode of spread worldwide for HIV remains heterosexual transmission.[199]

Economic impact

A graph showing an number of increasing lines followed by a sharp fall of the lines starting in mid-1980s to 1990s

Changes in life expectancy in some hard-hit African countries.                      Botswana                     Zimbabwe                     Kenya                     South Africa                     Uganda

HIV/AIDS affects the economics of both individuals and countries.[162] The gross domestic product of the most affected countries has decreased due to the lack of human capital.[162][200] Without proper nutrition, health care and medicine, large numbers of people die from AIDS-related complications. They will not only be unable to work, but will also require significant medical care. It is estimated that as of 2007 there were 12 million AIDS orphans.[162] Many are cared for by elderly grandparents.[201]

By affecting mainly young adults, AIDS reduces the taxable population, in turn reducing the resources available for public expenditures such as education and health services not related to AIDS resulting in increasing pressure for the state’s finances and slower growth of the economy. This causes a slower growth of the tax base, an effect that is reinforced if there are growing expenditures on treating the sick, training (to replace sick workers), sick pay and caring for AIDS orphans. This is especially true if the sharp increase in adult mortality shifts the responsibility and blame from the family to the government in caring for these orphans.[201]

At the household level, AIDS causes both loss of income and increased spending on healthcare. A study in Côte d’Ivoire showed that households with an HIV/AIDS patient, spent twice as much on medical expenses as other households. This additional expenditure also leaves less income to spend on education and other personal or family investment.[202]

Religion and AIDS

Main article: Religion and HIV/AIDS

The topic of religion and AIDS has become highly controversial in the past twenty years, primarily because some religious authorities have publicly declared their opposition to the use of condoms.[203][204] The religious approach to prevent the spread of AIDS according to a report by American health expert Matthew Hanley titled The Catholic Church and the Global Aids Crisis argues that cultural changes are needed including a re-emphasis on fidelity within marriage and sexual abstinence outside of it.[204]

Some religious organisations have claimed that prayer can cure HIV/AIDS. In 2011, the BBC reported that some churches in London were claiming that prayer would cure AIDS, and the Hackney-based Centre for the Study of Sexual Health and HIV reported that several people stopped taking their medication, sometimes on the direct advice of their pastor, leading to a number of deaths.[205] The Synagogue Church Of All Nations advertise an “anointing water” to promote God’s healing, although the group deny advising people to stop taking medication.[205]

Media portrayal

One of the first high-profile cases of AIDS was the American Rock Hudson, a gay actor who had been married and divorced earlier in life, who died on 2 October 1985 having announced that he was suffering from the virus on 25 July that year. He had been diagnosed during 1984.[206] A notable British casualty of AIDS that year was Nicholas Eden, a gay politician and son of the late prime minister Anthony Eden.[207] On November 24, 1991, the virus claimed the life of British rock star Freddie Mercury, lead singer of the band Queen, who died from an AIDS related illness having only revealed the diagnosis on the previous day.[208] However he had been diagnosed as HIV positive during 1987.[209] One of the first high-profile heterosexual cases of the virus was Arthur Ashe, the American tennis player. He was diagnosed as HIV positive on 31 August 1988, having contracted the virus from blood transfusions during heart surgery earlier in the 1980s. Further tests within 24 hours of the initial diagnosis revealed that Ashe had AIDS, but he did not tell the public about his diagnosis until April 1992.[210] He died, aged 49, as a result on 6 February 1993.[211]

Therese Frare’s photograph of gay activist David Kirby, as he lay dying from AIDS while surrounded by family, was taken in April 1990. LIFE magazine said the photo became the one image “most powerfully identified with the HIV/AIDS epidemic.” The photo was displayed in LIFE magazine, was the winner of the World Press Photo, and acquired worldwide notoriety after being used in a United Colors of Benetton advertising campaign in 1992.[212] In 1996, Johnson Aziga a Ugandan-born immigrant Canadian was diagnosed as a HIV-positive, but then he had unprotected sex with 11 women without telling them he has HIV. Since 2003, seven of them were infected with HIV, and two of them died of complications of AIDS.[213][214] At last Aziga was convicted of first-degree murder and be liable to a life sentence.[215]

Denial, conspiracies, and misconceptions

A small group of individuals continue to dispute the connection between HIV and AIDS,[216] the existence of HIV itself, or the validity of HIV testing and treatment methods.[217][218] These claims, known as AIDS denialism, have been examined and rejected by the scientific community.[219] However, they have had a significant political impact, particularly in South Africa, where the government’s official embrace of AIDS denialism (1999–2005) was responsible for its ineffective response to that country’s AIDS epidemic, and has been blamed for hundreds of thousands of avoidable deaths and HIV infections.[220][221][222] Operation INFEKTION was a worldwide Soviet active measures operation to spread information that the United States had created HIV/AIDS. Surveys show that a significant number of people believed – and continue to believe – in such claims.[223]

There are many misconceptions about HIV and AIDS. Three of the most common are that AIDS can spread through casual contact, that sexual intercourse with a virgin will cure AIDS, and that HIV can infect only homosexual men and drug users. Other misconceptions are that any act of anal intercourse between two uninfected gay men can lead to HIV infection, and that open discussion of homosexuality and HIV in schools will lead to increased rates of homosexuality and AIDS.[224][225]


Main article: HIV/AIDS research

HIV/AIDS research includes all medical research which attempts to prevent, treat, or cure HIV/AIDS along with fundamental research about the nature of HIV as an infectious agent and AIDS as the disease caused by HIV.

HIV/AIDS research includes following the usual advice given by doctors in responding to HIV. The most universally recommended method for the prevention of HIV/AIDS is to avoid blood-to-blood contact between people and to otherwise practice safe sex. The most recommended method for treating HIV is for HIV-positive people to receive attention from a doctor who would coordinate the patient’s management of HIV/AIDS. There is no cure for HIV/AIDS.

Many governments and research institutions participate in HIV/AIDS research. This research includes behavioral health interventions such as sex education, and drug development, such as research into microbicides for sexually transmitted diseases, HIV vaccines, and antiretroviral drugs. Other medical research areas include the topics of pre-exposure prophylaxis, post-exposure prophylaxis, and Circumcision and HIV.


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Male circumcision key in preventing HIV/AIDS – Health Consultant

Tuesday, February 12th, 2013


Dr. Gloria Asare, a Public Health Consultant, has said male circumcision was one key area of HIV and AIDS prevention and appealed to families to circumcise their male children. She said circumcision could also help in the prevention of other sexually transmitted diseases and other infections.

Dr. Asare said this at the Western Regional dissemination forum for the National HIV and AIDS and Sexual Transmitted Infections Policy at Takoradi.

She said the foreskin of the penis could serve as a receptive tank for all manner of germs, bacteria and other harmful viruses and that it could also serve as breeding grounds for the HIV and AIDS virus and other sexually transmitted diseases.

Using Facebook to prevent HIV among at-risk groups

Tuesday, February 12th, 2013

Stanford university

New research suggests that social networking sites, such as Facebook, could be effective tools in increasing awareness about HIV and potentially reducing infection rates among at-risk groups.

For the study, UCLA researchers created Facebook groups on topics such as HIV general knowledge, stigma and prevention, and they offered the opportunity for users to request at-home HIV-testing kits. Next, they recruited 112 African-American and Latino men who have sex with men through community organizations, bars, gyms and schools, and through online ads on Craigslist, Facebook and MySpace. The study involved a 12-week intervention and one-year follow-up, and, as described in a Science Daily story:

Participants were randomly assigned on Facebook to either a general health group or a secret HIV-prevention group — one that could not be accessed or searched for by non-group members.

The researchers found that participants in the HIV-prevention group freely discussed HIV-related topics such as prevention, testing, knowledge, stigma and advocacy. Those over the age of 31 were more likely to discuss prevention, testing, stigma and advocacy topics, while younger members were more interested in HIV knowledge–related discussions.

In addition, participants who posted about prevention and testing had over 11 times the odds of requesting an HIV testing kit than participants who did not discuss those topics.

The work appears in the current issue of the journal Sexually Transmitted Diseases.

HIV drugs only available to sickest patients in Myanmar

Sunday, October 21st, 2012

Thein Aung has been trained not to show weakness, but he’s convinced no soldier is strong enough for this.

He clenches his jaw and pauses, trying to will his chin to stop quivering and his eyes not to blink. But he’s like a mountain that is crumbling. His shoulders shake, then collapse inward, and he suddenly seems small in the denim Wrangler shirt that’s rolled up to his elbows and hanging loosely off his skinny arms. Big tears drip from his reddened eyes, and he looks away, ashamed.

As he sits outside a crowded clinic on the outskirts of Myanmar’s biggest city, he knows his body is struggling to fight HIV, tuberculosis and diabetes – but he can’t help wishing he was sicker.

Although Aung is ill enough to qualify for HIV treatment in other poor countries, there’s simply not enough pills to go around in Myanmar. Only the sickest of the sick are lucky enough to go home with a supply of lifesaving medicine here. The others soon learn their fate is ultimately decided by the number of infection-fighting cells found inside the blood samples they give every three months.

The World Health Organization recommends treatment start when this all-important CD4 count drops to 350.

In Myanmar, it must fall below 150.


Antiretroviral therapy, in the past considered a miracle only available to HIV patients in the West, is no longer scarce in many of the poorest parts of the world. Pills are cheaper and easier to access, and HIV is not the same killer that once left thousands of orphaned children in sub-Saharan Africa.

But Myanmar, otherwise known as Burma, remains a special case. Kept in the dark for so many decades by its reclusive ruling junta, this country of 60 million did not reap the same international aid as other needy nations. Heavy economic sanctions levied by countries such as the United States, along with virtually nonexistent government health funding, left an empty hole for medicine and services. Today, Myanmar ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.

“Burma is like the work that I did in Africa in the’90s. It’s 15, 20 years out of date,” says Dr. Chris Beyrer, an HIV expert at Johns Hopkins University who has worked in Myanmar for years. “If you actually tried to treat AIDS, you’d have to say that everybody with every other condition is going to die unless there are more resources.”

Of the estimated 240,000 people living with HIV, half are going without treatment. And some 18,000 people die from the disease every year, according to UNAIDS.

The problem worsened last year after the Global Fund to Fight AIDS, Tuberculosis and Malaria canceled a round of funding due to a lack of international donations. The money was expected to provide HIV drugs for 46,500 people.

But as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions. The Global Fund recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015. It would also fight tuberculosis, a major killer of HIV patients. TB in Myanmar is at nearly triple the global rate as multi-drug resistant forms of the disease surge.

The aid group Doctors Without Borders has tried to take up the slack by providing more than half the HIV drugs being distributed. But every day, physicians at its 23 clinics must make agonizing decisions to turn away patients like Aung, who are desperately ill but still do not qualify for medicine because their CD4 counts are too high.

“It’s very difficult to see those kind of situations,” says Kyaw Naing Htun, a young doctor with a K-pop hairstyle and seemingly endless energy, who manages the organization’s busy clinic in Insein. He says about 100 patients who should be on drugs are turned away every month in Yangon alone. “It takes a lot more resources when they come back sicker. It’s a lose-lose game.”


Aung first learned about the virus living inside him in April. He had dropped weight and wasn’t sleeping well, but figured it was the TB and diabetes running him down.

When the test came back positive for HIV, he was shocked and scared: How? Why?

“I wanted to commit suicide when I found out the results,” he says softly, looking away. “What upset me most was my wife. She says I shouldn’t die now because we have children.”

The questions swarmed and consumed him, followed by a flood of worry and guilt that he had possibly infected his spouse. Then the bigger concern: What’s next?

Unlike many living in a country closed off to the world for the past half century of military rule, Aung, an Army staff sergeant, had some firsthand knowledge about HIV.

He had watched the disease rot one soldier from the inside out, punishing him with a cruel death. But he also saw another get on treatment and live a normal life, despite the military kicking him out.

With the images of those two men locked in his head, Aung decided to fight to save himself and ultimately his family. No one but his wife could know, or he would lose his job and their home on the military base because of the deep fear and discrimination surrounding the disease. Drugs were his only chance to keep the secret.

“If I get the medicine, and I can stay in this life longer, I will serve the country more and my family will not be broken,” he says. “My family is invaluable.”

At the clinic in Insein, an area of Yangon better known for a notorious prison, Aung, who is using another name to protect his identity, waited nervously for the results of his first blood test.

CD4 count: 460. Low enough for drugs in the U.S., but well above the 150 cutoff in Myanmar. He was given TB meds and told to come back in three months.


Many of the 200 people crammed into the two small buildings of an HIV center just outside Yangon are simply waiting to die.

Beloved opposition leader Aung San Suu Kyi visited patients there in November 2010, just days after being freed from house arrest, appealing to the world for more medicine. She also spoke passionately in July about the stigma of HIV via a video link to the International AIDS conference in Washington, saying, “Our people need to understand what HIV really is. We need to understand this is not something that we need to be afraid of.”

There are no doctors or nurses stationed at the hospice supported by Suu Kyi’s National League for Democracy party, forcing patients to care for each other. One man hangs a drip bag on a plastic string from the ceiling over an emaciated body. Other caregivers – many of whom are also infected – wave paper fans beside their loved ones for hours, providing the only relief they can offer.

Infected children whose parents have already passed away play barefoot in the stuffy, crowded rooms. Bodies, some nothing more than breathing corpses, are stacked side by side on bamboo slats above dirt floors.

Another room is packed with 20 women stretched out on straw mats crisscrossing the wooden floor. A young mother sobs in one corner as she breast-feeds a 7-day-old baby girl. She did not take HIV drugs until late in her pregnancy, and now must wait up to 18 months to know for sure whether her only child is infected.

“The funding is limited for the enormous number of patients,” says newly elected parliament member Phyu Phyu Thin, who founded the center in 2002 and was jailed by the former government for her HIV work. “Waiting to get the medicine under the limits is too risky for many patients because they can only get it when their health is deteriorating.”


Aung looks the part of a soldier with his shaved head and wiry build. He spent the first decade of his 27 years in the military fighting in domestic ethnic wars, away from his wife and two children.

It’s this past life that devours him each night when sleep refuses to come. He served as a medic then, and regularly came into contact with the blood of wounded soldiers. He also had sex with other women. The question that haunts him most is, which one is to blame? He’ll never know.

He takes sleeping pills every night to be released from these thoughts. But relief does not come, as chills and night sweats drench his body and the constant urge to urinate keeps him running to the toilet.

He’s lost 10 pounds in the past month, dropping from 130 pounds to 120. His cheeks are starting to sink, and his eyes look hollow. His strength is also fading, and he can no longer lead grueling daily runs with the trainees. He uses his TB as an excuse, but he fears his superiors will not be fooled much longer.

“I try to hide it as much as I can, but some people have started rumors about me, so I try not to face them directly,” he says. “I want to be strong like the other people. I’m trying, but now my body cannot follow my mind.”

His wife refuses to be tested until Aung gets on the drugs. She worries if she comes back positive, her guilt-ravaged husband will kill himself.

“She doesn’t want me to be depressed,” he says. “If she is positive, I will be very, very depressed.”

The disease has forced him to rethink who he is. He’s killed people in combat, cheated on his wife and witnessed many horrors in his lifetime. But he wants a chance to make up for his wrongs.

As a Buddhist, he believes his disease is a punishment for misdeeds in a previous life. He vows to be a better man by helping others and giving what little he has to charity.

He says sicker patients deserve treatment first. Still, as he sits waiting for his second blood test, he can’t help wishing his immune system was weak enough to help him reach the magic number.

But when the doctor reads his results, he knows he will leave empty-handed again.

CD4 count: 289. Still too high.

His only choice is to try again in three months, hoping he’ll be sick enough then.

Swiss acupuncturist charged in 16 intentional HIV infections

Monday, September 3rd, 2012


A self-styled healer has been indicted by a Swiss court on charges that he intentionally infected 16 people with HIV, the virus that causes AIDS, in cases going back more than a decade, authorities said Thursday.

The unidentified man was indicted by a five-judge panel in Bern-Mitelland regional court on charges of intentionally spreading human disease and causing serious bodily harm, offences that carry maximum penalties of five to 10 years respectively, said the regional prosecutor’s office in Bern, the Swiss capital.

The office said in a statement that most of the victims attended a music school that the man operated.

A spokesman for the prosecutor, Christof Scheurer, said the man also practiced as an unlicensed, self-styled acupuncturist — a trade which he is believed to have used between 2001 and 2005 as a pretext to prick and infect some of his victims with blood that was infected with AIDS.

HIV is transmitted through bodily fluids such as blood, semen or breast milk.

The police investigation concluded that the man had used various pretexts to prick his victims, but it remained unclear exactly what objects he had used. In other cases, the investigation found, the self-described healer — who is not HIV-positive — had served his victims drinks that made them pass out so he could infect them.

“The defendant denies everything that is alleged,” the prosecutor’s statement added.

The cases apparently came to light when Bern hospital Inselspital began to investigate similar complaints of infections in connection with a so-called healer.

Prosecutors say the probe, which was launched after one alleged victim filed a criminal complaint in early 2005, has finally been completed, but that it took years because of a number of difficulties ranging from the use of genetic testing to identifying victims while adhering to protections for patient privacy.

Proceedings against a second suspect in the case have been permanently closed, the statement said, because his involvement could not be confirmed.

New immune-system disease found in Asians, causes AIDS-like symptoms

Sunday, August 26th, 2012

Vancouver Sun

Researchers have identified a mysterious new disease that has left scores of people in Asia and some in the United States with AIDS-like symptoms even though they are not infected with HIV.

The patients’ immune systems become damaged, leaving them unable to fend off germs as healthy people do. What triggers this isn’t known, but the disease does not seem to be contagious.

This is another kind of acquired immune deficiency that is not inherited and occurs in adults, but doesn’t spread the way AIDS does through a virus, said Dr. Sarah Browne, a scientist at the National Institute of Allergy and Infectious Diseases.

She helped lead the study with researchers in Thailand and Taiwan where most of the cases have been found since 2004. Their report is in Thursday’s New England Journal of Medicine.

“This is absolutely fascinating. I’ve seen probably at least three patients in the last 10 years or so” who might have had this, said Dr. Dennis Maki, an infectious disease specialist at the University of Wisconsin in Madison.

It’s still possible that an infection of some sort could trigger the disease, even though the disease itself doesn’t seem to spread person-to-person, he said.

The disease develops around age 50 on average but does not run in families, which makes it unlikely that a single gene is responsible, Browne said. Some patients have died of overwhelming infections, including some Asians now living in the U.S., although Browne could not estimate how many.

Kim Nguyen, 62, a seamstress from Vietnam who has lived in Tennessee since 1975, was gravely ill when she sought help for a persistent fever, infections throughout her bones and other bizarre symptoms in 2009. She had been sick off and on for several years and had visited Vietnam in 1995 and again in early 2009.

“She was wasting away from this systemic infection” that at first seemed like tuberculosis but wasn’t, said Dr. Carlton Hays Jr., a family physician at the Jackson Clinic in Jackson, Tennessee.

Nguyen was referred to specialists at the National Institutes of Health who had been tracking similar cases. She spent nearly a year at an NIH hospital in Bethesda, Maryland, and is there now for monitoring and further treatment.

“I feel great now,” she said Wednesday. But when she was sick, “I felt dizzy, headaches, almost fell down,” she said. “I could not eat anything.”

AIDS is a specific disease, and it stands for acquired immune deficiency syndrome. That means the immune system becomes impaired during someone’s lifetime, rather than from inherited gene defects like the “bubble babies” who are born unable to fight off germs.

The virus that causes AIDS — HIV — destroys T-cells, key soldiers of the immune system that fight germs. The new disease doesn’t affect those cells, but causes a different kind of damage. Browne’s study of more than 200 people in Taiwan and Thailand found that most of those with the disease make substances called autoantibodies that block interferon-gamma, a chemical signal that helps the body clear infections.

Blocking that signal leaves people like those with AIDS — vulnerable to viruses, fungal infections and parasites, but especially micobacteria, a group of germs similar to tuberculosis that can cause severe lung damage. Researchers are calling this new disease an “adult-onset” immunodeficiency syndrome because it develops later in life and they don’t know why or how.

“Fundamentally, we do not know what’s causing them to make these antibodies,” Browne said.

Antibiotics aren’t always effective, so doctors have tried a variety of other approaches, including a cancer drug that helps suppress production of antibodies. The disease quiets in some patients once the infections are tamed, but the faulty immune system is likely a chronic condition, researchers believe.

The fact that nearly all the patients so far have been Asian or Asian-born people living elsewhere suggests that genetic factors and something in the environment such as an infection may trigger the disease, researchers conclude.

The first cases turned up in 2004 and Browne’s study enrolled about 100 people in six months.

“We know there are many others out there,” including many cases mistaken as tuberculosis in some countries, she said.

Compound discovered that boosts effect of vaccines against HIV and flu

Sunday, August 26th, 2012

Science news

Oxford University scientists have discovered a compound that greatly boosts the effect of vaccines against viruses like flu, HIV and herpes in mice. An ‘adjuvant’ is a substance added to a vaccine to enhance the immune response and offer better protection against infection.

The Oxford University team, along with Swedish and US colleagues, have shown that a type of polymer called polyethyleneimine (PEI) is a potent adjuvant for test vaccines against HIV, flu and herpes when given in mice.

The researchers were part-funded by the UK Medical Research Council and report their findings in the journal Nature Biotechnology.

Mice given a single dose of a flu vaccine including PEI via a nasal droplet were completely protected against a lethal dose of flu. This was a marked improvement over mice given the flu vaccine without an adjuvant or in formulations with other adjuvants.

The Oxford researchers now intend to test the PEI adjuvant in ferrets, a better animal model for studying flu. They also want to understand how long the protection lasts for. It is likely to be a couple of years before a flu vaccine using the adjuvant could be tested in clinical trials in humans, the researchers say.

‘Gaining complete protection against flu from just one immunisation is pretty unheard of, even in a study in mice,’ says Professor Quentin Sattentau of the Dunn School of Pathology at Oxford University, who led the work. ‘This gives us confidence that PEI has the potential to be a potent adjuvant for vaccines against viruses like flu or HIV, though there are many steps ahead if it is ever to be used in humans.’

HIV, flu and herpes are some of the most difficult targets to develop vaccines against. HIV and flu viruses are able to change and evolve to escape immune responses stimulated by vaccines. There aren’t any effective vaccines against HIV and herpes as yet, and the flu vaccine needs reformulating each year and doesn’t offer complete protection to everyone who receives it. Finding better adjuvants could help in developing more effective vaccines against these diseases.

Most vaccines include an adjuvant. The main ingredient of the vaccine — whether it is a dead or disabled pathogen, or just a part of the virus or bacteria causing the disease — primes the body’s immune system so it knows what to attack in case of infection. But the adjuvant is needed as well to stimulate this process.

While the need for adjuvants in vaccines has been recognised for nearly 100 years, the way adjuvants work has only recently been understood. The result has been that only a small set of adjuvants is used in current vaccines, often for historical reasons.

The most common adjuvant by far is alum, an aluminium-containing compound that has been given in many different vaccines worldwide for decades. However, alum is not the most potent adjuvant for many vaccine designs.

‘There is a need to develop new adjuvants to get the most appropriate immune response from vaccines,’ says Professor Sattentau, who is also a James Martin Senior Fellow at the Oxford Martin School, University of Oxford.

The Oxford University team found that PEI, a standard polymer often used in genetic and cell biology, has strong adjuvant activity.

When included in a vaccine with a protein from HIV, flu or herpes virus, mice subsequently mounted a strong immune response against that virus. The immune response was stronger than with other adjuvants that are currently being investigated.

The team also showed that PEI is a potent adjuvant in rabbits, showing the effect is not just specific to mice and could be general.

Another potential advantage of PEI is that it works well as an adjuvant for ‘mucosal vaccines’. These vaccines are taken up the nose or in the mouth and absorbed through the mucus-lined tissues there, getting rid of any pain and anxiety from a needle. Mucosal vaccines may also be better in some ways as mucosal tissues are the sites of infection for these diseases (airways for respiratory diseases, genital mucosa for HIV and herpes).

Professor Sattentau suggests that: ‘In the best of all possible worlds, you could imagine people would have one dose of flu vaccine that they’d just sniff up their nose or put under their tongue. And that would be it: no injections and they’d be protected from flu for a number of years.

‘It’s just a vision for the future at the moment, but this promising adjuvant suggests it is a vision that is at least possible.’

Gilead’s All-in-One HIV Pill: Not One, Not Two, But Three?

Monday, August 20th, 2012

RTT news

The concept of a single-tablet regimen for HIV represents the simplification of antiretroviral therapy. At the altar, awaiting the regulatory decision is Gilead Sciences Inc.’s (GILD:Quote) Quad, the third single-tablet HIV regimen. Atripla, approved in 2006, and Complera, approved in 2011, are the other two single-tablet HIV regimens.

Quad contains Gilead’s two investigational drugs – Elvitegravir, which is an integrase inhibitor, and Cobicistat, a boosting agent, in combination with Truvada (Emtricitabine and Tenofovir disoproxil fumarate). If approved, Quad would be the only once-daily, single-tablet regimen containing an integrase inhibitor. Unlike other classes of antiretroviral drugs, integrase inhibitors interfere with HIV replication by blocking the ability of the virus to integrate into the genetic material of human cells.

Gilead’s Atripla contains three HIV medicines in one pill – Sustiva (efavirenz), Emtriva (emtricitabine) and Viread (tenofovir disoproxil fumarate). Complera contains Emtriva, Edurant (rilpivirine) and Viread combined in one pill. Truvada, Gilead’s second-largest sales-getter, combines Emtriva and Viread in one tablet.

In pivotal phase III studies, Quad demonstrated comparable efficacy with Atripla and ritonavir-boosted atazanavir plus Truvada in achieving viral suppression and increasing CD4 cell counts after 24 and 48 weeks. In May of this year, an FDA panel voted 13 to 1 in support of approval of Quad for the treatment of HIV-1 infection in adults. The FDA usually follows the recommendations of its advisory panels, although it is not required to do so. The FDA’s decision date is set for August 27, 2012.

Gilead submitted the NDA for Quad’s components – Elvitegravir and Cobicistat in June of this year. The company has made regulatory filings for Quad, Elvitegravir and Cobicistat in Europe also.

HIV drugs namely, Atripla, Truvada, Viread, Complera and Emtriva account for a major chunk – making up 85%-86% of the company’s total revenue. In the second quarter of 2012, Gilead’s HIV franchise sales were up 15% to $1.986 billion. Quad, if approved, will be the next to join Gilead’s HIV product portfolio.

Shares of Gilead have thus far hit a low of $34.45 and a high of $58.84. The stock closed Friday’s trading at $56.75, up 0.11%.

HIV prevention pill advised for heterosexuals in U.S.

Monday, August 13th, 2012


U.S. health officials said Thursday that doctors should consider giving an AIDS prevention pill to women and heterosexual men who are at high risk for getting the virus.

The U.S. government previously advised doctors to give the once-a-day pill Truvada to high-risk gay and bisexual men only. However, more than a quarter of new HIV cases each year are heterosexuals, according to the U.S. Centers for Disease Control and Prevention.

Truvada has been on the market in the U.S. since 2004 to treat people who already have the AIDS virus.Truvada has been on the market in the U.S. since 2004 to treat people who already have the AIDS virus. (Jeff Chiu/Associated Press)

“That’s not a portion of the epidemic we want to ignore,” said Dr. Dawn Smith, the CDC physician who was lead author of the new guidance.

Truvada has been on the market since 2004 to treat people who already have the AIDS virus. But after studies showed it could help prevent infection among gay and bisexual men, U.S. health officials last year said doctors could prescribe it as a preventive for men at high risk.

Since then, studies have found it also can prevent the virus in women and heterosexual men.

Last month, the U.S. Food and Drug Administration formally approved the sale of Truvada as a preventive measure for healthy people at high risk of getting HIV.

The CDC is not recommending the pill for all sexually active heterosexuals. And even among couples where one person has HIV, regular condom use generally is effective protection. There are an estimated 140,000 heterosexual couples in which one person is infected with the AIDS virus.

But the pill would be a good option for a couple that wanted to have a baby, Smith said, describing one possible scenario.

The drug’s manufacturer, Gilead Sciences Inc., said this week it’s difficult to break down what portion of Truvada sales have been for prevention.

When used as a preventive, the pill is taken once a day. It costs between $6,000 and $12,000 US a year, although some private insurers and Medicaid programs have been covering it, Smith said.

Treating gonorrhea

The CDC also had new advice about treatment for another sexually transmitted disease — gonorrhea.

Health officials are recommending that whenever possible, doctors stop using an antibiotic commonly used to treat it. They’re worried about signs that gonorrhea is becoming resistant to it.

The antibiotic is a pill called cefixime, and it belongs to the last remaining class of drugs effective for gonorrhea. The one remaining recommended drug is a shot called ceftriaxone.

Cefixime is still effective in most cases. But officials feel they can’t take a chance that the resistance they’ve begun to see will continue. If it does, that could also strengthen gonorrhea to resist ceftriaxone, they believe.

“This change is a pre-emptive strike” to preserve the last treatment option, said Dr. Gail Bolan, who oversees the CDC’s sexually transmitted diseases prevention programs.

Gonorrhea, once known as the clap, was once the scourge of soldiers and sailors. It was tamed by penicillin, but the germ is now resistant to that and to several drugs that followed.

Can mass HIV testing really end AIDS?

Sunday, August 5th, 2012

Macleans Canada

“And if we can stop the transmission, we can stop the disease.”—Dr. Julio Montaner, director of B.C.’s Centre for Excellence in HIV/AIDS, July 19, 2012

At first glance, it seemed wasteful, almost insanely so. After the international AIDS conference in Washington, D.C., last week, health officials from B.C. were trumpeting mass population screening for HIV in their province, and eventually, beyond. According to the media reports, if we could get everyone who has ever been sexually active tested (on a volunteer, not mandatory, basis) it could mean “the beginning of the end” of AIDS.

Of course, there was much overselling in the media—with headlines like: “B.C. aims to end HIV/AIDS with widespread testing“ and “B.C. launches massive program to wipe out HIV/AIDS.” But this screen-everybody approach also seemed dubious from a public health viewpoint. Given the well-known problems associated with over-testing, over-screening, and over-diagnosis in other areas of medicine—from PSA testing to pap smears—why try the catch-all method with HIV? What about the traumas related to false positives and the sheer monetary cost of such an encompassing plan? Plus, Canada doesn’t have a high prevalence of HIV/AIDS. Why would we adopt mass screening for a disease that mainly impacts marginalised or hard-to-reach groups that probably wouldn’t be captured anyway? Science-ish called Dr. Julio Montaner, one of the leading proponents of the program, to find out more.

The goldmine

Dr. Montaner, in his charming Argentinian drawl, began by working backwards to explain that the treatment of HIV (which causes acquired immunodeficiency syndrome or AIDS) is the most effective preventative tool we have. Once you identify a person with the virus, you can get her on antiretrovirals, which can extend her life and bring her viral load down so that she is less infectious. “What we have seen is that HIV testing is the entry point into this whole cascade of care,” he explained. The trouble in B.C. was that public health officials had actually exhausted HIV testing in the at-risk communities. But it was difficult to capture the minority who may not have a known risk factor and may be living with the virus. With mass screening, he said, “We’re hitting the gold mine.” 

Dr. Montaner’s idea of “the gold mine” comes from the results of a mass-screening pilot project that rolled out last October in the internal medicine departments of three Vancouver hospitals—St. Paul’s, Mount Saint Joseph and Vancouver General. Between 2,500 and 3,000 people were tested for HIV. Of those, about one per cent tested positive. According to Dr. Montaner, at least half of those people did not know they were at-risk and wouldn’t have been tested otherwise.

In a related review of people in Vancouver who tested positive in the last three years, researchers found that more than half of them could have been diagnosed during earlier visits to the doctor or the hospital, which suggests they were being tested (and treated) too late. By offering screening whenever people go see a health-care practitioner, the logic goes, you may identify those living with HIV sooner, get them on treatment sooner, and improve their personal health and that of those around them.

Shaky assumptions?

This idea, though, rests on a few assumptions. According to Dr. Theo Lorenc, research fellow at the London School of Hygiene and Tropical Medicine, there’s some promising evidence in modelling studies that mass, voluntary testing, along with early antiretroviral therapy, has been effective in Southern Africa, where the incidence of HIV and AIDS is believed to be the highest in the world. “But it’s much less clear that such approaches would be effective or cost-effective in a low-prevalence setting like Canada.” As well, there’s the question of whether transmission rates can be reduced with mass screening. Previous studies on specific populations, such as men who have sex with men, found that community-based programs involving rapid testing and counselling did not necessarily lead to upticks in the number of people getting tested, and did not detect previously undiagnosed infections at a notable rate.

Besides, what about people who are scared of testing—those who suspect they might be HIV-positive but don’t want to get tested so they can tell others they don’t know? “I’m not sure the evidence gives us any clear guidance as to how to overcome these barriers,” said Dr. Lorenc. According to Dr. Montaner, some 97 per cent of people in the Vancouver pilot accepted an HIV test when offered. What do we know about the motivations of that other 3 per cent who didn’t?

‘HIV negative’

Still, it’s worth noting that B.C.’s plan had a very smart workaround. Patients in Vancouver were asked whether they’d like to take the test to confirm they were HIV negative. “Since 99 per cent of people are going to be, that’s the right way to ask the question,” Dr. Montaner explained. “What this allows us to do is to create a different approach and infrastructure to the problem.” If the question about the test is flipped on its head, and testing is offered on a routine basis, it may seem less threatening. As Dr. Montaner envisions it, “The campaign aims to normalize HIV testing so that ultimately your GP will offer you the test just as they offer PAP tests or PSA tests to eligible patients.”

Another assumption underlying the plan to reduce transmission rates by increasing testing is that people who are found to have HIV will actually undergo and continue treatment, especially when it’s not fully subsidized in some provinces as it is in B.C. “Antiretroviral treatment is a complex regimen, often with some side-effects, and maintaining adherence can be a problem at the best of times, even in symptomatic infections,” explained Dr. Lorenc. “When people are asymptomatic, this is going to be even more difficult. And when patients may not be accessing standard health services, may have chaotic lifestyles, this will become even more of an issue.”

The money question

There are also financial costs to consider. Is this the best way to allocate health dollars? To find out, Science-ish emailed Dr. Greg Zaric, who specializes in cost-effectiveness analysis at Western University. He noted that two articles published in the New England Journal of Medicine in 2005 both found that routine HIV screening south of the border would be cost effective in settings with an HIV prevalence as low as 0.1 per cent. “In B.C., Dr. Montaner has estimated that there are approximately 3,500 people who are HIV-infected but not aware of their status. The province has a total population of approximately 4.6 million, of whom approximately 3.5 million might be in the target age range for this screening program.” This corresponds to roughly 0.1 per cent. While it is “dangerous” to say that U.S. results are generalizable to Canada, “it is certainly plausible that the new program could turn out to be cost effective.” We just don’t know yet.

Stigma elimination

The B.C. program will be expanding to emergency and surgery departments at the three Vancouver hospitals, as well as to primary-care settings. The results of these efforts will be measured and published down the road, as researchers try to determine the optimal frequency and health-care setting for routine testing. Before we begin trumpeting mass screening as the way to end HIV/AIDS, let’s keep an eye on what this pilot does for B.C.

And, for the sake of context, let’s keep in mind that we’ve only ever been able to eradicate one virus: smallpox. That came as a result of mass immunization with vaccines. “Getting rid of a virus through screening, diagnosis, treatment, and prevention of transmission has never been done, and would be much more difficult,” said Dr. Greta Bauer, an epidemiologist at Western University.

In fact, the most important outcome of B.C.’s experiment might be its contribution to shedding the HIV stigma. As it stands, in Canada, we have what Dr. Bauer calls “the world’s most punitive laws regarding HIV criminalization.” Non-disclosure of status before sexual activity is criminalized, even if the virus is not transmitted. “It may be better, from a criminal and liability standpoint, to not know one’s HIV status,” she noted. That, indeed, seems like the greatest deterrent of all.

Unique Vancouver clinic provides comfort to HIV/AIDS patients Read it on Global News: Tucked away in a corner of St. Paul’s Hospital in downtown Vancouver is a one of a kind clinic for HIV/AIDS patients.

Sunday, August 5th, 2012

Global Edmonton

VANCOUVER – Tucked away in a corner of St. Paul’s Hospital in downtown Vancouver is a one of a kind clinic.

The waiting room at the John Ruedy Immunodeficiency Clinic (IDC) is filled with people from all walks of life – professionals, students, mothers, fathers, and grandparents. Some come from middle-class families, others from one of Canada’s poorest neighbourhoods – Vancouver’s downtown eastside. And many who come here have left unspeakable abuse and torture and come to Canada as refugees.

But there is one thing they all share in common – they have all been diagnosed with HIV.

Unlike in the 1980s when this clinic first opened its doors, living with HIV today means just that: living.

With tireless research into finding – not just a cure – but better treatments to live with the disease, people who test positive are no longer sentenced to death. Many live healthy, full lives with new drug treatments that make their viral counts almost undetectable.

It’s a message clinical nurse Carole Kellman, who has worked on the front lines of HIV care in Vancouver for more than 20 years, is dedicated to getting across. “I’ve always had that passion to keep pushing the envelope, keep raising awareness,” she tells Global News.

Despite advances in care, people living with HIV still have to pay more attention to their health than the average Canadian living without the disease. As a result, the clinic doesn’t just have doctors and nurses, but counsellors, nutritionists and social workers as well. It’s the only clinic in Canada to offer this kind of care under one roof.

Patient comfort is obviously a top priority. Staff don’t just treat the medical conditions caused by HIV, but also the other issues that come with living positive.

“We look at patients not just in terms of their blood work. We see them as more than just their HIV. They are a whole person with very different needs and every patient is different,” explains IDC program director Scott Harrison.

Julie Kille, a nurse and the operations leader, says she and her colleagues have gone beyond the call of duty to help patients. “(If) you need a way to get to the clinic, we’ll help you do that. There’s a lot of things that we go sort of outside the box on. We’ve come up with some interesting ways of dealing with some client needs.”

“We’ve had people actually go out and buy bags of food for people,” Kille adds.

HIV also still needs to be managed with drugs. Left unchecked or untreated, it can be deadly.

An estimated 25 per cent of Canadians still don’t know they have contracted HIV, and that means it can be spread unintentionally.

With infection rates on the rise among women and heterosexuals, Kellman urges everyone to practice safe sex, get tested and educated.

“Twenty-seven per cent of new diagnoses are heterosexuals, and out of that population, women are most at risk
and particularly, women over the age of 50,” says Kellman.

New rapid HIV tests are available, meaning there is no longer a tense waiting game.

For anyone hesitant about getting tested, one HIV-positive patient who frequents the clinic has this advice. “I would say get over it, go get tested. It’s the only way you can live a happier, healthier lifestyle, really.”

According to amfAR (the American Foundation for AIDS Research)

• More than 34 million people live with HIV/AIDS

• About 10 per cent of them are 15 years old or younger

• Every hour, almost 300 people are infected with HIV (that works out to roughly 7,000 people per day)

• In 2011, an estimated 2.5 million contracted HIV

• 230,000 of them were 15 years old or younger

© Global News. A division of Shaw Media Inc., 2012.

HIV prosecutions may deter testing

Monday, July 23rd, 2012

Register Citizen

Should people living with HIV be charged with a crime if they fail to disclose their status to sex partners?

That’s currently the law in many places. But a new study suggests that such prosecutions might actually deter at-risk individuals from seeking medical advice and getting tested — thus making them more likely to transmit the virus.

In the wake of a series of high-profile HIV nondisclosure prosecutions, researchers surveyed men who have sex with men in Ottawa, Canada. They found that a significant minority of participants — 17 percent — said the prosecutions had “affected their willingness to get tested for HIV,” and nearly 14 percent said the prosecutions “made them afraid to speak with nurses and physicians about their sexual practices.”

The researchers found that this same group reported receiving less testing for HIV and other sexually transmitted infections, was more likely to engage in higher-risk sexual activities, and had a higher number of recent sexual partners.

The findings provide the first empirical support for the contention that HIV-related criminal laws might pose an obstacle to HIV testing. Until now, advocates for those living with HIV have only been able to point to anecdotal evidence that some people at risk for infection might avoid getting tested out of fear of being prosecuted — a phenomenon they have dubbed “take the test, risk arrest.” The reasoning? Knowing of an HIV-positive status can make one criminally liable, while not knowing can be a defense against prosecution.

Patrick O’Byrne, a professor in nursing at the University of Ottawa and the study’s lead author, cautioned that the research has several limitations. The sample was not randomized, subjects were recruited in high-risk sexual activity locations, and the demographic skews to white, gay men. The results, therefore, cannot be generalized.

In addition, O’Byrne says that the research “must be interpreted within its context: Ottawa, Canada within one year after a nondisclosure prosecution involving headline, front-page media attention.” O’Byrne pointed specifically to a case in which law enforcement officials ”released the [accused’s] full name, photograph, and sexual orientation.”

Indeed, according to a 2010 report by the Global Network of People Living with HIV, Canada has convicted more than 60 people of HIV-related crimes. That’s second only to the United States, which has convicted more than 300. (However, other countries had higher rates of prosecution per 1,000 people living with HIV.)

Carol Galletly — a professor, lawyer, and researcher at the Medical College of Wisconsin — says the results of the Canadian study might not translate to U.S. experiences. According to Galletly, preliminary analysis from at least one U.S. study on HIV criminalization currently undergoing review “did not reveal a deterrent effect” on testing.

Still, Galletly says scientists “can’t afford to ignore” O’Byrne’s research.

While HIV nondisclosure laws might be intended to stem HIV transmission, studies have suggested that they have little impact on risk behavior.

“Incidence of HIV infection in states with and without HIV exposure laws does not differ, as one would expect if the laws were preventing new infections,” says Galletly, who has been a leading researcher on the impact of HIV criminalization laws on behavior.

In addition, research suggests these laws may provide a misplaced sense of safety in relying on a partner to disclose his or her infection.

According to Galletly, “Preliminary data from an unpublished study seem to indicate that among persons who are at increased risk for HIV infection, awareness that one’s state has an HIV exposure law may be associated with increased confidence in [HIV-positive] status disclosure — a very problematic HIV prevention strategy.”

The issue of criminalization is slowly shaping into an international dialog. In several U.S. states, citizen groups are working to repeal HIV-specific laws. In Congress, a bill has been introduced by Rep. Barbara Lee that would encourage reform of state and federal HIV policies. And in 2010, President Barack Obama’s National HIV/AIDS Strategy called on states to revisit their laws.

Last week, the Global Commission on HIV and the Law recommended that HIV-specific laws be repealed. The report also recommends that those convicted under such laws be pardoned.

U.S. blacks, gay and straight, have biggest struggle with HIV

Monday, July 23rd, 2012

Chicago Tribune

CHICAGO/WASHINGTON (Reuters) – As a gay black man growing up in Chicago’s infamous Cabrini Green public housing project, Arick Buckles knows first-hand how the stigma of HIV can keep people infected with the virus from seeking treatment.

It took him six years after he tested positive for the human immunodeficiency virus, or HIV, to get care. By then, Buckles was frail and wore turtleneck sweaters to hide his severely swollen lymph nodes.

“I didn’t want to accept it was the HIV that was disfiguring my face, my neck. It was visible,” Buckles said. He finally sought care after suffering pneumocystis pneumonia, a lung infection that strikes HIV patients as their immune systems weaken.

The predominantly black housing project where Buckles grew up was such a hub of crime and poverty that the city tore it down several years ago.

“We thought growing up in Cabrini Green that it was a gay disease. If I were to disclose my status, I felt my homosexuality would be outed,” said Buckles, 40, who was so fearful of that prospect that he kept his HIV status, and his sexual orientation, in the closet.

“It’s looked upon as disgraceful” in the black community, he said.

Buckles’ tale is still too common, despite widespread U.S. efforts to foster awareness of the virus that causes AIDS and its treatment over the last three decades, says Dr. Kevin Fenton, director of the National Center for HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention (CDC).

“Stigma is a huge issue,” Fenton said. It can keep people from getting tested, and for those who know they are HIV positive, it can keep them from getting the treatment they need.

He said stigma affects a broad swath of communities in different forms, but for many blacks in America, it exists on top of poverty, poor access to treatment and poor outreach for effective prevention services.

HIV transmission rates have fallen from 130,000 new infections per year during the epidemic’s peak in the mid-1980s to 50,000 a year, a level little changed since the mid-1990s.

Part of the problem is that many Americans are infected and do not know it. Of the estimated 1.1 million Americans living with HIV, nearly one in five of those individuals remain undiagnosed.

Up to 44 percent of new infections are clustered in 12 major cities, including Chicago, Washington, New York and Los Angeles, CDC data show. Within these communities, HIV rates are highest among blacks, Hispanics and gay and bisexual men of all races.

CDC researchers will present the latest U.S. data this week at the International AIDS Society’s AIDS 2012 conference in Washington, where scientists will gather to discuss better ways to prevent, treat and seek a cure for the disease.


According to a report released last week by the Black AIDS Institute, black gay and bisexual men make up one in 500 Americans overall, but account for one in four new HIV infections in the United States.

It found that by the time a black gay man reaches 25, he has a one in four chance of being infected with HIV. By age 40, he has a 60 percent chance of being infected.

Fenton said there is nothing unique about blacks that make them more vulnerable to HIV infection. Once higher infection rates are seen in a community, the chances of new members becoming infected are simply higher.

“What we believe is that the infection is becoming concentrated in these minority groups as a reflection of the social and structural drivers of health inequalities overall,” he said.

A CDC study published on Friday in the Lancet medical journal found that black men who have sex with men in the United States are 72 times more likely than the general population to be HIV-positive.

HIV testing kits recalled over accuracy fears

Thursday, December 29th, 2011

Business daily
More than one million HIV testing kits have been recalled following a global alert by the World Health Organisation over their accuracy.

The Public Health and Sanitation ministry has said the Standard Diagnostic Bioline, one of the three kits used for HIV testing in the country, had diagnosed patients as HIV negative when they were positive.

“Following the World Health Organisation (WHO) global alert, the Government of Kenya has instituted an immediate recall of all Bioline rapid test kits supplies from all health facilities and VCTs in the country,” said the National Aids and STI Control Programme (Nascop).

The Public Health ministry directed provincial directors and Aids and sexually transmitted diseases sector co-ordinators to remove the kits from health facilities. The Director of Public Health and Sanitation, Shanaz Sharif, said Bioline rapid test kits constituted about a tenth of the tools in circulation which he estimated at 10 million units.

WHO issued the directive following increased cases of discrepancies in results from the testing kits. The kit is manufactured by Standard Diagnostic Inc, a South Korean medical equipment maker. The recall suggests failure on the part of government laboratories which conduct quality tests on equipment and approve use. Medical practitioners use three test kits to check the presence of the HIV virus in a patient. The first test, called screening test, is performed using the Determine kit, which detects if someone is HIV positive.

Bioline is used to detect HIV negative blood samples. In cases where the two don’t give consistent results, the Unigold test is used as a tie breaker.

Following the anomaly, the government has replaced the Bioline kit with Unigold for confirmatory tests.

The Long Elisa method will be used as a tie breaker in cases of discrepancies, with Determine being used for screening. “Unigold will replace Bioline as the confirmatory HIV test kit,” said Dr Sharif.

In cases of discrepancies, HIV testing and counselling service providers will now have to send dried blood samples to the National HIV Reference Laboratory by courier service for determination of final test results.

Officials at Kenya Medical Research Institute (Kemri), however, said that Bioline was not widely used. “About seven per cent of Kenyans coming for HIV tests are positive. Given that Bioline is used to detect negative status, there are less of the Bioline kits out there,” said Dr Matilu Mwau, a paediatrician with Kemri.

HIV positive man claims he had sex with thousands of people

Thursday, December 29th, 2011

KENT COUNTY, Mich. (NEWSCHANNEL 3) – Health officials in Kent County are still trying to track down any possible victims of a man who was trying to spread HIV.

David Smith told detectives he had sex with “thousands” of people without telling them he had the virus.

While investigators doubt that number is accurate, a new alleged victim did come forward yesterday.

The second victim in this case is identified only as Jane Doe. She will remain anonymous, as will any other victims who come forward.

Yesterday Smith was arraigned on a second charge of trying to spread AIDS to an uninformed partner.

Investigators believe Smith has some mental health issues, but they also say he knew exactly what he was doing by seeking multiple sex partners for the purpose of spreading the virus.

Smith’s bond has been raised to $100,000, meaning he’ll likely remain behind bars.

Police say anyone who had contact with Smith should call them immediately, then head to the health department for testing.

Supreme Court weighs disclosure of HIV status

Thursday, December 1st, 2011


Reporting from Washington—

The Supreme Court gave a generally skeptical hearing to a recreational pilot from San Francisco who wants damages from the government for disclosing his HIV status to the Federal Aviation Administration.

The case before the court Wednesday began in 2002, when the FAA heard a report of a pilot who had hidden his severe medical condition when he renewed his license to fly. Agents decided to check the records of 45,000 pilots in Northern California.

They learned from the Social Security Administration that Stanmore Cooper had obtained long-term disability benefits in 1995 because of his HIV condition. A year earlier, he had reapplied for his pilot’s license but failed to disclose his medical condition to the FAA. At the time, his illness may well have prevented him from renewing his license had it been revealed.

Cooper’s pilot’s license was revoked and he was charged with making false statements to the government. He pleaded guilty to a misdemeanor and was fined $1,000.

Cooper then sued the FAA for violating the Privacy Act, which permits claims for “actual damages.” Lower courts have been split for decades over whether these damages are limited to monetary losses or can also include claims for mental distress.

Justice Antonin Scalia said the 1974 law “goes far beyond” other privacy laws because it included instances where private records were not revealed to the public. Several justices joined Scalia in suggesting it was unlikely Congress wanted to open the door to damage suits for thousands of people who claim mental distress at learning their records had been examined by two agencies.

U.S. District Judge Vaughn Walker in San Francisco had ruled against Cooper and said the law did not include damages for emotional distress. But the U.S. 9th Circuit Court of Appeals disagreed and ruled last year that emotional damages, if proven, were included.

Obama administration lawyers appealed in FAA vs. Cooper. They said Congress did not intend to expose the government to damage claims for emotional distress from thousands of people if two agencies shared records, or even Social Security numbers.

Justices Ruth Bader Ginsburg and Sonia Sotomayor disagreed with the administration’s lawyer. They said the hurt suffered from an invasion of privacy was usually emotional or mental, not monetary. A person who is “subjected to embarrassment and humiliation” has suffered damage, Ginsburg said.

Raymond Cardozo, a San Francisco lawyer for Cooper, said his client would have to prove that he had suffered mental distress in order to win.

But most of the justices sounded as though they were inclined to limit the scope of the damages to monetary losses, such as the loss of a job or medical expenses.

HIV spreading in Europe, but AIDS cases declining: Study

Wednesday, November 30th, 2011


STOCKHOLM — HIV infections continued to rise in Europe in 2010, but thanks to treatment the number of cases of full-blown AIDS has dramatically declined in recent years, according to a report published Wednesday.

“The new data raises concern about the continuing transmission of HIV in Europe,” the World Health Organisation’s Europe office and the European Centre for Disease Prevention and Control (ECDC) said in their joint report, published a day before World AIDS Day.

Last year, 27,116 new cases of HIV infections were reported in the European Union and European Economic Area, which is an increase of around four percent from 2009, according to the report, which stressed that statistics from Austria and Liechtenstein had not been accessible.

“In contrast, the steady decrease of AIDS cases continued in 2010 with 4,666 reported cases in the EU/EEA region,” it said, pointing out that this was a drop of almost 50 percent from 2004 and stressing the importance of early HIV detection for reining in the AIDS epidemic.

According to a United Nations report published last week, a record 34 million people worldwide lived with HIV last year, while improved treatment has meant that the number of AIDS-linked deaths has steadily dropped from a peak of 2.2 million in 2005 to 1.8 million last year.

According to that report, about half of those eligible for treatment are now receiving it, something that saved the lives of 700,000 people in 2010.

“We need to demonstrate the political courage to focus on key populations most affected by HIV and to address the issue of late diagnosis of HIV infection which often leads to delayed treatment and higher rates of AIDS-related morbidity and mortality,” ECDC chief Marc Sprenger said in a statement issued by the Stockholm-based EU agency.

ECDC and WHO researchers noted that “HIV epidemics are remarkably distinct in individual countries but overall, HIV continues to disproportionately affect certain key populations.”

According to the report, HIV in Europe is still mainly transmitted through sex between men, while in cases of heterosexual contact, about one third of the reported cases originates with people from countries facing general epidemics of the virus.

People who inject drugs and people who are not aware that they carry the disease make up the biggest threat of transmission, according to the report.

The head of WHO Europe, Zsuzsanna Jakab, stressed the importance of creating “tailored responses” to HIV epidemics for different areas, since the characteristics can differ significantly.

Sprenger agreed, insisting that “only the knowledge of the characteristics of the epidemic in specific regions allows for effective responses” against the spread of the disease.

Anti-H.I.V. Trial in Africa Canceled Over Failure to Prevent Infection

Saturday, November 26th, 2011

New York Times

A new trial of a microbicide gel to protect women from infection with H.I.V.was canceled Friday after researchers reported that it was not working.


  • Health Guide: AIDS

The news was a major disappointment for AIDS research. It was not clear why the gel did not work in this trial, since it had seemed to work surprisingly well in a previous one.

Finding a vaginal gel that protects women against the virus that causes AIDS but still allows them to get pregnant has long been sought by AIDS researchers, because it can be used secretly by women who fear being refused or even beaten if they ask their sexual partner to use a condom.

The first trial, reported in South Africa in the summer of 2010, found that a vaginal gel containing the drug tenofovir protected 39 percent of the women who used it, and that those who used it most regularly reduced their chances of infection by 54 percent.

It was hoped that the new trial, nicknamed Voice (for Vaginal and Oral Interventions to Control the Epidemic), would confirm that earlier trial, called Caprisa after the clinic in Durban that ran it.

The Voice trial, which began in 2009, enrolled more than 5,000 women in South Africa, Uganda and Zimbabwe. It was divided into three experiments, or arms, comparing three different products against a placebo — the gel, a tenofovir pill or a Truvada pill (tenofovir and a booster drug).

The trial of the tenofovir pill was canceled in September because it, too, did not appear to be working.

But because part of the study is still continuing, all the collected data — meaning, in particular, who was on the gel and who was on the placebo — cannot be “unblinded” yet, so the researchers cannot try to figure out why it did not work.

“Even when we have more information available to us, understanding why our results differed from the Caprisa results may not be clear,” said Sharon L. Hillier, a lead researcher for the Microbicide Trials Network, which is based at the University of Pittsburgh medical school and oversees many trials.

She said was “surprised and disappointed” by the cancellation.

In a statement, she and Dr. Ian McGowan, another researcher for the network, speculated that the problem might have been that too few women used the gel regularly, that the dosing schedule was wrong, or that it somehow caused inflammation that led to easier entry by the virus. But, Dr. Hillier added, it was unlikely that they would be able to assess that until later next year.

Ethics of modern clinical trials require that at various midway points, enough data be revealed to a panel of outside experts so they can assess whether the intervention being tested is safe for the participants and whether it is working.

In this case, 6 percent of women using the tenofovir gel and 6 percent of those using the placebo had become infected by the time the outside panel looked at the data. It was found to be safe but not effective, which ethically requires the cancellation of the trial to keep any more women from becoming infected.

The trial is expected to go on until mid-2012 and the data are to be released in early 2013. Other trials of gels at different formulations and dosing are planned or under way.

Steve Jobs est-il mort du Sida ?

Friday, October 7th, 2011

Selon Wikileaks, Steve Jobs n’est pas mort en raison d’un cancer… mais suite à des complications liés au Sida !

Et on peut dire que les cyber-libertaires n’ont pas perdu de temps : seulement une minute après l’annonce officielle de la mort de Steve Jobs, le compte Twitter de Wikileaks proposait un lien vers une photo des (supposés) résultats sanguins du fondateur d’Apple.

Ces tests auraient été effectués en 2004 par un laboratoire indépendant et affichent un résultat positif au test HIV… Pour enfoncer le clou, Wikileaks ajoute :

« Steve Jobs suivait un régime alimentaire parfois recommandé aux malades du sida comme une thérapie alternative. »

Néanmoins, le site précise que “ces images ne doivent pas être prises à leur valeur nominale”, ce qui signifient donc que les documents ne sont pas certifiés exacts…

HIV Cases in U.S. Stable At 50,000

Sunday, August 7th, 2011

Overall U.S. HIV incidence has been relatively stable but increases in new infections are being observed among young, black gay and bisexual men, officials say.

Dr. Jonathan Mermin, director of the Centers for Disease Control and Prevention’s division of HIV/AIDS prevention, says overall HIV incidence in the U.S. has been relatively stable, with approximately 50,000 annual new infections a year. However, new HIV infections increased 48 percent – from 4,400 in 2006 to 6,500 in 2009 – among young, black men who have sex with men.

“We are deeply concerned by the alarming rise in new HIV infections in young, black gay and bisexual men and the continued impact of HIV among young gay and bisexual men of all races,” Mermin says in a statement. “We cannot allow the health of a new generation of gay men to be lost to a preventable disease. It’s time to renew the focus on HIV among gay men and confront the homophobia and stigma that all too often accompany this disease.”

The estimates, published in the online scientific journal PLoS ONE, says the incidence estimates are based on direct measurement of new HIV infections with a laboratory test that can distinguish recent from long-standing HIV infections, reports.

“HIV infections can be prevented,” Dr. Thomas Frieden, director of the CDC, says. “By getting tested, reducing risky behaviors, and getting treatment, people can protect themselves and their loved ones.”

HIV is a virus, not a crime

Sunday, August 7th, 2011

The Gleaner

CALLS FOR laws to address the “reckless and conscious transmission” of HIV touch a nerve. The ensuing public dialogue and quick political feedback are fuelled by increased awareness of the Caribbean’s 18,000 new HIV infections every year, 2,100 of which are in Jamaica. Support for criminalisation reflects a desire to reduce the spread of the virus while exacting justice for those who were intentionally infected.

The situation points to something more: the difficulty over the last decade in reducing the number of new HIV cases, the failure to develop and maintain programmes targeted at populations at highest risk, and the fallout of limited access to treatment. Another reality of HIV in this time is that treatment has been proven to be 96 per cent effective in preventing transmission between couples. Expanding access to such treatment, supporting increased condom use and bolstering the uptake of testing and counselling services are effective ways of reducing the transmission of HIV and protecting the most vulnerable. Criminalisation isn’t.

There’s no need for HIV-specific criminal laws

There are persons who maliciously transmit HIV with intent to harm others, and they should face appropriate criminal prosecution. For these cases there is no need to create HIV-specific legislation. The alternative is to invoke existing laws relating to assault or criminal negligence. In determining whether an act of transmission should attract criminal penalties, the complexities of human sexual behaviour must be carefully and fairly discerned. What are the reasonable and enforceable lines between criminal and non-criminal behaviour when it comes to HIV transmission?

There are several circumstances in which an HIV-positive person either does not present a significant risk of transmission or does not have criminal intent. Does the individual know that he is HIV positive? Does she understand how HIV is transmitted? Did he tell his partner that he was HIV positive or believe that his partner knew his status? Did she practise safe sex and regularly take medications? Was there an understanding that intimacy involved a certain degree of risk? A criminal law specifically related to HIV would cast all persons living with the virus as potential criminals and intensify the hysteria surrounding the virus.

Criminalisation is counterproductive

The stigmatisation of people living with HIV has implications for society as a whole. There are serious repercussions for public health when constructive responses are undermined by ineffective laws. Our legacy of legislating human sexual behaviour – from prostitution to abortion, to sodomy – bears out that statutes are often irrelevant to individual decision making surrounding sex. Before or after conviction, in or out of prison, the law does nothing to stop an individual from engaging in risky activities.

But while these laws may not be effective deterrents they do have an impact: the behaviours they are meant to curb are driven underground and become more difficult to address. The most powerful tools for promoting disclosure and safer sex are interventions anchored by voluntary testing and counselling and outreach. Criminalisation could reduce people’s willingness to learn their status and access treatment and support.

Criminal laws are often unfairly and selectively enforced. Where they exist these laws are often applied to people who are the most socially or economically marginalised. Migrants, sex workers, gay men and other men who have sex with men (MSM) and transsexual people can become easy targets for arrest. Women are also more vulnerable to prosecution under such laws because they access health services more frequently than men and are therefore likely to find out about their HIV status sooner. The partner who is aware of his or her status is not always the one who first contracted HIV. Infidelity, rape, sexual coercion and unequal power relations are among the dynamics that increase women and girls’ vulnerability to both HIV infection and prosecution under such laws.

Criminal cases give the authorities the green light to investigate anyone they suspect of having passed on HIV. This can manifest as an invasion of privacy as well as a breach of confidentiality. It has the impact of creating distrust in relationships between HIV-positive people and their health-care providers. People may fear that information regarding their status may be used against them. The provision of quality treatment and care is anchored in trust, and there should be no wide-ranging basis for violating this principle.

Responsibility of HIV-positive person

Jamaica’s HIV prevalence rate is 1.7 per cent. Exposure to the virus is a risk that every sexually active individual has a personal responsibility to manage. But a law relating to HIV transmission squarely places responsibility for risk-reduction only on people living with HIV.

Additionally, criminalisation may create a false expectation that the law has eliminated any danger from engaging in unprotected sex. Not knowing a partner’s status or assuming that he or she does not have a disease are not sufficient reasons for neglecting to use protection, discuss each other’s status and get tested. Ultimately those are the behaviours that will lead to a decline in HIV.

The way forward

Jamaica must within the next two years reduce its number of new infections by 50 per cent. Criminalisation won’t accomplish this, but more effective prevention programmes can. We need better access to sound information, services and support for all individuals including young people, gay men and other men who have sex with men, sex workers and prisoners. We need more counselling and testing. We need better access to age-appropriate sexuality education. We need to make it easier for sexually active people to obtain condoms and personal lubricants. We need interventions that support HIV-positive people in disclosing and practising safer sex. We need to continue to combat stigma and discrimination so that people can make healthy, responsible and safe choices about their lives, including decisions relating to sex and reproduction.

Developing an isolated law to criminalise transmission intensifies the climate of denial, secrecy and fear, providing an ever more fertile ground for the spread of HIV. Comprehensive legal reforms to address discrimination and vulnerability along with policy directives to improve the reach and quality of prevention programmes are needed. The criminalisation of HIV transmission won’t help.

HIV drugs enhance prevention hopes

Sunday, July 17th, 2011

PARIS: Heterosexuals who take daily AIDS drugs reduce the risk of being infected by the human immunodeficiency virus (HIV) by nearly two-thirds, ground-breaking studies said on Wednesday.

Campaigners hailed what they described as a powerful new weapon in the three-decade war against AIDS.

“This is a major scientific breakthrough which reconfirms the essential role that antiretroviral medicine has to play in the AIDS response,” Michel Sidibe, executive director of the UN agency UNAIDS said.

“These studies could help us to reach the tipping point in the HIV epidemic.”

A trial called Partners PrEP, conducted by the University of Washington, followed 4,758 “sero-discordant” heterosexual couples — in which one person had HIV and the other was uninfected — in Kenya and Uganda.

The uninfected partner received either a dummy pill or a tablet containing either the HIV drug tenofovir or a combination of tenofovir and emtricitabine.

In the group receiving tenofovir, there were 62 percent fewer infections compared with the placebo group.

In the tenofovir/emtricitabine group, there were 73 percent fewer infections over counterparts taking the placebo.

The results were so remarkable that safety monitors recommended the probe be stopped early, for to continue it would have been unethical.

The second trial, conducted by the US Centers for Disease Control and Prevention (CDC), followed 1,219 uninfected men and women in Botswana who received either placebo or the tenofovir/emtricitabine combination.

Those who received the antiretroviral pill reduced the risk of HIV infection by 63 percent compared with the placebo group.

They are the first trials to show that so-called pre-exposure prophylaxis, or PrEP, can work among heterosexuals.

Last November a study, conducted among sero-discordant homosexual men, found a reduction of 44 percent in risk among uninfected partners who took HIV drugs.

In contrast, a smaller-scale trial, whose preliminary results were published earlier this year, found that PrEP did not protect heterosexual women.

In May, a big study conducted among sero-discordant heterosexual couples in Africa showed early use of drugs by the infected partner slashed the risk of transmitting HIV to the other partner by 96 percent.

Put together, these trials add massively to the argument that the world’s AIDS pandemic can be slowed by wider distribution of antiretrovirals, said activists.

“These results are tremendously exciting and confirm that we are at pivotal period,” said Mitchell Warren, executive director of US advocacy group AVAC.

“Now is the time to include ARV-based prevention in national plans, applications to the Global Fund to Fight AIDS, Tuberculosis and Malaria and donor priorities.

“(…) We need ambitious pilot and demonstration projects to guide programmatic design, along with national and international guidance on how best to use ARVs (antiretrovirals) as lifesaving prevention tools,” he said.

The International AIDS Society, which is hosting a major conference in Rome from Sunday, said data from the two trials was “compelling” and “adds to the cascade of evidence.”

But it also highlighted the looming debate about using drugs designed for treatment in the role of prevention.

Antiretrovirals are the famous “cocktail” of drugs, first introduced in 1996, that helped turn the tide against AIDS.

They suppress HIV in the body but do not eradicate it completely.

As a result, they reduce the risk of infection through contact with body fluids, although they are not a cure and taking them can carry inflict toxic side effects.

In addition, there is a potentially hefty financial cost if the pills are taken daily for prevention, although the price has fallen to as little as 25 US cents per tablet.

The “treatment as prevention” strategy has risen alongside male circumcision as new options in the global HIV/AIDS pandemic, which has claimed around 30 million lives over the past three decades.

More than 33 million people are living with the AIDS virus, according to estimates for 2009 released last year by UNAIDS. (AFP)

HIV infection not a death sentence: judge

Friday, July 15th, 2011


An Ottawa judge’s rejection of attempted murder charges against a man accused of knowingly transmitting HIV, saying it is no longer an “automatic death sentence,” reflects medical reality and should send a message to police and prosecutors, Canada’s AIDS experts say.

Ontario Court Justice David Wake dismissed four charges of attempted murder against Steven Paul Boone on Wednesday, declaring that death from HIV is a “possible consequence” but no longer an “inevitable consequence or even a probable consequence” of contracting the virus.

The ruling, following a preliminary hearing, removes the four most serious charges against Mr. Boone, 30, in the high-profile case, but he is still to face trial on 21 sex and assault charges involving eight men.

The judge’s reasons for committing Mr. Boone to stand trial on the other charges are covered by a routine publication ban designed to protect a fair trial.

The ruling speaks to the medical advances made in fighting HIV/AIDS in the 30 years since the virus first started terrifying the gay community, but also suggests police and prosecutors have not moved with the times, AIDS specialists and activists said.

“In a country like Canada, where antiretroviral drugs of the highest quality are available to everyone free of charge, the likelihood anyone is going to die over the next 25 years from HIV is extremely remote,” said Mark Wainberg, director of the McGill AIDS Centre based at the Jewish General Hospital in Montreal.

“So the very notion that anyone could be charged with attempted murder today seems strange.”

The ruling highlights the lag time in the justice system.

Back 15 or 20 years, when HIV was usually a death sentence, no such criminal charges were laid. By the time prosecutors caught up to the impact of the social problem, science had passed them by, experts said.

More than 80 people, mostly men, have been charged in Canada with criminal offences for exposing sexual partners to HIV.

The Supreme Court of Canada provided the legal basis in a 1998 ruling that someone who does not disclose he or she has HIV does not have their partner’s consent, making the sexual encounter an assault.

That was taken to new heights in the case of Johnson Aziga, the first person in Canada to be convicted of murder for spreading HIV.

In 2009, a jury found Aziga guilty of two counts of first-degree murder for having unprotected sex without telling partners, who later died of AIDS-related cancers, that he was HIV positive. Aziga, however, tested positive for HIV back in 1996 and was charged in 2003.

In that period, treatment advances have made a difference.

Barry Adam, a University of Windsor sociologist and research director of the Ontario HIV Treatment Network, said the ruling might be a sign that the courts are now catching up.

“Attempted murder seems a bit extremist,” Prof. Adam said.

“Maybe HIV is now being looked at just as other conditions are — treatable. This might be a trend in the courts that attempted murder is overkill. Maybe we are coming into line with the rest of the world.”

Jeremy Dias, gay rights activist and executive director of Ottawa diversity group Jer’s Vision, hailed the judge’s decision as progressive.

Even so, the ruling reignites debate over the issue of criminalizing AIDS transmission in the first place.

“The case is about police services impinging on the duties of health professionals,” said Mr. Dias. “What we have learned from other countries that have criminalized HIV is people don’t get tested. The majority of infections in Canada come from people who are untested. We need to get more people tested.”

Prof. Wainberg agreed.

“I’m the first to say that anybody who knows they are HIV infected and does not inform their partner is doing something morally reprehensible,” said Prof. Wainberg. “The question is whether it should be criminalized. We lose more than we gain by making HIV a crime.

“In rare instances, we gain a kind of revenge, some satisfaction as a society that we have used the criminal proceedings to incarcerate someone who engages in reprehensible behaviour. But the greater good for Canadian society is to try to limit new transmissions of HIV to as great an extent as we can; to encourage everyone to be tested.”

Victory! Court Overturns “Anti-Prostitution Pledge”

Friday, July 8th, 2011


Yesterday, a federal appeals court in New York ruled that the US cannot force organizations to formally pledge to denounce prostitution and sex trafficking in order to receive US funding for HIV and AIDS work. This is a significant victory for the global health community. Why is this good news? Because the policy—commonly known as the “anti-prostitution pledge”—is flawed.

The pledge requires all organizations—American or foreign—that receive US funds to fight HIV and AIDS abroad to adopt a formal position condemning prostitution and trafficking. I have been involved with international development organizations focused on HIV and AIDS.  I have never met anyone in the development community who is not firmly opposed to—or horrified by—trafficking. There are few issues that bring such universal abhorrence. One problem with the anti-prostitution pledge however is that it conflates prostitution and trafficking, which ignores realities on the ground. In many developing countries there are individuals who sell sex for their livelihood—food, shelter. And these individuals require and deserve access to health and social services, including HIV prevention and care. Condemning and judging by denouncing their livelihood can drive them further from the help they need, limit their ability to access health care, provide for their families, or even leave the industry.

The ambiquity of the pledge language adds to the challenge.  If, as in the case of one plaintiff, Pathfinder International, an organization works with sex workers to organize and empower them so that they can advocate for their rights (which is both an effective HIV prevention strategy as well as an effective means of reducing other harms of sex work, including violence and exploitation), is that “promoting prostitution?” No. For those of us in the development community, it means you’re helping those in need.

Perhaps even more problematic, the pledge, as defined by the Bush Administration who first enforced it and now the Obama Administration, applies not only to US government funding, but to private donations as well. That means that even if an organization is not using any government funds to provide services to sex workers, they could potentially lose US funding for their separate, privately-funded work.

Recognizing the issues with this policy, Pathfinder and Alliance for Open Society International originally brought the US Government to court in 2005. “Trust that it was not an easy decision for Pathfinder to take our largest funder—the US Government—to court,” Pathfinder President Daniel E. Pellegrom said. “However, we strongly believe vital principles were, and continue to be, at stake. Private organizations cannot be told what to think or believe; they cannot be compelled to espouse a government mandated position. And they must be free to challenge the status quo and to speak out on behalf of the vulnerable and disenfranchised.”

In 2008, more than 300 other organizations from coalitions at Global Health Council and InterAction also joined the case—a testament to the global health communities universal dismay over this policy.

This case has received little, if any, attention beyond the global health community, but it has huge consequences for our democracy, women, NGOs, and the global HIV battle. “This victory has profound implications not only for the rights of private, non-governmental organizations to operate without undue government interference, but for the health of vulnerable women, men, and adolescents in less developed countries,” President Pellegrom said.

Photo: Courtesy of Pathfinder International shows sex workers in India during a community-empowerment meeting as part of the Mukta Project.

Male circumcision: Another stride to curb HIV/AIDS

Monday, July 4th, 2011

Times Zambia

MALE circumcision  defined as the removal of the foreskin, or the extra skin that folds over and covers the head of the male private part is one of the oldest and most common medical procedures practiced globally.
The process has been practiced in Zambia and in many African countries such as DR Congo, Nigeria, among other nations.
Male circumcision is being promoted by the Ministry of Health in Zambia as part of the nation’s comprehensive HIV prevention strategy.
Baby boys below sixty days old as well as toddlers aged from seven, and men are queuing to be circumcised at both public and private health centres dotted across the country.
Male circumcision or MC is performed by first injecting the base of the male organ to numb the area that is in front of the private part.
Although the battle over who was the true discoverer of  AIDS, a pandemic that continues to ravage mankind from the time it was discovered on June 3,1981 is not known, the media and medical experts are now looking to other ways of reducing the risks of contracting HIV/AIDS.
Circumcision has been clinically proven to reduce the risk of HIV and some other Sexually Transmitted Diseases (STDs) in men, including Syphilis, Chancroid and Human Papiloma Virus (HPV).
HPV is a virus that can cause penile cancer in men and cervical cancer in women. It should be emphasised that male circumcision does not provide 100 per cent protection, hence it is important for  all circumcised men who are sexually active (after the six  week healing period is complete) to use condoms correctly and consistently every time they have sex.
To support the importance that the Government of Zambia attaches to tribes that revere the cultural practice of male circumcision, on December 2, 2002, former Minister of Health  Brian Chituwo noted that North Western Province had a peculiar lowest HIV/AIDS and Syphilis cases and partly attributed this to circumcision.
Dr Chituwo said this as former chairperson of the Cabinet committee on HIV/AIDS .
This was during the HIV/AIDS parliamentary seminar which was held at Lusaka’s Mulungushi International Conference Centre.
Dr Chituwo in recommending circumcision said the practice had proved to hold back the spread of STDs including HIV/AIDS.‘’North-Western Province has the lowest HIV/AIDS in the country because of some male practices like circumcision despite its causes of grievous bodily harm,” Dr Chituwo remarked.
“I  am ready to set up a camp and conduct the exercise.
There is no age limit for circumcision and parliamentarians should consider it as we fight HIV/AIDS in the country,” he said.
Dr Chituwo said HIV/AIDS was fuelled by poor health system, poverty, gender inequality as women could not negotiate for safer sex due to stigma and discrimination.
History seem to repeat itself to some extent.
In  the 15th  century syphilis, a venereal disease spread throughout Europe and claimed lives in many countries.
Later the disease became more of a chronic infection which remained incurable until the arrival of active Antibiotics just before the Second World War and it retained scars of stigma to people who became victims.
Then in 1981 came HIV/AIDS, a nemesis to mankind and deaths that have claimed millions of productive lives are still the irrevocable consequence that humanity is grappling with.
Sexually active people are either contracting AIDS through unprotected sex, while innocent children get the virus at delivery through their mothers.
Moreover some are infected through contact with contaminated razor blades and syringes among other ways.
For example in  2002 official statistics from the Central Statistical Office (CSO) indicated that Zambia’s population that stood at 9.3 million had an HIV/AIDS prevalence rate of 16 per cent of the adult population ranging between 15 to 49 years.
But   latest CSO statistics indicate that the population is slightly more than 13 million and the levels of new infections have drastically fallen, an indication that sexually active adults are cautious with their sexual lives.
According to Geoffrey Sikapizye, a clinician, though circumcision is not a remedy to the fight against HIV/AIDS, the removal of the foreskin in male circumcision makes it more difficult for HIV to enter the body.
“The skin on the neck of the manhood under the foreskin is very soft and moist.
During sex, this inner foreskin can get bruised or irritated.
When this happens, tiny openings appear in the foreskin that can allow the HIV virus to enter the body. Just below the foreskin there are a lot of special cells called “HIV target cells.”
There are more of these HIV target cells in the foreskin than any other part of the male body.
The HIV target cells in the foreskin act like a sponge, taking in any HIV virus that comes into contact with the private part.
Therefore after the healing process is complete in a circumcised male, the skin on the neck of the manhood becomes dry and many of these HIV target cells are removed making it more difficult for the HIV virus to enter the male body during sexual intercourse,” explained Mr Sikapizye.
Richard Zulu is one of the many people who has undergone the surgery and was full of smiles when he narrated his experience in an interview.
“I am now a real man because my organ has already been cut.
Even in the Bible it is written that Jesus Christ was circumcised immediately his parents saw it fit to take him for the practice so as to keep their tradition.
Against such biblical teachings and after observing that a Luvale friend of mine is circumcised, I became motivated as well,” Mr Zulu said.
Mr Sakapizye outlined how the process of circumcision is done.
“Before the circumcision procedure, one will be asked to participate in an education session led by a trained counselor or MC (male circumcision) provider where more detailed information about what to expect during the procedure is taught.
After the session, a client will have another one-to-one counseling session where an encouragement to take a confidential HIV test is discussed.
Knowledge of one’s HIV status before going for an MC assists in maximising the benefits of the process. Would be male clients should be informed that male circumcision is not recommended for people living with HIV.
In occasions where a client tests positive but still wants  to undergo MC ,they will need to be evaluated to see if their immune system is strong enough’’ Mr Sikapzye explained.
A clinical assessment is done before the operation to rule out any active or recent genital diseases.
If there is an active disease, it is treated before an MC is done.
Some injections of pain killing medicine is administered at the base of the private part  prior to the process to numb the entire manhood so as to enable one not to feel any pain while the foreskin is being removed.
The providers use clean needles and a special thread called suture to close up the private part  wound so it will heal quickly.
Clients are encouraged to wait for six weeks before having sex to enable the wound to heal properly.
If a client engages himself in sex, they risk damaging or delaying the healing of the sexual organ.
Besides that, one is actually at a high risk of contracting HIV and other STIs.
After all the information is gathered from experts on male circumcision and churned out for the public to know, it has to be alluded in plain language that circumcision is not a 100 per cent protection.
Circumcision is just but one of the many other interventions like abstaining and correct usage of condoms that should be employed to prevent spread of HIV.

HIV-positive Calgary man sent to hospital under isolation order

Wednesday, June 22nd, 2011

Calgary Herald

CALGARY — A Calgary man who pleaded guilty to a sexual assault when he did not tell his partner he was HIV positive will go to a psychiatric hospital in Ponoka under a rare public health isolation order.

Paul Thomson pleaded guilty in Red Deer court to a sexual assault and breaching a court order.

He was sentenced to 46 months in custody, which meant the time he has already served in custody because of a two-for-one credit.

Thomson originally faced 11 charges in relation to a sexual assault against a woman, who cannot be named, but that was dropped to two.

He’s been in custody since 2009 and his sentence ended with the plea Tuesday.

Crown prosecutor Robin Joudrey said on Tuesday the isolation order came from his defence lawyer and health team and she could not speak about it.

Alberta Health Services could not discuss the patient’s case.

According to the Public Health Act section on isolation orders, “a medical officer of health who knows of or has reason to suspect the existence of a communicable disease or a public health emergency within the boundaries of the health region in which the medical officer of health has jurisdiction may initiate an investigation to determine whether any action is necessary to protect the public health.”

Joudrey said Thomson had to provide a DNA sample as part of his plea.

“He’s on the sex-offender registry list,” said Joudrey.

Thomson’s lawyer, Richard Wyrozub, did not return calls Tuesday.

[email protected]

Scientists reveal HIV weakness

Tuesday, June 21st, 2011

Ever since HIV was revealed as the infectious agent behind the AIDS epidemic, scientists have been striving to develop a vaccine against the disease. However, the task has proven difficult, because HIV mutates so rapidly.

In a new finding that may allow vaccine designers to sidestep part of that obstacle, researchers at the Ragon Institute of Massachusetts General Hospital, MIT and Harvard University have identified sections of an HIV protein where mutations would actually undermine the virus’ fitness — its ability to survive and reproduce.

Vaccines that prime immune cells to specifically target those vulnerable regions could prove much more effective than previously tested vaccines, says Arup Chakraborty, the Robert T. Haslam (1911) Professor at MIT and senior author of a paper on the work appearing in the Proceedings of the National Academy of Sciences the week of June 20.

Though global HIV infection rates have dropped since 2000, there are still more than 33 million people living with AIDS. The vast majority of those people live in developing countries, where there is limited access to antiretroviral drugs that can control the infection.

“Even though we have treatments, the number of people in need globally is outpacing our ability to provide these drugs,” says Harvard Medical School Professor Bruce Walker, director of the Ragon Institute and a senior author of the new paper. “The only real solution is development of an effective vaccine.”

Lead authors of the paper are Vincent Dahirel, a former postdoc in Chakraborty’s lab who is now a professor of chemistry at the Université Marie et Pierre Curie in Paris; and Karthik Shekhar, a chemical engineering PhD student at MIT.


Viral vaccines usually consist of killed or weakened versions of a virus that prime the body’s immune system to respond when it later encounters the real thing. Most experimental HIV vaccines include some proteins found in the virus’s genetic material.

Vaccines provoke the recipient’s immune system to generate two types of responses: antibodies that can battle viruses in blood or outside cells, and memory T cells, which attack cells that display viral proteins on their surfaces — a sign of infection. However, HIV can escape these responses when its viral proteins evolve to new forms that the vaccine-induced antibodies and T cells no longer recognize. Most researchers believe that an effective HIV vaccine will have to include both an antibody and a T-cell component.

In recent years, designers of the T-cell arm of a vaccine have looked to target single amino acids (the building blocks of proteins) that seem unable to evolve to a different form, with the goal of inducing mutations that incapacitate the virus. So far, this strategy has had limited success, because mutations elsewhere in the viral protein can help restore the loss of fitness.

The Ragon Institute researchers took a broader approach, looking not just at single mutations, but trying to determine if there might be groups of amino acids within viral proteins that evolve together in a coordinated way. After identifying some such groups, they determined whether multiple mutations in those groups tended to be beneficial or harmful to the virus’s survival. A group in which multiple mutations are most harmful could be a good vaccine target, because the virus may undermine its own survival if it tries to mutate those sites, and escape pathways would be limited.

The Ragon team analyzed available HIV protein sequences obtained from infected patients using a mathematical approach, including a method called random matrix theory, which was developed by Eugene Wigner in the 1950s to study high-energy physics. Since then, it has been used in many other areas of physics, but has also been applied in other fields, including economics (to study stock market fluctuations) and biology (to analyze sequences of an enzyme family).

For example, Boston University physicist Eugene Stanley has used random matrix theory to find inherent correlations among the stock prices of companies whose economic activities are coupled. He was able to identify groups of companies whose prices fluctuate collectively, but independently of the fluctuations of other groups of companies. (For example, he found that oil and gas company stock prices fluctuate together, but essentially independently of stock prices in the financial sector.)

Multiple mutations

The Ragon team focused on an HIV polyprotein called Gag, which gives the virus much of its structure, and identified five co-evolving groups of amino acids within the protein. The researchers looked at each pair of sites within the groups, calculating whether a double mutation was beneficial or detrimental to the virus’s survival. (They also analyzed triplets and larger groups.) They discovered that one of the groups, which they term sector 3, had the highest proportion of detrimental multiple mutations.

Structural analysis revealed that amino acids in sector 3 are located at interfaces between proteins that form the viral capsid surrounding the virus’s genetic material. If you make multiple mutations to these amino acids, Chakraborty says, it is difficult for the virus to assemble the capsid.

The Ragon team then tested its findings against human clinical data, discovering that T cells in patients who control HIV without medication do in fact disproportionately target sector-3 amino acids at multiple points, and HIV strains with multiple mutations in this sector are rare, indicating that those strains are less likely to survive.

This finding strengthens the argument that these protein sequences would make good vaccine targets, notes Gregory Petsko, professor of biochemistry and chemistry at Brandeis University. “Tying it to the patient population is what sets this apart, in my mind, from a traditional computational study,” Petsko says.

The Ragon researchers suggest designs for test vaccines based on the vulnerabilities they found in the Gag protein, and are now looking for vulnerable targets in other HIV proteins.

Rafi Ahmed, professor of immunology at the Emory University Vaccine Center, says the paper offers an exciting new approach to designing HIV vaccines. “It breaks new ground in terms of vaccine design and potential insights into why elite controllers are more effective at controlling HIV infection, and it provides additional protein regions to examine,” Ahmed says.

Home / News / Local ‘Take the Test, Take Control’ on HIV Testing Day

Tuesday, June 21st, 2011

National HIV Testing Day is Monday, June 27, and local health officials are hoping that residents in The T&D Region will follow this year’s message, “Take the Test, Take Control.”

Hope Health-Edisto, the South Carolina Department of Health and Environmental Control Region 5 Public Health Department, the Minority AIDS Council, South Carolina State University’s Brooks Health Center, OCAB Community Action Agency, and the Community Engagement and Outreach Core of the Center of Excellence in the Social Promotion of Health Equity Research, Education and Community Engagement will be conducting free, confidential HIV testing at a few sites within the community to promote education and awareness. Testing times and sites for June 27 include:

– 10 a.m.-2 p.m. – CORE Center, 520 Hesseman St., Holly Hill.

– 10 a.m.-2 p.m. – Victory Tabernacle Church, 681 Broughton St., Orangeburg.

– 7 p.m. – South Carolina State University Student Center, 300 College St., Orangeburg.

“We are attempting to reach residents of Orangeburg and surrounding counties,” said Karen Clinton, senior community liaison for CCE-SPHERE. “This event is the first of many testing events to come. We are piloting testing at these three locations, and will replicate these services in other parts of the DHEC Region 5 service area in the future.”

Each year on June 27, the National Association of People With AIDS partners with the Centers for Disease Control and Prevention and other national and local entities across the country for National HIV Testing Day. This year’s National HIV Testing Day comes at a pivotal time, as the U.S. marks 30 years since the first reported diagnosis of what would later be known as AIDS.

Clinton said the testing at the local community sites will involve the Oraquick mouth swab, and individuals will have their results back in 20 minutes.

In addition to the testing scheduled for June 27, two sites will offer HIV testing on Thursday, June 23:

– 8:30-11 a.m. and 1-3:30 p.m. – Orangeburg County Health Department, 803-536-9060.

– 5-7 p.m. – Kingdom Life Ministries, Orangeburg, 803-536-9060 or 803-534-1980.

The Centers for Disease Control and Prevention estimates that more than 1.1 million Americans are living with HIV, and approximately 230,000 of them are unaware they are infected with the virus. DHEC statistics show more than 15,000 people are living with HIV in South Carolina.

According to SCDHEC’s Surveillance Report, through December 2009, the Edisto Health District reported a total of 1,166 HIV/AIDS cases, with a cumulative rate of 959 cases per 100,000 people – the highest rate in the state of people infected with HIV/AIDS.

“As of 2009, Orangeburg County is number five, Bamberg County is number two and Calhoun County is number 23 in the state for HIV cases per 100,000 (people),” Clinton said. “It is imperative that we get the message out about HIV testing because one out of five people living in the United States are unaware of their HIV status. NHTD is an opportunity for people locally and nationwide to learn their HIV status, and to gain the necessary knowledge to take control of their health and their lives.”

For more information, call Clinton at 803-240-3732, Willie Simon at 803-535-2272 or DHEC’s AIDS/STD Hotline at 1-800-322-AIDS, or visit

“HIV can be Spread in Beauty Salons,” AIDS Centre Tbilisi

Monday, June 20th, 2011

The FINANCIAL  — “Beauty salons without good hygiene measures are potential sources for the transmission of infectious diseases, including HIV,” said Maia Tsintsadze, doctor at the Epidemic Department of the AIDS Centre.


Many of the beauty salons in Tbilisi do not meet the standards of hygiene that can prevent the transmission of diseases, doctors believe. The majority of people who are often visiting beauty centres say that price, not quality, is their priority while choosing a salon.

“We don’t have registered cases of infection at beauty centres. But it is possible, as at salons the continuity of the skin is broken. As well as HIV/AIDS, Hepatitis B and C may be transmitted in beauty centres too,” said Maia Tsintsadze, doctor at the Epidemic Department of the AIDS Centre.

“We can’t say exactly who has become diseased from beauty salons but they are really risky places,” said Maia Gutsashvili, Deputy of the Director of the National Centre for Disease Control and Public Health. “Proper sterilization of instruments costs quite a lot and most salons can’t afford it. The prices at beauty centres which have good hygiene measures are expensive. The average citizen therefore can’t afford it.”

There are more than 2,000 beauty salons in Tbilisi . But centres with proper hygiene compliance are in the minority. Prices between salons differ significantly. Whereas at Natali and Green Salon a hairstyle costs 8 GEL, at “Beauty Salon” it costs 4 GEL and at Image – 5 GEL. A special occasion hairstyle at Natali costs 45-90 GEL, at “Beauty Salon” – 10-30 GEL.

“Unfortunately we don’t have any control over this. High standards must be mandatory for all salons. But now each beauty salon pays as much attention to the level of hygiene as they want. If it was up to my will, I’d close down many of them,” said Tamuna Sharashenidze, Organizer of the Beauty Salons’ Competition and Chief Editor of Magazine Saloni.

“I had a project about possible solutions to this problem. The first step has to be seminars for directors and hairdressers. Because they have variable knowledge and awareness of the risks of getting infected by a virus or skin disease by using wrongly or inadequately sterilized implements,” added Sharashenidze.

Failing to properly disinfect the tools could lead to the spread of infectious diseases. According to the statistics of Infectious Diseases, AIDS and Clinical Immunology Research Centre, by June 14, 2011 a total of 2,882 HIV/AIDS cases had been registered at the Centre, these include 2,123 men and 759 women. In 2010 the biggest number of infected people were registered – 455 individuals. This number has been growing since 1989, when the first case of HIV/AIDS was detected in Georgia.

All beauty salons claim that they have sterilizers and disinfect tools after each use. But according to specialists not all sterilizers can ensure safety.

“High hygiene measures are synonymous with our salon. We use imported sterilization liquid, which is used in surgical theatres at hospitals. Towels for pedicures are single use. For everything else we have a washing-machine,” said Lika Manjgaladze, owner of Green Salon, winner of the Beauty Salons’ Competition.

“Hygiene and cleanliness are our main priorities. For sterilization we use a special liquid imported from Spain. A modern sterilizer is used to hold nail implements immediately after each use. We are sure that our service is perfect and that’s why we suggest all kinds of service, including beard trimming for men,” said Sopo Nikoladze, Manager at beauty centre network Natali.

According to Maia Shakiashvili, owner of Beauty Salon in Tbilisi , they wash and disinfect all tools after each use by sterilizer.

“Our main clients are people living near our salon. They know that we have good hygiene and they are used to coming here. We have a sterilizer for manicure instruments, but we don’t have one for shaving. That’s why we don’t suggest it to our male clients,” said Shakiashvili.

Nata Kaulashvili, Manager of Image, a beauty salon in Sanzona, one of the suburbs of Tbilisi , says that they also don’t suggest beard shaving as they don’t have a proper sterilizer for the tools. In terms of everything else they are sure of their level of hygiene. After each use they disinfect implements in a sterilizer.

Representatives of these four beauty centres claim to have good hygiene measures, like others in Tbilisi . But Maia Gutsashvili, Deputy of the Director of the National Centre for Disease Control and Public Health says that not all beauty salons have as good hygiene as is necessary.

“I’m not saying that they don’t disinfect their tools. But most of the beauty salons have a simple sterilizer which just isn’t adequate. Special antiseptic liquid is also necessary. Modern sterilizers and sterilizing liquid, those that can really ensure hygiene, cost too much. Maybe it isn’t good of me to say this, but if all the salons had to buy proper equipment, lots of them would go bankrupt. At the moment they just have elementary hygiene levels,” said Gutsashvili.

Green Salon is 10 years old. At the beginning they also had just a simple sterilizer. But now they have evolved and don’t use it any more.

“Of course having a good sterilization machine and liquid costs a lot. But we can’t have it otherwise. Every day I come here and control the situation myself. We had a case of a manicure specialist who didn’t sterilize the implements after each use. We fired her immediately,” said Lika Manjgaladze.

“Currently the best solution would be if everyone carried their own tools to beauty salons. That would ensure perfect safety. If people don’t do so then they have to be sure that implements are properly sterilized before use. But still I would advise everyone to do manicures and pedicures at home,” added Maia Gutsashvili, the National Centre for Disease Control and Public Health.

Quebec HIV case challenges assumptions about nondisclosure

Friday, January 28th, 2011

NEWS / Steve Biron at the centre of what could be landmark case

Luna Allision January 2011

An HIV-positive man in Quebec City is in custody facing charges of aggravated sexual assault and aggravated assault for allegedly having bareback sex with 11 or more men between June and October 2010 despite knowing his poz status.
He faces up to 14 years in prison if the charges stick, but the story is not as simple as it would first seem.

Steve Biron, 32, first appeared on police radar Nov 5, 2010, when a fuck-friend of Biron’s came forward with a complaint against him, saying that Biron had lied about his HIV status before they had unprotected sex.

After processing the complaint, Quebec City police launched an investigation. They arrested Biron on Nov 22 and released a province-wide communiqué a week later, saying that he was being charged with aggravated assault and aggravated sexual assault and asking people to call the police if they had been in contact with Biron on the internet (Biron hooked up with most of the guys through The communiqué, along with Biron’s picture, ran in most newspapers, on web-based news outlets and on several TV channels across Quebec.

“We asked the population to call us if [anybody] was involved with him,” says Sandra Dion, a communications agent with the Quebec City Police Service. “He was on the internet and everything, so the investigator believed he had many partners. We’re not allowed by law to talk about his health status, so we could not say he has HIV. That’s why we asked people to contact the police.”

But there are growing questions about the validity of the case and how it’s being handled.

During a Dec 22 court appearance, the public heard from the investigating officer in the case, Detective Sergeant Louis Lachance. While on the stand, Lachance confused case details, as well as several terms related to HIV and the gay community. He excused himself by saying he didn’t have his papers in front of him. Judge Chantale Pelletier, who was presiding, said, “Well, you must know the case?” Lachance replied that he wasn’t comfortable with the case.

That day, it also came to light that the original complainant in the Biron case has done time for fraud, extortion and breach of conditions. His entire criminal record — totalling more than 40 criminal acts — was read into the court record by Judge Pelletier during the Dec 22 hearing.

Biron’s lawyer at the time, Herman Bédard, decided not to present any of the scientific evidence he had at his disposal about the effects of the antiretroviral meds that his client had been on since being diagnosed with HIV in 2007, or about Biron’s undetectable viral load — both of which significantly lower the risk of HIV transmission and may have influenced the decision to go to trial.

“The rule in Canada is that someone can be prosecuted for not disclosing his or her HIV-positive status before engaging in a sexual act that represents a significant risk of HIV transmission,” says Cecile Kazatchkine, a policy analyst with the HIV/AIDS Legal Network. “So, the courts take into account whether there was or was not a significant risk of transmission. We know now that someone’s viral load will have an impact on HIV transmission. The lower the viral load, the [lower] the risk of transmission. The courts cannot ignore the science anymore. We’re not talking about elimination of the risk; we’re talking about [there not being] a significant risk.”

“It is actually a real bastardization of the justice system… sexual assault as a charge removes any accountability within this context for any of the claimants involved — specifically regarding their other sexual activities within our community,” says Mikiki, a Toronto-based HIV/AIDS activist. “Not only does it further HIV stigma and homophobia and fear around testing for dudes who don’t know their status, it also reinforces the need for poz guys to conceal our status out of fear of criminal prosecution and not the opposite.”

Recent decisions in the Quebec and Manitoba Courts of Appeal state that HIV-positive people like Biron, who have an undetectable viral load, are not required by law to disclose their HIV status before engaging in sex because there is no significant risk of HIV transmission — even when it comes to unprotected sex. It was ruled by both courts that an undetectable viral load or the careful use of a condom represented a low risk of transmission, though both court decisions avoided stating that either scenario would automatically cancel out legal liability.

The Manitoba decision also suggests that the nature of the disease has evolved due to availability of new treatments and that HIV is no longer a death sentence.

These points were mirrored in the Quebec Court of Appeal’s decision on Dec 10.

Scientific evidence related to treatment options and viral load will certainly be introduced in court as part of Biron’s defence, but the work of investigative journalist Roger-Luc Chayer of Gay Globe Media is likely to contribute significantly to Biron’s case as well.

Chayer started digging into the case after being approached by a family member of Biron’s.

“I wasn’t aware of the case, so I asked what was happening. They gave me a briefing about the arrest,” says Chayer. “I was not happy with what Mr Biron did. Somebody is trying to transmit AIDS? This is not a good thing in society. Let’s just say I didn’t have a positive feeling about it. But, I said, of course I’ll look at the documents because I want to know the story. Then I saw the written statements that the [alleged] victims made to the police.”

The online names of the alleged victims were listed in their statements, so Chayer decided to go to the Gay411 site and try to view their profiles. He soon found out that most of the guys who were bringing complaints against Biron were still active on the site and looking for hookups.

“That’s interesting because, when you read the victims’ statements, most of them said that they were traumatized and sick with anxiety,” says Chayer. “In my mind, I was wondering if they would go as far as to do the exact opposite of what they said in their [statements].

“I decided to contact them — not telling them I was a journalist, of course, undercover. I said, you know, my trip is to have bareback [sex]. I want to feel the skin. Don’t talk to me about any condoms. If you talk to me about condoms, I’ll turn you away. Most of them said yes. They didn’t ask me any questions about HIV. I printed every conversation. In their statements, they said that they [had] all questioned Mr Biron about that before having sex with him. They said he gave them a guarantee that he was negative. The problem is that none of them asked me about my HIV status. This happened two or three weeks after Biron was arrested, so it [doesn’t make any sense].”

Chayer’s exposé raised doubt about whether safer sex was something that Biron’s sexual partners were looking for in the first place. The evidence Chayer gathered has been subpoenaed by the court, and he has agreed to release the information in the interests of a fair trial.

“Mr Biron called me once from jail,” says Chayer. “He said to me that before the investigation was published, he was being beaten and harassed. His life in jail was a nightmare. People would cut [out] the newspaper articles about him and put them everywhere so the prisoners would read that and attack him. When the investigation showed that the [alleged] victims were very problematic, his quality of life got a lot better.”

Biron has been in custody since his arrest. After hearing the Crown prosecutor’s evidence on Dec 22, Judge Pelletier refused bail for the accused, saying that he posed a serious threat to public safety.

The accused has parted ways with his counsel and is now represented by another Quebec City lawyer, Denis Bernier.
Bernier will soon petition the court for the right to approach the Quebec Court of Appeals in the hopes of overriding the imprisonment order against Biron, but the process will take between one and three months.

Biron will appear in a Quebec City court Jan 31 for his preliminary hearing.

Investigation: The Steve Biron case in Quebec City

Sunday, January 23rd, 2011

Steve Biron : Imprisoned in Quebec for having sex without a condom…

The importance of using the right words…

By Roger-Luc Chayer

[email protected]

The worst sex scandal to strike within the walls of Quebec City since OPERATION SCORPION targeted juvenile prostitution has grabbed the world’s attention by targeting a gay man for supposedly reckless acts.

The facts are simple: Steve Biron, currently imprisoned in Quebec City, is accused of cruising the internet in order to have unprotected sex with gay men, despite knowing he had contracted HIV.

The simple premise and the questions raised by the case very clear: What is a “safe” sexual act, what is a “clean” person and, above all, what is “barebacking”, because the whole case rests on these “fads” in the gay community in general.

Before Gay Globe’s investigation went to press, the court issued a publication ban, so we are unable to name the so-called “victims”, however their identity is unimportant since their conduct in this affair is the object of a lawsuit.

Within the Quebec gay community, the terms are important, since they are used on specialized websites such as Gay411 or Priape to arrange encounters. Members of these websites routinely use these terms, which are defined as:

SAFE: This word refers to the degree of safety of the sex act. It may involve the use of condoms but is usually used in terms of conduct. “Safe” sex can mean contact without exchange of fluid, massages, kisses, caresses, sex without penetration or using items like dildos or gels. The range of “safe” relationships is broad and cannot be limited or oversimplified as the use of a condom. It would be equally wrong to suggest that “safe” sex precludes HIV. A person with HIV can indeed have “safe” sex.

CLEAN: In addition to the term “safe”, the word “clean” is used to refer directly to a medical condition. It often means the absence of HIV and HIV-negative status but it is also applies to all sexually transmitted diseases such as gonorrhea, Chlamydia, syphilis, herpes or hepatitis and other diseases that can be transmitted by physical contact.

To some people, “clean” can also mean that they test positive but have an undetectable viral load. Indeed, for several years it has been known that triple therapy, when followed regularly, can reduce the HIV viral load to the point of becoming undetectable in blood making it more difficult to transmit the virus, since it there are not enough present to constitute a serious risk. Since 2010, UNAIDS has favored triple therapy over condoms as the best way to prevent HIV infection, and Canada subscribes to the position of this United Nations agency.

An assertion by a person with HIV whose viral load is undetectable following triple therapy treatment and calls himself “clean” is now supported by science. Using the same logic, some HIV-positive people refer to themselves as HIV-negative when they know it is undetectable. One may disagree with this opinion but, logically, the lack of evidence meets the criterion for an HIV-negative finding.

BAREBACKING: This practice is not entirely new, having emerged around 1996 in the gay community, mainly among HIV-positive people who refuse to use condoms. The consensus among community groups and Quebec Ministry of Health of Quebec specialists is that practitioners consciously lust for the thrill of risking unprotected sex in order to achieve an adrenaline-driven orgasm. Like playing Russian roulette, barebacking is synonymous with a conscious desire to flirt with death. Some depressed people who see no hope for the future practice barebacking, claiming that they won’t live long enough for an HIV infection to affect them. Barebacking is also sometimes considered a mental illness. All people seeking to bareback know that they are dallying with HIV — and death.

Police brutality and prejudice go hand in hand!

By Roger-Luc Chayer

[email protected]

When everything goes wrong, nothing works any more…”. That summarizes the handling of a very unique Quebec trial which has led to the imprisonment of a gay man, Steve Biron, for allegedly having unprotected sex despite knowing that he had HIV.

According to testimony by the officer in charge of the investigation during a Dec. 22 hearing at the Quebec City courthouse, it all started when Biron’s alleged victims filed complaints. Quebec City Police Detective Sergeant Louis Lachance looked quite awkward when, at the request of Crown prosecutor Rachel Gagnon, he tried to summarize the case to Judge Chantal Pelletier during a bail hearing.

Det.-Sgt. Lachance tried to explain the difference between the words “safe”, “clean” and “barebacking”, mixing up the definitions to the point that he acknowledged that he didn’t have the entire file at his fingertips with which to make the distinctions.

He also depicted Gay411 as a dating site reserved for “homosexuals” that offers nothing but anal sex, top or bottom. However it’s well-known, as a visit to the site confirmed, that Gay411 is a dating site for men (be they gay, bisexual or heterosexuals seeking alternative adventures), that, besides offering sexual services, provides many other services like friendship, chat-rooms or love. It is quite misleading to suggest that the site is only for tops or bottoms, as these practices are not common to all gays.

The officer’s testimony ended up being an embarrassing expression of prejudice against gay lifestyle, rather than the precise description of a gay dating site that one would expect during a criminal court hearing. The officer also confused the meaning of the words “safe” and “clean “, saying that safe means HIV-negative and that clean means the same thing, although this is untrue. Steve Biron’s lawyer, Herman Bédard, appeared to decide, to the surprise of all including his client—not to file his evidence and let the judge make a decision that seems not to be fully informed.

For example, during preparatory meetings with his client, members of his family and partner as well as with the author of this article, the lawyer stated that he was prepared to submit the findings of Gay Globe Media’s investigation, which demonstrated that some of the alleged victims were not as clean and innocent as they had claimed in their written statements to police.

The lawyer ought to have enabled judge Pelletier to consider medical advances such as triple therapy and undetectable viral load, which he ultimately failed to do, despite all the findings and documents in his possession. All this led to a ruling that has kept Steve Biron behind bars, awaiting further proceedings that include a preliminary hearing slated for January 31, 2011. Can justice be served when incompetence runs rampant at a criminal trial?

Manitoba Court of Appeal opts to release HIV victim undergoing triple therapy…

By Roger-Luc Chayer

[email protected]

In the case of the Crown vs. Mabior, the Manitoba Court of Appeal, the province’s highest court (just below the Supreme Court of Canada) issued a ruling which is not binding elsewhere in Canada, one which Judge Chantal Pelletier—who is hearing the Steve Biron case—chose to ignore. In its ruling, the court said that for a person to be convicted of sexual assault or serious aggression for not having disclosing his HIV status, the risk of HIV transmission must be significant. Based on the facts and the medical evidence presented in this case, the Court of Appeal held that if a condom is used carefully or if the accused’s viral load is undetectable, then the act does not involve significant risk of HIV transmission. Therefore, there is no requirement to disclose HIV-positive status in these circumstances.

True or trumped-up victims? That is the question…

By Roger-Luc Chayer

[email protected]

We could not set about publishing a full investigation into the Steve Biron case without looking into the activities of some victims who claim to be pure and chaste, according to their statements filed in court.

Since most of the victims said that they used the services of the Gay411 site to meet Steve Biron and since GayGlobe Media has an account there, it was very easy to locate victims under the guise of strict anonymity, long after their statements to the Quebec City Police Department led to the arrest of Steve Biron.

A common thread emerged, which can be easily summarized: Nearly all the victims told police that they weren’t seeking barebacking, that this unprotected sex was agreed to under false pretenses by Biron, that they were concerned about the possible transmission of HIV, that Biron at first assured them that he was not positive and that they had never before been involved in barebacking. It’s also worth noting that, for the moment, all the victims say that they remain HIV negative and that all tests confirm that since Biron’s arrest no one has been infected, supporting the thesis that a person with HIV who is being treated and whose HIV is undetectable cannot transmit the disease.

Gay Globe’s investigation leaves no doubt as to the fact that some of the “victims” appear to lie in their statements to police. First, a Gay Globe staff member who posed as a Gay411 member looking for unprotected sex attempted to communicate with some victims whose account was still open and working. It was not difficult to establish links with at least five of Steve Biron’s alleged victims. The web identity of the victims—in other words, their user name—was clearly stated in their complaints and their account of events to police.

Disturbingly, not only were the victims who said that they had been traumatized and were undergoing post-exposure preventive treatment still very active on the Gay411 site, three of them responded positively to our requests for “bareback”-type sex without asking a single question about our HIV status or our health and even agreed to meet us at a well-known Quebec City hotel. Essentially, people who claim to be victims of a barebacker who had lied about his HIV status were very actively trying to engage in bareback acts without a moment’s worry about HIV, completely contradicting their criminal complaints. In addition, since these victims know they are potentially HIV-infected—as they claim in their complaints—by witholding that information from our representative during their investigation into bareback sex, they committed themselves to the very acts that they complained Steve Biron had committed, showing how little importance they attach to the threat.

The identity of these individuals is known and will be unveiled to the Court, as counsel for Steve Biron has told Gay Globe that a subpoena has been served requiring us to disclose this information, which we will not object to since the freedom of an individual is at stake.

To conclude, Steve Biron, accused of knowingly conveying HIV, faces a prison sentence of up to 14 years. The issues at hand are simple: Had Biron truly intended to transmit the disease, why is he undergoing triple therapy whose only purpose is to reduce the viral load? Did Steve Biron really intend to commit a criminal act? There is a reasonable doubt in this case and, faced with that doubt, acquittal is the only possibility. That’s the way the law works in this country in which we live.

What are the risks of making false accusations?

By Roger-Luc Chayer

[email protected]

Any person who makes a false charge against another could face serious legal consequences. For example, police might charge the accuser with mischief, a crime that could lead to a fine or a prison term. A person who perjures himself in court would face similar consequences.

Finally, those who make false complaints to the police could face civil suits and potentially a judgment obliging them to pay significant damages. Food for thought…

48- Découverte: le Maraviroc

Saturday, April 17th, 2010

Santé Canada accepte de
soumettre à un examen prio-
ritaire le maraviroc de Pfi zer,
nouveau médicament contre
le VIH
Plutôt que de sʼattaquer au virus
à lʼintérieur des leucocytes, le
maraviroc lʼempêche de pénétrer
dans les cellules non infectées en
bloquant leur porte dʼentrée prin-
cipale, soit le corécepteur CCR5.
Sʼil est homologué, le maraviroc
sera le premier agent dʼune nou-
velle classe de médicaments pris
par voie orale à être lancé sur le
marché depuis plus de dix ans; il
contribuerait ainsi à combler le
besoin urgent des patients infec-
tés par le VIH pour de nouvelles
approches en matière de prise
en charge de cette affection.
Pour faire lʼobjet dʼun examen
prioritaire, les médicaments
doivent pouvoir offrir, sʼils sont
homologués, un tableau général
risques-avantages plus favora-
ble dans la prise en charge dʼune
Montréal, le 20 mars 2007 – Plus tôt cette semaine, Santé Canada a accepté de soumettre à un examen prio-
ritaire le maraviroc, médicament administré par voie orale qui empêche le VIH de pénétrer dans les cellules
Sʼil est homologué, le ma-
raviroc sera le premier médi-
cament anti-VIH destiné à la
voie orale lancé sur le marché
depuis plus de dix ans.
maladie ou dʼun état qui ne ré-
pond pas dʼune manière appro-
priée à un médicament actuelle-
ment commercialisé au Canada.
« Nous sommes très satisfaits
de la décision de Santé Canada
dʼévaluer le maraviroc en prio-
rité », déclare le Dr Bernard Pri-
gent, vice-président et directeur
médical de Pfi zer Canada.
« Nous croyons que les antago-
nistes du CCR5 deviendront rapi-
dement une classe thérapeutique
très importante pour les patients
qui présentent une résistance ou
une intolérance aux traitements
actuels », ajoute le Dr Prigent. La
décision de Santé Canada de sou-
mettre le maraviroc à un examen
prioritaire fait suite à la présenta-
tion, cette semaine, des résultats
dʼune étude déterminante sur le
Cette annonce fait suite à la
publication de nouveaux ré-
sultats cliniques qui montrent
que le maraviroc réduit signi-
fi cativement la charge virale
chez les patients déjà traités
par dʼautres médicaments.
maraviroc, lors de la XIVe
Conférence sur les rétrovirus
et les infections opportunistes
(CROI), une des plus impor-
tantes réunions dans le monde
portant sur la recherche en ma-
tière de VIH/sida. Ces résultats
montrent quʼenviron deux fois
plus de patients qui ont reçu le
maraviroc en plus de leur traite-
ment habituel affi chent des taux
sanguins de virus non détecta-
bles, comparativement à ceux
qui nʼont reçu que le traitement
optimisé. « Les données pro-
venant des études sont remar-
quablement constantes et mon-
trent que lʼajout du maraviroc
au traitement habituel entraîne
une réduction signifi cative de la
charge virale ainsi quʼune aug-
Le Programme dʼaccès
étendu permettra aux Cana-
diens dʼavoir accès à des mé-
dicaments expérimentaux qui
sʼattaquent au VIH dʼune ma-
nière entièrement différente.
mentation des taux de cellules
CD4 », affi rme le Dr Trottier,
médecin et directeur médical de
la recherche à la Clinique médi-
cale lʼActuel.
En décembre 2006, Pfi zer Inc a
annoncé quʼelle prévoyait met-
tre sur pied un programme mul-
tinational dʼaccès étendu, grâce
à un protocole dʼétude clinique
qui offrira le maraviroc à des
patients qui nʼont aucun ou pra-
tiquement aucun médicament
homologué à leur disposition en
raison dʼune résistance ou dʼune
intolérance aux traitements ac-
tuels. Santé Canada vient dʼap-
prouver ce programme, et lʼins-
cription des patients canadiens
devait sʼamorcer au cours des
prochaines semaines.

Mourir du SIDA en 2010

Saturday, February 27th, 2010

Mourir du SIDA: Alain Rhéaume est atteint du VIH/SIDA depuis longtemps et lentement se dirige vers la fin de sa vie. il le sait, il en a pleinement conscience et a décidé de partager quelques moments avec GGTV. Dans ce document unique, du jamais vu au Québec, Alain nous raconte le quotidien avec 105 médicaments à prendre par jour, et nous parle de la fin de vie au premier degré. ATTENTION, ce document est très intense, il a fait l’objet de travaux universitaires, quand on dit que le SIDA en 2010 se traite très bien, voyez la réalité en direct! Alain Rhéaume nous a autorisé cette rediffusion.

Le Sida en Russie

Monday, February 22nd, 2010

Le virus fait sa place en Russie et les autorités peinent à faire de la prévention
Un jeune de 18 à 24 ans sur cent est infecté par le virus de lʼimmunodéficience humaine (VIH) en Russie, a indiqué lundi le chef du centre fédéral de prévention et de lutte contre le sida, Vadim Pokrovski, cité par lʼagence Itar Tass.
«Si ces gens ne reçoivent pas des soins modernes, ils mourront du sida dans les dix années à venir», a-t-il averti.
«Nous enregistrons chaque jour une centaine de cas dʼinfections par le VIH», a-t-il ajouté, «un chiffre de 4% supérieur à celui de 2004»
Le centre de M. Pokrovski dispose dʼinformations sur 357 000 ressortissants russes infectés par le virus du sida dont 10 000 sont déjà morts, a-t-il précisé.
«Quelque 14 000 enfants nés de mères infectées sont en observation», a ajouté M. Pokrovski, cité par Itar Tass.
La situation est aggravée par lʼaugmentation de la transmission du sida par relations sexuelles qui représente 31% des modes dʼinfection contre 6% en 2001, a indiqué le spécialiste qui a cité le manque de programmes de prévention et le coût élevé des médicaments parmi les principaux problèmes de la lutte contre le sida en Russie.
Après une année difficile, La Capoterie annonce un retour en force
Après une année très difficile, résultat de nombreux travaux effectués par la Ville de Montréal sur la rue St-Denis, entre Sherbrooke et Ontario, La Capoterie, considérée comme le temple du latex de Montréal, annonce quʼelle est plus ouverte que jamais et que le fermeture de la rue St-Denis est maintenant histoire du passé.
Le commerce, comme de nombreux autres situés dans le même tronçon, avait souffert de lʼabsence de stationnement et de la fermeture de la rue pendant six mois, tout est donc revenu à la normale!

Elusive HIV Shape Change Revealed; Key Clue to How Virus Infects Cells

Thursday, October 1st, 2009


Structural biologists at Children’s Hospital Boston and Harvard Medical

School have shown how a key part of the human immunodeficiency virus

(HIV) changes shape, triggering other changes that allow the AIDS virus

to enter and infect cells. Their findings, published in the Feb. 24 issue of

the journal Nature, offer clues that will help guide vaccine and treatment


Researchers led by Howard Hughes Medical Institute Investigator Ste-

phen Harrison, PhD, and Bing Chen, PhD, focused on the gp120 protein,

part of HIV’s outer membrane, or envelope. gp120’s job is to recognize

and bind to the so-called CD4 receptor on the surface of the cell HIV

wants to infect. Once it binds, gp120 undergoes a shape change, which

signals a companion protein, gp41, to begin a set of actions that enable

HIV’s membrane to fuse with the target cell’s membrane. This fusion of

membranes allows HIV to enter the cell and begin replicating.

The structure of gp120 after it binds to the CD4 receptor and changes its

shape was solved several years ago by another group. Harrison and Chen

have now described gp120’s structure before the shape change, yielding

vital before-and-after information on how the molecule rearranges itself

when it encounters the CD4 receptor.

‘’Knowing how gp120 changes shape is a new route to inhibiting HIV – by

using compounds that inhibit the shape change,’’ says Harrison. He notes

that some HIV inhibitors already in development seem to inhibit the shape

change; the new findings may help pin down how these compounds work

and hasten their development into drugs.

‘’The findings also will help us understand why it’s so hard to make an

HIV vaccine, and will help us start strategizing about new approaches to

vaccine development.’’

The studies, performed in the Children’s Hospital Boston Laboratory of

Molecular Medicine, used the closely related simian immunodeficiency

virus (SIV) as a stand-in for HIV. By aiming an X-ray beam through a crystallized form of gp120, they obtained the first high-resolution three-

dimensional images of the protein in its unbound form. They surmounted

considerable technical challenges, including difficulty in getting gp120 to

form good crystals.

‘’Without very well-ordered crystals you get a very blurry picture,’’

explains Harrison. ‘’It took a very long time, and lots of computational

work, to get that picture to sharpen up enough to get an answer.’’

One of the lab’s first steps will be to determine which shape of gp120

– bound to the CD4 receptor, or unbound – is recognized by a person’s

antibodies. gp120’s shape change is an important ‘’escape mechanism’’

for HIV, allowing the virus to bind to and enter a cell before the immune

system can ‘’see’’ it, notes Harrison.

‘’We can now compare the bound and unbound forms and try to unders-

tand whether there are any immunologic properties that differ and that

might provide a route to new vaccine or drug strategies,’’ Harrison says.

Céline et René contre le SIDA

Wednesday, July 15th, 2009

Depuis près de 6 ans maintenant, deux personnalités très populaires et aimées du public québécois s’occupent un peu plus ouvertement de la prévention dans le domaine du SIDA et le font dans le cadre d’un magazine s’adressant à la communauté homosexuelle, Le Point. Céline Dion et René Angelil, son époux et agent, tentant par cette association de promouvoir la prévention à l’aide d’une phrase profonde de sens, pensée et conçue par Céline elle-même “Pour avoir le plaisir d’aimer, sans mourir d’aimer”… Il s’agit du thème de la campagne de prévention spécifique au Point.

Le SIDA est toujours, en 2009, la maladie la plus invalidante pour les personnes de la communauté gaie. Elle cause de nombreux décès chez les jeunes et la recherche médicale n’avance pas assez vite pour sauver toutes les vies. La plupart des jeunes, près de 99%, contractent l’infection lors de rapports physiques non protégés ou mal protégés d’où l’importance de rappeler que le meilleur moyen de se protéger de ce virus et de garder sa qualité de vie, dès la plus jeune âge, est de se protéger autant comme séronégatif qui souhaite le demeurer que comme séropositif qui ne doit pas devenir un vecteur de transmission.

Céline et René aident Le Point à publier des nouvelles sur la recherche, sur les avancées dans le domaine du VIH/SIDA et permettent la diffusion d’une information vitale pour les personnes de la communauté gaie.

Afin de mieux savoir la distinction à faire entre les actes physiques susceptibles de constituer un risque, Le Point invite les lecteurs à se rendre sur le site de Gay Globe TV au et à cliquer sur la photo de Céline en haut à gauche de la page d’accueil. Ce lien vous mènera vers la page d’accueil de la Clinique l’Actuel de Montréal qui offre la plus grande couverture médicale en matière de prévention VIH/SIDA et surtout, on y explique très bien les moyens de se protéger en toutes circonstances.

Nous avons la chance d’avoir au Québec des alliés puissants et des partenaires à la fine pointe de la recherche comme Céline Dion, René Angelil, l’équipe de la Clinique l’Actuel et le groupe média gai le plus populaire, Le Point/Gay Globe TV pour créer et transmettre une information de prévention la plus efficace possible dans les circonstances. Nous avons aussi le devoir d’informer les jeunes des moyens qu’ils peuvent prendre pour se protéger de la maladie qui, on ne le dit pas assez souvent, coûte très cher à l’État et aux familles des personnes atteintes soit en soins, en médicaments, en perte de qualité de vie et en drames quand la mort survient alors qu’elle pouvait être évitée.

Le SIDA au Canada: Selon Santé Canada, en 2006, environ 58,000 personnes étaient atteintes du VIH/SIDA et une nouvelle personne était infectée à toutes les deux heures. 27% des personnes atteintes ne se savent pas atteintes et ne sont pas traitées. Le taux actuel de transmission est sensiblement toujours le même à 2500 personnes par année même si le taux de mortalité a sensiblement diminué grâce aux nouveaux traitements qui ne guérissent pas la maladie. La thérapie ne fait que prolonger la vie, sans nécessairement améliorer sa qualité. Santé Canada considère la situation actuelle du SIDA au pays de “sévère et de profondément troublante”.

Les découvreurs du SIDA invitent à ne pas relâcher le combat

Thursday, May 21st, 2009

Par : Le Nouvel Obs
Les professeurs français Luc Montagnier, prix Nobel de médecine en 2008 pour la découverte du VIH, et américain Robert Gallo, ont lancé vendredi 8 mai un appel à ne pas relâcher les actions de lutte contre le sida. “Dans le monde, nombre de personnes se comportent comme si le VIH et le sida n’étaient plus la menace qu’ils étaient il y a 25 ans quand le virus a été identifié pour la première fois”, explique un communiqué. Ils précisent que “le VIH et le sida demeurent une menace sanitaire mondiale sans pareil et malgré les progrès dans les traitements -avec quelque 25 anti-rétroviraux disponibles- les choses pourraient empirer”. Six recommandations visant à vaincre le VIH et à s’en prémunir ont été signées.”Les recommandations que nous faisons sont la clé pour réduire et au bout du compte atténuer la catastrophe provoquée par le VIH et le sida”, affirment Luc Montagnier et Robert Gallo.

SIDA: Traiter pour prévenir

Thursday, May 21st, 2009

C’est une nouvelle page qui s’ouvre dans l’histoire de l’épidémie. Le Conseil national du sida (CNS) présente un avis et formule des recommandations sur “l’intérêt du traitement comme outil novateur de la lutte contre l’épidémie d’infections à VIH”. Le traitement doit-il devenir un outil de prévention contre le VIH? Faut-il proposer un traitement précoce aux séropositifs dans le but de diminuer les risques de transmission? Faut-il dépister plus pour traiter plus? À ces trois questions, le Pr Willy Rozenbaum, président du CNS, répond par l’affirmative. Traitement et prévention classique deviennent complémentaires avec pour objectif de diminuer le nombre de transmissions.

Nous savons depuis plusieurs années que la diminution de la charge virale sous traitement réduit aussi le risque de transmission. Au niveau collectif, traiter au moins 50% des personnes infectées permettrait, selon de nombreuses études, de diminuer le nombre de nouvelles contaminations. Sur un plan individuel aussi, le traitement, efficace, bien pris, induit une réduction de la transmission. Mais sur cet aspect, l’avis du CNS reste mesuré, car le risque résiduel de transmission existe. Les membres du Conseil ne vont pas, comme les autorités suisses, jusqu’à expliquer que les couples sérodiscordants peuvent abandonner le préservatif, à condition que le partenaire séropositif ait un traitement efficace. Pour Willy Rozenbaum, il est cependant indispensable d’informer les séropositifs et leurs partenaires de l’existence de cette nouvelle donne et de redéfinir la complémentarité des outils de prévention: oui la capote protège du VIH, mais le traitement aussi. Il serait inefficace de les opposer.
Bien entendu, cette stratégie fait porter sur le séropositif une nouvelle responsabilité, comme le souligne l’avis du CNS: “Avec le traitement, en revanche, apparaît un moyen, médicalisé et non comportemental, dissocié de l’acte sexuel, de rendre les personnes porteuses du virus très peu contaminantes. La maîtrise de ce moyen n’est plus également partagée par les partenaires, elle relève du seul partenaire infecté, qui porte alors entièrement, si aucune autre technique de protection n’est utilisée, la responsabilité de réduire le risque pour l’autre.

SIDA: génomes identifiés

Sunday, February 1st, 2009

Une avancée vient d’être effectuée dans la recherche sur le sida grâce au séquençage d’une partie du génome de patients infectés par le VIH-1. Plusieurs équipes de recherche ont identifié pour la première fois trois régions du génome impliquées dans la réplication du VIH et dans la constitution du réservoir viral. Ces résultats apportent de nouvelles pistes de recherche pour mieux comprendre les mécanismes de progression vers le SIDA et trouver, à terme, de nouvelles cibles thérapeutiques ou vaccinales. Ces travaux sont issus du programme de recherche « génomique »  de l’ANRS et sont financés par l’Agence. Les résultats sont issus de patients récemment infectés et de la cohorte de patients « contrôleurs du VIH » (ANRS EP 36). Ils ont été publiés dans la revue PLoS ONE du 24 décembre 2008.