News (Updated
December 17, 2010)
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By Miriam Stoppard
14/12/2010
Experts recently called
for routine HIV tests in casualty wards and GP surgeries in areas where
prevalence is high - roughly a quarter of primary care trusts in
The call came after
research from eight pilot projects revealed high numbers of people with HIV are
going undiagnosed.
Worryingly, one study of
emergency hospital admissions found that only a quarter of undiagnosed
HIV-positive patients were correctly targeted and diagnosed.
Normally I'm all for
patients having as much choice in their own health as possible but there are
cases where I believe there's something even more important at stake - the
health of the population as a whole.
Diagnosing this
potentially devastating condition early can make all the difference to the
success of treatment.
Despite vast improvements
in treatment over the past two decades, HIV still reduces life expectancy by 13
years in the
The later it's caught, the
more damage is done to the body and the harder (and more expensive) it is to
treat. The virus destroys important parts of the immune system, eventually
leading to pneumonia, organ damage, tumours and even brain damage.
And most importantly of all, the longer someone goes undiagnosed, the more
likely they are to have unwittingly passed the infection on to someone else.
Last year the Health
Protection Agency reported there were 86,500 people living with HIV in the
Make no mistake, HIV is no
longer a gay man's disease - half of all people needing HIV care in the
Don't assume the danger is
abroad - in 2009, a third of all heterosexuals diagnosed with HIV were thought
to have been infected in the
I believe routine testing
in high-risk areas would help stop the spread.
It was a similar policy
that led to the vaccination programmes that eliminated smallpox.
Encouragingly, more than
95% of people questioned in casualty wards and GPs' surgeries agree routine
testing is a good idea. So what are we waiting for?
Dec 14 2010
By Andrew Quinn
WASHINGTON (Reuters) - The
Eric Goosby said the
President's Emergency Plan for AIDS Relief (PEPFAR) was looking closely at both
the gels, which can protect women against infection during sex and
"pre-exposure prophylaxis (PrEP)," which involves giving AIDS drugs to
people in high-risk groups before they are infected.
"We would support
PReP in terms of high risk populations," Goosby, the U.S. Global AIDS
coordinator, told Reuters, adding that various country approval plans were
already under internal consideration.
Goosby said microbicide
gels -- a focus of hope since a South African clinical trial this year showed at
least one version lowered HIV infection rates -- could also play a part once
full regulatory approval is obtained and more is understood about how they work.
"We haven't worked
out the delivery system or the dosing or interval of application," Goosby
said. "We are absolutely positioned to engage in it as soon as we know
those."
Goosby spoke as PEPFAR
signed a new five-year deal with South Africa to bolster its AIDS fight,
signaling a deepening cooperation between Washington and a country once depicted
as representing the wrong approach to the AIDS epidemic.
"We are here at a
moment when
Goosby said the agreement
would commit the
SOUTH AFRICAN TURNAROUND
The
"We have developed a
level of trust that is extraordinary," Goosby said. "They are
revealing needs and vulnerabilities, and their ability to move forward has
allowed us to have a heads up on where their areas are that we can help."
Mbeki's successor,
President Jacob Zuma, has taken a different approach, promising drugs to more
people and fighting the deep social stigma attached to the disease.
The addition of PrEP and
microbicide gels could represent a potentially large new budget item for PEPFAR,
the $18.8 billion program launched by former President George W. Bush, but
Goosby said new efficiencies in both care and treatment were already
streamlining the overall bill.
He said
Last month researchers
showed that Truvada, a once-a-day pill combining two Gilead Sciences Inc HIV
drugs, markedly reduced the risk of men contracting HIV.
(Editing by Todd Eastham)
Julia Medew
December 13, 2010
HIV infections are on the
rise among young gay men in
Research published in the
Medical Journal of Australia today says the number of gay Victorian men being
diagnosed with HIV in their 20s has jumped from 36 in 2007 to 59 last year. This
occurred while infections stabilised or dropped among gay men aged 30 and above.
Authors of the research
from
Behavioural studies had
also shown that as HIV had become easier to treat, gay men under 35 were more
likely to have sex with more partners, while not knowing their own and their
partners' HIV status, the authors said.
''It has … been
suggested that younger gay men may be more susceptible to engaging in risky
sexual behaviour because they are less concerned about the implications of HIV
since the introduction of highly active antiretroviral treatment (HAART),'' the
authors wrote.
Head of HIV and STI
research at the Burnet Institute Mark Stoove said that as more HIV positive
people continued to live longer with treatment, there was also a greater pool of
people who could transmit the virus.
This came as more HIV
positive and HIV negative men were making decisions about sex according to the
chance of transmission, he said.
This could include the use
of different sex positions or knowledge about how infectious the HIV positive
partner was at a given time, according to recent tests.
Dr Stoove said these
factors had changed the way gay men perceived HIV and the risks involved.
''The perception of risk
around HIV has become shades of grey, whereas it used to be much more black and
white with health promotion messages revolving around condom use … We need
much more nuanced messages now around different ways to reduce risk,'' he said.
While overall infections
began to drop at the beginning of this year (52 in the first quarter of the
year, compared with 66 for the same quarter last year), Victoria's new Health
Minister David Davis said his government would produce a new HIV strategy by the
end of 2011.
''The long-term task of
managing the incidence of HIV requires constant focus,'' he said.
Dr Stoove said although
HIV had become easier to treat, there were many reasons to fear the virus,
including emerging links to cancer and heart disease for those who live on
treatment for long periods. Stigma in the community also persisted.
''It's certainly not
something to take lightly,'' he said.
14-Dec-2010
MDG 6 has as a target
detecting at least 70percent of new sputum smear-positive TB cases and curing at
least 85percent of these cases plus to reduce TB prevalence and death rates by
50percent relative to 1990 levels.
The authors of the SAHR
review chapter on HIV-Aids and TB pointed out that mortality due to TB and
treatment interruption remained high in
They attributed this to
the high HIV infection rates and weak "health care service delivery
mechanisms".
Before the emergence of
HIV, the
The SAHR confirms that the
challenges faced are substantial and include increasing caseloads in the face of
over-burdened health infrastructure, extremely poor cure rates in some
provinces, high mortality, high treatment interruption rates, high levels of
TB-HIV co-infection, increased levels of multi-drug resistant TB and the
emergence of extensively drug resistant TB.
Of the high burden TB
countries,
Other challenges facing
South Africa's ability to meet the MDGs are high treatment interruption rates,
late presentation of patients to health facilities, insufficient community
engagement, the HIV epidemic and poverty.
The SAHR revealed that of
the 2472 and 2572 cases of MDR-TB diagnosed in
The former health
department director-general Thami Mseleku defended the institutional model for
years though it was not reaching the majority of those with drug resistant TB.
Under Health Minister
Aaron Motsoaledi there has been a definite move towards decentralising the
management of MDR-TB.