News (Updated August 7 2011)

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Young gay men who use meth may risk HIV

Aug 3 2011

By Amy Norton

NEW YORK (Reuters Health) - Young gay and bisexual men who use methamphetamine are more likely to take sexual risks that boost their chances of contracting HIV, a new study suggests.

Researchers say the findings underscore the fact that meth, and its associated HIV risk, is not just a problem of middle-aged white men.

Methamphetamine triggers a massive release of the feel-good chemical dopamine in the brain, making users feel disinhibited, energized -- and prone to sexual risk-taking.

Studies of gay and bisexual men have found that roughly 43 percent have ever used meth, and that the habit is strongly linked to their risk of contracting HIV, the virus that causes AIDS.

But much less has been known about meth use and HIV risk among teenagers and young men.

So for the new study, researchers surveyed 595 12- to 24-year-old gay and bisexual males from eight U.S. cities. They found that 31 percent had ever used hard drugs -- one-third of whom had used methamphetamine.

And young men who'd used meth were more likely to report a range of risk factors for HIV.

Nearly 86 percent said they'd had sex with at least two different partners in the past 90 days (versus 63 percent of non-drug users). Almost 52 percent had ever had sex with an injection-drug user (versus 11 percent), and one-third had had sex with someone who was HIV-positive (against 11 percent).

Despite all of that, meth users were less consistent with condoms: one-third said they used them every time they had sex, compared with 54 percent of young men who'd never used hard drugs.

"In many ways, these findings mirror what's been seen in older MSM (men who have sex with men)," said Dr. Robert Garofalo of Children's Memorial Hospital in Chicago .

That's concerning, he told Reuters Health in an interview, and it also points to a large public health need.

"There are not a lot of proven HIV prevention programs for this age group," Garofalo said. More programs, including ones that target meth abuse, need to be piloted, according to Garofalo and his colleagues.

"We shouldn't wait," he said. "This is a real public health crisis."

The findings, which appear in the Archives of Pediatrics & Adolescent Medicine, are not representative of all young gay and bisexual men in the U.S. The researchers recruited their participants from clubs, bars, parks and other urban venues where they might find higher-risk young men.

But the researchers also consider that a strong point of the study.

"It tells us something about where to find these young men, and where we might be able to run some type of intervention," said lead researcher Peter Freeman, who is also with Children's Memorial.

For parents and teenagers, he said, the findings highlight the importance of having open conversations about both drug use and risky sexual behavior.

Garofalo said there still may be many parents who do not know that methamphetamine is something they need to worry about. So the current findings may be something of an eye-opener for some, he added.

Finding effective ways to curb HIV risk among young gay and bisexual men will only become increasingly important, according to Garofalo and Freeman.

In 2004, Americans between the ages of 13 and 24 accounted for 13 percent of new HIV diagnoses.

And gay and bisexual males, especially minorities, have been particularly vulnerable. A study of seven cities by the U.S. Centers for Disease Control and Prevention found that 14 percent of African-American gay and bisexual males ages 15 to 22 had HIV. The same was true of 7 percent of Hispanics.

SOURCE: bit.ly/qV4WTy Archives of Pediatrics & Adolescent Medicine, August 2011.

 

HIV at 'dangerous stage' in Russian Federation republic

29 Jul 2011

Source: member // World Vision - MEERO

'The HIV situation in Ingushetia has come to a dangerous stage', said the President's Advisor at a recent press conference, referring to an increasing rate of HIV infection driven by injecting drug use, lack of awareness and severe stigma around HIV in this small republic of the Russian Federation where around half the population is unemployed.

Azamat Nalgiev addressed government leaders, representatives of non-governmental organisations and republican media outlets at a press conference organised by World Vision in cooperation with the Republican HIV & AIDS Centre and the Spiritual Center of Muslims � both of whom partner with World Vision in an HIV advocacy project launched at the beginning of the year that reaches out to vulnerable groups, particularly youth, with information around HIV prevention.

In response to joint efforts to highlight the urgency of the HIV response in Ingushetia, including this press conference, the government commissioned an inter-agency committee to curb the spread of HIV and promote acceptance towards those living with HIV.

According to the Republican HIV & AIDS Centre, the number of people living with HIV has increased to 900 today as opposed to 700 registered two years ago.

'This is a significant number for our small republic and we do not have enough capacities to curb the spread of HIV alone', said Irina Malsagova, Head of the HIV & AIDS Centre.

In this strictly conservative republic, speaking about HIV is taboo. People living with HIV are pushed to the edge of society and people are less likely to come forward for testing. Children and their HIV-infected parent/s say their main struggle is against stigma and discrimination.

'The only place where I'm understood and accepted in this republic is the HIV & AIDS Centre', said a woman in her thirties, who is living with HIV.

World Vision launched the HIV advocacy project to raise awareness about the primary modes of transmission of HIV in the Republic � injecting drug use and sexual transmission - and to start to break down the stigma that is isolating women like this and preventing people from gaining the knowledge they need to protect themselves against contracting HIV.

Recognising the need to reach out to the wider population, especially youth, in a culturally relevant and sensitive way, World Vision began working with the Spiritual Centre of Muslims of Ingushetia, which today continues to partner with the HIV & AIDS Centre.

'To be honest, we did not have information about how serious the problems related to the spread of the HIV infection in our republic were. I would like to thank World Vision for the work in the area of HIV', said Ibragim Albakov, Deputy Mufti of the Spiritual Center of Muslims of Ingushetia.

'The success of our initiative could not be achieved without the support of the Ingush government and, especially, the Spiritual Center of Muslims whose imams are very much respected in all communities. I believe together we can achieve a lot and save thousands of lives', said Murad Tangiev, World Vision's HIV Advocacy Project Coordinator in the Russian Federation .

The inter-agency committee will comprise representatives from the ministries of Health, Education, Labor and Social Development, Culture, Internal Affairs, Youth Committee as well as deputies of Ingush Parliament, representatives of Spiritual Center of Muslims, Ingush Department of Red Cross and representatives of republican media agencies.

World Vision's work around HIV prevention is one key component of a health programme in the Russian Federation that aims to ensure all children enjoy good health.

 

UPDATE 3-Gilead 2nd quarter profit rises with HIV drugs

Tue, Jul 26 2011

By Bill Berkrot

NEW YORK, July 26 (Reuters) - Gilead Sciences Inc reported higher second-quarter profit as sales of its most important HIV drugs topped Wall Street estimates, bouncing back from a disappointing first quarter.

Sales of Atripla, which combines Gilead 's Truvada with Bristol-Myers Squibb Co's Sustiva into a single pill, rose 15 percent to $822 million, topping analysts' forecasts of between $810 million and $812 million.

Sales of Truvada rose 11 percent to $711.3 million, also exceeding Wall Street estimates of about $708 million.

First-quarter sales of the two drugs had missed analysts' estimates as they were hit by temporary cutbacks in state-funded AIDS drug assistance programs in Florida and Texas .

Gilead is expected to unveil key data on its Quad HIV pill later this quarter and said it plans to file its application seeking U.S. approval in the first quarter of 2012.

Quad, which will combine four medicines, is considered to be Gilead 's most important future growth driver by many analysts.

The company said it is also planning to seek U.S. Food and Drug Administration approval to amend the Truvada label to include data from recent studies showing the drug can help prevent new HIV infections.

The world's top maker of HIV medicines posted net profit of $746.2 million, or 93 cents per share, compared with a profit of $712.1 million, or 79 cents per share, a year ago.

Excluding special items, Gilead earned $1.00 per share, beating analysts' average expectations by a penny, according to Thomson Reuters I/B/E/S.

"The sales were a little bit above consensus and our estimates," said Cowen and Co analyst Philip Nadeau, calling the results "solid."

"It looks like business did bounce back from the first quarter," he said.

The company maintained the full-year forecast it provided earlier this year for product sales of $7.9 billion to $8.1 billion.

Total revenue for the quarter rose to $2.14 billion, exceeding Wall Street estimates of $2.07 billion.

Revenue from royalties and collaboration fell 19 percent to $97.7 million, primarily due to a drop in royalties from Roche Holding AG for its Tamiflu flu treatment. Tamiflu sales have been lower as fears and flu pandemic preparation subsided from a year ago.

Gilead shares were relatively unchanged in extended trading, slipping 3 cents to $42.13 from their Nasdaq close at $42.16. (Reporting by Bill Berkrot; editing by Andre Grenon)

 

Gilead kickstarts patent pool for AIDS drugs

Jul 12 2011

By Ben Hirschler

LONDON (Reuters) - Gilead Sciences, the leading maker of HIV drugs, is to share intellectual property rights on its medicines in a patent pool designed to make treatments more widely available to the poor.

The California-based group is the first drugmaker to sign up to the new Medicines Patent Pool, whose organizers now expect other major pharmaceutical manufacturers to join the initiative.

Ellen 't Hoen, the pool's executive director, told Reuters she was negotiating terms for similar deals with ViiV Healthcare -- a GlaxoSmithKline and Pfizer joint venture -- as well as with Bristol-Myers Squibb, Roche, Boehringer Ingelheim and Sequoia Pharmaceuticals.

"This is not just a one-off. The whole field is changing ... there will be more to follow," she said.

Around 33 million people worldwide have the human immunodeficiency virus (HIV) that causes AIDS. Most live in Africa and Asia , where medicines have to be very cheap to allow those who need them to be able to afford them.

The Medicines Patent Pool, launched by the UNITAID health financing system that is funded by a tax on airline tickets, aims to address this problem by creating a system for patent holders to license technology to makers of cheap generics in exchange for modest royalties.

In the case of Gilead , the agreement allows for the production of generic copies of tenofovir, emtricitabine, cobicistat and elvitegravir, as well as a combination of these products in a single HIV pill known as the "Quad."

Significantly, cobicistat, elvitegravir and the Quad are still in clinical development, and their inclusion in the deal should speed the flow of new treatments in poor countries.

"Through systematic licensing of intellectual property related to HIV products, people in developing countries will have access to low-cost versions of those products almost at the same time that people in rich countries do," 't Hoen said.

Traditionally, patients in developing countries have to wait for years before they can get access to new drugs.

CHANGE IN ATTITUDE

Gilead will receive a 3 percent royalty on generic sales of tenofovir, which is also approved for use in hepatitis B, and 5 percent on the other products.

The licenses will allow for the supply of tenofovir and emtricitabine in 111 countries, for cobicistat in 102 countries, and for elvitegravir and the Quad in 99 countries.

Assuming other companies come on board, the patent pool could save poor countries more than $1 billion a year in drug costs.

But the revenue stream to Gilead and other patent holders is likely to be small, since generic drug prices in Africa could be just 1 or 2 percent of those in high-income countries.

The decision by Gilead and others to work with UNITAID on the new patent pool marks an evolution in thinking by Big Pharma toward the thorny problem of drug access in the developing world.

Ten years ago, the world's pharmaceutical industry took a very different stance when it sued South Africa over legislation that was passed by former President Nelson Mandela and which favored generics.

That battle proved a public relations disaster, and since then individual companies have struck a series of voluntary licensing deals, allowing generic copies of HIV products on a case-by-case basis.

The patent pool system, however, goes beyond this by providing an effective "one-stop shop" for generic firms to secure rights to manufacture patent-protected drugs.

The U.S. National Institutes of Health became the first organization to sign up to the pool last September. The concept has been harder for some drugmakers to swallow.

ViiV, for example, was initially unwilling to consider pooling its patents -- and Abbott Laboratories, Merck & Co and Johnson & Johnson have yet to enter formal negotiations, although 't Hoen said her team was now discussing the idea with all three companies.

(Reporting by Ben Hirschler; Editing by David Hulmes)

 

Syphilis up among minority gay, bisexual men

Aug 1 2011

By Amy Norton

NEW YORK (Reuters Health) - The rising U.S. syphilis rate appears to be disproportionately striking minority gay and bisexual men, the Centers for Disease Control and Prevention (CDC) reported Monday.

Syphilis is a sexually transmitted bacterial infection that can be easily cured with antibiotics in the early stages. But many people do not have symptoms early on, or don't recognize the symptoms, and continue to transmit the infection.

In the U.S. , syphilis has been on the rise since 2000, when the national rate hit an all-time low of 2.1 cases per 100,000 people.

That increase has been largely among men, who had a rate of just under 8 cases per 100,000 in 2009 (versus 1.4 cases per 100,000 women), according to the CDC. And studies have suggested that gay and bisexual men now account for a majority of new syphilis cases.

Health officials are concerned about the resurgence not only because of syphilis itself, but also because the infection makes people more vulnerable to contracting HIV, the virus that causes AIDS.

Now the new findings, reported in the Annals of Internal Medicine, show that minorities -- and young men, in particular -- are being hit hardest by syphilis.

Using data from 27 states, CDC researchers found that between 2005 and 2008, the syphilis rate among black gay and bisexual men rose at an 8-times faster clip compared with their white counterparts.

Hispanic gay and bisexual men, meanwhile, had more than twice the increase of white men.

By 2008, the syphilis rate among black gay and bisexual men was 19 per 100,000. Those figures were just over 7 per 100,000 among Hispanic men, and 4 per 100,000 among white men.

What's more, the CDC says, there has been a shift in the age group most affected by syphilis. Ten years ago, outbreaks of the STD were largely reported among gay and bisexual men in their 30s.

But since 2005, teenagers and men in their 20s have shown the biggest increase in syphilis cases. And 20- to 29-year-olds had the highest rates in 2008 -- at around 12 cases per 100,000.

Racial disparities in syphilis and other STDs have long been seen among U.S. men in general. So the current findings are not especially surprising.

But the magnitude of the racial gap in this study is concerning, said lead researcher Dr. John R. Su, a medical epidemiologist at the CDC.

It's hard to pin down the precise reasons, Su told Reuters Health in an interview.

But he said it could reflect factors like lower incomes and education levels, and poorer access to healthcare -- in other words, some of the same race-related disparities seen among Americans in general.

As for young gay and bisexual men, some recent studies suggest that they are increasingly engaging in risky sex, including having unprotected intercourse and multiple partners.

The bottom line for gay and bisexual men is awareness, according to Su.

"First, you have to know you're at risk," he said. "Then have a frank discussion about it with your healthcare provider."

It's recommended that all sexually active gay and bisexual men be tested at least once a year for syphilis and other STDs, including HIV and gonorrhea, Su said. Staying in a monogamous relationship with a partner whose been tested, and using condoms consistently, reduce the chances of contracting syphilis and other STDs.

But the recent re-emergence of syphilis may require "novel" public-health responses, according to an editorial published with the study.

"For example, many MSM (men who have sex with men) with newly diagnosed syphilis or HIV met their sexual partners recently on the Internet," write Dr. Kenneth H. Mayer and Matthew J. Mimiaga of the Boston-based Fenway Institute, which specializes in healthcare for gay, bisexual and transgender patients.

So education and screening efforts, they say, need to target men where they go: online, and at clubs, bars and bathhouses.

Su agreed that more-innovative steps, like using the Internet or text-messaging to spread health messages, are promising.

He also pointed to programs that use "peer educators" -- lay people who are trained to help get health messages out to their local community.

Along with getting regular screening, at-risk men should know the potential signs of syphilis infection. The first is usually a single painless sore on the genitals, rectum or mouth (wherever the bacterium entered the body). Some weeks after that, a non-itchy rash may develop on different parts of the body. Some people also have flu-like symptoms such as a fever, sore throat, body aches and swollen glands.

About 15 percent of people with untreated syphilis eventually develop long-term complications, according to the CDC. Those include damage to the brain, nerves, heart and blood vessels that can prove fatal.

SOURCE: bit.ly/an7XRm Annals of Internal Medicine, online August 1, 2011.

 


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