Governments in southern Africa need to work harder at treatment scale-up, say activists
Governments in southern Africa are still failing to honour their own commitments to scale up access to antiretroviral therapy despite the growing availability of international donor support to do so, according to a new report from the Southern Africa Treatment Access Movement (SATAMo).
Southern Africa: a long road to male circumcision
Looking to get circumcised to reduce your risk of HIV infection? If you’re living in Southern Africa, you might have a long wait until services become more widely available.
Chinese HIV prevention with drug users undermined by police
Chinese police and security forces are driving injecting drug users away from prevention services, undermining the country’s efforts to contain a growing epidemic among China’s drug users, according to a new report issued this week by Human Rights Watch.
Study highlights bootlenecks in ARV supply in West Africa
In West and Central Africa, large amounts of money are spent on buying antiretroviral (ARV) drugs but weak distribution systems mean many HIV-positive patients never get them, said speakers at the 15th International Conference on AIDS and STIs in Africa (ICASA) in Dakar, Senegal, last week.
Botswana expects HIV treatment numbers to reach 225,000 by 2016
Botswana’s government expects the number of citizens receiving antiretroviral therapy (ART) to increase by more than 50% in the next eight years, reaching 220,000 by 2016, President Ian Khama said last week.
Improved knowledge of sexual health not translating into HIV decline in adolescents in 8-year trial
A large randomised controlled trial of sexual and reproductive health interventions in schools, health services and communities and Tanzania has found that while the interventions increased adolescent knowledge about sexual health, they had no significant impact on HIV transmission or other sexually transmitted infections, nor on pregnancy rates.
Community support improves HIV treatment outcomes for patients in South Africa
Community support initiatives significantly improve responses to antiretroviral therapy amongst patients in South Africa, a study published in the November 30th edition of AIDS shows. The research also showed that baseline characteristics were also important for the first six months, and the investigators suggest that community support is particularly valuable at this time for patients who start HIV treatment with a low CD4 cell count and high viral load.
High prevalence of pre-cancerous anal lesions in women with HIV
HIV-positive women have a high prevalence of pre-cancerous anal lesions, American investigators report in the January 2nd 2009 edition of AIDS. The researchers found that 12% of HIV-positive women had low-grade pre-cancerous lesions and that high-grade lesions were present in 9% of women. Anal infection with human papilloma virus was an important risk factor for the presence of pre-cancerous anal lesions.
High prevalence of vitamin D deficiency in patients with HIV
Almost a third of HIV-positive patients have vitamin D deficiency, Dutch researchers report in the November edition of AIDS Research and Human Retroviruses. Dark skin colour was the most important risk factor for this disorder. Amongst patients with white skin, more patients taking NNRTI-based HIV treatment had vitamin D deficiency than did patients taking antiretroviral therapy based on a protease inhibitor.
Promising early results for large-scale study of community-level HIV prevention initiative
Uptake of voluntary counseling and testing increased dramatically in intervention communities during the first two years of a community-randomised controlled HIV prevention study in four countries, according to an article in the December 1st edition of the Journal of Acquired Immune Deficiency Syndromes. Project Accept seeks to reduce HIV transmission by changing community norms through a combination of community mobilisation activities; high-quality HIV mobile voluntary counseling and testing (VCT); and post-test support services.
Fluconazole shown to be more effective against cryptococcal meningitis at higher dose
A small Ugandan study has shown that 1200mg of fluconazole per day appears to be a better treatment for cryptococcal meningitis than 400 to 800mg per day, which is the dosage typically administered to patients in many African health facilities. The study was reported in the December 15th edition of Clinical Infectious Diseases.
GNP+ launches website documenting global HIV exposure / transmission laws and prosecutions
The United States tops the world table of criminal prosecutions for HIV exposure or transmission according to data published this week by the Global Network of People Living with HIV (GNP+). The past few weeks have also seen the publication of three important new documents highlighting why so many of these prosecutions make for poor public policy.
Different paediatric responses to antiretroviral therapy in Uganda and the United Kingdom/Ireland may reflect differences in nutrition and access to cotrimoxazole
Researchers have reported that while HIV-positive children in Uganda and the United Kingdom/Ireland responded similarly to antiretroviral therapy in most regards, the Ugandan children lagged behind in CD4 cell recovery and body growth. The study, published in the December 1st issue of Journal of Acquired Immune Deficiency Syndromes, calls attention to the potential for malnutrition and opportunistic infections to undercut the benefits of antiretroviral therapy.
Children starting HIV treatment in sub-Saharan Africa have a low risk of death
There is a low risk of death for children starting HIV treatment in sub-Saharan Africa, an international team of investigators report in the December 15th edition of the Journal of Acquired Immune Deficiency Syndromes. The risk of death after starting HIV treatment was 7% and three-quarters of deaths occurred in the six months after antiretroviral therapy was started.
Widespread resistance to antiretrovirals among children in the Central African Republic
HIV-positive children who are being treated with antiretroviral drugs in the Central African Republic are infected with a wide variety of HIV subtypes, don’t adhere well to their treatment, and seldom have an undetectable viral load, according to a study published in the December 15th edition of the Journal of Acquired Immune Deficiency Syndromes. The investigators also found that resistance to antiretroviral drugs was widespread.
HIV testing for mothers and children must expand, UN report shows
Access to HIV testing and antiretrovirals for prevention of mother to child HIV transmission has grown substantially over the past four years in the countries most severely affected by HIV, UN agencies reported today – but around 40% of women in the high prevalence countries of southern Africa are still not being offered an HIV test during pregnancy.
Traditional healers could play key role in ART rollout
Traditional healers could potentially be an important source of HIV treatment in some African settings, according a study published in the December 1st edition of AIDS. Investigators from Zimbabwe and the University of Pennsylvania found that patients reported better quality of life after a visit to a traditional healer than did patients who accessed orthodox medical services.
Mbeki's opposition to ARVs cost 330,000 lives, shows study
The refusal of the Mbeki government to roll-out antiretroviral therapy and treatment to prevent mother-to child transmission in South Africa resulted in 330,000 needlessly premature HIV-related deaths and 35,000 avoidable case of mother-to-child HIV transmission according to estimates published in the December 1st edition of the Journal of Acquired Immune Deficiency Syndromes.
Universal testing and treatment could reduce new HIV infections in southern Africa by 95% in 10 years
Universal HIV testing and immediate antiretroviral therapy for everyone diagnosed with HIV in a country with very high HIV prevalence could reduce new infections from 20 per thousand to 1 per thousand within ten years (a 95% reduction), according to findings from a mathematical modelling exercise carried out by the World Health Organization, published on November 26th by The Lancet.
Excellent outcomes from five years of antiretroviral use in Botswana
The first five years of a large-scale antiretroviral programme have resulted in excellent, sustained rates of virologic suppression, CD4 cell count increases, and improved clinical outcomes among adults in Botswana, according to a study reported in AIDS.
CD4 cell count increases sustained up to five years in developing-world treatment programmes
According to a large-scale collaborative analysis reported in AIDS, antiretroviral programmes have led to significant and sustained increases in CD4 cell counts among people in low-income countries who are able to remain on therapy. Among nearly 20,000 people receiving antiretroviral therapy (ART) in African, Latin American, and Asian study cohorts, median CD4 cell counts increased from a baseline of 114 cells/mm3 to 395 cells/mm3 after five years on treatment.
Second-line combinations fail twice as often as first-line ones in the first year
Although the success rates are still encouraging, a study from London’s Royal Free Hospital has found that roughly twice as many second-line anti-HIV drug regimens stop working in the first year as first-line regimens, and that this difference in failure rates persists until at least the third year after therapy initiation.
If you can't switch, better to stay on failing treatment than stop it, studies show
Patients on failing drug regimens maintain stable CD4 counts with detectable viral load levels up to 10,000 copies/ml, as long as they remain on HIV treatment, a study presented at the Ninth International Congress on Drug Therapy in HIV in Glasgow showed this week.