Health Alert: Return of the AIDS epidemic

From voanews.com

Thirty-six million people currently live with AIDS, a disease that claimed the lives of nearly 1 million people last year. Experts predict that by 2030, 100 million people will have been infected with the HIV virus.

Despite the alarming numbers, there have been great strides in treatment. HIV is no longer a death sentence, and researchers say people receiving treatment for HIV are able to live normal lives and do not pose a risk to others when they are being treated proactively.

But success carries a price: complacency. Funding for AIDS research and treatment has declined, and in some places, so has government interest.

“When we talk to ministers of finance, they always say to me, ‘I thought HIV was over because I don’t see anybody dying,’” said Dr. Deborah Birx, a U.S. Global AIDS coordinator who oversees the President’s Emergency Plan for AIDS Relief (PEPFAR).

J. Stephen Morrison of the Center for Strategic and International Studies, said, “We’re not reaching goals.” He added, “There’s going to be a struggle to hold ground. … There’s a widening deficit of political will and financial capacity that we face some really daunting challenges in prevention.”

Dr. Chris Beyrer, with Johns Hopkins Medicine, predicted that things will get worse if governments and civilians continue their complacency.

“We are not done with AIDS,” he said. “It is much too early to declare victory, and the risks of a resurgent epidemic are real.”

Read the full article.

Kofi Annan’s AIDS legacy

From thebody.com

When Mr Annan began his term as the new United Nations Secretary-General in 1997, the outlook for the AIDS epidemic was bleak — some 23.9 million people were living with HIV, there were 3.5 million new HIV infections and access to life-saving treatment was only available to a privileged few.

Kofi Annan, 1938-2018 (Courtesy of UNAIDS)

He cajoled world leaders, humbly, diplomatically, and when the message did not sink in he spoke out publicly and forcefully. “Friends, we know what it takes to turn the tide against this epidemic. It requires every president and prime minister, every parliamentarian and politician, to decide and declare that ‘AIDS stops with me. AIDS stops with me,'” he said.

Under his leadership, in 2000 the United Nations Security Council adopted resolution 1308, identifying AIDS as a threat to global security. In 2001, the United Nations General Assembly Special Session on HIV/AIDS was held — the first-ever meeting of world leaders on a health issue at the United Nations.

In 2000, at a time when less than US$ 1 billion was being invested in the AIDS response, he called for a war chest of at least US$ 7-10 billion for AIDS, tuberculosis and malaria. That call, and his concerted lobbying of world leaders, led to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which went on to save millions of lives. Mr Annan remained a patron of the Global Fund, helping to ensure that it is fully funded.

Read the full article.

Neurological manifestations of HIV

Dr Faktorovich, Department of Neurology, Icahn School of Medicine, Mt Sinai, New York, NY

From Neurologytimes.com

Human immunodeficiency virus (HIV) is responsible for a wide spectrum of neurological manifestations, with etiologies ranging from inflammatory, infectious, neoplastic. and more. The development of antiretroviral therapy (ART) has dramatically increased life expectancy, however neurological complications remain a significant cause of long-term disability. Understanding and recognizing these conditions is crucial in effectively managing HIV.

Dr Svetlana Faktorovich, Department of Neurology, Icahn School of Medicine, explains the various forms of neurological manifestations of HIV in this Neurologytimes.com article.

Why STDs are on the rise in America

From the Economist online

Much of the increase in STDs has come from gay and bisexual men. Although a relatively small share of the population, they accounted for 81% of male syphilis cases in 2016, according to the Centres for Disease Control. As with heterosexuals, this seems to be because sex is now seen as less risky. That is due to the advent of PrEP, a prophylactic drug cocktail which gay men can take to nearly inoculate themselves from HIV. The reduced chances of catching HIV—along with the fact that a positive diagnosis is no longer a death sentence—seems to encourage men to drop their guard. A recent study of gay and bisexual men, published in the Lancet, a medical journal, found that as more began taking PrEP, rates of consistent condom usage dropped from 46% to 31%. Recent studies have shown that uptake of PrEP is strongly associated with increased rates of STD infection.

All this shows that changing sexual mores, and a reduced fear of the risks of unprotected sex, seem to be at fault—especially since the problem is not just limited to America. England experienced a 20% increase in syphilis diagnoses in 2017 and a 22% increase in those of gonorrhoea. Other countries in western Europe have seen ever worse outbreaks, sometimes exceeding 50%. Dwindling public spending on STD prevention—which in America has fallen by 40% in real terms since 2003—is not helping matters. Yet the chief methods of prevention, abstinence and condoms, are tried and true. Should these options seem too chaste or chaffing, then prospective partners ought to get an STD test (especially since most infections can be cleared up with a simple course of antibiotics). Verified testing is vital since verbal assurances, especially on the cusp of a liaison, can be misleading.

Read the full article.

CDC’s Eugene McCray discusses HIV prevention advances from AIDS 2018 in Amsterdam

Eugene McCray MD

From AIDS.gov

Advances in HIV prevention and program implementation were among the topics in the spotlight at the 22nd International AIDS Conference (AIDS 2018) this week. Eugene McCray, MD, Director of CDC’s Division of HIV/AIDS Prevention (DHAP)

reflects on some of the conference highlights. The division he oversees works to prevent HIV infections and reduce the incidence of HIV-related illness and death across the United States. Read more about their work.

During a live interview on Facebook, Dr. McCray discussed research being presented by CDC researchers at the conference, other HIV prevention research findings shared here at the conference, and shares his personal reflection on what how it feels like to be at this conference at this stage of the epidemic.

Watch the video.

New HIV research findings from AIDS 2018 with NIH’s Dr. Carl Dieffenbach

From AIDS.gov

The first full day of sessions at the 22nd International AIDS Conference (AIDS 2018) in Amsterdam was filled with new scientific findings shared by researchers from around the world. In a Facebook Live interview with HIV.gov, Carl Dieffenbach, Ph.D., discussed highlights of three studies presented today at the conference, including:

  • an update on a potential association between the HIV treatment medication dolutegravir and birth defects;
  • additional research on the effectiveness of HIV treatment as prevention among gay male serodifferent couples; and
  • a study on whether there may be drug-drug interactions between PrEP and feminizing hormone therapy for transgender women.

Dr. Dieffenbach is the Director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID).

Watch the video here.

22nd International AIDS Conference (AIDS 2018) underway in Amsterdam

From HIV.gov

As the 22nd International AIDS Conference (AIDS 2018) got underway in Amsterdam, HIV.gov began their coverage of HIV research advances and other conference highlights with an interview of Anthony S. Fauci, M.D. Dr. Fauci is the Director of the National Institute of Allergy and Infectious Diseases at the NIH.

Interview of Anthony S. Fauci, M.D.

The International AIDS Conference is the largest conference on any global health issue in the world. First convened during the peak of the AIDS epidemic in 1985, it continues to provide a unique forum for the intersection of science, advocacy, and human rights. According to its organizers, each conference is an opportunity to strengthen policies and programs that ensure an evidence-based response to the epidemic.

The theme of AIDS 2018 is “Breaking Barriers, Building Bridges,” drawing attention to the need of rights-based approaches to more effectively reach key populations. AIDS 2018 aims to promote human rights based and evidence-informed HIV responses that are tailored to the needs of particularly vulnerable communities – including people living with HIV, displaced populations, men who have sex with men, people in prisons and other closed settings, people who use drugs, sex workers, transgender people, women and girls and young people – and collaborate in fighting the disease beyond country borders.