FACT Bucks County offers up to date information on HIV/AIDS related topics…see this section on news as taken from AVERT…
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US approves Truvada as an HIV prevention drug
(Article as taken from AVERT; AVERTing HIV & AIDS) In May 2012 the advisory committee to the US Food and Drug Administration (FDA) had recommended the antiretroviral drug, Truvada, to be used for the prevention of HIV infection among at-risk groups in the US. The FDA announced their approval of Truvada for the US market as a pre-exposure prophylaxis (PrEP) drug – the first time a drug of this kind has been approved as an HIV prevention tool. Truvada will be provided to people who are not infected with HIV, but are considered at high risk of exposure to the virus, such as HIV negative people in a sexual relationship with an HIV positive partner.
While the approval of Truvada in the US has the potential to reduce the number of new HIV infections, concerns remain about its roll out. The drug, which is taken once a day, is only effective if adhered to correctly. If taken sporadically drug resistance may occur, meaning people will no longer be protected, but may not realise. Additionally, the drug has not been found to be 100% effective, therefore it is important that is taken as part of a combination of HIV prevention strategies (e.g. continuing to use condoms). Truvada also has significant side effects, such as diarrhoea and weight loss, and more research is needed into the effects of long-term use. Finally, the drug is expensive (approximately $14,000 per year) and is unlikely to be available to those without health insurance.
If used in the correct way and under the right circumstances PrEP as an HIV prevention method could be effective, but should be used in conjunction with other HIV prevention methods, such as condoms. It is important to remember that there is no cure or vaccine for HIV and that no one strategy can single-handedly stop the HIV epidemic – an informed and comprehensive approach to HIV prevention is needed.
Discriminatory laws are restricting the global AIDS response
(Article as taken from AVERT; AVERTing HIV & AIDS) A landmark report published this week by the Global Commission on HIV and the Law concludes that punitive laws and a lack of recognition of human rights are hampering the AIDS response at global level. The report entitled ‘HIV and the Law: Risks, Rights and Health’ is based on input from over 1000 people affected by HIV-related laws across 140 countries, and a commission led by key stakeholders in the fight against HIV and AIDS. It is the first global report of its kind, providing evidence and tools to challenge discriminatory policies and laws that are creating barriers to an effective response to the HIV and AIDS epidemic.
The commission recognised that in many parts of the world there exist major inequalities between women and men in all aspects of living – from employment opportunities and availability of education, to power inequalities within relationships. These gender roles can confine women to positions where they lack the power to protect themselves from HIV infection.
The criminalisation of certain at-risk groups including men who have sex with men, transgender people, sex workers, and injecting drug users has also been shown to exacerbate HIV epidemics. The commission cited key evidence demonstrating that laws targeted towards these groups drives them further away from HIV and AIDS prevention and health services, and reinforces stigma and discrimination in society. The criminalisation of HIV transmission was also highlighted by the commission; calling for these cases to be limited to incidences where HIV transmission actually occurred and was intentionally and maliciously transmitted.
UNAIDS Executive Director Michel Sidibé stated that the report goes beyond a “superficial description of stigma and discrimination to question the legal and structural fabrics that sustains inequality, injustice and human rights violations in the context of HIV”. The report will be used as an advocacy tool to lobby governments who fail to uphold the human rights of all people living with and at risk of HIV.
Antiretroviral therapy significantly decreases tuberculosis incidence
(Article as taken from AVERT; AVERTing HIV & AIDS) Antiretroviral therapy (ART) has been shown to significantly reduce the risk of contracting tuberculosis (TB) in people living with HIV in the developing world. According to a study published in PLoS Medicine, TB incidence was reduced by up to 65% when HIV positive adults were on ART, regardless of their CD4 count at treatment initiation.
Tuberculosis is a major public health issue in its own right, yet also significantly impacts upon the global HIV epidemic as the leading cause of death of people living with HIV. In many parts of the world,TB rates are increasing despite rates being in decline in the previous 40 years. Escalating tuberculosis rates over the past decade in many countries in sub-Saharan Africa and in parts of South-East Asia are mainly due to the HIV epidemic.
The authors conducted both a systematic review and a meta-analysis of relevant research with the aim of discovering if ART uptake had any effect on TB incidence in the developing world. The most noteworthy finding showed TB incidence decreased by 57% in those who started ART when their CD4 counts were above 350 cells/mm3. This is significant considering The World Health Organisation’s (WHO) current guidelines recommend initiating treatment for all HIV positive individuals with CD4 counts below 350 cells/mm3. This evidence gives further credence to the discussion surrounding the benefits of starting treatment earlier.
The authors state that “initiating antiretroviral therapy as early as possible strengthens the WHO Three I’s for HIV/TB strategy by building upon antiretroviral therapy’s synergy with isoniazid preventive therapy.” They called for these findings to be taken into consideration by healthcare providers and policy makers when considering both the risks and benefits of starting people on treatment earlier. It also demonstrates the importance of full integration of HIV and TB programming when tackling these co-epidemics.