Most Gay Men Worldwide Cannot Access Basic HIV Prevention, Study Finds

via The Global Forum on MSM & HIV, by Jack Beck

A new survey of more than 5,000 participants worldwide indicates that the majority of men who have sex with men (MSM) globally find it difficult or impossible to access HIV testing, HIV counseling, free condoms and free lubricant. Released to coincide with World AIDS Day, the preliminary findings underscored the importance of universal access to HIV prevention and treatment, a central theme of this year’s World AIDS Day observance.

Initial analysis of the survey’s results indicates that fewer than half of MSM worldwide have access to even the most basic HIV prevention and services. Of all respondents, only 39 percent reported easy access to free condoms and barely one in four reported easy access to free lubricant. A full 25 percent said free lubricant was completely unavailable. Large percentages of men reported that it was difficult or impossible to access other essential services as well, including HIV testing (57 percent), HIV education materials (66 percent) and HIV treatment (70 percent).

Conducted by the Global Forum on MSM & HIV (MSMGF) in collaboration with Dr. Patrick Wilson, Assistant Professor at Columbia University's Mailman School of Public Health, the survey was carried out online in Chinese, English, French, Russian, and Spanish. Circulated through the MSMGF’s global networks and those of its partner Fridae.com, the survey closed with a total of 3,875 MSM and 1,009 MSM service providers participating – another 375 participants did not identify themselves as MSM or provider. Nearly three quarters of all study participants were from low or middle income countries.

“Since the beginning of the epidemic, it has been widely recognized that condoms, lubricant, testing and treatment, when combined with community-led behavior change and support programs, are the most reliable tools available in the fight against HIV among MSM,” said Dr. George Ayala, Executive Officer of the MSMGF. “More than 25 years in, it is inexcusable that MSM around the world continue to have such restricted access to these basic lifesaving resources.”

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

UNAIDS Report on the Global AIDS Epidemic 2010 - Slide Show

UNAIDS Report on the Global AIDS Epidemic 2010

View more presentations from UNAIDS.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Revista Catarina Feature ...

Miło mi poinformować, że wzmianaka o mnie pojawia się w brazylijskim piśmie modowym Revista Catarina. Znajdziecie mnie na 14 stronie.   

 

PrEP Implementation Where Homophobia Reigns?

MSM groups hail pill to prevent HIV, but...
via PlusNews

Excerpt:

"We are as happy as anyone out there about the findings from this study, but fear that unless our countries reconsider their laws, many MSM will not benefit from its results," said David Kuria, chairman of the Gay and Lesbian Coalition of Kenya.

Read the whole item.

And speaking of homophobia,

The GAY AND LESBIAN COALITION OF KENYA has not been invited to World AIDS Day activities in that country...

From the GALCK website:

For the first time since 2006, GALCK has not been invited by the National Aids Control Council to this year’s World Aids Day – normally marked on the 1st of December each year. This is particularly ironical because this year’s theme “Access and Human Rights” resonated so uniquely with the plight of our community.

It is to be remembered that the last two years have increasingly been difficult for GALCK and the groups because even though officially invited, often there would be no space allocated for us. Given the enormous preparation that goes into participating into the event, we had previously taken up available free spaces – often spaces not allocated to anyone.

Perhaps given the recent hostile reception of the message from the Minister for Special Programs, Hon., Esther Murugi, requiring the government and society to give services to men who have sex with men – MSM and sex workers, and the pending recognition of NACC as a parastatal through an Act of Parliament, NACC wants to distance themselves from criminalized groups such as sexual minorities.

Read the rest. 


And more homophobia


Kenya PM Orders Gays' Arrest - via Daily Nation



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Build on Prevention Science Advances this World AIDS Day

New Prevention Advances: Can We Now Imagine a World Without AIDS?
via Huffington Post, by Jeffrey L. Sturchio, Ward Cates and Salim Abdul Karim

Last week, UNAIDS announced that at least 56 countries have stable or declining incidence of HIV/AIDS. Yet on World AIDS Day this week, there are still two new infections for every person put on antiretroviral therapy. However, a series of promising new scientific results in prevention, including three breakthrough trials in just 16 months, offer the first glimmer of hope that we may finally be able to achieve the "three zeros" -- zero new infections, zero stigma/discrimination and zero AIDS deaths. 

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Celebrities Die Digitally for AIDS

Farewell, Digital World. (It’s All for a Cause.)
via New York Times, by Amy Wallace 

ON Wednesday, Kim Kardashian is going to die a little. So is her sister, Khloé, not to mention Lady Gaga, David LaChapelle, Justin Timberlake, Usher, Serena Williams and Elijah Wood.

That day is World AIDS Day, and each of these people (as well as a host of others — the list keeps growing) will sacrifice his or her own digital life. By which these celebrities mean they will stop communicating via Twitter and Facebook. They will not be resuscitated, they say, until their fans donate $1 million.

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Burberry Prorsum...

Tę kolekcję zna już zapewne każdy, kto choć trochę interesuję się modą. Czytałem o niej już na wielu blogach i stronach internetowych. Chciałem już wcześniej coś o niej napisać, jednak stwierdziłem, że tyle już zostało powiedziane o tej kolekcji, że nie wniosę nic nowego. Cały czas tak myślę, jednak za każdym razem jak oglądam zdjęcia z pokazu, nie mogę wyjść z podziwu . Może trafi się jakimś cudem ktoś kto pierwszy raz u mnie zobaczy te zdjęcia i tak jak ja, jakiś czas temu, zostanie zauroczony.
 Ta kolekcja przyciąga wzrok jak żadna inna. Znajdziecie tu połączenie wszystkich trendów obowiązujących w tym sezonie. Obok stylu militarnego zobaczycie super awiatorki, obok popularnego camelu pojawi się świetnie skrojona i dopasowana do ciała marynarka. Co mnie zachwyciło w tej kolekcji?! Przede wszystkim wielkie kożuchy, które nie tylko wyglądają bardzo szykownie, ale również są bardzo grube i ciepłe. W sam raz na naszą zimę. Poza tym awiatorki, które w tym sezonie przeżywają prawdziwy renesans swojego istnienia. Żadna inna z kurtek tego typu nie zrobiła na mnie takiego wrażenia jak ta z Burberry. Mega wielki podwójny kołnierz z kożuszkiem sprawia, że nie sposób ją pomylić z modelem innej firmy. Kolejnym niezwykle udanym, w mojej opinii , zabiegiem jest zastosowanie w płaszczach dużych, złotych guzików, które poza oczywistym nawiązaniem do stylu militarnego, nadają płaszczom ekskluzywnego wyglądu i budują cały look.

Poza tymi wszystkimi zachwytami nad całą kolekcją pojawia się jeden zasadniczy problem i nie mówię tu o cenie, bo ta jest oczywistą barierą nie do pokonania. Gdybyś miał do wyboru jedną rzecz z tej kolekcji, co byś wybrał??? Dla mnie wybór jest wręcz niemożliwy. I want it All…. I want it now!!!

 

Meet a Friendly Rectal Microbicide Advocate: Jim Maynard

via IRMA

“I quickly discovered what a powerful tool a microbicide would be in the battle against HIV transmission. I’m involved in IRMA because of their wholehearted advocacy of safe, effective, and affordable rectal microbicides as a way to protect our community.” –Jim Maynard

Jim Maynard is the Associate Director for Community Engagement at Fenway Health, an organization serving the LGBT community in Boston. Through Fenway Health’s association with the Microbicide Trials Network (MTN), an NIH-funded network committed to the development and testing of vaginal and rectal microbicides, Maynard learned about IRMA and microbicide development.

Maynard is anxious to add microbicides to the “prevention tool belt,” recognizing that while condoms have been a powerful tool in preventing the spread of HIV, in many cases they aren’t being used. He realizes that some people see condoms as keeping them from the sex they want, and that human behavior, especially when it comes to something so powerful and enjoyable as sex, is difficult to change.

Maynard advocates for microbicides both at work and outside, talking to friends, family, coworkers and neighbors in the hopes of creating a “booty buzz” around rectal microbicides. Maynard also plays tennis and reads, and spends time with his husband and two sons.

Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Meet a Friendly Rectal Microbicides Advocate: Mariama Kamara

via IRMA


Kamara is the Operations Manager for the African HIV Policy Network (APHN), an alliance of African community-based organizations and their supporters that are working for fair policies for people living with HIV/AIDS in the UK. As the only African organization in the UK whose work is dedicated to policy, advocacy and national and international representation, the APHN provides training, support, research and information focused on HIV and sexual health among Africans in the UK.

“I think that rectal microbicides are important because individuals need different options that have the potential to strengthen HIV Prevention efforts by enabling women and men to choose from and use a wide range of methods to protect themselves from contracting HIV and other STIs.”

Kamara, a native of Sierra Leone, first encountered IRMA via the UK African Microbicides Working Group; a group of individuals from several UK HIV organizations that are working to accelerate the ethical development and global delivery of microbicides and other HIV prevention options. The Working Group stays abreast of current issues in microbicide development by hosting ‘buzz cafes,’ one of which is featured on the IRMA blog, and by engaging with scientists and the media.

When she's not fighting HIV/AIDS, Kamara loves to travel and meet new people, or spend time with family and friends.

Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Flying High...

Jakoś tak się złożyło, że 80 % moich okryć wierzchnich pochodzi z lumpa. Na dodatek są to tego typu rzeczy, które i tak chciałem mieć! Ten płaszcz to również łup z Sh. Raczej już muszę chować go do szafy, gdyż na mrozy które nadchodzą, nie nadaje się. 

W zasadzie to zamiast tracic czas w internecie powinienem się wziąć za pisanie pracy mgr. Braki mi jednak motywacji, no i chęci. W końcu do czerwca daleko...

Alarming Drop in Condom Use Following HIV Prevention Trial in Zimbabwe

via IRIN PlusNews

When researchers returned to Zimbabwe several months after the end of a trial involving condom and diaphragm use, they were disappointed to find that condom use - which had risen to 86 percent during the trial - had reduced significantly.

"What happens after trials has always remained very much a mystery, and today, with biomedical prevention that has proved to be partly efficacious, such as the microbicide gel from the CAPRISA trial [which found that a vaginal gel containing tenofovir, an antiretroviral (ARV) drug, was 39 percent effective at reducing women's risk of contracting HIV during sex], it would be interesting to see what happens after the trial," Ariane van der Straten, lead author of a recent study on the issue, told IRIN/PlusNews.

"We were disappointed to see that all the effort and intense counselling provided to participants didn't seem to have a long-lasting effect - in effect, condom use went back to enrolment levels."

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

IZUM.ua Feature ...

Jakiś czas  temu napisała do mnie Tatiana Grinuova z ukraińskiego portalu modowego IZUM.ua. Miałem przyjemność udzielić jej wywiadu, który możecie przeczytać tutaj. Od razu zaznaczam, że przeznaczony on jest tylko i wyłącznie dla amatorów języka ukraińskiego ( tudzież rosyjskiego). Ja co prawda uczyłem się rosyjskiego dosyć długo, ale niewiele pamiętam z tego (wszystko odbyło się po angielsku).

Meet a Friendly Rectal Microbicide Advocate: Rita Labbett

via IRMA

“It is crucial we get the word out about all that is available to help reduce (and hopefully eradicate) HIV.  Each and every year, we as advocates, researchers, scientists and doctors have to advance and ‘up the game’ in the fight against HIV.  Rectal microbicides is something I remember when it was only in the “what if we could” stages.  Now, I am astounded on how far it has come.” –Rita Labbett, MPH

Rita Labbett, a Pittsburgh, PA native, is the Research Recruiter for Project Gel, a RO1 study being conducted under the umbrella of the Microbicide Trials Network (MTN). In her role at Project Gel, she will recruit participants for a longitudinal acceptability and adherence study of a placebo gel, including clinical and behavioral evaluations.

Labbett was introduced to IRMA by fellow advocate Dr. Ian McGowan, and as an IRMA advocate is excited to be in such great company. Besides recruiting for studies with MTN, Labbett studies the behavioral aspects of safer sex and microbicide acceptance. She is even including rectal microbicide use as a sub-topic for her Ph.D. dissertation on sexual health behaviors and myths surrounding sexual health.

When she’s not working, Labbett spends time with her busy son, Michael and loves cooking and dancing hip hop.
Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

HIV-1 Evades Natural Killer Cell Lysis: Another breakthrough in understanding HIV's mechanism of action

via Science Magazine

The study, posted online this week in the peer-reviewed journal Cell Host & Microbe, marks the "beginning of a fascinating story that will shed new light on an important but still poorly understood aspect of the interaction of HIV with natural killer cells," according to an editorial in the journal.

"With this information, we now have a major new target for drug therapies that could potentially stop HIV and allow the body's natural killer cells to do what they are designed to do -- protect the body from this lethal virus," said Edward Barker, PhD, associate professor of immunology and microbiology at Rush University and lead author of the study.

HIV, like any virus, is bent on producing progeny. It infects a cell, replicates itself over and over, and spreads throughout the body by using its "accessory" proteins to both take over the machinery of the cells it inhabits and thwart the arsenal of immunological cells that might destroy it.

Oddly, some of these proteins work at cross purposes. One, the Vpr protein, initiates what is called DNA damage repair, stopping the host cell in its tracks so that the virus can take over. But that action also sends a message to the cell surface that something is amiss. A ligand, called ULBP, is sent to the surface of the cell, which the prowling natural killer cells recognize and latch onto -- the initial steps just before moving in for a kill.

Read the rest

Read the article in Cell Host and Microbicide

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

"I have not cried this hard in years" - Mayer reflects on iPrEx and the future of HIV prevention

HIV Chemoprophylaxis:
New Optimism and New Challenges

by Ken Mayer, Fenway Community Health, IRMA steering committee member

Friday night, on the last leg of a trip from Geneva, heading home to Boston, I started crying, which is not my usual response to reviewing medical literature.

The tear-producing document was shared with the world on Tuesday morning in the New England Journal of Medicine (see IRMA post). It shows that taking a daily antiretroviral pill can protect HIV-uninfected men who have sex with men from becoming infected.

I have not cried this hard in years.

I cannot help but to think about Ira Gold whom I met when I was a medical student in 1975; Ducan Erley, another friend from the Chicago days; Nick Rango, who went on to head the New York State AIDS Program;  Fred Mandel, one of the first men I met in Boston,  whose picture is on my office wall at Fenway Health (one of the sites involved in the new study). Fred is leaning over then-Mayor Ray Flynn so that he glad hand Dr. Everett Koop’s (he was a gregarious human rights lawyer), during one of the first AIDS walks in the mid-1980’s; less than 10 years later, he died a horrible death before he was 40, like the other mentioned friends.

In my reverie, I recall the women and men I have cared for in Providence (the inconsolable sobs of a police chief father with his wasted daughter in his arms, blindness and dementia in a university professor and other nightmares), and the disenfranchised patients receiving world class treatment at YRGCARE, a community-based organization in Chennai, India. 

Along with so many others, they remain constant reminders of the ineffable toll. Too many, too young, and why?  Many years after their passing, and millions of needless deaths later, lots to think about now.

It is always sobering to recall where you were at a key moment in history. I heard that JFK was shot during shop class in 7th grade, and remember the sad weekends after the Challenger disaster and the death of Princess Diana. As the decades increase, so do the memories.

The  results of the iPrEx study, the first trial to prove that a pill can protect against HIV, are now being shared with the world. Over the past few years, data  from primates  that supported the rationale for chemoprophylaxis, plus the increased tolerability of newer anti-HIV medications, and the expectation that developing a highly effective preventive vaccine will take some time, led the National Institutes of Health and the Bill and Melinda Gates Foundation to  support this study in 11 sites, 6 countries and 4 continents. The dedication of almost 2500 participants and the study staff enabled the research team to evaluate this approach among people with enhanced risk for HIV.

Now that the data are public, after having undergone peer review (i.e. a group of researchers who had no association with the work have deemed it worthy of publication in a high profile medical journal), the results are exciting and challenging. The main conclusion is that using pills for prevention works, if people take the medication, in conjunction with a comprehensive package of counseling and other services. 

Before starting the trial, participants had to be educated about risks and benefits, and indicate that they knew what they were doing. The informed consent document that spelled out their rights and risks indicated that they had a 50-50 chance of getting a placebo, and the researchers did not know if the medication would work.  

Using the most rigorous analytical methods, men who were assigned to take the active medication were 43.8% less likely to become HIV-infected, whether they actually adhered to the regimen or not.  Among men who reported taking at least half their pills, the risk of becoming HIV-infected decreased by more than half.  More impressively, if drug was detected in samples from men assigned to take medication, the protective effect exceeded 90%.

The medicine was protective when taken, but many men did not routinely adhere to the regimen. So, what next?

Now that we have proof that oral medication can partially protect against HIV, the first question is whether we can do better?  Will men who are now informed that the medication works become more adherent , since previously the protective effect was only a theoretical possibility? What about women, heterosexual men, people at risk of becoming HIV-infected through unsterile syringes? 

Fortunately, there are multiple studies underway, looking at different populations, dosing strategies, modes of drug delivery. A topical gel containing tenofovir, one of the drugs used in the iPrEx study, was shown to decrease HIV transmission in South African women this summer. This was the first proof in humans that using antiviral medication before exposure to HIV is protective.

Other studies of vaginal and rectal gels are underway, as well as study in African women to see whether a gel or a pill is more protective. Very soon, there will be about 20,000 men and women involved in studies of chemoprophylaxis. 

The short term difference between the approaches is that there is no FDA-approved gel yet, while the medication used in iPrEx is prescribable now.  Some have raised the concern that using the same drugs for treatment as prevention could promote the spread of resistant strains, so other trials are evaluating  different drugs, which might be able to be solely used for chemoprophylaxis.  However, many of the question will take time to answer; the promising data revealed this week are  only part of  a long journey that could take many years.

Most prevention researchers and public health officials hope that the use of antiretroviral drugs for prevention will be a stopgap, which could prevent millions of infections on the road to an effective AIDS vaccine. For antiretroviral chemoprophylaxis to be effective, sufficient drug has to be concentrated in the relevant tissues at the right time. This will present some operational challenges, given that for each of more than 35 million HIV-infected persons, many more are at risk for becoming infected, and the majority of them are unaware when they are being exposed.

Rolling out chemoprophylaxis has the potential to strain underfunded and underdeveloped treatment systems, many have only recently  been strengthened by the U.S. President’s Emergency Fund (PEPFAR), the  multi-donor Global Fund, and other philanthropies.

On the other hand, since chemoprophylaxis involves medications that are familiar to clinicians who treat HIV, and many of their infected patients have uninfected partners or at risk friends, hese  experts should be engaged to help roll out chemoprophylaxis. This begs the issue of who will pay, since even generic antiretroviral medications may be relatively expensive in resource-constrained environments. 

Although  the iPrEx  study found the pill to be safe, long term monitoring will be necessary to anticipate later stage infrequent toxicities. Some of the newest studies underway are trying to establish what is the least amount of pre and post-exposure medication needed to prevent the maximal number of infections. Chemoprophylaxis raises questions of equity of access to preventive health care services, and major donors must think creatively of ways to offer comparable standards of prevention across the globe.

Chemoprophylaxis is a work in progress, and iPrEx suggests that this approach will only be effective if it is part of a comprehensive prevention package that continues to promote condoms and safer sex (some of the men who took more than 50% of their pills still became infected), medication adherence, diagnosis and treatment of other sexually transmitted infections, and ongoing behavioral counseling.

This is clearly not an approach for the general population in most countries, even among those at increased risk. The shorter the duration, the more cost effective PrEP will be. The more comfortable clinicians are in assessing risks and in encouraging HIV testing, antiretroviral drugs will be used most strategically. 

Unfortunately, most of the people living with HIV on this planet are unaware of their infection. Even in the US, several hundred thousand Americans are unaware of their infection and/or not linked into care. Testing and HIV status determination remain the cornerstone of any effective prevention strategy.

Chemoprophylaxis is not a panacea, nor a substitute for providers becoming comfortable assessing sexual and other risk behaviors. Newly diagnosed HIV-infected patients can be offered treatment for their health, and to decrease their infectiousness to others; those at risk who are not infected may benefit from chemoprophylaxis, after careful risk assessment and counseling.

In the wake of a global recession, many donor countries, foundations, and transnational bodies may not be keen to bear the costs of rolling out chemoprophylaxis. More refinements are needed, but  this cannot be a substitution for inaction. HIV-infected people must still have universal access to care. But, the iPrEx results suggest that a pill that is already FDA-approved can help protect people from contracting an incurable infection . 

Maybe It is an upcoming decennial birthday, maybe it is the musings after so much loss, but I hope the world will quickly understand that we have a new tool to arrest the ongoing epidemic, which should not be ignored.

After more than 60 million infections and more than 25 million deaths, it is time for the global community to wrestle with how to use these drugs most expeditiously to prevent unnecessary deaths and new infections.

In the halcyon days of youth, I could not anticipate a global pandemic with its personal and broad-reaching toll, and now, I hope that the chastened World will not ignore new hope.

No one said it would be easy.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

AIDS Drug Shown to Prevent HIV in Multinational Trial of HIV-Negative Gay Men; Data Suggests Need for Rectal Gel Option

[IRMA press release - click here for PDF]

Results of the world’s first efficacy trial of an HIV-prevention approach called oral pre-exposure prophylaxis, or PrEP, were released online in the New England Journal of Medicine today. Data from this trial, called iPrEx, indicated an estimated 43.8% reduction of new HIV infections among men who took an antiretroviral tablet daily to prevent HIV, compared to those who took a placebo pill. [Click here for the article.]

“This discovery alters the HIV prevention landscape forever. While this level of efficacy is relatively strong, PrEP is not quite ready for prime time and work remains before this strategy is rolled out. However, we are thrilled to have a new prevention option beyond male and female condoms visible on the horizon,” said Jim Pickett, Director of Advocacy at AIDS Foundation of Chicago and Chair of IRMA – International Rectal Microbicide Advocates.

The iPrEx trial evaluated the safety and efficacy of the antiretroviral (ARV) drug TDF/FTC (brand name Truvada) taken once daily for HIV prevention among HIV-negative gay men, transgender women, and other men who have sex with men (MSM).

The participants, 2,499 in all, included individuals from Peru, Ecuador, Brazil, South Africa, Thailand and the United States. Half the men were randomized into the active arm that received Truvada, and the other half were randomized into the placebo arm and received a look-alike pill with no active ingredient. The participants and the researchers did not know who was in either arm.

Enrollment for the trial began in June 2007 and was completed in December 2009. The primary analysis of the results released today includes participants who were followed until May 1, 2010, or for an average of 14 months.

Each participant was tested for HIV at monthly trial visits and given intensive pre-and-post test counseling. Additionally, they were regularly screened for sexually transmitted infections and received condoms, making up a very robust prevention package.

At the end of the trial, there were 36 infections in participants who received Truvada and 64 in recipients who took the placebo. Researchers calculated that the use of Truvada reduced new HIV infections by an estimated 43.8% overall when compared to placebo. While there appeared to be few side effects reported by the men who were taking the Truvada tablet, it is clear that much more information is needed regarding long term safety of this drug.

Other PrEP trials are ongoing. Results from studies among heterosexuals in Africa and injection drug users in Thailand are expected next year.

It is important to emphasize the factors that led to successful use of Truvada to prevent HIV in iPrEx. Taking the pill regularly was one of the most important. Efficacy appeared to be higher among those participants who took the study drugs consistently. Men who did not take the pill regularly did not see a protective benefit. Regular HIV testing and ongoing monitoring by a physician was also critical. For this strategy to work, each of these pieces, including a doctor’s prescription, need to be in place.

“The study team found that about half of the men in the active arm of the trial were in fact not taking their pills regularly, if at all,” said Pickett. “It is not clear why this happened, but it certainly suggests that alternate means of using ARVs to prevent HIV infection may be more acceptable for these men. The primary means of transmission among gay men and other MSM is through unprotected anal intercourse. If we develop an ARV as a gel or lubricant applied rectally – a rectal microbicide – it could be more acceptable for some individuals who don’t like taking pills.”

Many gay men and other MSM already use lubricants for anal intercourse, so they wouldn’t have to modify their behavior to achieve higher levels of protection with a rectal microbicide formulated as a lubricant. Adopting a new behavior—such as taking a pill every day—can be a considerable challenge for some.

Dr. Ian McGowan, one of the principal investigators of the Microbicide Trials Network and Scientific Vice Chair of IRMA agreed. "The data from the iPrEx study are encouraging but the less than ideal adherence rate to oral PrEP clearly show that we need additional prevention approaches such as rectal microbicides that could be used by men and women at risk of HIV infection through unprotected receptive anal intercourse," he said.

The world's third rectal microbicide trial is currently underway with sites in Pittsburgh, Pennsylvania; Boston, Massachusetts; and Birmingham, Alabama. Scientists are testing the rectal safety and acceptability of tenofovir gel, a microbicide developed for vaginal use that has shown promise for preventing HIV through vaginal intercourse. Depending on the outcome of this new study, tenofovir gel could be further evaluated to determine if it can reduce the risk of HIV among both men and women who engage in receptive anal intercourse.

This new Phase I rectal microbicide study, known as MTN-007, aims to determine if rectal use of tenofovir gel is safe, and in particular, does not cause cells in the rectum to become more vulnerable to HIV. Investigators will also ask trial participants questions regarding the gel's desirability. The trial is planning to recruit a total of 60 men and women.

While the rectal microbicide field has gained significant momentum, more focus and resources are needed. In 2010, U.S. $7.2 million is being spent globally on rectal microbicide research. IRMA has calculated that annual investments must increase by 40% from 2011 – 2014, to U.S. $10 million/year and must increase further to U.S. $44 million (a six-fold increase) in the years 2015 – 2020. These targets need to be met to ensure a minimum of candidate products are moving through the research pipeline into late stage testing for effectiveness.

Just as we use a combination of drugs to treat individuals living with HIV, we need a combination approach to prevention. That approach should include male and female condoms, sterile syringes, and access to treatment as well as new interventions like PrEP, topical microbicides, and vaccines. Adequate funding must continue for all of the methods we currently have, and it must continue for the new strategies that are still being developed as well.

In a global context where millions of individuals do not have access to life saving medications, it is imperative that funding provided for PrEP accessibility not compete with funding for treatment. Treatment funding has not kept pace with the need.

IRMA congratulates the trial sponsors, scientific collaborators and partners who conducted this landmark trial, with special thanks to the 2,499 participants in the study who volunteered so much of their time and energy. Their extraordinary contribution to HIV prevention science brings us another step closer to a day without AIDS, and for that we are supremely grateful.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

JUST OUT - New UN Report on the Global AIDS Epidemic

Hot off the UNAIDS presses

More unaids

Article on the report via BBC:
HIV epidemic 'halted', says UN

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

FashionMan...

Każdy kto zagląda na The Sartorialist zapewne kojarzy tego Pana. Jego styl jest na tyle charakterystyczny i rozpoznawalny, że nie sposób pomylić go z kimś innym. Mowa o Angelo Flaccavento.

Angelo jest niezależnym dziennikarzem modowym, piszącym dla takich pism jak Vogue Uomo , Vogue Italia, Fantastic Man, JC , Zoo, GQ Style Italia i Luxury24. Swój styl określa jako „paradoksalnie klasyczny, pełen zasad i szaleńczo zdyscyplinowany”. Jego znakiem rozpoznawczym są na pewno muchy. Małe, duże, jednokolorowe lub we wzorki.  Zakłada je zawsze, do wszystkiego i za każdym razem wygląda równie genialnie. Poza muchami na pewno okulary. Bez nich nie rusza się z domu.

Dodatkowo marynarki i koszule. Jak sam mówi „ urodził się w marynarce”. Wszystkie jego stylizacje są dopracowane w każdym calu. Nawet jego , wielka i wydawałoby się niechlujna broda,  jest idealnie przycięta. Nic w jego stroju nie jest przypadkowe.  Wszystko to sprawia, że patrzy się na niego jak na kogoś z innej planety. 

Dla mnie jest mega wielką inspiracją. Podziwiam go za styl i odwagę w doborze poszczególnych elementów ubioru. Za lekkość z jaką łączy detale.

Meet a Friendly Rectal Microbicide Advocate: Zoe Duby

via IRMA

“There is a need to provide people with choices about how to prevent the transmission of HIV. From what we know, condom use for anal sex, particularly between men and women, is very low. Rectal microbicides may provide a safe, feasible and user-friendly answer to preventing HIV transmission through anal sex." -Zoe Duby

Zoe Duby hails from Cape Town, South Africa, and is a social science and public health researcher specializing in the social context of HIV, high risk sex and most-at-risk-populations (MARPs). Duby has found IRMA to be a great resource for her Master's and PhD research, which focuses on heterosexual anal sex and HIV.

Through work with the Desmond Tutu HIV Foundation, Duby organizes and facilitates the MSM Sensitivity Training for Health Care Workers in Africa. With the Foundation, she has successfully trained over 160 health care workers in South Africa, and distributed 500 MSM Sensitivity Manuals. A second edition of the manual is currently being developed, and 400 more health care workers will be trained over the next year.
Duby is also an active advocate for bringing anal sex and anal health (heterosexual, bisexual and homosexual) onto the HIV Prevention and Treatment agenda. Much of her work aims to highlight anal sex (especially between men and women) as a neglected vector for HIV transmission.

When she's not spurring social change, Duby is outside surfing, climbing, running, hiking and cycling.

Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

UNAIDS Director Praises Pope's Condom Shift

via CNN.com

There could be single cases that can be justified, for instance when a prostitute uses a condom ...

Pope Benedict XVI's possible shift on condom use is a "significant and positive step forward," the head of the United Nations anti-AIDS campaign said, welcoming the potentially historic remark.

"This move recognizes that responsible sexual behavior and the use of condoms have important roles in HIV prevention," UNAIDS executive director Michel Sidibe said in a statement.

"This will help accelerate the HIV prevention revolution," he said Saturday.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Will EU Trade Deal Keep Needed Drugs out of Developing Nations?

via Aljazeera, by Andrew Wander

Until recently, Loon Gangte thought the days of watching his friends die of Aids because they couldn't get access to medicine were firmly in the past.

In a decade and a half since being diagnosed with HIV, Gangte, a 43 year-old living in New Delhi, has seen his illness transform from a death sentence into a manageable condition, thanks largely to the availability of cheap medicines produced in India.

"When I was diagnosed in 1997 there was medicine, but I could not afford it," he says. "Only rich people from the West could pay for it, so I had no treatment. All I could do was eat healthily, sleep regularly and hope."

But with no access to essential anti-retroviral treatment, his condition deteriorated. "According to the books, I was in the final stage of HIV - I had Aids," he explains. But as he prepared for the worst, he was given a lifeline: Indian-made generic medicines became available at a fraction of the price charged by Western drug companies.

"My life changed totally. I'd lost 99.9 per cent of my best friends to Aids," he says. "Why did I live and they die? It's simple- I had access to these drugs."

Gangte's story should have ended there, another human life prolonged by the steady march of medical progress. Instead, seven years later, he says he is coming to terms with a new threat to his health: an international trade agreement being brokered between the European Union and India that medical experts warn could leave millions of HIV sufferers in developing world without the drugs they need to stay alive.

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Jazz me...

Dzisiaj marynarka z poprzedniego posta w nieco bardziej eleganckiej wersji. Spodnie wyszukałem w Sh, a następnie zaniosłem do krawcowej :) Powiedzmy, ze efekt końcowy jest zadowalający. Miało być trochę inaczej, ale ogólnie jestem z nich zadowolony.  Mucha, to z kolei nowy nabytek - w zasadzie to prezent. Dostałem ją na prezentacji kolekcji Lanvin dla H&M. No i na koniec buty. W końcu je mam! Długo szukałem - głownie ze wzglądau na brak rozmiaru - ale w końcu niezawodny Asos przyszedł z pomocą. I to jeszcze przecenione :) Pozostaje się cieszyć. 

BowTie - Lanvin For H&M

Shirt - Sh

Blazer - NewLook.com

Shoes - Asos.com

Trousers - Sh

Belt- Asos.com

Meet a Friendly Rectal Microbicide Advocate: Gerard Nkundimana

via IRMA

“Building on the growing scientific evidence around the escalating numbers of new HIV infections resulting from unprotected anal sex, I believe that everybody born on this earth needs to understand the urgency to develop safe, effective, affordable and acceptable rectal microbicides among the new HIV prevention technologies.” Gerard Nkundimana

Nkundimana was born and raised in Butare town of southern Rwanda. He is a fifth year medical student at the National University of Rwanda and serves as an advisor and fundraising task force coordinator for the Medical Students’ Association of Rwanda (MEDSAR). Nkundimana became involved with IRMA in 2009 through the Prevention Research E-Learning Centre (http://www.hivpreventionresearch.org/), created by the Global Campaign for Microbicides to help trial staff, advocates, policy makers and other stakeholders understand and speak about the complexities of HIV prevention research. In the last year Nkundimana has used IRMA resources to stay up to date on the scientific, political and funding issues around rectal and vaginal microbicide development, and to engage with experts that are discussing HIV prevention research results and their implications in the real world.

Nkundimana also loves to socialize and to make friends, and enjoys taking part in the global student effort to prevent HIV/AIDS.

“Rectal microbicides are needed to help protect men and women who engage in anal sex. It is clear that they need and deserve protection from HIV and it makes a sense for the world to give it serious consideration on the global agenda to meet their needs.”-Gerard Nkundimana

Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

FDA Panel Recommends HPV Vaccine to Prevent Anal Cancer

via Medscape, by Emma Hitt, PhD

Human papillomavirus (HPV) quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant (Gardasil; Merck), was recommended for an expanded indication — prevention of anal cancer in males and females ages 9 through 26 years — at a US Food and Drug Administration (FDA) advisory panel meeting yesterday.

The FDA's Vaccines and Related Biological Products Advisory Committee mulled over the recent data to consider the expanded indication.

Panelists were asked to comment on 2 discussion topics: the strength of the data to support an indication for the prevention of anal intraepithelial neoplasia (AIN) and anal cancer in males and the scientific rationale for extrapolating efficacy in the prevention of AIN and anal cancer to females.

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Governments Remove Sexual Orientation from UN Resolution Condemning Extrajudicial, Summary or Arbitrary Executions

via International Gay and Lesbian Human Rights Commission (IGLHRC), by Sara Perle and John Fisher

(New York, November 17, 2010) – The International Gay and Lesbian Human Rights Commission (IGLHRC) and ARC International are deeply disappointed with yesterday’s vote in the Third Committee of the United Nations General Assembly to remove a reference to sexual orientation from a resolution on extrajudicial, summary or arbitrary executions.

The resolution urges States to protect the right to life of all people, including by calling on states to investigate killings based on discriminatory grounds. For the past 10 years, the resolution has included sexual orientation in the list of discriminatory grounds on which killings are often based. The removed reference was originally contained in a non-exhaustive list in the resolution highlighting the many groups of people that are particularly targeted by killings - including persons belonging to national or ethnic, religious and linguistic minorities, persons acting as human rights defenders (such as lawyers, journalists or demonstrators) as well as street children and members of indigenous communities.

Mentioning sexual orientation as a basis on which people are targeted for killing highlights a situation in which particular vigilance is required in order for all people to be afforded equal protection. The amendment removing the reference to sexual orientation was sponsored by Benin on behalf of the African Group in the UN General Assembly and was adopted with 79 votes in favor, 70 against, 17 abstentions and 26 absent.

"This vote is a dangerous and disturbing development,” said Cary Alan Johnson, Executive Director of IGLHRC. “It essentially removes the important recognition of the particular vulnerability faced by lesbian, gay, bisexual and transgender people - a recognition that is crucial at a time when 76 countries around the world criminalize homosexuality, five consider it a capital crime, and countries like Uganda are considering adding the death penalty to their laws criminalizing homosexuality."

This decision in the General Assembly flies in the face of the overwhelming evidence that people are routinely killed around the world because of their actual or perceived sexual orientation and renders these killings invisible or unimportant. The Special Rapporteur on Extrajudicial, Summary or Arbitrary Executions has highlighted documented cases of extrajudicial killings on the grounds of sexual orientation including individuals facing the death penalty for consensual same-sex conduct; individuals tortured to death by State actors because of their actual or perceived sexual orientation; paramilitary groups killing individuals because of their actual or perceived sexual orientation as part of “social cleansing” campaigns; individuals murdered by police officers with impunity because of their actual or perceived sexual orientation; and States failing to investigate hate crimes and killings of persons because of their actual or perceived sexual orientation.

"It is a matter of great shame that the responsible Committee of the United Nations General Assembly failed in its responsibility to explicitly condemn well-documented killings based on sexual orientation," said John Fisher, Co-Director of ARC international. "The credibility of the United Nations requires protection of all persons from violations of their fundamental human rights, including on grounds of sexual orientation and gender identity. We thank those States which supported the inclusion of sexual orientation in the text, and will redouble our collective efforts to ensure that Member States of the United Nations maintain the standards they have sworn to uphold."

The amendment runs counter to other positive developments in UN and regional human rights systems where there is increased recognition of the need for protection from discrimination regardless of sexual orientation and gender identity. At a September 2010 panel held in conjunction with a session of the Human Rights Council in Geneva, UN Secretary General Ban Ki-moon unequivocally recognized "the particular vulnerability of individuals who face criminal sanctions, including imprisonment and in some cases the death penalty, on the basis of their sexual orientation or gender identity." Sixty-eight countries have also signed a joint statement in the UN General Assembly on human rights, sexual orientation and gender identity which calls for an end to "human rights violations based on sexual orientation and gender identity … in particular the use of the death penalty on this ground [and] extrajudicial, summary or arbitrary executions."

IGLHRC and ARC International urge all States, regardless of their vote on this amendment, to sign the UNGA joint statement affirming support of the human rights of all people, regardless of sexual orientation and gender identity and to continue in efforts to decriminalize same-sex conduct and to end other discrimination, including violence, on the basis of sexual orientation and gender identity.

The votes to amend the resolution were as follows:

In favor of the amendment to remove sexual orientation from the resolution on extrajudicial, summary or arbitrary executions (79):
Afghanistan, Algeria, Angola, Azerbaijan, Bahamas, Bahrain, Bangladesh, Belize, Benin, Botswana, Brunei Dar-Sala, Burkina Faso, Burundi, Cameroon, China, Comoros, Congo, Cote d’Ivoire, Cuba, Democratic People's Republic of Korea, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guyana, Haiti, Indonesia, Iran, Iraq, Jamaica, Jordan, Kazakhstan, Kenya, Kuwait, Lebanon, Lesotho, Liberia, Libya, Madagascar, Malawi, Malaysia, Maldives, Mali, Morocco, Mozambique, Myanmar, Namibia, Niger, Nigeria, Russian Federation, Rwanda, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and Grenadines, Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, Sudan, Suriname, Swaziland, Syrian Arab Republic, Tajikistan, Tunisia, Uganda, United Arab Emirates, United Republic of Tanzania, Uzbekistan, Viet Nam, Yemen, Zambia, Zimbabwe

Opposed to the amendment to remove sexual orientation from the resolution on extrajudicial, summary or arbitrary executions (70):
Andorra, Argentina, Armenia, Australia, Austria, Belgium, Bhutan, Bosnia-Herzegovina, Brazil, Bulgaria, Canada, Chile, Costa Rica, Cyprus, Czech Republic, Denmark, Dominican Republic, Ecuador, El Salvador, Estonia, Finland, France, Georgia, Germany, Greece, Guatemala, Hungary, Iceland, India, Ireland, Israel, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Mexico, Micronesia (FS), Monaco, Montenegro, Nepal, Netherlands, New Zealand, Norway, Panama, Paraguay, Peru, Poland, Portugal, Republic of Korea, Republic of Moldova, Romania, Samoa, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Former Yugoslav Republic of Macedonia, Timor-Leste, Ukraine, United Kingdom, United States, Uruguay, Venezuela

Abstain (17):
Antigua-Barbuda, Barbados, Belarus, Cambodia, Cape Verde, Colombia, Fiji, Mauritius, Mongolia, Papau New Guinea, Philippines, Singapore, Sri Lanka, Thailand, Trinidad and Tobago, Tuvalu, Vanuatu

Absent (26):
Albania, Bolivia, Central African Republic, Chad, Dominica, Equatorial Guinea, Gabon, Gambia, Guinea, Guinea-Bissau, Honduras, Kiribati, Kyrgyzstan, Lao People's Democratic Republic, Marshall Island, Mauritania, Nauru, Nicaragua, Palau, Sao Tome Principe, Seychelles, Solomon Islands, Togo, Tonga, Turkey, Turkmenistan

Read more about IGLHRC

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Meet a Friendly Rectal Microbicide Advocate: Gerald Díaz Panduro

via IRMA

Panduro is a psychologist from Huánuco, Perú that focuses on HIV/AIDS and people living with HIV/AIDS.

While recruiting participants for a UCLA rectal microbicide study in Lima, Panduro stumbled upon IRMA-ALC, which had also been involved with the study. Since then, Panduro has been spreading the word about rectal microbicides and raising interest in the hopes that a rectal microbicide study might take place in Perú.

Panduro believes that once there is an effective microbicide available, when it's combined with condoms it will be the best tool to fight HIV/AIDS.

Panduro also enjoys going to the movies and photography.

Read about other friendly rectal microbicides advocates

Learn more about IRMA membership

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]