AIDS Health Foundation (AHF) Questions Truvada's Use as PrEP

via Business Wire News Releases, by AIDS Healthcare Foundation

AIDS Healthcare Foundation (AHF) unveiled a new print ad today that lays out data on the use of Gilead's blockbuster HIV treatment drug Truvada as a pre-exposure prophylaxis (PrEP) or HIV prevention pill raising questions about the wisdom of pursuing approval by the U.S. Food & Drug Administration (FDA) for this new use of the drug. The information detailed in the "Gilead's Truvada as Prevention - Just the Facts" ad illuminates the reasons why it is premature for the U.S. Food & Drug Administration to consider approval of Truvada as PrEP. In the ad, AHF also calls on Gilead "to make certain that their drug when used for prevention does no harm to the individual or the overall public health."

The ad is scheduled to begin running this week in eight publications aimed at an LGBT (Lesbian, Gay, Bisexual and Transgender) audience: Bay Area Reporter in San Francisco, California; GA Voice in Atlanta, Georgia: Gay City News in New York, New York; South Florida Gay News in Miami/Ft. Lauderdale, Florida; Washington Blade in Washington, D.C.; and Windy City Times in Chicago, Illinois. It will begin running next week in the following publications: Frontiers Magazine in Los Angeles, California and Out Front in Denver, Colorado.

The push for FDA approval of PrEP has increased since November 2010 when the results of the iPrEx study were released. The study of 2,499 high-risk men who have sex with men (MSM) found that the once-daily pill could decrease the likelihood of HIV infection by 42%. Since then many have raised concerns about the consequences of widespread use of PrEP and its possible affect on behavior. Letters signed by 618 doctors and advocates have been sent to the FDA and to drug-maker Gilead Sciences urging a halt to pursuit of FDA approval for use of Gilead's blockbuster AIDS treatment drug Truvada as PrEP. In the letter sent by doctors--spearheaded by AHF--the doctors expressed concern that widespread use of PrEP, based on the available data, will unwittingly lead to more risky behavior, and more HIV infections. Lack of real-world data has also been cited as a concern.

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[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.]

When addressing the challenge of changing behavior, it's "easy to blame the victim"

via Huffington Post, by Simon McCormack

When addressing the challenge of changing behavior, Marjorie Hill says it's easy to blame the victim.

"There's always a tendency to look at the person and say, 'why don't you just stop smoking or eating red meat or start exercising?'" The Gay Men's Health Crisis CEO and HuffPost blogger says.

But when it comes to dealing with HIV and AIDS, Hill says, it's more complicated.

"We think that personal responsibility is important and we certainly encourage it," she said. "But when you look at the numbers and understand the epidemiology, the most common factor that those 33 million people who have the disease share is poverty. Poverty doesn't transmit HIV, but certainly being in a situation where someone has less access to information, resources, education and power -- those are factors that influence HIV."

That's what GMHC, the world’s first provider of HIV and AIDS prevention, care and advocacy, works to change, Hill said.

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[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.]

Victory! Court Overturns “Anti-Prostitution Pledge”

Via Care2, by Jaime-Alexis.

Yesterday, a federal appeals court in New York ruled that the US cannot force organizations to formally pledge to denounce prostitution and sex trafficking in order to receive US funding for HIV and AIDS work. This is a significant victory for the global health community. Why is this good news? Because the policy—commonly known as the “anti-prostitution pledge”—is flawed.

The pledge requires all organizations—American or foreign—that receive US funds to fight HIV and AIDS abroad to adopt a formal position condemning prostitution and trafficking. I have been involved with international development organizations focused on HIV and AIDS. I have never met anyone in the development community who is not firmly opposed to—or horrified by—trafficking. There are few issues that bring such universal abhorrence. One problem with the anti-prostitution pledge however is that it conflates prostitution and trafficking, which ignores realities on the ground. In many developing countries there are individuals who sell sex for their livelihood—food, shelter. And these individuals require and deserve access to health and social services, including HIV prevention and care. Condemning and judging by denouncing their livelihood can drive them further from the help they need, limit their ability to access health care, provide for their families, or even leave the industry.

The ambiquity of the pledge language adds to the challenge. If, as in the case of one plaintiff, Pathfinder International, an organization works with sex workers to organize and empower them so that they can advocate for their rights (which is both an effective HIV prevention strategy as well as an effective means of reducing other harms of sex work, including violence and exploitation), is that “promoting prostitution?” No. For those of us in the development community, it means you’re helping those in need.

Perhaps even more problematic, the pledge, as defined by the Bush Administration who first enforced it and now the Obama Administration, applies not only to US government funding, but to private donations as well. That means that even if an organization is not using any government funds to provide services to sex workers, they could potentially lose US funding for their separate, privately-funded work.

Recognizing the issues with this policy, Pathfinder and Alliance for Open Society International originally brought the US Government to court in 2005. “Trust that it was not an easy decision for Pathfinder to take our largest funder—the US Government—to court,” Pathfinder President Daniel E. Pellegrom said. “However, we strongly believe vital principles were, and continue to be, at stake. Private organizations cannot be told what to think or believe; they cannot be compelled to espouse a government mandated position. And they must be free to challenge the status quo and to speak out on behalf of the vulnerable and disenfranchised.”

 Read the rest here.

[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.]