New HIV Treatment Guidelines to Cut Millions of Deaths

(Medscape)

KUALA LUMPUR, Malaysia — The World Health Organization has unveiled its much-anticipated new HIV treatment guidelines. Officials say the new approach will prevent 3 million deaths by 2025 and will stop 3.5 million new infections.

“The WHO estimates that these new guidelines will have an unprecedented impact,” director-general Margaret Chan, MD, told a packed room here at the 7th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention.

An estimated 17 million people are eligible to take antiretroviral drugs, but under the new recommendations this number will increase to 26 million.

The approach reflects the growing body of evidence that treating patients earlier at higher CD4 cell counts, when immune systems are still largely intact, can greatly reduce mortality and prevent HIV transmission.

“Prior WHO guidelines had been for treatment at much later stages of disease,” IAS president-elect Chris Beyrer, MD, professor and associate director for public health, Johns Hopkins Center for Global Health, Baltimore, Maryland, toldMedscape Medical News. “These revisions are based on our new understanding that earlier treatment can have a huge impact on the clinical care of the patient,” he said. “It also turns out that it has a big impact on reducing tuberculosis morbidity and mortality, which is very important in the Asia-Pacific region and Africa.”

The other critical improvement with these new recommendations, said Dr. Beyrer, is the reduction in HIV transmission. “This is a very important announcement, really. WHO guidelines play a normative roll — they’re paid attention to by global ministers of health, and that really matters.”

The new guidelines recommend starting antiretroviral therapy in all patients with a CD4 cell count of 500 cells/mm² or less. Other people should be started on antiretrovirals right away — regardless of CD4 counts — such as HIV-positive serodiscordant couples, patients with hepatitis-B coinfection, women pregnant or breast-feeding, and children younger than 5 years of age.

Read the complete article here.

GrantCraft Workshop on the Federal Grant Process

For JHMI Faculty, Postdoctoral & Clinical Fellows. Among the topics covered: the federal grant process and “grant culture”, mechanisms of particular interest to new investigators, choosing a “fundable” research problem, writing a competitive application, the NIH system of peer review, developing a budget and budget justification.

Mountcastle Auditorium
Tuesday, July 23, 2013
9am-4pm

To register: https://docs.google.com/spreadsheet/viewform?formkey=dGFUZWxyNDdNMFB3a0ZqdV9yaUZ2aEE6MQ#gid=0

For more information

Malaysia Meeting at ‘Exciting Time for HIV’

(Medpage)

KUALA LUMPUR — The 2013 meeting of the International AIDS Society, here in Malaysia, comes at an “exciting time for HIV science,” according to society president Francoise Barre-Sinoussi, PhD.

The meeting, held in the years between the biennial International AIDS Conferences, focuses on the science needed to combat the pandemic — basic, clinical, prevention, and implementation research.

This year, Barre-Sinoussi told reporters in a telephone briefing, a central focus will be on early treatment of HIV with antiretroviral drugs.

That because evidence has been mounting that early treatment has a cascade of benefits: better health for patients, a lower risk of transmission, and — intriguingly — the possibility of a cure.

“Cure is one of the priorities of the IAS,” Barre-Sinoussi said, and the conference will hear more details of two important studies that seem to show that very early treatment can lead to cure.

In the first, a baby born to an HIV-positive mother was given antiretroviral therapy within an hour of birth, after tests showed she carried the virus.

Mother and daughter fell off the radar screen and their treatment lapsed, but — as reported earlier this year — when physicians next saw the baby, she had no sign of HIV infection.

Investigator Deborah Persaud, MD, of Johns Hopkins University School of Medicine is to give a more detailed report in an invited lecture on July 3.

Read the full article here

Community-level Income Inequality, HIV Infection, and Stigma toward Injection Drug Users in Vietnam: A Quantitative and Qualitative Study

Thesis Defense Seminar
Community-level Income Inequality, HIV Infection, and Stigma toward Injection Drug Users in Vietnam:  A Quantitative and Qualitative Study
Wednesday, July 3, 2013
9am- 10am

 

Travis Lim, DrPh Candidate
Department of International Health

National HIV Testing Day Call to Action!

Tell your Senators TODAY to fully support programs vital to people living with HIV/AIDS in Fiscal Year 2014!

BACKGROUND:

– Members of the Senate Appropriations Committee plan to vote on the federal spending bill that supports Fiscal Year 2014’s domestic HIV/AIDS programs in early July.

– As a part of National HIV Testing Day today, June 27, we need to let Senators know that in addition to HIV testing, they should support full access to HIV prevention, care, treatment and research!

• Please help us to prevent further cuts by urging Congress to fully fund these programs now!

ACTION NEEDED:

– Today, June 27, National HIV Testing Day, please call your Senators and tell them to prevent harmful cuts and to fully fund HIV prevention, care, treatment and research programs!

• To call your Senators, dial the U.S. Capitol Switchboard at 202-224-3121. To find out who your Senator is, click here.

MESSAGE:

– I am calling on National HIV Testing Day to ask my Senator tofully fund and prevent additional cuts to HIV prevention, care, treatment, and research programs.

•  
• Supporting access to HIV testing means supporting access to the full continuum of HIV programs needed, including HIV prevention, care, treatment, and research.
• Early identification through HIV testing, and reliable access to effective HIV care and treatment helps people with HIV live healthy and productive lives and is cost efficient. Investing in HIV prevention today translates into fewer new infections and less spending on care and treatment in the future.
• In my state, such programs already have been cut and are greatly needed, because (insert local details or
  tell personal story).

To find HIV testing locations and services near you, click here.

If you have questions, please contact Donna Crews, Director of Government Affairs at AIDS United, at dcrews@aidsunited.org or (202) 595-4165. Thank you!

Methodologies and Formative Work for Combination HIV Prevention Approaches (R01) RFA-MH-14-180

This FOA invites applications to advance science that is needed for optimal HIV combination prevention intervention approaches. Recent advances in biomedical interventions with critical behavioral aspects (e.g., Pre-exposure Prophylaxis [PrEP], Treatment as Prevention) have changed how HIV prevention and treatment are conceptualized. Significant local, city, state, and federally funded efforts are shifting towards community-level interventions to reduce HIV incidence, and these efforts are informed by recent advances regarding: the importance of treatment uptake and retention in care; the effectiveness of combined behavioral and biomedical interventions; and the need to implement interventions community-wide for optimal public health impact. Reductions in HIV incidence will only be achieved through implementation of combinations of interventions that include biomedical and behavioral interventions, as well as components that address social, economic, and other structural factors that influence HIV prevention and transmission. However, combined prevention intervention approaches rely on synergies of multiple elements that can be challenging to design, implement, and evaluate. This initiative will support methodological, formative, and implementation research designed to better understand the processes and outcomes of combination intervention efforts and that will enhance the implementation of these interventions.

LOI due: August 3, 2013
AIDS Application due date: September 3, 2013

Read the full RFA here

Integrated Preclinical/Clinical Program for HIV Microbicides and Biomedical Prevention (IPCP-MBP) (U19) RFA-AI-13-023

 

The purpose of this Funding Opportunity Announcement (FOA) is to support integrated and iterative multi-project, multi-disciplinary preclinical development and exploratory clinical studies with the goal of advancing, strengthening and maintaining an innovative pipeline of non-vaccine biomedical prevention (nBP) strategies, including microbicides, PrEP, and Multipurpose Prevention Technologies (MPT). The focus of the IPCP-MBP is to stimulate and support a strong, diverse base in preclinical discovery and development of nBP candidates that includes development of single and combination nBP delivered pericoitally and by sustained delivery systems to the male and female genital and gastrointestinal (GI) tracts to prevent HIV acquisition/transmission. This objective will be accomplished by supporting the translation of candidates and strategies from preclinical to pre-Phase I clinical studies delivered by a variety of drug delivery systems (DDS), including gels, films, quick dissolving tablets, intravaginal rings (IVR), implants, oral, injection and MPT-based DDS strategies. This FOA has significant modifications to previous offerings of the Integrated Preclinical Clinical Program. Applicants are urged to read the FOA carefully.

LOI due: October 13, 2013
Application due: November 13, 2013

Read the full RFA here.

Free Webinar: Keeping Nurses Front and Center in Critical Healthcare Discussions

Keeping Nurses Front & Center in Critical Healthcare Discussions

Friday, June 28, 2013 – 3:00 pm – 4:00 pm EST

Presented by Carole Treston, RN, MPH – ANAC Policy Consultant

Join Carole Treston, ANAC’s Policy Consultant, this Friday, June 28 to hear how ANAC has been involved in critical discussions about important policy issues that impact your practice and your patients.  Carole will update everyone on ANAC’s involvement and nurses’ roles in the following discussions and issues:

• The Affordable Care Act & Ryan White Programs: Funding and Reauthorization
• HIV Criminalization: Impact on Patients, Nurses and Public Health
• National Viral Hepatitis Action Plan
• Health literacy, patient education & peer navigator programs

We’ll also briefly discuss other relevant legislative and policy items of interest to ANAC members.

We are leaving a lot of time for discussion, so we invite you to bring your questions about these important issues and be sure to let us know of other issues that are impacting you in your region, jurisdiction or state!

ANAC’s Policy Consultant, Carole Treston, RN, MPH, will present this webinar and lead discussion.  Carole is an RN, and received her MPH from Columbia University, where she focused on health policy and management.  Most recently, Carole was the Executive Director of AIDS Alliance for Children Youth and Families, a leading Washington DC based organization involved in HIV public policy and advocacy efforts.  She also has been Executive Director of Children’s Hope Foundation, an organization that worked to improve the quality of life for children, youth and families affected by HIV/AIDS in NYC. Carole has also served as the Director of Operations for the Pediatric AIDS Clinical Trials Group, an NIH sponsored global network of pediatric and maternal research sites.  She is an ANAC member and has served as faculty for the Pennsylvania / MidAtlantic AETC.

ANAC is hosting this free webinar, and encourages you to register today to participate in this important and interactive session.

If you have any questions, please email ANAC.

Getting Men to Want to Use Condoms (NYTimes)

It takes just a peek at the online store Condomania to appreciate the variety of condoms out there.

Flavors like island punch, banana split and bubble gum. Vibrating condom rings with batteries that last up to 20 minutes. Glow-in-the-dark condoms promising “30 minutes of glowing fun.”

And under the category “Celebrity Condoms,” there is the “Obama Condoms Stimulus Package,” each condom embossed with an image of the president giving two thumbs up.

But even if that presidential seal of approval were real, it would not overcome a chronic and serious public health obstacle: Most men do not like condoms.

Now an influential player in global health, the Bill and Melinda Gates Foundation, is getting into the game. The foundation just finished collecting applications for what it calls a Grand Challenge: to develop “a next-generation condom that significantly preserves or enhances pleasure.”

The goal is to address two significant problems: unintended pregnancies and sexually transmitted diseases like AIDS. Condoms cheaply and effectively prevent both, but around the world only 5 percent of men wear them and there are 2.5 million new H.I.V. infections a year. To stem that tide, health experts say, the number of men regularly using condoms needs to double.

“Decreased sexual pleasure is typically the predominant reason for not using them,” said Stephen Ward, a program officer for the Gates Foundation. “Can we actually make them more desirable? That’s what we’re shooting for.”

Read the complete article here.

Panel supports hepatitis C screening for baby boomers

(NATURE)

A US government advisory panel today recommended  that individuals born between 1945 and 1965 be screened for the hepatitis C virus. The announcement, which strengthens the panel’s earlier advice, increases the likelihood that health-care payers, including Medicaid, will cover screening costs for baby boomers, and that physicians will follow the guidance.

The US Preventive Services Task Force (USPSTF), a group of health experts assembled by the US Department of Health and Human Services,  had before only weakly endorsed generational screening. In adraft recommendation released in November, the USPSTF said that screening the country’s more than 72 million baby boomers would generate a marginal net health benefit, grading the recommendation a  ‘C.’ Since many health-care payers follow only recommendations dubbed B or higher by the panel, experts wereconcerned that physicians would not implement hepatitis C screening for baby boomers.

But in its final statement, the USPSTF upgraded that recommendation to a B.  Acknowledging that not all people who test positive for hepatitis C will develop disease, and treatments often have significant side effects, the panel said that new studies helped make the case that generation-wide screening would be substantially beneficial.

“This is a rapidly moving field and the treatments are always advancing,” says USPSTF panel member Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco.

The move aligns the USPSTF with the US Centers for Disease Control and Prevention, which in August unequivocally recommended that people  between the ages of 48 and 68 years old be tested for the blood-borne virus, which causes liver disease and cancer. Experts estimate that about 4 million people in the United States are infected with hepatitis C, and  three-quarters of those infected are members of the baby-boom generation — possibly owing to intravenous drug use or past transfusions of unscreened blood.

Overall, up to 75% of those infected with hepatitis C may be unaware of their status owing to the slow onset of diseases caused by the virus. Proponents of routine testing for US baby boomers have argued that the cheap, non-invasive screening could identify more than 800,000 new cases of hepatitis C — which could then be treated using new drugs that are highly effective at eliminating the infection.

David Thomas, a viral-hepatitis specialist at Johns Hopkins University in Baltimore, Maryland, said the USPSTF decision was “a major step forward in the public-health response to hepatitis C infection”. Regardless of what factors influenced the panel’s opinion, “the major message”, says Thomas, “is that we have everyone on board”.

Read the news blog here.