IRMA - Rectal Microbicide Advocacy

Send an IRMA Advocate to Pittsburgh!

noreply@blogger.com (IRMA) — Wed, 04 Nov 2009 15:00:00 +0000

Will you chip in?

by Roy Wadia, IRMA Steering Committee Member

I was one of the lucky recipients of the first round of John Shaw scholarships, to attend Microbicides 2008 in New Delhi. I'd been with IRMA (the former IRMWG) for a while by that time, and while I'd done a lot of HIV/AIDS advocacy and communications work during my time at WHO China and then at the BC CDC in Canada, I'd never really focused on microbicide issues until my introduction to this amazing group.

The more I delved into the subject matter, which initially seemed rather arcane, the more I realized its importance in the global response to the prevention and control of HIV/AIDS and STI. By focusing on rectal microbicides, an issue linked directly to the need to focus on anal sex and its role in the HIV/AIDS picture -- and yet one that is still not widely discussed or given its due in both scientific and advocacy circles -- IRMA and its membership has helped fill a conspicuous gap, prodding scientists, researchers and advocates alike.

The Delhi conference itself was an amazing chance to network, to meet some extraordinary individuals, and to experience that rather wonderful and long-overdue moment when the health minister of India, the conference host country, mentioned rectal microbicides as a weapon in the (if you'll pardon the unfortunate pun) arsenal to fight HIV/AIDS. It brought home the work that IRMA had been doing, and renewed our sense of mission and purpose. For this scholarship recipient it vindicated the work that's being done by so many of us, and I can only say that the John Shaw scholarship (named after a fearless advocate and lovely man) needs to continue and to be strengthened in the years to come.

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IRMA created the John Shaw Memorial Scholarship Fund in late 2007. John was a valued, enthusiastic and delightful member of the IRMA Steering Committee for over a year. He passed away Thursday, September 27, 2007. An LGBTQ/human rights advocate for over 20 years, John was also a Person With AIDS since at least 1990.

His fund helped rectal microbicide advocates attend the M2008 conference in New Delhi. Click here for a list of scholarship recipients.

TODAY - thanks to the generosity of the Elton John AIDS Foundation, we already have $3,000 in the Fund to help support IRMA advocates to attend the Microbicides 2010 conference this coming May in Pittsburgh.

We would like to bring that total to $10,000 - and here is where you come in. Will you chip in to help a rectal microbicide advocate attend M2010?

To donate to the John Shaw Memorial Scholarship fund, you may do so securely right here on this blog. In the upper left hand corner, there is a Chip In! box that allows you to donate whatever amount you would like via PayPal - securely.

The planners of M2010 are providing a large number of scholarships – so IRMA plans to fill in the gaps for rectal microbicide advocates who were unable to secure that support. We plan to release information on IRMA’s competitive scholarship process in December 2009. Microbicides 2010 will be announcing their scholarships on February 1 – and IRMA will announce recipients of our support by March 1, 2010. IRMA scholarship recipients are required to have applied for M2010 support to be considered.

Thank you for your support!

High prevalence of anal chlamydia in Swiss HIV-positive gay men

noreply@blogger.com (IRMA) — Mon, 02 Nov 2009 15:00:00 +0000

via Aidsmap, by Michael Carter

A large proportion of HIV-positive gay men in Switzerland have anorectal infection with chlamydia, investigators report in the November15th edition of Clinical Infectious Diseases. The researchers suggest that undiagnosed anal chlamydia infections could be contributing to the continued spread of HIV amongst gay men in Switzerland.

Gay and other men who have sex with men remain the group most affected by HIV in many industrialised countries, including Switzerland. Sexually transmitted infections also disproportionately affect gay men. If left untreated these infections, including chlamydia, can significantly increase the risk of acquiring HIV. As reported on aidsmap.com UK investigators found that many chlamydia infections in gay men were in the rectum, and that HIV-positive gay men were disproportionately affected by rectal chlamydia

Investigators from the Swiss HIV cohort therefore postulated that anorectal chlaymdia infection could be contributing to the ongoing HIV epidemic amongst gay men in the country.

They therefore screened 147 HIV-positive men who reported unprotected receptive anal sex in the previous two years for the infection. The aims of their study were to determine the prevalence and symptoms of anorectal chlamydia, and to see if they could identify any risk factors associated with the infection.

Read the rest.

The End is Near - Obama to Officially End Travel Ban - TODAY(?)

noreply@blogger.com (IRMA) — Fri, 30 Oct 2009 13:09:00 +0000

UPDATE - The ban has been lifted!!!

President Obama announced today that his administration is lifting travel restrictions into the country for those with HIV/AIDS.

"If we want to be a global leader on HIV/AIDS, we have to act like it," he declared, before signing a bill extending the HIV/AIDS treatment act named for Ryan White, who was diagnosed with AIDS at 13 and died in 1984. The bill provides medical care, medication, and support services to about 500,000, mostly poor, people.

The travel ban, imposed 22 years ago, will be lifted in January, according to a final regulation that will be published Monday, Obama said.

Read the rest.

via Advocate, by Kerry Eleveld

President Barack Obama is expected Friday to announce an end to the HIV Travel and Immigration Ban during a signing ceremony for the Ryan White HIV/AIDS Treatment Extension Act scheduled for 11:50 a.m., according to a source at an agency that works closely with the Administration.

"My understanding was that this would be announced the same day as the Ryan White Act was signed into law," said the source, who spoke to The Advocate on the condition of anonymity. "The White House wanted to be out in front on this."

Read the rest.

Read the rule from HHS.

Confusion surrounds HPV vaccine for men

noreply@blogger.com (IRMA) — Thu, 29 Oct 2009 16:00:00 +0000

Among HIV-negative gay men, the rate of anal cancer is "as high as cervical cancer in women before the introduction of Pap smears. And if you are HIV-positive, it's about double that," Chin-Hong said.

via Bay Area Reporter, by Bob Roehr

Should men routinely receive the vaccine for human papillomavirus (HPV) that protects against cervical and anal cancers and warts? Those hoping for a clear answer will have to settle for something less, at least for now.

The federal Food and Drug Administration approved Gardasil for use in women in 2006 to protect against four types of HPV that cause the vast majority of cancers and warts. It waited for completion of a trial in gay men to give the nod for that indication on October 16 of this year.

But a week later, on October 23, a Centers for Disease Control and Prevention advisory committee said Gardasil should not be added to the recommended list of vaccines for all pre-teens. That is important because the vaccine is most effective if it is given before one becomes sexually active.

Read the rest.

Related: Despite Approval, Evident Roadblocks to HPV Vaccine for Males Continue

BBC: Kenya to launch homosexual census

noreply@blogger.com (IRMA) — Thu, 29 Oct 2009 15:57:00 +0000

"Most of the gay community think that having sex with men is safe. There's no information here about safety measures."
- Gay rights activist Peter Njane

via BBC

Kenya is to carry out a census of its gay population in an effort to bolster the fight against HIV/Aids - despite homosexuality being against the law.

Nicholas Muraguri, head of Kenya's Aids prevention programme Nascop, told the BBC it was vital that the government reached out to the gay community.

He said gay people suffered from a lack of information about the disease.

But analysts say many gay people will be afraid to come forward in a country where homosexuality can result in jail.

Mr Muraguri conceded that an accurate count was unlikely.

But he told the BBC's Network Africa programme that getting a clearer idea of the number of gay people would be a huge help with targeted interventions such as provision of condoms.

Read the rest, including audio.

Kenya Update - politics and planning in heteronormative society

noreply@blogger.com (IRMA) — Mon, 26 Oct 2009 13:47:00 +0000

by IRMA Steering Committee Member Larry Misedah

Kenya has been seen as one of the progressive countries given a public health approach in dealing with MSM and WSW. The Kenya National AIDS Strategic Plan recognizes these subgroups as the most at risk populations which are part of the target groups for intervention in the HIV/AIDS pandemic. There have been research programs that have been carried out in both Nairobi and Mombasa about MSM. In one of the current research program led by Dr. Vasu and Dr. Theo, one of the recommendations was to have research on the efficacy of the different kinds of lubricant people use locally and their efficacy, a common idea shared with Ishtar MSM during their strategic Planning Process.

Where as it may be seen that the political situation in Kenya is different from the neighbouring East African Countries, the Constitutional Review Committee already pointed out that they will not include lesbian or gay issues in the constitution as this will lead to its rejection in the referendum - a controversial issue even within the National AIDS Intervention Programming. This therefore pauses a major questions about the future of further researches i.e. on rectal microbicides in a heteronormative society where sex is only viewed when done through the vagina and the penis. This notwithstanding the fact that even heterosexual couples have anal sex and that most MSM in Nairobi also have sex with Women because of the cultural reasons that have led them to get married.

There is therefore a need for an analysis and proper strategies to be put in place to ensure the continuity of the already ongoing work that has been taking place and a bold step to take in issues of rectal microbicides in the already ongoing programs. Perhaps an issue that needs to be picked up with the newly formed Panafrican MSM Network AMSHeR.

Sudan: Addressing an African Taboo, HIV Prevention with MSM

noreply@blogger.com (IRMA) — Sat, 24 Oct 2009 18:02:00 +0000

via International AIDS Alliance

[thanks to the Global Forum on MSM and HIV for putting this on the IRMA radar.]

Talib Aboi stands in a small courtyard building in Juba, south Sudan. He talks to a group of men about HIV, telling them how to protect themselves by using a condom.

He is a courageous, pragmatic man, who is willing to tackle a subject that in Sudan and across Africa is taboo – HIV prevention for men who have sex with men (MSM).

“If we don’t teach about HIV all our other work will mean nothing. For the children who came to adolescence during the war they didn’t become the people expected by the community. They don’t know what it is to be good, what it is to be bad.”

Aboi is the humanitarian director of Mubadaroon a development organisation, supported by the International HIV/AIDS Alliance. He has been working in development for over ten years.

“People are not coming out about men who have sex with men. We are learning that older people are infecting young boys. We want more information but most people are illiterate so we need materials that they can use. We need to do something specifically for men who have sex with men.

Read the rest.

How American Evangelicals are Killing Gay People in Africa

noreply@blogger.com (IRMA) — Sat, 24 Oct 2009 17:35:00 +0000

via Change.org, by Michael A. Jones

Hate never made for a good export. But that hasn't stopped a prominent group of American evangelicals from trying to ship their anti-LGBT principles abroad. One glaring example of right-wing theology run amuck across the globe is fresh out of Uganda, where legislative efforts to attack Ugandan LGBT people reached fever pitch this week.

Uganda is an interesting example of how the radical religious right in the United States has sought to take their battle against all things related to homosexuality to a global level. Earlier this year, a prominent group of evangelicals -- among them representatives from Exodus International and Defend the Family International -- attended a conference in Uganda aimed at discussing ways to fight homosexuality. The goal of the conference was to brainstorm ways that the government, schools and churches in Uganda could "wipe out" homosexuality from the country.

Read the rest.

Related: read "The Final Solution"? Gay Ugandans Could Face Death Penalty Under New Law on RH Reality Check

Ten percent of South African women report anal sex in the past three months

noreply@blogger.com (IRMA) — Wed, 21 Oct 2009 13:56:00 +0000

via Aidsmap, by Roger Pebody

A cross-sectional survey has found that 14% of men and 10% of women in Cape Town, South Africa, report having heterosexual anal intercourse. Condoms are used at roughly equivalent frequency as for vaginal sex, it is reported in the online edition of Sexually Transmitted Infections.

The study’s authors believe that while anal intercourse needs to be addressed in behavioural interventions, it makes only a minor contribution to the South African epidemic.

However, the authors of an accompanying editorial argue strongly that this conclusion is premature, and point out that unaccounted-for anal intercourse could skew the findings of microbicide trials.

Anal intercourse between men and women has generally not received as much attention as anal intercourse between men. However, there is evidence (especially from the United States) that anal sex is practised by large numbers of sexually active adults, suggesting that it may play an important role in HIV transmission amongst heterosexuals.

Read the rest.

Related: Check out the presentations below from the IRMA teleconference exploring this subject

Implications of Anal Intercourse and Rectal use of Products in Vaginal Microbicide Trials (Ian McGowan)

Measuring Anal Intercourse in Microbicide Studies (Pamina Gorbach)

Anal cells appear to be the major HIV risk factor

noreply@blogger.com (IRMA) — Mon, 19 Oct 2009 22:04:00 +0000

via GayNZ.com

The risk of anal transmission of HIV appears to be more associated with the presence and concentration of vulnerable cells than to low level physical damage associated with anal sex, according to information presented to a sexual health conference at the weekend.

Anal sex, sexually transmitted infections among gay men, and biological infection risk factors were hot topics at the 21st NZ Sexual Health Society conference which convened in Paihia.

Read the rest.

New Coalition to Address MSM Issues in Africa

noreply@blogger.com (IRMA) — Sun, 18 Oct 2009 19:00:00 +0000

via Behind the Mask, by Simangele Mzizi

In their effort to step up the fight against the high HIV prevalence amongst men who have sex with other men (MSM) some concerned men have formed a coalition titled African Men for Sexual Health and Rights (AMSHeR) aiming to increase visibility of issues affecting MSM in Africa.

Established in March this year, “AMSHeR was formed to strengthen the capacity of national agencies and individuals working to improve legislation and programming related to MSM’s sexual and reproductive health”, said Joel Nana, Executive Officer for AMSHeR.

The coalition consists of 15 organisations from 13 African countries working with lesbian, gay, bisexual, transgender and intersex (LGBTI) people, mainstream HIV and human rights organisations that work to address the vulnerability of MSM to HIV.

“We intend to extend invitations to other countries and organisations to ensure the visibility and representativeness of all aspects of MSM and transgender lives in the continent”, Nana said.

Currently AMSHeR is hosted by OUT LGBT Well-being, a South African LGBT health organisation based in Pretoria.

As a regional coalition of MSM and LGBTI led organisations, AMSHeR also aims to advocate for the elimination of discriminatory laws and policies affecting MSM.

Nana pointed out that, AMSHeR’s development process has been divided into two phases and the first phase started on 1 October this year and will end on 30 March next year.

“During this period, AMSHeR intends to develop its management mechanisms, establish its administrative systems, acquire a legal identity, develop its strategic plan and strengthen its funding base for the implementation phase or second phase”, said Nana.

According to a 2006-2007 HIV and AIDS report by UNAIDS to the UN General Assembly Special Session, MSM are a group that has long been overlooked with no documented evidence to confirm their existence.

Meanwhile studies show that research on MSM in Africa has been limited and largely focused on the heterosexual spread of HIV and as a result leaves MSM highly stigmatised and hard to reach, even though this population is particularly vulnerable to HIV infection.

The executive committee of the coalition includes Samuel Matsikure from the Gays and Lesbians of Zimbabwe, Steave Nemande from Alternatives-Cameroun, David Kuria from the Gay and Lesbian Coalition of Kenya and Chivuli Ukwimi from Zambia.

History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a Six-City Study of HIV-Positive Men Who Have Sex with Men

noreply@blogger.com (IRMA) — Sun, 18 Oct 2009 16:45:00 +0000

Among a population of HIV-positive men who reported unsafe anal intercourse with other men in the preceding year, the authors assessed rates of childhood sexual abuse and its demographic and mental health correlates. The researchers conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men (MSM), who were enrolled in the "Positive Connections" intervention.

Forty-seven percent of participants reported childhood sexual abuse, with 32 percent reporting the frequency of abuse was sometimes or often. The MSM reporting abuse were more likely to be Latino (odds ratio [OR]: 2.6; 95 percent confidence interval [CI]=1.6, 4.2; P<.001) or African American (OR=1.8; 95 percent CI=1.2, 2.7; P=.005) than white. Among MSM reporting abuse, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR]=1.3; P<.001) and unsafe anal intercourse (often, RR=1.5; sometimes, RR=2.0; P<.001) compared to men who were not abused.

"History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color," the authors concluded. "Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections."

Adapted from:
American Journal of Public Health 06.01.2009; Vol. 99; No. 6: P. 1079-1086; Seth L. Welles, Sc.D., Ph.D.; A. Cornelius Baker, B.A.; Michael H. Miner, Ph.D.; David J. Brennan, Ph.D.; Scott Jacoby, M.A.; B.R. Simon Rosser, Ph.D., M.P.H. This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.

Uganda AIDS Activists Protest Homophobic Bill

noreply@blogger.com (IRMA) — Sun, 18 Oct 2009 16:26:00 +0000

via IRIN/Plus News

A draft bill before the Ugandan parliament that seeks to impose stricter sanctions on homosexuality would drive men who have sex with men further underground, making it even more difficult for them to access HIV services, according to AIDS activists.

According to Uganda's New Vision newspaper, the draft bill, tabled by ruling party MP David Bahati, proposes a seven-year jail term for anyone who "attempts to commit the offence" or who "aids, abets, counsels or procures another to engage in acts of homosexuality".

"If this bill is passed it will be a clear violation of human rights and will push men who have sex with men even further underground than they are," Beatrice Were, a Ugandan HIV/AIDS activist, told IRIN/PlusNews.

Read the rest.

Gujarat gets India's first old age home for gay men

noreply@blogger.com (IRMA) — Sat, 17 Oct 2009 14:30:00 +0000

Uganda MP urges death for gay sex

noreply@blogger.com (IRMA) — Fri, 16 Oct 2009 12:53:00 +0000

Ugandan gay people have long alleged persecution
via BBC

A Ugandan MP has proposed creating an offence of "aggravated homosexuality" to be punishable by death.

Ruling party MP David Bahati wants the death penalty for those having gay sex with disabled people, under-18s or when the accused is HIV-positive.

Read the rest.

'Islam Needs a Sexual Revolution'

noreply@blogger.com (IRMA) — Wed, 14 Oct 2009 10:07:00 +0000

Interview via SPIEGEL ONLINE International

In the run-up to the Frankfurt Book Fair, German-Turkish writer Seyran Ates discusses her new book, which describes the necessity of a sexual revolution in the Islamic world, the recent integration debate in Germany and the arrogance of German women's rights activists.

Excerpts:

"Part of the process is that sexuality has to be recognized as something that every individual determines for himself or herself. Institutions like moral and religious police must be abolished," she says.

"They didn't sit down and say: Dear daughter, you are a girl, and that's why you can't have a boyfriend, because we don't want you to sleep with a man before marriage. Or: Dear daughter, you have a hymen, and we have to make sure that that hymen remains intact until your wedding. The entire system is designed so that everyone is given unspoken instructions on what to do -- or rather, what not to do."

Read the entire interview.

UNAIDS Head visits outreach programme for men who have sex with men in Mumbai

noreply@blogger.com (IRMA) — Tue, 13 Oct 2009 16:49:00 +0000

Because sex between men doesn’t lead to procreation, it is not taken seriously in India. At Humsafar, we never ask who you are; we’re only interested in whether you’re playing safe or not.

During his visit to The Humsafar Trust site in Mumbai, Executive Director of UNAIDS Michel Sidibé shared with its founder, gay activist Mr Ashok Row Kavi, his vision of achieving universal access to HIV prevention, care and treatment in India by 2010.

Mr Sidibé was visiting Mumbai during his first visit to India as Executive Director of UNAIDS, he also congratulated The Trust on its contribution towards making the annulment of Section 377 of the Indian Penal Code a reality. The organization was part of the petition filed in a Delhi court against Section 377 which criminalized homosexual sex.

Read the rest.

New trial of HIV vaccine in gay men begins

noreply@blogger.com (IRMA) — Mon, 12 Oct 2009 19:53:00 +0000

via edge Los Angeles, by Matthew S. Bajko

AIDS researchers have begun recruiting gay men in various American cities for a new HIV vaccine trial they are hopeful will be more successful than a previous vaccine trial that was abruptly aborted in 2007 for fear it was increasing some participants’ risk of contracting the virus.

The new study, known as the HVTN 505 Study, will examine if the new vaccine can decrease the viral load of those people who become infected with HIV. While it may also help prevent HIV infections, researchers will be closely monitoring participants to see if they do become HIV-positive what impact the vaccine may have on the onset of their illness.

Read the rest.

Exploring HIV Risk among MSM in Kigali, Rwanda

noreply@blogger.com (IRMA) — Mon, 12 Oct 2009 19:48:00 +0000

Thanks to the Global Forum on MSM and HIV for putting this on the IRMA radar.]

Executive Summary

This report presents findings from a behavioral surveillance study (BSS) of men who have sex with men(MSM) in Kigali carried out in 2008-2009. The aim of this study was to describe the population of MSM in Kigali and explore the nature of sexual activity between MSM.

This study utilized a snowball sampling strategy involving peer recruiter/s with a double-incentive structure. That is, men completing the questionnaire were asked to recruit their friends, acquaintances and sexual partners into the study and they received a small incentive for completing the study and for each eligible respondent that they recruited. The questionnaire was interviewer-administered and took approximately one hour to complete. Ninety-eight (98) MSM aged 18 to 52 years, participated in the study. Key results include:

• Ninety-four respondents reported previous anal sex with another man, and 88 reported anal sex with another man in the 12 months prior to survey.Men reported an average of two male sexual partners in the 12 months prior to survey (median;mean=3.4; range: 1 to 36).

• Thirty-seven respondents reported casual sex in the one month prior to survey and 18 of these men reported unprotected sex with a casual sex partner in this timeframe.

• MSM have wide sexual networks. Sex with men whilst traveling outside Kigali was commonly reported. One-quarter of respondents reported sex with a woman in the year prior to survey and one in seven men reported commercial or transactional sex with a woman in the same time frame.

• Condom use among MSM in Kigali is low. Thirty-four respondents reported that they had never previously used a condom with a male or female sexual partner. Among men reporting sex with another man in the 12 months prior to survey,one-third reported consistent condom use with all male partners. One-third of respondents reporting sex with a female partner in the 12 months prior to survey reported condom use at last sex with a female partner.

Read the whole report.

Factors associated with unprotected anal intercourse between HIV-positive men and regular male partners in a Sydney cohort

noreply@blogger.com (IRMA) — Mon, 12 Oct 2009 19:35:00 +0000

Int J STD AIDS. 2009 Oct;20(10):704-7.

Begley K, Chan DJ, Jeganathan S, Batterham M, Smith DE.
Albion Street Centre, Prince of Wales Hospital, Sydney.

Blood plasma HIV-RNA load (BPVL) is the strongest predictor of HIV-1 transmission during sex. Unprotected anal intercourse (UAI) is the highest risk activity for transmission among men who have sex with men (MSM). Awareness of BPVL may influence rates of UAI. We assessed whether optimism towards antiretroviral therapy (ART) and/or biomedical factors influenced sexual activities with regular partners. Questionnaires were administered to 109 HIV-positive MSM participating in a cross-sectional study of BPVL and seminal viral load. The survey assessed HIV transmission beliefs and sexual practices with regular male partners in the past three months. Sixty-nine of 109 (63.3%) had been in a regular relationship and 42 reported having had anal sex. Unprotected receptive anal intercourse without ejaculation (URAI - e) was associated with awareness that their most recent BPVL was detectable (>50 RNA copies/mL) and not taking ART. Receptive UAI with ejaculation (URAI + e) was associated with not taking ART, having a sexually transmissible infection and having an HIV-positive partner; the latter was also associated with insertive UAI with ejaculation (UIAI + e). Treatment optimism was not associated with UAI.In this cohort, sexual practices were based more upon knowledge of biomedical factors rather than attitudes regarding transmission risks.

PMID: 19815916 [PubMed - in process]

Another way to deliver a rectal microbicide?

noreply@blogger.com (IRMA) — Sun, 11 Oct 2009 04:44:00 +0000

The challenges of sex workers for microbicides development

noreply@blogger.com (IRMA) — Mon, 05 Oct 2009 13:25:00 +0000

via peripheries

Reacting to a peripheries post on microbicides, Cheryl Overs commented “These [definition of microbicides] are a hint of the skewed propaganda about microbicides and an insight into the absence of consideration of how they will affect the millions of sex workers worldwide. Sex workers will lose any hope of using a 99% effective product against STIs, HIV and unwanted pregnancies, condoms” adding that, “The idea that sex workers will buy and use a combination of different products for different orifices/sex acts is absurd. Especially when one of those products will still have to be a condom.” Cheryl is summing up various concerns expressed in the “Sex work and the new era of HIV prevention and care” report she produced for the Asia Pacific Network of Sex Workers (APNSW).

The report, available online, addresses the significant changes that have happened recently in the field of HIV prevention and HIV care and treatment and their implications for sex workers. The section on microbicides is well written and provides an accurate and comprehensive picture of the basic science, opportunities and what interests us here, challenges of using microbicides for sex workers.

Read the rest.

SOUTH AFRICA: "Lower Risk of HIV Infection Among Circumcised MSM: Results from the Soweto Men's Study"

noreply@blogger.com (IRMA) — Fri, 02 Oct 2009 20:27:00 +0000

IAS Conf on HIV Path, Treatment & Prevention 2009 (07.20.09):: T. Lane; H.F. Raymond; S. Dladla; J. Rasenthe; H. Struthers; W. McFarland; J. McIntyre

Male circumcision has been found to reduce female-to-male HIV transmission through vaginal sex in randomized controlled trials. However, one recent meta-analysis of observational data found insufficient evidence of a protective effect with men who have sex with men (MSM), while noting the lack of data from high-prevalence settings. In the Soweto Men's Study, researchers examined the association between insertive anal intercourse and HIV infection among MSM in a peri-urban South African community.

Researchers enrolled 378 MSM through respondent-driven sampling and surveyed the men about their sexual behavior with their last five partners. Participants were asked whether their sexual role with male partners was insertive, receptive or both. Circumcision status was self-reported, and HIV status was determined by rapid antibody testing. Results were adjusted for network size and recruitment patterns and reported with 95 percent confidence intervals (CI).

Overall, 36.4 percent of MSM were circumcised; HIV prevalence was 13.2 percent (12.4-13.9 percent); and 76.4 percent reported exclusive insertive anal intercourse (75.4-77.3 percent). Among those exclusively insertive, 88.1 percent (87.1-89.1 percent) also reported having female partners. In multivariable analysis, the odds of infection among uncircumcised MSM reporting exclusive insertive anal intercourse with male partners were significantly higher than among insertive circumcised MSM (adjusted odds ratio 4.5; 95 percent CI 3.1-6.7).

"Circumcision may be effective at reducing HIV transmission between men in high-prevalence settings such as Soweto where MSM practice a high degree of sexual role segregation," the researchers concluded. "It may be feasible to conduct a randomized controlled trial of circumcision among MSM in such communities. The acceptability and ethical implications of male circumcision in MSM populations must be assessed prior to initiating clinical trials."

NEW Rectal Microbicide Trial is Recruiting

noreply@blogger.com (IRMA) — Wed, 30 Sep 2009 10:29:00 +0000

Official Title: “A Two-site, Phase 1, Partially-blinded, Placebo-controlled Safety, Acceptability and Pharmacokinetic Trial of Topical, Vaginally-formulated Tenofovir 1% Gel Applied Rectally Compared With Oral 300 mg Tenofovir Disoproxil Fumarate in HIV-1 Seronegative Adults”

Clinical Trial Phase: Phase 1 | Start Date: September 2009

Overall Status: Recruiting

Estimated Enrollment: 18

To date, the majority of microbicide research has focused on the assessment of the safety and effectiveness of vaginal microbicides used for the prevention of HIV transmission via the vaginal compartment. Receptive anal intercourse (RAI) is common among men who have sex with men (MSM), and there is increasing evidence that heterosexual women in the developed and developing world also practice anal sex. It can, therefore, be anticipated that once vaginal microbicides are licensed, they will be used in both the vaginal and rectal compartments. As a consequence, there is a need to evaluate both the rectal and vaginal safety profile of candidate microbicides. Therefore, the primary objective of this study is to evaluate the systemic safety of 1% vaginally formulated tenofovir gel applied rectally.

In addition, this study will evaluate the immunotoxicity of the gel and evaluate its acceptability; it will also use the oral tenofovir disoproxil fumarate tablets (TDF), rectally-applied tenofovir gel,and a placebo gel to compare their systemic and compartmental pharmacokinetic (pK) profiles.

Read the rest of the info on this study here.

US activist group urges caution on vaccine trial results

noreply@blogger.com (IRMA) — Mon, 28 Sep 2009 17:02:00 +0000

by Keith Alcorn, via Aidsmap

The results of the RV 144 HIV vaccine trial should be treated with caution until further data are presented, US advocacy organisation Treatment Action Group said on Friday, following the announcement that the combination of vaccines used in the study resulted in a 31.2% reduction in the risk of HIV infection.

“Based on the limited amount of information that has been released, it appears that the statistical significance [of the result] hangs on very few cases of HIV infection. TAG urges caution in interpreting the findings until more detailed information is available,“ the group stated in a press release.

Seventy-four out of 8198 volunteers in the placebo group became infected, compared with 51 out of 8197 volunteers who received a combination of two vaccines, ALVAC vCP1521 and AIDSVAX B/E. Participants in both the vaccine group and the placebo group received counselling on how to reduce their risk of HIV infection.

Although the difference in the risk of infection was statistically significant, the confidence intervals for the estimate were extremely wide.

Read the rest.