Positively Aware at the United States Conference on AIDS, Sep. 12-15
Delaware ADAP to be Managed by Ramsell Public Health Rx
Salk Institute Receives $21 Million for New Study
Vitamin A, Beta-Carotene Increase HIV in Breast Milk
Studies Find HIV Can Hide in the Brain
Gay and Bisexual Men Overlooked in HIV Data and Prevention Efforts
Positively Aware at the United States Conference on AIDS,
September 12-15.
Positively Aware magazine will be in attendance at this year’s United States Conference on AIDS being held at the Hilton Orlando Bonnet Creek, in Orlando, Florida from September 12-15. Be sure to stop by and visit us at booth #107!
Delaware ADAP to be Managed by Ramsell Public Health Rx
Ramsell Public Health Rx, a pharmacy benefit and information management company, announced it is working with the state of Delaware to administer its AIDS Drug Assistance Program (ADAP). The state program will utilize Ramsell's ADAP Management system to function electronically for the first time, allowing for streamlined coordination and access to critical medication for participants.
The Delaware ADAP provides HIV/AIDS-related prescription drugs to 1,300 uninsured or underinsured individuals living with the disease. According to a August 30 press release, “Ramsell is responsible for program enrollment and eligibility administration, coordination of benefit services, pharmacy network management, claims processing, and related services. By utilizing Ramsell's ADAP Management System, the state can access relevant program data used for the management of ADAP drug spending and trending. The online system also allows for quicker claims processing, invoicing, and payment processing.”
“We are proud to be working with the state of Delaware on this important program to provide services that can help improve the lives of people with HIV and AIDS,” said Sophia Byndloss, President of Ramsell Public Health Rx. “With state budgets being stretched thin, it is more important than ever to maximize every dollar while eliminating waste and duplication of services, which is exactly what our ADAP solution is geared to do.”
Salk Institute Receives $21 Million for New Study
The Salk Institute in La Jolla, California recently announced that it will lead a $21 million study on the human immune system's response to initial exposure to the AIDS virus.
Â
The National Institutes of Health is funding the project, which is intended to yield new and better therapies. Salk immunologist John Young will lead the research into how proteins work at the cellular level to create a defense against the virus.
"With the exception of a few specific proteins there is actually very little known about how cellular innate immune factors and pathways defend against HIV infection," Young said.
The Salk research effort will involve scientists from the Sanford-Burnham Medical Research Institute in La Jolla, University of California San Francisco, University of California San Diego, Mount Sinai School of Medicine, Northwestern University, and the University of Pennsylvania.
Vitamin A, Beta-Carotene Increase HIV in Breast Milk
Epidemiologist Eduardo Villamor of the University of Michigan School of Public Health conducted a pair of new studies and warns that vitamin A and beta-carotene supplements are unsafe for HIV-positive women who breastfeed because they appear to increase the amount of HIV in breast milk, thereby increasing the chances of transmitting the infection to the child.
Villamor's findings appear in two separate articles in the August 25 editions of The American Journal of Clinical Nutrition and the Journal of Nutrition. The results are significant because they provide biological explanations for a previous report that supplementation with these nutrients increased chances of mother-to-child HIV transmission. This may be partly because the same nutrients increase the risk of developing subclinical mastitis, an inflammatory condition which causes blood plasma to leak into the mammary gland and viral particles to then leak into the milk, Villamor says.
Mother-to-child HIV transmission is a problem in developing countries where HIV is prevalent. In 2008 alone, there were 430,000 new infections, most in sub-Saharan Africa, and more than 95% of those resulted from mother-to-child transmission.
Villamor said tests trying to separate the effects of each nutrient showed that beta-carotene seemed to increase the amount of HIV in breast milk independent of vitamin A, but an effect of vitamin A alone cannot be ruled out. The findings are potentially controversial because vitamin A is an important supplement for postpartum women in countries where HIV infection is highly prevalent, but supplementation programs may not take into account a woman's HIV status.
“The takeaway is that daily supplementation of HIV-infected pregnant or lactating women with vitamin A and beta-carotene at the doses tested is probably not safe and efforts need to be strengthened on preventing mother-to-child transmission through other interventions such as anti-retroviral regimens,” Villamor said.
Studies Find HIV Can Hide in the Brain
Studies conducted at the University of Gothenburg, Sweden showed that the spinal fluid of patients being treated with anti-HIV drugs contained traces of the virus when it was not present in their blood. Researchers concluded that, though antiretroviral (ARV) drugs suppressed replication in other areas, virus infecting the brain was largely unaffected.
“Antiviral treatment in the brain is complicated by a number of factors, partly because it is surrounded by a protective barrier that affects how well medicines get in,” said Arvid Edén, doctor and researcher at the Institute of Biomedicine at the Sahlgrenska Academy. “This means that the brain can act as a reservoir where treatment of the virus may be less effective.”
The research was done in two studies: one of 15 and a second of 70 participants who had been effectively treated with ARV drugs for several years. In the second study, HIV was found in the spinal fluid of about 10 percent of the participants, “even though the virus was not measurable in the blood, which is a significantly higher proportion than previously realised,” according to Edén.
The results of both studies would suggest that current HIV treatment cannot entirely suppress the effects of the virus in the brain, although it is not clear if a risk of future complications would be increased.
“In my opinion, we need to take into account the effects in the brain when developing new drugs and treatment strategies for HIV infection,” says Edén.
Gay and Bisexual Men Overlooked in HIV Data and Prevention Efforts
In an August 25 article in Scientific American entitled “Closeted Calamity: The Hidden HIV Epidemic of Men Who Have Sex with Men,” author Bob Roehr contends that many nations ignore epidemiological evidence due to cultural values such as “machismo, homophobia, and religion,” dominating prevention policy and funding.
According to the article, men who have sex with men (MSM), regardless of whether or not they identify as gay, in developing countries “are 19 times more likely to be infected with HIV than the general population, according to a 2007 literature review. Even in Africa, at the heart of the pandemic, in Malawi, 21 percent of MSM are infected with the virus compared with 11 percent of the general population, whereas Zambia's rates are 33 percent versus 15 percent, respectively.
 “Some 85 countries still criminalize sexual activity between adults, and eight, including Nigeria and several Islamic countries, impose the death penalty for homosexual acts. Uganda has been embroiled much of the past year in a debate about whether or not to write such a death penalty into their statutes, with evangelical Christians, both local and in the U.S., fanning the flames,” the article points out.
"We have a situation where laws and their arbitrary, inappropriate enforcement are increasing risk and vulnerability—thereby imposing barriers to effective HIV responses for those most vulnerable and the general population," said Jeffrey O'Malley, director of the United Nations Development Program (UNDP) HIV Group.
.
At the recent International AIDS Society Conference in Vienna, just 2% of the presentations focused on gay and bisexual men, according to George Ayala, executive officer of the Global Forum.
Roehr concluded, “This trend toward scientific omission has reinforced local social stigma and violence directed against this minority. The results are an amplification of new infections that might otherwise have been reined in, and a continued expansion of the pandemic.”
To read the complete article, go to http://www.scientificamerican.com/article.cfm?id=closeted-calamity-the-hidden-hiv-epidemic.