The Effect of Contraceptives on HIV Transmission
9 years ago
Ongoing debates over injectable contraceptives for HIV prevention, and the idea that there is an increased risk of contracting HIV when using such, have been escalating. Researchers have found their studies inconclusive – some reports show that risk increases and some claim that it does not. So why the discrepancies, and what is the biological reason for such findings?
To start, the contraceptive being accused of aiding the transmission of HIV is known as Depo-Provera or DMPA. Reports that it increases the risk for HIV infection are growing, yet studies come up with data that is contradictory. To determine the real risk, along with an explanation, a thorough investigation was made. Over 800 women were analyzed. All started out HIV free and were enrolled in family planning clinics. The women were divided into three groups. One group used oral contraceptives, the other DMPA, and the final group did not use hormonal contraceptives. Later, 200 of the participants became infected with HIV. A look at the vaginal flora of the women within each group gave researchers the explanation they had been searching for.
For each group, there were those with a healthy vaginal environment and those with infections from either parasites, bacteria, or fungi. Further, it was confirmed that those taking the DMPA contraceptive presented with more changes to the immune system, which meant more vaginal infections, increased inflammation, and an increased risk of contracting HIV. The compromised vaginal state proved a poor resistor to infection, including contracting HIV. Certain protein levels are known to attract and aid HIV in spreading. However, the results of this study also showed that certain oral contraceptives could alter the immune system or suppress it. This too can lead to environmental changes within the vagina that can lead to easier transmission of HIV.
It is the hope of those researchers that the information from this study will move institutions to educate their patients and their partners. That way individuals can make informed choices about the types of contraceptives they decide to use, especially for HIV prevention. Thus, spread of HIV can be slowed and hopefully, in many cases, prevented.
Studies Show Fewer Gay Teens Seek HIV Testing
9 years ago
There is a reason that HIV is once again on the rise for young homosexual men. A recent study revealed that only about 20% of individuals in this high-risk group have ever been tested for the disease. Testing is critical for multiple reasons. For example, it can aid in the prevention of further transmission as well as get the infected individual lifesaving treatment. So why are so few getting tested?
“Where Can I Get an HIV Test?”
One of the primary reasons that young gay men say they have never been tested is because they simply do not know where to go for testing. One suggestion is that schools begin to provide testing, so that teens do not need to look for a place to get tested.
“What If Someone Sees Me?”
No one wants to be known as the kid at school with HIV. It is still tough enough for many gay teens to be known as a homosexual. Now add to that the stigma of being seen going for testing. It sends a message that kids don’t want to broadcast in world full of bullies and fearmongering.
“It Will Never Happen to Me”
Most teens feel invincible. They may say, “I take precautions. I’ll never get it,” or, “I know my partner isn’t infected.” Unfortunately, that sort of thinking is the perfect breeding ground for the spread of HIV.
The Wrong Trend
In 2008, a study of gay 18 and 19-year-old males showed that three-quarters had been tested for HIV. The drop in the number of young men getting tested has fallen significantly in just a few short years. This is a big deal when we’re talking about the single highest-risk group on the planet for the contraction of HIV.
Researchers see knowledge and ease of access as the primary means to combat this negative trend. Providing testing in schools would take away some of the stigma and make it easier for teens to get tested. This, in turn, can lead to greater prevention and earlier treatment, something vital for a high success rate.
Genetics May Account for Some HIV Drug Failures
9 years ago
When anti-HIV drugs fail to suppress the condition or prevent transmission, the situation is usually blamed on a patient who does not take the treatment as is needed for it to work correctly. Recent research, however, shows that some individuals, and even some parts of the body may be genetically predisposed to treatment failure.
Consider the drug Tenofovir. It is on the market under the brand name Viread, and the FDA approved this medication back in 2001 as an HIV treatment. Then in 2012 approval was given for use as an oral prophylactic, this time with the goal of preventing HIV transmission.
Unfortunately, some people, and also some parts of the body, have enzymes that take the active Tenofovir and return it to an inactive state that does not combat HIV. The research showed different enzymes to be at work in the vagina and rectum causing the treatment to have different results depending on where it was used on the body. But even when used in the same manner, results still varied.
That is because the location of the treatment was not the only determining factor. About one in 12 women who were part of the study suffered from a genetic variation that rendered the medication inert regardless of how it was used.
Learning this is a big step for researchers since it was previously just assumed that human error was involved when the drug didn’t work. Now the realization is that genetics may be involved. The next stage of research may reveal that genetic testing can determine in advance if Tenofovir is a viable treatment option or not for a particular individual.
The next step is a clinical trial. It is hoped that such continued research will determine how anti-HIV drugs function and what variants definitely affect how successful the treatment will be from person to person.
Consistent HIV Treatment Reduces Heterosexual Transmission
9 years ago
by ADMIN
in HIV Management
Recent studies show that HIV treatment that is effective in suppressing the disease works well at preventing the spread of the disease between heterosexual partners. These Canadian findings were the result of a trial funded by NIAID.
The idea of lessening HIV transmission with treatment is not entirely new. In fact, one study from 2011 revealed that the risk of spreading HIV to a partner is reduced by 96 percent when treatment starts early and is taken consistently. The study focused specifically on heterosexual couples in which only one partner was HIV positive.
More than 1,700 heterosexual couples across four continents signed up to be a part of the clinical trial. As a part of the study, all of the couples received training on how to avoid transmission of HIV. Infected individuals were assigned at random to either begin immediate antiretroviral treatment or to delay starting treatment until immunocompromised. Approximately 600 couples did not complete the entire trial, but the data from the other 1,100+ was sufficient to get results. What was learned?
The healthy partner was 93 percent less likely to contract HIV if the infected partner began treatment immediately. In the case of couples where the treatment was begun early on, only eight partners ended up being infected. In fact, four of those individuals were diagnosed early on, showing that the longer treatment went on, the less likely the health partner was to be infected.
It is also important to note that in all four individuals who were infected later on, the partner receiving treatment had not had the disease fully suppressed for one reason or another. In the case of those for whom the treatment worked, there was no transmission after the early part of the study. Another important discovery was that, for those who waited to start treatment, it took longer to suppress the virus, thus leaving a longer window where transmission risk was higher.
The moral of the story: to protect your partner, start treatment early and stick with it to ensure suppression.
An Ounce of Prevention Could Save Tons of Money in the War on HIV
9 years ago
by ADMIN
in HIV Management
A study performed in Canada showed that every dollar a community spent on HIV-prevention methods resulted in saving five dollars in treatment. Over the past 25 years, programs costing about $1.3 billion dollars have resulted in approximately $6.5 billion less in treatment. That is a tremendous savings for an already financially burdened health care system. Let’s take a look at why prevention is so cost effective as opposed to treatment.
The Economic Burden of HIV
HIV treatments now allow patients to live a long, full life. That is good news for patients, but financial burdensome for health care systems because it means patients receive treatment for years longer than they once did. For example, in the US, it costs, on average, more than a quarter of a million dollars to treat an HIV positive person over the course of their lifetime, some costing as much as $400K. The same holds true in Canada with lifetime treatment costing a little over $285,000 USD per patient.
Where Community-Based Programs Prove Most Effective
Preventative programs are generally run by local and national non-profit groups. These organizations work to provide ongoing:
- Education
- Prevention
- Support Services
These programs target at-risk groups including, but not limited to:
- Homosexual men
- Those who use injectable drugs
- HIV endemic populations
Other Prevention Savings Considerations
The researchers claim that not all of the HIV-prevention methods were taken into account in the study and that even more savings took place than was recorded. Specifically, claims are made that an additional 70,000 infections were prevented by other programs. This resulted in an additional $25 billion in health care savings. This includes a treatment option that was released back in 1997 called highly active antiretroviral therapy, or HAART. Three or more drugs are combined for HAART treatment, and these medications delay the onset of HIV symptoms, preventing the disease from progressing into AIDS.
