Posts tagged HIV prevention
HIV Runs Rampant in Violent Hot Spots
Change in economic and social climates has long been known to affect health trends. Times of war and periods of peace yield different results when it comes to public health. The spread if HIV is no different. Many studies have been conducted over long periods of time to try and track just how some of these factors change the spread of the infection. While the concept is simple enough, trying to gather data in times of violent conflict is difficult. For this and other reasons, the research that has been done up to this point has proven inconclusive. In some instances, the research has been contradictory.
As Tensions Rise, So Do Infection Rates
Efforts to help clear up some of the mystery behind the numbers have met with some success. One recently concluded study was able to track the number of HIV infections in times leading up to violent conflicts. Interestingly, the results pointed to higher rates of infection starting about five years before a conflict broke out. Increase in HIV infections was drastic enough to make a clear dividing line between the period before economic and/or social strife began to escalate—and general peace.
The institutions that gathered the information hope to use these conclusions as a springboard to better understand how external environments contribute to the spreading of the virus. It is their goal to be able to reduce HIV transmission before social conditions worsen in an area.
Conflicting Data During Violent Wartime
Just how violent conflict itself changes the rate of infection is still a bit of a mystery. During turbulent times involving bloodshed, the number of new infections seems to decline. Those in the medical community in these areas have their doubts. As mentioned, gathering information in such situations is difficult, and many researchers believe that the numbers may be significantly higher than what is recorded. Once the violence in an area dissipates, the number of newly reported infections begins to increase once again.
The period of time with the highest vulnerability to public health is definitely in the years before violence breaks out. Further insight into how social change and violence affect behaviors may hold answers into how spreading HIV can be curbed during such times.
DC Proves Needle Exchanges Have Value for Prevention
Sometimes, less is more. For HIV prevention programs, this is truly the case in needle exchange programs. One simple idea, in concept and execution, has saved one city millions of dollars and has prevented over 100 new cases of HIV in just two short years.
The needle exchange program is one of the easiest ways to help prevent HIV (and other viral infection) outbreaks and new cases in general. Along with that, it is by far one of the most cost effective tools on the war front against AIDS today. The program’s success is also helping in the ongoing debate over program funding. One study has put that success into numbers.
Simple idea, big results – that sums up the program. Basically, patients who need prescription medications that are administered via needles must return their used needles before they are given their next doses. For a while, the government aided in the funding for these and similar programs. Congress placed a ban on programs such as this in 1998. The ban prohibited the use of federal funds for needle exchange programs. States and their cities were, of course, allowed to use their own funds to support the programs, but many were unable to do so.
In late 2007, this ban was lifted in DC. Almost immediately, the Department of Health reinstituted the needle exchange program and programs for HIV testing, plus programs for aid addiction treatment. Once the ban lifted and the programs went into effect, researchers began to track the programs’ progress.
When comparing the numbers, from those during the ban to those after, impressive results were seen. The team first determined how many new injection drug use (IDU) cases presenting with HIV has occurred. Using the information they had gathered, an estimated 296 cases of HIV would have presented during two more years of the program funding ban. This is compared to the 176 injection drug users who did become infected with HIV with the programs in effect. Lifting the ban saved over 100 people from possibly contracting HIV in just two short years! There are financial benefits as well. Treatment for 120 people would have cost millions. It is estimated that taxpayers saved $44.3 million.
DC is not the only area benefiting from these types of programs. Regions across the US are reporting similar results.
The Effect of Contraceptives on HIV Transmission
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
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
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.