Vaginal sex

July 30, 2009

HIV is found in the sexual fluids of an infected person. For a man, this means the pre-come and semen fluids that come out of the penis before and during sex. For a woman, it means HIV is in the vaginal fluids which are produced by the vagina to keep it clean and to help make intercourse easier.

If a man with HIV has vaginal intercourse without a condom then HIV can pass into the woman's body through the lining of the vagina, cervix and womb. The risk of HIV transmission is increased if the woman has a cut or sore inside or around her vagina; this will make it easier for the virus to enter her bloodstream. Such a cut or sore might not always be visible, and could be so small that the woman wouldn't know about it.

If a woman with HIV has sexual intercourse without a condom, HIV could get into the man's body through a sore patch on his penis or by getting into his urethra (the tube that runs down the penis) or the inside of his foreskin (if he has one).

Any contact with blood during sex increases the chance of infection. For example, there may be blood in the vagina if intercourse occurs during a woman's period. Some sexually transmitted infections – such as herpes and gonorrhoea – can also raise the risk of HIV transmission.

Infection from Oral Sex

July 28, 2009

Oral sex with an infected partner does carry a small risk of HIV infection. If a person gives oral sex (licking or sucking the penis) to a man with HIV, then infected fluid could get into their mouth. If the person has bleeding gums or tiny sores or ulcers somewhere in their mouth, there is a risk of HIV entering their bloodstream.

The same is true if infected sexual fluids from a woman get into the mouth of her partner.

There is also a small risk if a person with HIV gives oral sex when they have bleeding gums or a bleeding wound in their mouth. Saliva does not pose a risk.

HIV infection through oral sex alone seems to be very rare, and there are things you can do to protect yourself.

What's the right way to use condoms?

July 27, 2009

Using condoms the right way is important to make sure you are protected. Latex condoms should be used during all sex acts, including anal, vaginal and oral sex. If you are allergic to latex, use a polyurethane condom. For oral sex on a woman, she can use a condom split lengthwise to place between her body and her partner's mouth.

If you are thinking about using a spermicide, be aware that research has shown that spermicides containing nonoxynol-9 can cause genital irritation and increase your risk of catching an STI. However, using a condom with nonoxynol-9 is better than not using a condom at all.

Use only water-based lubricants (such as K-Y jelly) with condoms. Oil-based lubricants, such as petroleum jelly (such as Vaseline), baby oil or lotions, cause the rubber in condoms to break.


Use a latex or polyurethane condom. Condoms made from natural membranes, such as sheep gut, aren't as good because HIV is small enough to get through the tiny pores in these condoms.

- Put the condom on before any contact is made.   
- Unroll the condom over an erect penis. The unrolled ring should be on the outside. Unroll the condom to the base of the penis. Leave about a half-inch of space in the tip so semen can collect there.
- Squeeze the tip of the condom to get the air out.
- Pull out after ejaculating ("coming") and before the penis gets soft. Hold the condom against the base of the penis so it doesn't slip off.
- Throw away the condom. Don't reuse condoms.

South Africa to test AIDS vaccine

July 21, 2009

South Africa is launching clinical trials of the first AIDS vaccines created by a developing country, a feat by scientists who forged ahead even when some of their political leaders shocked the world with unscientific pronouncements about the disease.

Trials to test the safety in humans of the vaccines begin this month on 36 healthy volunteers, Anthony Mbewu, president of South Africa's government-supported Medical Research Council, said in an interview Sunday. Mbewu's respected organization shepherded the project.

A trial of 12 volunteers in the United States began earlier this year.

Mbewu said the vaccine was designed at the University of Cape Town with technical help from the U.S. National Institutes of Health, which also manufactured the vaccine.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease and a leading AIDS researcher, was in South Africa for the launch.

During nearly 10 years of denial and neglect, South Africa developed a staggering AIDS crisis. Around 5.2 million South Africans were living with HIV last year — the highest number of any country in the world. Young women are hardest hit, with one-third of those aged 20 to 34 infected with the virus.

In 1999, the ministries of health and of science and technology founded the vaccine initiative and poured 250 million rand into it over nearly 10 years.

Some 250 scientists and technicians worked on the project, along the way gaining scores of doctorates and producing work for professional publications as well as a model for continued biotechnology development in South Africa.

The government decided it was important to develop a vaccine specifically for the HIV subtype C strain that is prevalent in southern Africa "and to ensure that once developed, it would be available at an affordable price," Mbewu said.

"We have the biggest problem" in the world, Mbewu said on the sidelines of an international AIDS conference in Cape Town.

"Every emerging country is trying, wants to develop their own capacity to design and develop vaccines — Brazil, Korea," Mbewu said.

But the South Africans are the first to reach the clinical trial stage, though years of testing will be needed.

The field of AIDS vaccine research is so filled with disappointments some activists are questioning the wisdom of continuing such expensive investments, saying the money might be better spent on prevention and education.

Mbewu said the crisis in South Africa more than justifies the expenditure.

"With 5.2 million already infected and with hundreds getting infected every day despite all the condom distribution and behavioral education programs, we know that a vaccine really is what we need," he said.

And he said there are many other benefits. The cadre of South African scientists now able to develop complex technological vaccines for HIV can use that same expertise to fight tuberculosis and avian flu.

"When the next influenza pandemic hits the world, every country will be scrambling to develop a vaccine ... so it is important that countries like South Africa have the technology and capacity to develop vaccines and the industry to manufacture them," Mbewu said.

South Africa was the site of the biggest setback to AIDS vaccine research, when the most promising vaccine ever, produced by Merck & Co. and tested in a study in South Africa in 2007, found that people who got the vaccine were more likely to contract HIV than those who did not.

In the 1990s, South Africa's then-President Thabo Mbeki denied the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, mistrusted conventional anti-AIDS drugs and made the country a laughing stock trying to promote beets and lemon as AIDS remedies.

At the conference opening, co-chairman Dr. Hoosen Jerry Coovadia reminded the thousands of scientists, researchers, doctors and activists of the importance the international scientific community had made to South Africa's progress in mounting an effective AIDS response in 2000, when the largest international AIDS meeting was held in the South African port city of Durban.

Some 5,000 scientists signed the Durban declaration that affirmed the human immunodeficiency virus was the cause of AIDS.

Coovadia, who is professor in HIV/AIDS research at the University of Natal-Durban, said today the international science community must ensure that governments keep their commitment to ensuring universal access to life-giving anti-retroviral drugs.

It was the Durban conference that opened the way for the rollout of ARV therapy in poor and middle-income countries where today more than 3 million people are receiving treatment, said Dr. Julio Montaner, president of the International AIDS Society.

He said those gains are threatened today by warnings that the global financial crisis must affect supplies of ARVs.

Montaner said it was extraordinary that the United States is the only member of the G8 conference of rich developing countries that has paid up what it promised to fight AIDS.

"We must hold the G8 leaders accountable for their failure to deliver on their promises," Montaner said.

"A retrenchment now would be catastrophic for the nearly 4 million people who are already on treatment in resource-limited countries" and some 7 million others waiting for treatment.

"AIDS is not in recession!" South African AIDS activist Vusikeya Dubula said to cheers from the conference. "


July 19, 2009

Health minister Kapembwa Simbao is calling on men to consider taking HIV/AIDS tests to help support their families.

The Times of Zambia reports that Mr Simbao believes that more husbands should set an example and encourage their relatives to take part in HIV/AIDS Voluntary Counselling and Testing.

He stressed that the male head of the family could play an important part in reducing the spread of HIV/AIDS in Zambia by becoming more involved in HIV/AIDS awareness projects.

"However, male involvement in HIV programmes is still minimal. This creates a big gap considering that men are the major decision-makers even in behavioural change," explained the minister.

At present, just 15 per cent of Zambians are aware of their current HIV status despite it being vital to reducing the spread of the virus.

UAIDS estimates that around 15.2 per cent of Zambians aged 15 to 49 are living with HIV

UAE: 750 expats with HIV repatriated in 2006

July 16, 2009

ABU DHABI -- In 2006, 750 expatriates were repatriated to their respective countries for testing HIV-positive during medical screening, according to a senior health official.

"Out of 1.5 million expatriates who underwent HIV/AIDS screening for residency visa in 2006, 750 were found to be infected with the disease," said Ministry of HealthMinistry of HealthLoading... Undersecretary Dr Mariam Mattar.

As per the existing UAE residency law, expats with HIV cannot stay in the country because a prerequisite for residence in the country is HIV/Aids-free status.

Speaking to Khaleej Times, the official said the prevalence of HIV is low in the UAE. "Around 570 UAE nationals are living with the disease. In 2006, 42 new cases were discovered among nationals," said Dr Mattar.

She said heterosexual transmission and IV drug (drugs injected directly into the blood stream) use are the two major causes for the deadly disease.

She underlined that studies are currently being undertaken by the MoHMoHLoading... to identify high-risk groups, and health awareness campaigns are being focused on them.

"The ministryministryLoading... adopts health awareness programmes for the community through public areas like schools, mosques and malls. Our primary target is youth in the age group of 18 years and above," said Dr Mattar.

She revealed that the MoHMoHLoading... is embarking on preparing a five-year national strategy, in cooperation with international organisations and government institutions, to increase public awareness and knowledge about Aids, and ensure availability of quality healthcare services.

"The plan which will commence in 2008 will focus on developing healthcare infrastructure, upgrading ongoing continuous medical education and increasing awareness programmes on healthy life-styles," she said.

The strategy would also ensure availability of health services to all in the emirates, pay parity for all health employees and health insurance for all, Dr Mattar pointed out.

World AIDS Day

July 15, 2009

World AIDS Day, observed December 1 each year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. It is common to hold memorials to honor persons who have died from HIV/AIDS on this day. Government and health officials also observe the event, often with speeches or forums on the AIDS topics. Since 1995, the President of the United States has made an official proclamation on World AIDS Day. Governments of other nations have followed suit and issued similar announcements.

AIDS has killed more than 25 million people between 1981 and 2007, and an estimated 33.2 million people worldwide live with HIV as of 2007, making it one of the most destructive epidemics in recorded history. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed an estimated 2 million lives in 2007, of which about 270,000 were children.

World AIDS Day was first conceived in 1987 by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the World Health Organization in Geneva, Switzerland. Bunn and Netter took their idea to Dr. Jonathan Mann, Director of the Global Programme on AIDS (now known as UNAIDS). Dr. Mann liked the concept and agreed that the first observance of World AIDS Day should be December 1, 1988.

Bunn suggested the date of December 1 to ensure coverage by western news media, something he believed was vital to the success of World AIDS Day. He felt that because 1988 was an election year in the U.S. media outlets would be weary of their post-election coverage and eager to find a fresh story to cover. Bunn and Netter felt that December 1 was long enough after the election and soon enough before the Christmas holidays that it was, in effect, a dead spot in the news calendar and thus perfect timing for World AIDS Day.

Bunn, originally a reporter covering the epidemic for KPIX-TV in San Francisco, along with producer Nancy Saslow, also conceived and initiated “AIDS Lifeline” - a public awareness and health education campaign that was syndicated to television stations in the U.S. "AIDS Lifeline" was honored with a Peabody Award, a local Emmy, and the first National Emmy ever awarded to a local station.

On June 18, 1986 the “AIDS Lifeline” project was honored with a Presidential Citation for Private Sector Initiatives, presented by President Ronald Reagan. Bunn was then asked by Dr. Mann, on behalf of the U.S. government, to take a two-year leave-of-absence from his reporting duties to join Dr. Mann (an epidemiologist for the Centers for Disease Control) in the creation of the Global Programme on AIDS. Mr. Bunn accepted and was named the first Public Information Officer for the Global Programme on AIDS. Along with Mr. Netter he created, designed, and implemented the inaugural World AIDS Day observance – now the longest-running disease awareness and prevention initiative of its kind in the history of public health.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) became operational in 1996, and it took over the planning and promotion of World AIDS Day. Rather than focus on a single day, UNAIDS created the World AIDS Campaign in 1997 to focus on year-round communications, prevention and education.

In its first two years, the theme of World AIDS Day focused on children and young people. These themes were strongly criticized at the time for ignoring the fact that people of all ages may become infected with HIV and suffer from AIDS. But the themes drew attention to the HIV/AIDS epidemic, helped alleviate some of the stigma surrounding the disease, and helped boost recognition of the problem as a family disease.

In 2004, the World AIDS Campaign became an independent organization.

China Gay Community HIV/AIDS Risk

July 14, 2009

The incidence of HIV/AIDS among Beijing's drug users is in decline but the city's gay community remains the most at-risk group, a local health official said on Friday

He Xiong, deputy director of the Beijing center for disease control and prevention (CDC), said that based on figures for the first seven months, 1.5 percent of the city's drug users are HIV positive, compared with 5 percent in 2001.

In comparison, 5 percent of gay men in the capital are HIV positive, while 0.5 percent of unlicensed prostitutes are infected with the virus, He said, without giving figures for 2001.

"More than 43 percent of all newly reported cases are attributed to people having unprotected sex, and gay men are the most at risk," he said.

Research carried out over the past three years has shown that less than 50 percent of gay men use condoms, so promoting better health awareness among them is a major task, he said.
During the first seven months of the year, 563 new HIV cases were reported in Beijing, 118 of which involved local people and the rest migrant workers, He said.

New cases were reported in each of Beijing's 18 districts and counties, he said.

In the whole of last year 1,190 new cases were reported, up slightly on 2006, he said.

While the development of a comprehensive HIV/AIDS monitoring network - comprising 69 clinics and 128 laboratories - has helped keep the spread of the virus in check, high-risk groups must become more aware of the dangers, the head of a local volunteer group told China Daily Monday.

Xiao Dong, chief of the Chaoyang Chinese AIDS Volunteer Group, said: "Gay people must voluntarily practice safe sex and take regular tests."

The efforts of groups like Xiao's are vital to reducing the health risks faced by Beijing's gay community, He said.

"They work closely with gay people and provide free condoms and confidential consultancy and test services."

Between January and July, more than 1 million people in Beijing had received an HIV test, He said.

Also, prevention and treatment clinics throughout the city now have intervention teams to work with high-risk groups. These people help not only with essential medical treatments, but also everyday matters such as problems at work, he said.

Scientists now trying to outflank HIV/AIDS virus

July 11, 2009

Like a general whose direct attacks aren't working, scientists are now trying to outflank the HIV/AIDS virus.

Unsuccessful at developing vaccines that the cause the body's natural immune system to battle the virus, researchers are testing inserting a gene into the muscle that can cause it to produce protective antibodies against HIV.

The new method worked in mice and now has proved successful in monkeys, too, they reported Sunday in the online edition of the journal Nature Medicine. The team is led by Dr. Philip R. Johnson of the Children's Hospital of Philadelphia.

That doesn't mean an AIDS vaccine for people is in the wings, Johnson said. Years of work may lie ahead before a product is ready for human use.

Nevertheless, the report was welcomed by Dr. Beatrice Hahn, an AIDS researcher the University of Alabama at Birmingham, who was not part of Johnson's team. "It basically shows there is light at the end of the tunnel," she said in a telephone interview.

"It shows thinking outside the box is a good idea and can yield results, and we need perhaps more of these nonconventional approaches," she added.

According to the International AIDS Vaccine Initiative, AIDS is one of the most devastating pandemics. More than 20 million people have died so far and about 33 million are living with HIV. The Center for Disease Control and Prevention last year estimated there are about 56,000 new HIV infections annually in the United States.

Most efforts at blocking AIDS have sought to stimulate the body's immune system to produce antibodies that fight the disease. This model has worked for diseases such as measles and smallpox. It hasn't done as well with HIV/AIDS; test vaccines have failed to produce a protective reaction.

Lesbians at Risk for HIV, GMHC Report Shows

July 11, 2009

On Thursday, June 25, Gay Men's Health Crisis (GMHC) released a report on the vulnerability of lesbians, bisexuals and other women who have sex with women (WSW) to HIV infection, a complicated public health issue that is perplexing to some and ignored by many.

The review of research found that while there are no documented cases of female-to-female HIV transmission, lesbians and bisexual women are still at risk of contracting HIV. Some homosexually active women also have sex with men or inject drugs.

One 2005 study described in the GMHC report, found that lesbians and bisexual women are more likely to inject drugs than heterosexual women. Another study found lesbian and bisexual women are less likely to seek health care than heterosexual women, a risk factor for receiving a late HIV diagnosis.

With more than 15 years of experience, the Lesbian AIDS Project (LAP) at GMHC knows firsthand that there are lesbians and WSW living with HIV/AIDS. GMHC researched the risks lesbians and WSW face as there were growing indications that some lesbians/WSW engage in high risk behaviors that place them at risk for HIV transmission. The objective of the report is not to debate that lesbians/WSW are at the same risk as their heterosexual counterparts, but to acknowledge that there is significant risk of HIV, other sexually transmitted infections (STIs), and additional health disparities for lesbians.

"These risks are exacerbated by racial disparities in health care access, as well as by homophobia, sexism, and stigma," said Marjorie J. Hill, PhD, Chief Executive Officer of GMHC. "We seek to clarify confusion regarding lesbians and WSW risk in order to create visibility for this marginalized subpopulation of women. Prevention and policy interventions must reach more deeply into communities of women and take into account the context of their lives."

The report underscores the range of risks that lesbians could face in contracting HIV which are directly related to experiences and behaviors, and not solely determined by the use of labels to identify an individual's sexuality and sexual identity.

LAP is part of the Women's Institute at GMHC.

The GMHC report connects to an article in the June issue of POZ Magazine entitled, "The L+ Word." The article focuses on lesbians living with HIV/AIDS, the Lesbian AIDS Project and safer sex tips to prevent woman-to-woman transmission of HIV.

Older people face greater HIV infection risks

July 09, 2009

Doctors failing to screen for HIV in older patients; HIV progresses faster to AIDS in those aged 50-plus; Older people more likely to risk unprotected sex.

Doctors are failing to diagnose HIV in older patients, who are exposed to greater risk of infection as erectile dysfunction drugs extend their sex lives, a study published by the World Health Organization said on Tuesday.

The report in the WHO Bulletin found that increasing numbers of sexually active people aged 50 and upwards -- who are more likely to risk unprotected sex than younger people -- are contracting the AIDS virus.

And although many people are having sex into their twilight years, HIV is still rarely considered as a cause of illness in older individuals. "Screening is less common for older adults, who are assumed not to be at risk," the study found.

"HIV prevalence and incidence in the over-50-year-olds seem surprisingly high and the risk factors are totally unexplored," the authors from the WHO and Minnesota's St. Olaf College said.

Patients over the age of 50 make up roughly 8 percent of new HIV diagnoses in Europe and 11 percent in the United States, where rising numbers of older people are infected with the virus that spreads through sex, transfusions, and needle-sharing.

"These individuals have a shorter time from diagnosis to the onset of AIDS, reflecting both age-related faster progression to AIDS and doctors' failure to consider HIV as a diagnosis," the report said.

Among the aged, the study said sexual activity is the most likely mode of HIV transmission. One reason for the increase in frequency is the use of impotence treatments that have allowed both men and women to have more sexual partners.

"Since 1998, erectile dysfunction drugs have been extending the sex life of many older individuals and, at the same time, may be extending the HIV epidemic into older age groups," the study said.

"Older individuals are less likely than their younger counterparts to practice safer sex," it said.

While the sexual activity of older people in poor countries has not been studied, and there is no data about the prevalence of HIV among the aged in the developing world, the WHO Bulletin study said similar trends were likely occurring there.

"While erectile dysfunction is common and erectile dysfunction drugs are widely available in developing countries, no study has been done of their possible impact on the HIV epidemic, although their use in industrialized countries has been associated with risky safety practices," the report said.

Older women appear to be at higher risk of contracting HIV if they have sex without a condom because of thinning with age of the vaginal mucous membrane, which gives natural lubrication.

Antiretroviral drugs have dramatically extended the life expectancy of people who catch HIV in rich economies, such as NBA basketball star Magic Johnson who announced his infection more than 16 years ago.

But for those infected with HIV after the age of 65, the study said life expectancy is only four years. "Waning immunity with age may be the reason," it said. About 33 million people worldwide are living with HIV, mostly in Africa.

AIDS in Malaysia

July 07, 2009


New HIV infection reported in Malaysia

Source: AIDS/STI Unit, Ministry of Health Malaysia
Prepared by: Resource Center. Malaysian AIDS Council

MALAYSIA (from 1986 until DECEMBER 2007)

Source: AIDS/STI Unit, Ministry of Health Malaysia
Prepared by: Resource Center. Malaysian AIDS Council

MALAYSIA (from 1986 until DECEMBER 2007)

Total number of HIV / AIDS related death
Source: AIDS/STI Unit, Ministry of Health Malaysia
Prepared by: Resource Center. Malaysian AIDS Council

MALAYSIA (1986-2005 and DECEMBER 2007)


Source: AIDS/STI Unit, Ministry of Health Malaysia
Prepared by: Resource Center. Malaysian AIDS Council

Sex main cause of HIV prevalence in China today

July 06, 2009

Chinese Health Minister Chen Zhu has revealed that the rates of new HIV/AIDS infections in the country are declining, and that the disease is now being transmitted mainly through sex.

"At present, the AIDS epidemic in China is spreading at a slower rate. Sexual transmission is now the main route for the spread," the China Daily quoted him as telling a new conference in Beijing on Thursday.

The conference was organised in the run-up to World AIDS Day, on 1 December. It saw Chen citing a joint report by the Ministry of Health, the World Health Organization (WHO) and UNAIDS.

The minister said that the country estimated to have 50,000 new infections in 2007, down from 70,000 new cases in 2005.

The report said that 44.7 per cent of the new infections came from heterosexual transmission, 12.2 per cent from men having sex with men, 42 per cent from intravenous drug use, and 1.1 percent from mother-to-infant transmission.

It also revealed that by the end of October 2007, a total of 223,501 people had contracted HIV, including 62,838 people with fully blown AIDS.

The Ministry, the WHO and UNAIDS, however, have also estimated that China will have as many as 700,000 people living with HIV/AIDS by the end of 2007, including 85,000 AIDS patients.

The 38-page report said that the difference between the estimated figures and official figures was party because people were reluctant to come forward for treatment.

"China's HIV epidemic remains one of low prevalence overall, but with pockets of high infection among specific sub-populations," the report said.

Chen admitted that there was need to address a number of core issues like better advocacy, improved treatment and care, and more focused education and discrimination reduction.

He said that the Chinese leadership was strengthening its commitment to HIV/AIDS prevention and treatment at different levels of the government.

According to him, the amount spent in 2007 had risen to 126 million dollars, from 114 million dollars in 2006.

Chen insisted that the Government would put more focus on traditionally marginalized groups, like the gay community and drug users. 

Condoms no longer to be considered a proof of prostitution in China

July 06, 2009

According to an official with the AIDS prevention committee under the State Council of China, condoms will no longer be considered as an evidence of prostitution by Public security departments.

Han Mengjie, also secretary of the National Center for AIDS Control and Prevention, said that from now on police departments at all levels will not use condoms as evidence of illegal sex activities.

"Now police departments at all levels no longer use condoms as proof of illegal sex activities in entertainment venues," China Daily quoted Mengjie, as saying.

Han said that the change has gradually been adopted by police departments after the health authorities’ obligation of condoms to be provided in public places to prevent the spread of HIV/ AIDS.

According to national surveillance figures, the rate of regular condom use among prostitutes in China rose from 14.7 percent in 2001 to 41.4 percent in 2006.

Therefore, The Regulation on AIDS Prevention and Control, issued by the State Council in January last year, urged all public places designated by provincial or municipal governments to provide condoms or condom-vending machines.

"Sex has become the main channel through which the HIV virus is contracted," said Minister of Health Chen Zhu. (ANI)

HIV-positive gay men in UK still disproportionately affected by syphilis and LGV

July 05, 2009

The resurgent syphilis epidemic in the UK shows no signs of abatement, a new report from the Health Protection Agency (HPA) shows. In 2007, over 3700 cases of the infection were diagnosed, the focus of the epidemic being gay men.

More encouragingly, however, there are some indications that the pace of the lymphogranuloma venereum (LGV) epidemic appears to be slowing.

By the late 1990s, syphilis had become a rare sexually transmitted infection in the UK. In 1997, however, an outbreak occurred amongst heterosexuals in Bristol, followed by a series of outbreaks from 2001 onwards amongst gay men in Brighton, London and Manchester.

Between 1997 and 2007 there was a ten-fold increase in the number of syphilis infections diagnosed in the UK, from 301 in 1997 to 3762 in 2007.

Over the last ten years, 73% (9560) of all syphilis cases have involved gay men. The HPA report notes that “the characteristics of these patients have changed little over the course of the epidemic.” Around a third of patients are aged between their mid-30s and mid-40s, 90% are white, and a third are also infected with HIV. The infection is thought to have been contracted through oral sex in a third of cases.

Contract tracing has traditionally been an important component of syphilis control, but the HPA notes that 56% of cases involving gay men were reported to have been acquired from casual partners, making this strategy impractical.

There have also been 3375 syphilis diagnoses in heterosexuals. In 2008, 68% of new infections were acquired in the UK and 63% involved white patients. As with gay men, a third of infections were diagnosed in individuals aged between 35 and 44.

Diagnoses of congenital syphilis have also increased markedly, from 136 in 1999 to 448 in 2007. Antenatal screening can detect the infection in pregnant women, but the HPA notes that in some areas only 77% of pregnant women are being screened for the infection.

After the introduction of antibiotics, LGV became a very rare sexually transmitted infection in the UK. However, the infection reappeared in 2003/04 and by the end of 2008 a total of 849 cases had been diagnosed in the UK.

As with syphilis, the infection’s main focus has been in white gay men aged between 35 and 44. Most cases of LGV in the UK have involved HIV-positive men (75%). Moreover, a third were also infected with another sexually transmitted infection.

New diagnoses reached a peak in the third quarter of 2005, when there were 80 cases. There has been a general downward trend since then and, in the last quarter of 2008, there were just 25 diagnoses.

The vast majority (72%) of LGV cases have been in London, with smaller outbreaks in Brighton (7%) and Manchester (4%). However, the HPA notes that isolated cases have been reported throughout the UK. Only 7% of LGV infections are thought to have been acquired abroad.

“The epidemics of infectious syphilis and LGV have both been influenced by developments in the HIV epidemic,” comment the report’s authors. Both infections have disproportionately affected HIV-positive gay men, a group who have more sexual partners and often select other HIV-positive men for unprotected sex. This has facilitated the spread of these, and other infections, through networks of HIV-positive gay men. “The delivery of effective interventions within the context of these dynamic, diverse epidemics remains a challenge,” add the authors.

Syphilis and lymphogranuloma venereum: resurgent sexually transmitted infections in the UK. Health Protection Agency, 2009.

World Bank: Financial crisis threatens HIV treatment for 1.7 million

July 05, 2009

Up to 1.7 million people in Africa, Eastern Europe, the Caribbean and Asia are at risk of antiretroviral treatment interruption due to the global financial downturn, according to a survey published by the World Bank.

The World Bank report Averting a human crisis during the global downturn was published in advance of the World Bank’s spring meeting in Washington DC. It states unequivocally: “The international community is obligated to continue to support the people it has placed on ART…The international community has made an unambiguous commitment towards universal access to treatment for people with HIV who need it.”

Failure to meet this commitment, the report notes, will call into question the legitimacy of development assistance for health, threaten the gains in health system capacity delivered through HIV treatment programmes and will ultimately result in greater long-term costs due to higher rates of transmission, more TB cases and larger numbers requiring expensive second-line drugs for both HIV and TB.

The World Bank questioned national AIDS programmes in 69 countries in March 2009.

The World Bank calculated that continuity of treatment could be threatened for around 70% of people currently on treatment in eastern and southern Africa. Around 50% in the Asia-Pacific region, 35% in the Caribbean and 25% in Eastern Europe and Central Asia could be affected too.

The report notes the fragility of financing arrangements for countries largely dependent on external aid for their HIV programmes. Eighteen of 47 countries that provided data said that grants from the Global Fund to Fight AIDS, TB and Malaria end in 2009 or 2010. The Global Fund faces a funding shortfall of $4 billion in 2010, director Professor Michel Kazatchkine said last week. The Global Fund has postponed its Round 9 funding allocations until November 2009 in order to allow more time to mobilise funding.

Middle-income countries appear less vulnerable, with no countries in Latin America anticipating a reduced ability to pay for antiretroviral treatment during the next year.

Analysing the institutional capacity to make rapid adjustments in financial planning and the fiscal capacity to move domestic funds into treatment at short notice, the World Bank found that all countries would need either a high level of technical support or maintenance of external financing in order to sustain treatment programmes during the next 12 months.

The report emphasises the cost of even minor treatment interruptions: up to 50% of people taking first-line treatment may need a second-line regimen if their treatment is interrupted for more than 15 days, due to the development of drug resistance.

The report also highlights the vulnerability of eastern and southern Africa treatment programmes that are largely dependent on donor aid. Some countries are already experiencing problems:

  • Tanzania has cut its HIV/AIDS budget by 25%;

  • Kenya has reduced its overall health budget;

  • South Africa anticipates that private sector spending on prevention programmes will decline due to pressure on industry to cut costs.
Thirty-four countries representing 75% of people living with HIV said that they expected prevention programmes to be negatively affected, and national AIDS programmes anticipated greater impact on prevention than treatment, with prevention targeting marginalised groups such as men who have sex with men and injecting drug users at greatest risk, according to respondents. Eastern Europe and Central Asia was identified as the region where prevention work with marginalised groups is at greatest risk due to the economic downturn.

The report recommends “a more rigorous and determined push for efficiency and cost-effectiveness in HIV prevention”, together with efforts by donors to identify cash flow problems that might result in treatment interruptions, so that bridging funds can be provided as quickly as possible.

UNAIDS has begun developing an Economic Crisis Impact Assessment Tool that will assist countries in reviewing their epidemics and current responses, and how responses should be revised in the face of the economic crisis.

Taiwan Marks Increased Numbers Of HIV-Positive Students

July 04, 2009

The Taiwan AIDS Foundation said that according to Department of Health's Centers for Disease Control statistics, the average age of HIV positive people in the country is getting younger, the China Post reports. Lin Chiung-chao, the foundation's secretary-general, said that the number of HIV-positive students rose to 156 in 2008, up from 110 in 2007. "The figures mark an alarming 42 percent year-on-year surge," he said, adding, "This is a general world trend, as the AIDS prevention publicity campaign has failed to catch up with the tendency that the average age of youngsters having sex for the first time has dropped to 16"

'Fast, Inexpensive' HIV Test Could Be Used To Test Babies During Their First Year

July 04, 2009

An HIV test that uses dried blood samples is "fast, inexpensive, and could aid the testing and treatment of HIV-positive babies in the first year of life, scientists say," SciDev.Net reports. Researchers tested the technique, which extracts and amplifies the virus' genetic material from a sample of blood that is blotted onto filter paper. Scientists found the test was "accurate as well as twice as fast and 40-fold cheaper than commercial viral tests. It was also just as accurate after samples were stored at 37 degrees Celsius for seven days."

HIV Symptoms - A Rash

July 01, 2009

Possibly the most common of the HIV symptoms is the HIV rash. A rash can be one of many HIV symptoms or can be related to medications. An HIV rash can be the result of an adverse drug reaction or allergy. While most rashes will fade on their own, a rash due to a drug allergy can be a serious health threat.

Important Fact! - If you develop a rash, you should contact your HIV physician immediately.

There are some things you can do to relieve the symptoms of an HIV rash. They include:

  • Heat will aggravate a rash. Avoid direct sunlight and hot baths and showers.

  • Use over the counter medications such as Benadryl or Hydrocortisone Cream to shrink raised rashes and control their itching.

  • Note any new foods, medicines, or soaps that may have been started prior to developing the rash to identify possible allergies.

  • If you stop your medicines after developing a rash, DON'T restart them until instructed to do so by your doctor. Ideally, you should talk to your doctor before stopping your medications.

HIV and gay men - safe sex

July 01, 2009

In Australia, the human immunodeficiency virus (HIV) is most commonly spread through unprotected anal or vaginal intercourse with an infected person. Gay HIV positive men with HIV negative partners can still enjoy physically intimate relationships if they follow safe sex practices.

It is important to remember that the virus is transmitted by bodily fluids – for men this includes, blood, ejaculate and pre-ejaculate – entering the bloodstream. Remember that the risk goes both ways – for example, it is commonly believed that only the partner who is penetrated (the ‘bottom’) is at risk, but the HIV virus can be transmitted to the partner who penetrates (the ‘top’) via small cuts and abrasions on his penis.

Unsafe sexual activities
Unsafe sexual activities include:

  • Unprotected anal sex, since the virus can enter the bloodstream through mucus membranes or small cuts or abrasions

  • Withdrawing before ejaculation, since pre-ejaculate fluid can contain the virus

  • Using pre-ejaculate as a lubricant prior to anal intercourse

  • Sucking ejaculate from the anus (felching)

  • Activities involving razors or shaving, as blood can be drawn from small nicks and cuts

  • Any sexual activity that draws blood.
Safe sexual activities
Sexual activities that are considered safe include:

  • Kissing

  • Cuddling

  • Stroking and massage

  • Masturbation

  • Mutual masturbation

  • Ejaculating on unbroken skin

  • Urinating on unbroken skin

  • Oral sex (with a condom or no ejaculate in the mouth)

  • Protected anal intercourse (using condoms).
Safer sex suggestions
Some suggestions for safer sex, including when to avoid some practices:

  • Anal sex – use condoms and plenty of water-based lubricant.

  • Oral sex – there are a small number of recorded cases of people getting HIV from performing oral sex and taking ejaculate into their mouth. In almost all of these cases, the person had herpes sores, wounds, cuts or infections in their mouth. It isn’t easy for HIV to enter the bloodstream through the mouth or throat when sucking. However, to be sure of being safe, the HIV positive partner shouldn’t ejaculate into their partner’s mouth. To further reduce the risk, a condom can be worn. The HIV negative partner should avoid performing oral sex if they have cuts or sores in their mouth, a throat infection, have recently undergone dental work or have just brushed or flossed their teeth.

  • Penetration of the anus with finger or fist – avoid if there are cuts or abrasions on the fingers, hand or arm. To be absolutely sure, wear a latex glove.

  • Licking and kissing the anus (oral–anal contact or ‘rimming’) – HIV can’t be transmitted via oral–anal contact, but other diseases can. These include hepatitis A and intestinal parasites and bacteria (for example, shigella). Use a barrier such as a dental dam or clear plastic wrap (but not the ‘microwave safe’ variety – it has tiny holes in it).

  • Urinating on skin – avoid this practice if there are cuts or abrasions on the skin. Don’t allow urine to come in contact with the eyes or mouth, in case there is blood in the urine.

  • Faeces – HIV can be transmitted if there is blood in the faeces. Don’t allow faeces to come in contact with the eyes, mouth or cuts on the skin. Other illnesses, such as hepatitis and intestinal parasites, can also be transmitted by faeces.

  • Sex toys – always put a condom on any sex toy (such as a dildo) before use. Wash all sex toys after use with warm water and soap. Consider having a separate collection of sex toys for each partner.
What you can do after unprotected sex
Sometimes, a couple may slip and have some form of unprotected sex. Suggestions include:

  • If the broken skin of the HIV negative partner comes in contact with the ejaculate, blood, urine or faeces of their HIV positive partner, wash well with warm water and soap.

  • Seek advice from your doctor. Post-exposure prophylaxis (PEP) is a month-long course of medications for people who have been exposed to the HIV virus. To be most effective, they should be commenced within 72 hours of exposure. It is best to take them as early as possible after exposure. These drugs can be toxic on the body with unpleasant side effects such as vomiting, nausea and lethargy. PEP is not an alternative to safe sex.

  • Talk about the factors that led to the unprotected sex and work out ways to avoid the same mistake in future.

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