Progress in microbicidal ring development, effect of circumcising HIV positive men on HPV spread, and more…

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The following “What We’re Reading” selection is a compilation of recent articles and reports making headlines in HIV and TB news.

Circumcision of HIV-infected men and transmission of HPV to female partners: This article published in The Lancet Infectious Diseases analyzes data from a randomized trial in Rakai, Uganda, in which HIV-infected men aged 15-49 years with CD4 counts greater than 350 cells/mL were randomly assigned to undergo medical male circumcision immediately (intervention group – 447 men) and after 24 months (control group — 448 men). The trial found that circumcision of HIV-infected men did not affect transmission of high-risk human papillomavirus (HPV) to their female partners.

New UNAIDS report shows HIV epidemic at critical juncture in Asia-Pacific region: According to a UNAIDS press release, although the Asia-Pacific region has seen a 20 percent drop in new HIV infections since 2001 and a three-fold increase in access to antiretroviral therapy since 2006, insufficient funding from both domestic and international sources is threatening progress. A new UNAIDS report, entitled “HIV in Asia and the Pacific: Getting to Zero,” explains that this is especially evident among key high-risk populations, and even in countries where HIV prevalence was previously low. “In the city of Cebu [Philippines], HIV prevalence among people who inject drugs increased from 0.6 percent to 53 percent between 2009 and 2011. In Manila and Cebu, HIV prevalence among men who have sex with men is estimated at five percent,” according to the release.

HIV Surveillance, Public Health, and Clinical Medicine — Will the Walls Come Tumbling Down?: This “perspective” piece in The New England Journal of Medicine by Amy Fairchild, PhD, MPH, and Ronald Bayer, PhD, addresses the “important ethical and operational questions about the relationship between clinical medicine and public health” that have surfaced since the HPTN 052 study results showed that treating an HIV-infected patient early reduces their chances of transmitting the virus to their uninfected sexual partners by more than 96 percent as compared to those who are not on treatment. The piece takes a close look at the history of collecting surveillance data (HIV registries) for public health purposes, and the pros and cons.

Priorities in operational research to improve tuberculosis care and control:  The Stop TB Partnership, the World Health Organization Stop TB Department, and the Global Fund to Fight AIDS, Tuberculosis and Malaria have jointly developed and launched a publication describing the priority areas in which knowledge gaps hamper optimal implementation of TB control activities. The five key areas identified and explored in the document include: Access, screening and diagnosis of TB; Sustainable collaboration with all care providers for TB control; Prevention of TB in people living with HIV, and joint treatment of HIV and TB; Access to and delivery of treatment for drug-susceptible and multidrug-resistant and extensively drug resistant TB; and Capacity-building for operational research. “In each of these five areas, critical and outstanding questions to improve TB care and control at the national and international levels were identified,” according to the executive summary.

Report Marks Progress in HIV Preventing Microbicidal Ring Development: The International Partnership for Microbicides (IPM) released its 2010 annual report, “Building on Breakthroughs” highlighting their progress in the development of a long-acting microbicidal ring “and other products designed to help expand women’s HIV prevention options where new solutions are urgently needed,” according to CEO Dr. Zeda F. Rosenburg.  “In the coming year, IPM, with its partner, the U.S. National Institutes of Health-funded Microbicide Trials Network, will advance a long-acting antiretroviral-based microbicide ring into a Phase III licensure program, including expanded safety studies. The ring could provide sustained protection against HIV for a month at a time or longer,” according to the report.

Meeting the Psychosocial Needs of Children Living with HIV in Africa Technical Brief:  Developed by AIDSTAR One, this technical brief describes practices in critical services related to the psychological and social wellbeing of perinatally-infected children up to 12 years old in Africa. These include the identification, testing and counseling of children sothey are linked to appropriate support as early as possible, as well as the provision of on-going psychosocial support to help children and their families manage disclosure, stigma and grief and bereavement processes.

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