Posts Tagged ‘Africa


Herpes Medication Does Not Reduce Risk of HIV Transmission, Study Finds

ScienceDaily (Jan. 25, 2010) — A five-year international multi-center clinical trial has found that acyclovir, a drug widely used as a safe and effective treatment taken twice daily to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2.

The results of the study are published in the New England Journal of Medicine.

Up to 90% of people with HIV infection also have HSV-2 infection. Most people who are infected with HSV-2 do not know they have the virus because symptoms can be mild or absent. HSV-2 infection can cause recurrent sores and breaks in the skin of the genital region, which can be mild and often go unnoticed. HSV-2 infection also attracts immune cells called CD4 T-cells to the genital region, which HIV uses to establish or pass infection.

Multiple studies have shown that frequent genital herpes recurrences increase the amount of HIV in the blood and genital tract. The HIV virus is also shed from genital herpes ulcers and persons with such ulcers transmit HIV to others more efficiently. Five preliminary studies showed that it is possible to decrease the amount of HIV in the blood and genital tract through treatment to suppress HSV-2, but these studies did not measure whether this translated into a reduction in HIV transmission. Researchers had hoped that acyclovir’s ability to suppress the herpes virus, which causes symptomatic genital sores and breaks in the skin but also frequently is active without symptoms, could reduce the likelihood of sexual transmission of HIV from a person with HIV and HSV-2. The study is the first to determine whether twice daily use of acyclovir by individuals who are infected with both HSV-2 and HIV reduced the transmission of HIV to their sexual partners. The authors conclude that daily acyclovir therapy did not reduce the risk of transmission of HIV, in spite of the fact that acyclovir reduced plasma HIV RNA by a ¼ log and the occurrence of genital ulcers due to HSV-2 by 73%.

Led by the University of Washington in Seattle and funded by the Bill & Melinda Gates Foundation, the Partners in Prevention HSV/HIV Transmission Study was conducted among 3,408 African HIV serodiscordant couples, in which one partner had HIV and the other did not. In all the couples, the partner who had HIV also had HSV-2 infection. The study took place at 14 sites in seven countries in eastern and southern Africa (Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia). In sub-Saharan Africa, the majority of new HIV infections occur among heterosexual HIV discordant couples, many of whom are in stable partnerships and unaware that one partner has HIV and the other does not. Genital herpes is thought to be a factor in a substantial proportion of new HIV infections in Africa.

The study began recruitment in Nov. 2004 and ended follow-up of participants in Oct. 2008. Results were first announced in May 2009 and were presented at the International AIDS Society (IAS) meeting in Cape Town, South Africa, on July 22, 2009.

In the primary analysis of HIV transmissions determined by laboratory testing to have occurred within the couple and not acquired from an outside partner, there were 41 infections in the acyclovir arm and 43 in the placebo arm — not a significant difference. Of the partners who were infected with HIV, 68 % were women. Acyclovir suppressive treatment did show significant reductions in the frequency of genital ulcers (by 73%) and the average amount of HIV in the blood (by 0.25 log10 copies/milliliter, a reduction of 40%), compared to the placebo arm.

“As is often the case with large efficacy trials, you learn to expect surprises,” said Dr. Connie Celum, the leader of the study and a UW professor of Global Health and Medicine in the Division of Allergy and Infectious Diseases. “We found that, in spite of a significant reduction in plasma HIV levels and genital ulcer disease with acyclovir suppressive therapy, there was no reduction in HIV transmission. This was a disappointing finding, but a critical outcome of this study is the understanding that interventions must achieve a bigger reduction in HIV levels in order to reduce HIV transmission, especially among persons with high HIV levels. This will be important in informing future interventions to reduce HIV infectiousness.”

Celum said the study is a direct assessment of the impact of herpes suppression on HIV transmission and is the most direct way to see if it’s possible to make a person less infectious and less likely to transmit HIV to their partner. Although the primary outcome of reducing HIV transmission was not observed, Celum said the study achieved many significant mile¬stones that will help to inform HIV prevention research in a number of ways. Among these were HIV testing of approximately 55,000 couples of unknown HIV serostatus, screening of more than 6,500 HIV serodiscordant couples, and enroll¬ment of 3,408 couples in which the HIV- infected partner was dually infected with HSV-2 and not eligible for antiretroviral therapy, based on national guidelines. Adherence to twice daily acyclovir was high, with 88% of doses dispensed (the drug was not dispensed during pregnancy or if visits were missed), and 96% of dispensed doses taken, as measured by pill counts. Retention of study participants at 24 months of follow-up was 92% for HIV infected partners and 84% for HIV uninfected partners.

The Partners in Prevention HSV/HIV Transmission Study is the first clinical trial to directly test whether suppressing HSV-2 infection in HIV-infected persons could reduce rates of HIV transmission and HIV disease progression. The study was randomized, placebo-controlled and double-blinded, meaning that both participants and the care providers did not know which treatment the participants were receiving. Both the placebo and treatment groups received standard HIV prevention services, which included being supplied with condoms, treated for other sexually transmitted infections, and provided care for HIV infection. All participants received extensive counseling, both individually and as a couple, throughout the study period, on how to reduce the risk of HIV infection.

“This was an ambitious study, and I applaud our collaborators at the University of Washington, the investigators and study teams in Africa, the study participants, and the communities where the study was done, for their dedication over the past five years,” Celum said. “We will continue to learn from this study about risk factors for HIV transmission, which will bear fruit for both the HIV prevention and the vaccine fields for years to come.”


7% of Sub-Saharan’s old people living with HIV

SENIOR Citizens Association of Zambia National Co-ordinator Rosemary Sishimba has said seven per cent of the older people in Sub-Saharan African countries are living with HIV/AIDS pandemic.

Officiating at media breakfast organised by Helpage International on Wednesday, Sishimba said it was sad that the media had not prioritised coverage of the elderly in society.

“Little is known about the vital role of older persons in social development, in the context of the HIVand AIDS pandemic a disease that has ravaged African countries socially and economically,” Sishimba said.

She said the evidence suggests that the older persons had taken the burdensome role of caring for the children as a result of HIV and AIDS in sustaining families,usually with scanty resources.

“We carried out regional consultative meetings on HIVand AIDS for the older people in eight African countries and we found out that in Kenya 72,550 older people were living with the pandemic,” she said. “As at now we have not yet established the per centage rate for Zambia as we are still carrying out the survey,” Sishimba said.

She said it was important for the government and cooperating partners to ensure that the older people in society were sensitised on the social norms of condom use.

“The problem that the older people are facing right now is that they think HIV and AIDS is a disease that can only be contracted by the young in society,” she said. “The existing preventive education message targets younger people, leaving out or programme that would be relevant to older people,”

Sishimba said the media should play an active role in reporting and sensitizing the aged in society about the pandemic.

“The Non-Governmental Organizations (NGO) need to collaborate with media to sensitize the public and government about the need and circumstances of older people in general and older care givers. It is however very unfortunate that the media houses hardly have interest in reporting on issues concerning the older people in society,” Sishimba said.

She said if the Sub-Saharan countries were to win the fight against HIV and AIDS more concerted efforts was an important aspect.


United States Global AIDS Coordinator Ambassador Eric Goosby traveled to Malawi recently to meet with senior officials of the government of Malawi, members of the international donor community, and representatives of Malawi’s civil society to discus joint efforts in the fight against HIV/AIDS and other health challenges.

Ambassador Goosby visited programs jointly supported by the Global Fund, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Government of Malawi and other cooperating partners.

U.S. Ambassador to Malawi Peter Bodde and Malawi’s Minister of Health Professor Moses Chirambo joined Ambassador Goosby in Lilongwe on December 15 at a ceremony inaugurating the HIV Department of Malawi’s Ministry of Health, which was built with funding from the United States government.

The new 960 square meter office complex, built at a cost of over $1 million, is a state-of-the-art building that will support prevention, care, and treatment for HIV/AIDS. It represents the growing partnership between the 2 nations in fighting HIV/AIDS.

Ambassador Goosby noted that HIV/AIDS remains a high priority for the U.S. government. “We have increased funding, and we will continue to support this program and expand it in prevention, care and treatment,” he said.

Ambassador Goosby said he was impressed by the Malawi government’s commitment at the district and national levels to fight the AIDS epidemic. “The Malawian government has shown strong leadership in responding to the AIDS epidemic,” said Ambassador Goosby. “It has created the National AIDS Commission. It has created a number of groups that are in advisory as well as implementation and oversight roles within the Ministry of Health that engage with civil society, patients affected with HIV, as well as the faith based community.”

PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria have supported countries in placing more than 3.7 million people on antiretroviral treatment and delivered prevention interventions to millions more globally. Malawi has received support for the prevention, care and treatment of HIV and AIDS and for health systems strengthening initiatives. The government of Malawi and its partners, including PEPFAR and the Global Fund, provide life-saving antiretroviral therapy to over 170,000 Malawians, and have delivered counseling and testing for HIV to over 300,000 pregnant Malawian women.

The U.S. is committed to working with Malawi, other nations and international partners in the fight against HIV/AIDS.


Don’t hang HIV carriers; educate them

Wednesday, 23 December 2009 08:18 By Ariel Rubin

Hardly a day goes by in Uganda without a case of defilement making the rounds in newspapers and media outlets. From the lurid tales spewed out daily by the Red Pepper tabloid to disheartening articles in the Daily Monitor and New Vision of allegations of police defiling rape victims and young women killing attempted rapists, these stories are garnering more and more attention. But why? No other country seems to be as focused on defilers as Uganda. Indeed, one of the major justifications for the controversial “Anti-Homosexuality Bill 2009” is that the proposed law is a necessary measure to counteract the increasing amount of sexual abuse being perpetrated by homosexuals throughout the country.

According to a recent report by the African Network for Prevention against Child Abuse and Neglect (ANPPCAN) Uganda Chapter, 16 children were sexually abused daily in the first six months of this year in Uganda. A total of 9,480 child-abuse related cases were reported to various sources and of these, around 2,600 were defilement. According to Anselm Wandega, the national coordinator for research, information and advocacy at ANPPCAN, the number of child abuse cases in Uganda is “unacceptably high.” He blamed the high incidences of defilement on breakdown in the family system. 

This “breakdown of the family” and the fear it has engendered in Ugandans is one of the major pillars of Bahati and company’s arguments for further marginalising and criminalising Uganda’s gay community. This sentiment was echoed by Topher Mugumya, then-programme coordinator for research, information and advocacy at the ANPPCAN Uganda Chapter, who noted in 2007 that the widespread myth that having sex with a young child can “cleanse” one of HIV had led to a spike in child rape by HIV-positive men. This blanket statement, without any substantial qualification, is all that supporters of the anti-gay bill need to further stoke the fire. A quick glance at comments on Andrew Mwenda’s November 10th op-ed piece in this magazine shows just how many visceral, fear-driven reactions there are.

Instead of a nuanced and intelligent debate about the legality and ethicality of such a bill, the discourse revolves around a sinister cabal of homosexuals fiendishly preying upon innocent school children. Perversely, this renders the two terms synonymous, thus permitting proponents of the Anti-Homosexuality Bill to stifle opposition by calling any supporter a homosexual and thus invariably a defiler of small children. Even though the Penal Code Act already includes provisions which criminalise rape and defilement, Pastor Martin Ssempa can still vehemently argue that, “For too long we have had a problem that boys are raped and sodomised in school settings. Now when we deal with aggravated homosexuality, we are trying to provide equal protection before the law.”

 Unfortunately much of the debate over the Anti-Homosexuality Bill 2009 and the serious problem Uganda faces regarding child abuse seem to have become confused, allowing those like Ssempa to articulate that this deeply unfair bill is one that promotes equality. Indeed, ANPPCAN’s numbers pose a serious problem to Ugandan society but the spurious and offensive notion of a massive homosexual recruitment and rape drive is not the reason why. The difference between pedophilia and homosexuality must be elucidated so that the real reasons behind this bill can be understood and the appropriate responses to child abuse can be generated.

Ultimately, it would be prudent to investigate just how many cases of child rape by HIV-positive men are occurring as this is the kind of claim which can (and given the popular support for the bill, clearly has) stoke serious and often spurious biases against one small segment of the population. It is worth noting that according to one World Vision survey, 60% of girls reported sexual abuse while the number for boys was only 13%, indicating that heterosexual defilement is still a significantly bigger issue than same-sex abuse. As Dr Sylvia Tamale noted in a recent speech at Makerere University, “Over 50% of child sexual abuse reports involve children below 10 years of age, and the perpetrators are heterosexual men who are known to the victim.”  However, no one is tabling an “Anti-Heterosexuality Bill” in Parliament. 

There is no doubt that sexual abuse of minors poses a serious problem but it must not be conflated with the practice of consensual homosexual relations between two adults. The two issues have to be separated and dealt with accordingly. Instead of spending so much time and money advocating the execution of those with HIV/AIDS, the government would be wise to start educating.



Manto Tshabalala-Msimang, South Africa’s former health minister who gained notoriety for her promotion of lemons, olive oil and garlic to treat HIV and AIDS, has died at the age of 69.

Nicknamed “Dr Beetroot” after another one of her suggested remedies for the conditions, Ms Tshabalala-Msimang served as the country’s health minister for a total of nine years.

The Associated Press notes that while she was one of the most unpopular government ministers in post-Apartheid South Africa, she made some advances, such as forcing down the price of medicines and improving services in rural areas.

In a statement, the ANC said: “We pay homage to this gallant fighter and will forever treasure the contribution she made in the struggle for liberation and the building of our democracy.”

According to UNAIDS, in 2008, there were 22,400,000 people living with HIV in sub-Saharan Africa.

Written by Clare DevlinADNFCR-1663-ID-19518706-ADNFCR


HIV/AIDS: The incurable epidemic

FOR nearly 30 years scientists have been trying to break the back of the AIDS epidemic. Two recent studies show just how difficult and how distant that goal is.

Researchers announced Monday that their trial of a microbicide to prevent the transmission of HIV to women failed. The trial involved 9,385 women from South Africa, Uganda, Zambia and Tanzania over four years. The gel, known as PRO 20000, worked well in the lab and as part of a small trial in February. Unfortunately, it bombed in the large-scale trial. While 4 percent of those who were given a placebo tested HIV-positive, 4.1 percent of those given the microbicide tested positive.

The failure comes on the heels of the disappointment over what was believed to be a breakthrough in the development of an AIDS vaccine. In September, there was great excitement over a study funded by the National Institutes of Health whose preliminary results suggested a trial vaccine reduced the chances of HIV infection. After more than two decades of failure, a clinical trial had shown a measure of protection against HIV infection for the first time. But secondary analyses of the data published in October tempered the initial enthusiasm. The vaccine trial involved more than 16,000 people in Thailand. Over a six-year period, half received a combination of two previously failed vaccines. The other half received a placebo. In the three years after their shots, 51 participants who got the vaccine became HIV-positive, while 74 who got the placebo contracted the disease. This suggested that the risk of HIV infection was reduced by 31 percent.

Several concerns about that study existed. For instance, the vaccine was tailored to combat a strain of HIV common in Southeast Asia. So its impact on strains prevalent in Europe, North America and Africa is unknown. And there was the possibility that the success was a fluke. When only those who received all six doses on schedule are taken into account, scientists found that the vaccine reduced the risk of infection by 26.2 percent. But there was a 16 percent possibility that the results were due to chance; that percentage shouldn’t go above 5.


Still, there’s hope that information garnered from the experiment will be useful in developing a vaccine that works. “This is the first time that any vaccine trial in humans of an HIV vaccine has shown any positive effect, very modest thought it was,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told us. “In my mind, this does not constitute this vaccine as an ‘effective’ vaccine since the effect was so modest . However, it does now form the basis for trying to dissect out any ‘correlates’ of protection that we might identify and then try to optimize or maximize them in the development of future HIV vaccines.”

One thing that caught our attention is this: Of the more than 16,000 people in the vaccine trial, only 125, or 0.7 percent, became HIV positive. All participants were counseled on how to protect themselves from HIV and were given condoms. (Those who contracted the disease will receive free anti-retroviral treatment for life.) While scientists continue searching for a vaccine or a cure, prevention remains paramount.



Travis McCoy Premieres Solo Track To Support HIV/AIDS Activists


Travis McCoy premiered a new solo track titled “One at a Time” Wednesday night at a charity event in New York City’s Lower East Side. The single is meant to reflect Travis’ time spent touring the globe with MTV’s Staying Alive Foundation — a nonprofit organization that aims to support young people working to prevent the spread of HIV and AIDS in their community.




As Gym Class Heroes frontman traveled to South Africa, India and the Philippines, meeting young HIV/AIDS activists, he was encouraged to put his experience to music.


“That was kind of the catch of the trip,” Travis told MTV News. “I had to write a song that encompassed everything I saw and felt on the trip … and also gives the listener an idea of what they can do.”


“One at a Time” showcases a more serious and contemplative side we don’t often get to see from McCoy. When asked about a specific message in the new track, Travis started reciting some of the lines: “I feel like my generation complains about things we don’t have/ But if you think about it, we ain’t got it so bad / Trust me, I know bad, and I’ve met worse / And it’d be so sad to sit and let it get worse.”


McCoy’s experiences abroad are also being turned into a documentary, “Travis McCoy’s Unbeaten Track,” which will air on MTV networks around the world on World AIDS Day, December 1. Talking to the singer, it’s clear that he is proud of the film, and hopes that viewers will tune in and gain something from seeing the work of the many young people he met.


“If there was one thing I would want people to take away from my experiences with this documentary, just educate yourself and be aware,” he said. “You know, awareness is the key to knowing what’s going on, for one, and also finding out what you can do to help the situation.”


You can find out more about Travis’ trip at, and the charity single will be available as a digital download on iTunes starting on December 1. All proceeds from the sale of the single will go to the projects supported by the Staying Alive Foundation.











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