Prevention News Archives

Following are links to the Kaiser Daily HIV/AIDS Report (and occasionally other sources) and summaries from the CDC HIV/STD/TB Prevention News Update.

Fall News

FDA To Require Vaginal Contraceptives Containing Nonoxynol-9 To Include Warning Label That Products Do Not Protect Against STIs, Including HIV
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49485

FDA proposes requirements for human blood & blood components intended for transfusion or further manufacturing use
FDA HIV/AIDS Update (12/14/07)
The Food and Drug Administration (FDA) proposes to revise and update the regulations applicable to blood and blood components, including Source Plasma and Source Leukocytes, to add donor requirements that are consistent with current practices in the blood industry, and to more closely align the regulations with current FDA recommendations. FDA is taking this action to help ensure the safety of the national blood supply and to help protect donor health by requiring establishments to evaluate donors for factors that may adversely affect the safety, purity, and potency of blood and blood components, or the health of a donor during the donation process.

Written or electronic comments on the proposed rule, identified by Docket No. 2006N- 0221, may be submitted to the agency until February 6, 2008. See FDA Update.

MDCH Capacity Development Trainings
The HAPIS Community Partnerships Unit is planning a series of capacity development trainings designed to help HIV-prevention service providers better understand and access hard-to-reach populations. Please contact Jane Conklin at conklinjane@michigan.gov or 517.241.5938 for information and registration forms.

HIV Vaccine Trial Participation Might Lead to Negative Social Consequences, Study Says http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49160

Statehealthfacts.org Adds Updated Data About Needle-Exchange Programs
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49162

DISTRICT OF COLUMBIA:
"Needle Exchange Funding Urged"
Washington Post, (11.28.2007) David Nakamura
Monday's report on the District's HIV/AIDS epidemic pays too little attention to the role of drug injecting, said Del. Eleanor Holmes Norton (D-D.C.). "The report does a disservice in creating headlines that the District has the highest AIDS rate without, at the very least, mentioning the possible effect of many years without fully operating and lifesaving needle exchange programs," she said. Norton has long fought the congressional policy that prohibits the District from using local funds to support needle exchanges. Now she predicts that ban will soon be overturned.

Lack of HIV Prevention Efforts Among MSM Fueling Increase in New Diagnoses, JAMA Commentary Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49078

Benefits of HIV/AIDS Programs in Workplace Outweigh Costs, Report Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48876

Some Experts Emphasizing 'Proven, Lower-Tech' Strategies To Prevent HIV After Merck's Vaccine Trial Was Halted, Washington Post Reports
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48572

New York State AIDS Advisory Council Passes Resolution That Recommends Eliminating Written Consent Requirement for HIV Tests
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48369

Advocates of Legal Drug Injection Center in San Francisco Discuss Support of Idea http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48340

Lambda Legal and Partners Provide Guidance to Recipients of New CDC Funding
Following last week's CDC Awards of $35 Million to 23 state and local public health departments for one-year projects to target HIV testing expansion in African-American communities where rates of HIV/AIDS are most acute, Lambda Legal, AIDS Foundation of Chicago and the Center for HIV Law and Policy are sending a set of 15 HIV testing principles to help guide them. In addition, members of the Congressional Black Caucus joined with the Black AIDS Institute and other civil rights organizations last week in calling for a campaign to provide HIV testing to 1 million African-Americans by December 2008 as part of a mass mobilization campaign. See Lamda Legal Press Release (10/4/07)

NASTAD Releases Primer on Implementing HIV Testing in EDs
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47971

HAPIS HIV Prevention Referral Guidelines and Toolbox is now available to view and download.

CALIFORNIA:
"Wider HIV Testing Sought: Bill for Routine Screening Is on Governor’s Desk"
Sacramento Bee, (09.26.2007) Aurelio Rojas
California could soon adopt legislation that would make HIV screening a part of standard medical care. AB 682, which calls for patients 13-64 to have such tests done routinely by physicians unless they, or their caregiver, decline, passed the Legislature just one vote shy of unanimous bipartisan support. The bill is backed by the 35,000-member California Medical Association. It now awaits Gov. Arnold Schwarzenegger's signature. CDC Summary

New York City Records Increasing Number of HIV Cases Among MSM Younger Than Age 30
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47434

California Assembly Passes Bill To Encourage Routine HIV Testing
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47435

Condoms Distributed in STI Prevention Effort Meet Federal, Industry Safety Standards, Washington, D.C., Health Officials Say
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47315

Summaries

FDA proposes requirements for human blood & blood components intended for transfusion or further manufacturing use
FDA HIV/AIDS Update (12/14/07)

The Food and Drug Administration (FDA) proposes to revise and update the regulations applicable to blood and blood components, including Source Plasma and Source Leukocytes, to add donor requirements that are consistent with current practices in the blood industry, and to more closely align the regulations with current FDA recommendations. FDA is taking this action to help ensure the safety of the national blood supply and to help protect donor health by requiring establishments to evaluate donors for factors that may adversely affect the safety, purity, and potency of blood and blood components, or the health of a donor during the donation process.

Through the years, FDA has issued a number of guidance documents containing recommendations intended to assure a safe, pure, and potent blood supply. The Notice of Proposed Rulemaking discusses the recommendations contained in current guidance that fall under the proposed regulation, including donor eligibility and screening for HIV and certain other transfusion-transmitted infections. FDA believe the proposed rule will more explicitly describe donor eligibility standards and will clarify the relationship between the regulations and the applicable recommendations.

The proposed rule, among other things, provides for the establishment of minimum criteria for the assessment of donor eligibility, and the suitability of the donation of blood and blood components. The rule is expected to have a minor net impact on blood establishments because it is already usual and customary business practice in the blood industry to assess donors for eligibility, and donations for suitability. FDA believes the primary impact of the rule will be the one-time review of current SOPs that the proposed rule would require each blood collecting establishment to conduct.

Written or electronic comments on the proposed rule, identified by Docket No. 2006N- 0221, may be submitted to the agency until February 6, 2008 through any of the following methods:

Electronic Submissions Submit electronic comments in the following ways: Federal eRulemaking Portal: http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.regulations.gov. Follow the instructions for submitting comments.

Agency Web site: http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&log=linklog&to=http://www.fda.gov/dockets/ecomments. Follow the instructions for submitting comments on the agency Web site.

Written Submissions: Submit written submissions in the following ways: FAX: 301-827-6870. Mail/Hand delivery/Courier [For paper, disk, or CD-ROM submissions]: Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852.

CALIFORNIA:
"State Meth Campaign to Include Gay, Bi Men"
Bay Area Reporter (San Francisco), (12.07.2007) Seth Hemmelgarn
On Nov. 28, California's Department of Alcohol and Drug Programs announced a $10 million ad campaign to address methamphetamine use among men who have sex with men (MSM), women of childbearing age and youths. Gov. Arnold Schwarzenegger declared the date Methamphetamine Awareness Day.

Lisa Fisher, a state spokesperson, said the ads will begin running in January in San Francisco, Los Angeles, San Diego, Sacramento, and Fresno. They will appear on TV, in gay bars and in bus shelters. Dana Van Gorder, executive director of Project Inform, said the ads will include "a very positive message for gay men."

Van Gorder, who promoted the campaign to the state legislature while at the San Francisco AIDS Foundation, said the L.A. Gay & Lesbian Center also worked on the campaign. The focus at first was just to target gay men, but the campaign broadened as state officials reviewed research on other groups of concern.

Dr. Jeffrey Klausner of the San Francisco Department of Public Health said, "I think it's a good idea to try to increase general awareness about the problem." He noted that while the rate of methamphetamine use in San Francisco is highest among MSM, users statewide are increasingly younger and straight.

Michael Siever, PhD, director of the Stonewall Project, said research over the years has shown that 15-20 percent of gay men in San Francisco use the drug at least occasionally. The Stonewall Project runs tweaker.org, which provides a harm reduction approach to methamphetamine use.

Health advocates maintain that methamphetamine users are several times more likely to contract HIV and other STDs, since they are more likely to have multiple sex partners and to practice unsafe sex.

For more information, visit www.adp.ca.gov .

UNITED STATES:
"Gay Blacks at Highest AIDS Risk"
Baltimore Sun, (12.04.2007) Jonathan Bor
Yesterday at the 2007 National HIV Prevention Conference in Atlanta, CDC researchers said black men who have sex with men (MSM) are more than twice as likely to be HIV-infected as their white counterparts. "[MSM] account for almost half of all people estimated to be living with HIV in the United States, and African Americans are the most heavily impacted," said Kevin Fenton, the director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

According to a CDC study conducted two years ago, 25 percent of 1,700 gay men in five cities were HIV-positive. That compares with well under 1 percent of the general population. A total of 46 percent of black MSM were infected, twice the rate for whites. Nearly half of those testing HIV-positive were unaware of their infection.

The reasons for the disparity among MSM are not yet clear. A recent study found little difference in the rates of unprotected sex among black and white MSM: The practice was common among both groups.

Another study determined that black MSM were more likely to be infected with an STD, possibly making them more susceptible to HIV. African-American MSM were also less likely to be on antiretroviral treatment, which can lower HIV's concentration in the bloodstream and thus the chance of transmitting it to others.

In Maryland, health officials say a decline in federal prevention dollars has affected their efforts in targeting black MSM. Heather Hauck, director of Maryland's AIDS Administration, said the drop has forced the state to make hard choices about where it spends its money. "We do not have the resources to do adequate prevention for everyone," she said.

The ‘Generals’ in the U.S. HIV/AIDS Fight Speak Out: Invest More Now or Run the Risk of Losing the Battle
NASTAD Release (11/29/07)
WASHINGTON, D.C., November 29, 2007 — On World AIDS Day 2007, the nation’s AIDS directors send a clear message to the U.S. government and public: Increase America’s investment in HIV prevention or run the risk of losing the war against HIV/AIDS in the U.S.

As stewards of more than fifty percent of the Centers for Disease Control and Prevention’s $663 million domestic HIV prevention program budget, as well as the significant resources from their own jurisdictions, AIDS directors are responsible for implementing a comprehensive HIV/AIDS response in each state, territory and directly-funded city in the U.S. This unique role positions them as consummate leaders in the nation’s fight to end the epidemic.

With fullest vigilance, AIDS directors released today their vision for America’s prevention response, A New Blueprint for the Nation: Ending the Epidemic Through the Power of Prevention, and a companion policy agenda.

In the early days of the epidemic, the success of programs implemented at the state and local levels led to a 75 percent decrease in the rate of HIV transmission in the U.S. Despite steady erosion in funding and a steadily increasing number of people capable of transmitting the virus, these programs have been able to keep the epidemic stable for more than 15 years.

Unfortunately, AIDS directors know the nation is reaching a tipping point. Because of continued under-funding, restrictive policies and more than 1.2 million people estimated to be living with HIV/AIDS, the success of the nation’s prevention response is being threatened.

“Each year, tens of thousands of opportunities are missed, despite our relentless efforts. As long as the nation remains apathetic to prevention, our potential to be victorious in this fight diminishes,” says Dr. Andre Rawls, Chair of the National Alliance of State and Territorial AIDS Directors (NASTAD), the organization founded to be the voice of state AIDS directors.

To stave off the looming crisis, AIDS directors are poised to scale up their programs. In their Blueprint, they clearly articulate a vision for what is necessary to win the battle against HIV/AIDS in the U.S. To achieve this vision, they offer three specific action steps.

Adequately fund CDC’s prevention program at the level of at least $1.3 billion dollars annually.
Meaningfully invest in services that work to prevent infection, including access to sterile injection equipment, research to develop new population-specific interventions, enhanced programming in correctional settings and abandonment of abstinence-only-until-marriage programs in favor of comprehensive sexuality education.
Meaningfully invest in programs that support HIV prevention including STD treatment, substance abuse prevention and treatment, mental health services, housing and expanded research to identify an HIV vaccine and effective microbicides.

AIDS directors call on the federal government to make a commitment to end the epidemic in America and to ensure leadership on the local level is fully supported and funded. To close the Blueprint, they offer their commitment to working toward an America without HIV/AIDS.

“We can never forget: HIV disease is preventable. By building on the successes of the nation’s health department prevention programs—by far the most significant force we have in this fight—we can, as the Blueprint says, ‘turn the tide on the domestic HIV/AIDS epidemic’,” says Julie M. Scofield, Executive Director of NASTAD.

UNITED STATES:
"Growing Focus on Reused Medicine Vials"
New York Times, (11.17.2007) Sarah Kershaw
The case of a Long Island, N.Y., anesthesiologist who used unsafe infection control practices is bringing fresh attention to the risk of transmitting blood-borne diseases through multidose medicine vials. Dr. Harvey Finkelstein told health officials that while he used a new syringe on each patient, he would use the syringe to draw medicine from more than one vial. So far two hepatitis C infections are linked to Finkelstein's practice; 628 patients he treated from 2000 to 2005 have been advised to undergo testing.

CDC earlier this year updated its infection control guidelines, advising that providers use sterile disposable syringes and noting that single-dose medicine vials "are preferred" because they are much easier to keep sterile.

Viruses spread most easily when needles are reused, said Dr. Michael Bell, CDC's associate director of infection control. But even if sterile needles are used, infections can spread if the medicine vials become contaminated and are reused on other patients, Bell said.

State health officials say they have spoken with CDC several times in recent years about how to make the use of medicine vials safer. They said they also wanted to discuss the issue with the Food and Drug Administration. But FDA officials said they were unaware of a federal recommendation regarding single-use vials. A statement from the agency said, "There is no issue using multidose vials, if they are designed to be multidose vials, so long as sterile procedures are used to enter the vial and obtain the medication."

UNITED STATES:
"Redesigning a Condom So Women Will Use It"
New York Times, (11.13.2007) Donald G. McNeil Jr.
Public health experts once held high hopes that the female condom would give women worldwide the ability to protect themselves from STDs. But due to a range of problems - the device was perceived as awkward, unsightly, and noisy - it made little headway with females other than sex workers. Six billion male condoms are delivered annually to developing countries, compared to only 12 million female condoms.

Now a second-generation version has been developed by the Seattle-based nonprofit PATH. It reportedly offers several advantages: It is inserted using a tampon-like bunched end, instead of a stiff rubber ring. A softer, thinner polyurethane was used to better transmit warmth and provide a more natural feel. Adhesive dots on the outside cling to the vaginal walls, expanding with them during arousal. In testing among couples in Seattle, Thailand, Mexico, and South Africa, more than 90 percent liked the new device's comfort and ease of use, and 98 percent rated its feel during sex as "OK to very satisfactory," PATH said.

But PATH has encountered a major roadblock to bringing the new female condom to market. While the Food and Drug Administration designates male condoms as Class 2 medical devices, so that they must only pass tests for leakage and bursting, female condoms are designated Class 3. This puts them in the same category as pacemakers and heart valves, meaning that any new design must clear clinical trials at a cost of $3 million to $6 million. "That's… close to a 100 percent block, because no one's willing to put up that sort of money," said Dr. Michael J. Free, PATH's head of technology.

The original product was never able to fulfill scientists' goal of being a form of protection a woman could use without her male partner's knowledge. This was the female condom's biggest failure, and one the redesign process could not correct.

CALIFORNIA:
"Wider HIV Testing Sought: Bill for Routine Screening Is on Governor’s Desk"
Sacramento Bee, (09.26.2007) Aurelio Rojas
California could soon adopt legislation that would make HIV screening a part of standard medical care. AB 682, which calls for patients 13-64 to have such tests done routinely by physicians unless they, or their caregiver, decline, passed the Legislature just one vote shy of unanimous bipartisan support. The bill is backed by the 35,000-member California Medical Association. It now awaits Gov. Arnold Schwarzenegger's signature.

The bill's sponsor, Assembly member Patty Berg (D-Eureka), and the Test for Life California coalition say state estimates show around 40,000 Californians do not know they are HIV-infected. "My bill makes HIV screening a routine part of your medical exam, just like screening for cholesterol and diabetes," Berg said Tuesday. Currently, patients must provide specific written consent to have their blood tested for HIV.

Michael Weinstein, president of the AIDS Healthcare Foundation, said AB 682 "is part of a long road toward normalizing the treatment of HIV." Written informed consent is a major barrier in emergency rooms and other fast-paced medical settings, and doctors complain of being overburdened with paperwork, he said.

In addition, CDC figures show between 50 percent and 70 percent of new infections "occur via a person who doesn't know they are infected with HIV," Weinstein said. "When people know, they will act to protect their partners."

Donna Wood, vice president of the Sacramento chapter of the National Coalition of 100 Black Women, said the issue is of particular importance to minorities, who are far more likely to learn of their HIV status less than a year before developing AIDS, often too late to receive effective treatment.

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