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HIV Prevention
Research and Reports
Following are links to the Kaiser Daily U.S. HIV/AIDS Report or other sources,
and summaries from the CDC NPIN
News Update.
March 2010 Titles and Briefly
AUSTRALIA:
"AIDS Drugs Haven't Changed HIV Risk with Anal Sex"
Reuters Health , (02.22.2010)
Although highly active antiretroviral treatment (HAART) can lower HIV in the
blood to undetectable levels, it does not reduce the risk of contracting the
virus during a single act of unprotected anal sex, according to a new study of
men who have sex with men.
Dr. Fengyi Jin, of the National Center in HIV Epidemiology and Clinical Research
at the University of New South Wales, and colleagues estimated the HIV risk for
each episode of unprotected insertive or receptive anal sex. A total of 1,427
men who reported homosexual sex at least once in the past five years were
recruited from June 2001 to December 2004. Participants were interviewed about
their sexual behavior every six months and tested for HIV annually until June
2007.
During follow-up, 53 men contracted HIV. The riskiest type of sexual activity
was receptive anal sex with ejaculation into the rectum, with a per-contact risk
of HIV transmission of 1.43 percent. Withdrawal prior to ejaculation lowered the
receptive partner’s risk to 0.65 percent. The estimated transmission risk for
insertive unprotected sex in participants who were circumcised was 0.11 percent
and 0.62 percent for uncircumcised men.
The team noted the findings were “very similar” to those of a US study from the
early 1990s: It found a 0.82 percent risk for every instance of receptive anal
sex regardless of whether or not withdrawal occurred.
About 70 percent of HIV-infected men are on HAART in Australia, and about
three-quarters of these individuals have no detectable virus in their blood.
Thus, the authors said it is “surprising” that the risks associated with
unprotected sex are similar to what they were in the pre-HAART era.
The team said the findings apply to the population of gay men as a whole, but
“caution should be exercised before interpreting the results at the level of
individual men.” The researchers noted that 12 participants contracted HIV after
having unprotected anal sex less than 10 times, while six did not contract the
virus even though they had “extremely large numbers” of receptive anal sex
episodes with HIV-infected partners.
The study, “Per-Contact Probability of HIV Transmission in Homosexual Men in
Sydney in the Era of HAART,” was published in the early online edition of AIDS
(2010;doi:10.1097/QAD.0b013e3283372d90).
"World Failing to Do Enough to Curb HIV, Study
Shows"
Australian Associated Press , (03.01.2010) Danny Rose CDC NPIN
Summary
HIV prevention and treatment service coverage for injecting drug users (IDUs) is
too low in many countries to prevent transmission, a discrepancy that impacts
infection rates at the local level, new research shows.
“Governments that have not made needle and syringe programs and opioid
substitution available need to be convinced that these interventions are the
most effective ways to stop HIV spreading among [IDUs], and to the wider
community,” said lead author Dr. Bradley Mathers of the University of New South
Wales National Drug and Alcohol Research Center.
Australian health authorities distribute 213 clean needles per IDU each year,
compared with 188 for the United Kingdom, 46 in Canada and 22 in the United
States. In Russia, which has the second-largest IDU population after China,
there is no methadone substitution. Other prevention measures among Russian IDUs
are, similarly, virtually non-existent. HIV prevalence among Russian IDUs is 40
percent, versus just 1.5 percent among IDUs in Australia.
“Our high level of prevention in Australia has paid off with low levels of HIV
infection among [IDUs] compared with countries with a similar level of injecting
drug use,” Mathers said.
Globally, just 8 percent of IDUs had access to a syringe exchange program last
year, Mathers said. Coverage ranged from 100 percent in the Czech Republic and
Ireland to less than 3 percent in China, Malaysia and Thailand. Opioid
substitution therapy was available in only 70 of 151 countries with known IDU
populations.
Only one of every 25 HIV-positive IDUs globally is receiving antiretroviral
treatment. The worst treatment coverage was found in Kenya, Pakistan, and
Russia.
The full report, “HIV Prevention, Treatment, and Care Services for People Who
Inject Drugs: A Systematic Review of Global, Regional, and National Coverage,”
was published in The Lancet (2009;doi:10.1016/S0140-6736(10)60232-2).
See Jan-February Archived Reports
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