Health experts are developing plans to increase HIV/AIDS awareness in the Canadian province of Saskatchewan in response to the virus’ rising incidence in the province, Moira McKinnon, Saskatchewan’s chief medical health officer, said recently, the Regina Leader-Post reports.

McKinnon said a committee recently created to address the province’s HIV incidence has “met with a number of stakeholders and devised a plan” and also has developed several additional steps that can be taken to curb the spread of the virus, including increased HIV testing. “We’ve still got a lot of work to do in looking at the challenges from different points of view,” McKinnon said, noting that both the federal and provincial governments and various other partners are involved in the process. According to the Leader-Post, Saskatchewan recorded 174 new cases of HIV in 2008, an increase from the 124 new cases recorded in 2007. About 60% of the new cases in 2008 were associated with injection drug use.

McKinnon said a communications plan that targets specific groups, especially young women, is important to address HIV in the long term. McKinnon said, “We need to work out what we’re saying to people. We want to keep it positive: Get tested, get on treatment. Those kind of messages.” The plans for how those messages will be conveyed to the public still are under development and additional funding and advocates on the ground will be needed, she noted.

The partners in the communications plan “know that there are resource implications, so we’ll be sitting down and getting final detail on that in the next week or so,” McKinnon said. Don McMorris, Saskatchewan’s health minister, said that the government “is supporting aggressive measures to respond to this important public health issue, in addition to the current programs and services already funded” (Hall, Regina Leader-Post, 3/28).

“This is very, very depressing news, especially considering HIV’s profound impact on minority communities,” said Anthony Fauci, director of the National Institutes of Health’s program on infectious diseases. “And remember: The city’s numbers are just based on people who’ve gotten tested.”

The epidemiology report warns that the true number of D.C. residents infected with HIV “is certainly higher.”

Meanwhile, another study scheduled to be released Monday by city health officials looks at heterosexual sexual behavior, and attempts to dissect people’s choices before they are tested for or become infected with HIV. It was conducted by the George Washington University School of Health and Health Services with funding from the Centers for Disease Control and Prevention.

The study found that three in five D.C. residents who had connections in neighborhoods with high poverty and AIDS rates were aware of their HIV status and that three in 10 had used a condom the last time they had sex, among other findings.

According to Gandhi, asking patients themselves for information about their drug regiments can have inherent issues. “We often ask the patient what is their adherence to their medication,” she said, adding that physicians ask, “How much are they taking of their medication when we’re trying to predict why they’re not doing well. And self-reported adherence has its own set of limitations. There’s, you know, bias in how people present their level of adherence and there’s literally just memory problems in people not remembering how much they’re taking.” In addition, blood samples to test antiretroviral levels can present problems, according to Gandhi. “The problem there was everyone’s blood levels of drugs varies day by day,” she said, adding, “So depending on what I ate for breakfast that morning or if I smoked that morning or if I took another medication that interfered, the levels are sort of going to be up and down every day.”

Although some hairs are useful for testing, others are not, according to Gandhi. “We have tested it on all types of hair, African hair,” she said, adding, “We actually have some projects in Uganda with African hair. It works on fine hair. It works on gray hair. One thing is that people ask can we use pubic hair for these measurements. And we don’t’ think that those are going to be useful because hair in those areas grow to a certain length and then they stop. … But you really want to measure hair that’s sort of growing continuously and that’s really scalp hair.”

VOA News reports that the test has been called easy, painless, bloodless and free of biohazards. Although hair clipping can be conducted in rural areas in developing countries, a costly machine at a central laboratory still is needed for analysis (DeCapua, VOA News, 3/13).

For the study, Rockefeller University researchers examined antibodies present in the blood of six long-term HIV survivors who appeared to have a degree of natural immunity to the virus (Connor, Independent, 3/16). The researchers isolated 433 antibodies from the patients, all of which targeted HIV’s protective outer coating, or “envelope.” The researchers then cloned the antibodies and observed which elements of the envelope each antibody targeted and how effectively it neutralized HIV. During the research, Johannes Scheid, a doctoral student at Rockefeller University, identified a new structure on the HIV envelope that scientists previously had not recognized as an antibody target. Although the researchers determined that each antibody individually had a weak effect on HIV, they also found that the antibodies as a group effectively targeted the virus (PA/Google.com, 3/15). In addition, the researchers determined that a prototype vaccine developed from several of the antibodies can prevent the growth of HIV in human cells in a test tube.

Nussenzweig said the study identified “many different antibodies that individually have limited neutralizing ability but together are quite powerful.” According to Nussenzweig, only about one in every 1,000 HIV-positive people produces the neutralizing antibodies. He said the research attempts a new approach to HIV vaccine development by “copying what exists in nature and that we know can work because of the long-term survivors.” He added, “Instead of inventing something that doesn’t exist, it’s trying to copy something that does exist.” Nussenzweig said the study’s results “should make people think about what an effective vaccine should look like.” According to the Independent, the researchers next plan to conduct further trials of vaccine candidates on laboratory animals and human volunteers.

The Independent also profiled Kai Brothers, a San Francisco man who has been living with HIV for 28 years without developing AIDS or requiring antiretroviral medications. The Independent reports that Brothers, who did not participate in the new study, might be one of “a few — perhaps as few as one in 5,000″ — HIV-positive people who have natural immunity to the virus. Brothers said he has participated in HIV research for 10 years, adding, “I feel dedicated to giving back something because of my good fortune” (Independent, 3/16).

USAID/GHARP, a President’s Emergency Plan for AIDS Relief program, was launched in 2004 and will come to a close at the end of April, the Stabroek News reports. According to Ramsammy, the project has a place in Guyana’s development because of its contribution to reducing the spread of HIV. He said that 1.1% of pregnant women tested HIV-positive at the end of last year, compared with between 4.9% and 7% in 2000. Ramsammy reported that over the past two years, 90 pregnant women tested positive for HIV and that three infants were born with the virus. According to the health minister, the number of HIV cases among commercial sex workers and men who have sex with men remains high, although there has been some reduction in the number of cases. According to the News, Lisa Thompson, senior USAID/GHARP program officer, said that the program has helped to refurbish health care facilities to improve prevention of mother-to-child HIV transmission and to increase the number of facilities offering these services. In addition, Thompson said voluntary counseling and testing centers were rebuilt under the program, adding that mobile testing teams brought these services to hard-to-reach rural communities.

According to the News, USAID/GHARP worked with other stakeholders to develop HIV/AIDS programs targeting young people still in school, as well as programs for youth no longer in school. The program also launched a condom marketing initiative. Family Health International, Management Sciences for Health, Cicatelli Associates Incorporated and Howard Delafield International also supported the program.

Ramsammy said that in order for Guyana to continue to be successful in curbing the spread of HIV, a national strategy is needed. He also noted that the ministry is developing its third strategy (Alleyne, Stabroek News, 3/14).

According to the Post, District Mayor Adrian Fenty on Monday also released a report by George Washington University’s School of Public Health and Health Services, which looked at heterosexual behavior in the district. According to Donald Blanchon, head of the district’s Whitman-Walker Clinic, the study found that 70% of those surveyed did not use condoms during a recent sexual encounter. Blanchon called these findings “unbelievable,” adding, “This is 2009. We need each district resident to know his and her status and talk about their sexual behaviors and practices with their physicians and their partners.” Fenty said, “We know we have a lot of work to do as a government to educate and to get the information out, and as a community to step up and realize how dangerous we are with our sexual behavior.” Fenty also joined Pierre Vigilance, director of the district’s Department of Health, in calling for residents to exercise personal accountability. David Catania, chair of the D.C. Council’s Committee on Health, said “We cannot protect you if you’re not willing to protect yourself.”

Blanchon said that after the Post on Sunday published information about the district’s HIV/AIDS report, Whitman-Walker’s two district-based clinics Monday saw a 50% increase in people seeking testing compared with a typical day. According to Fenty, the district’s HIV/AIDS report also found some positive trends regarding the disease in the city. He said the city recorded one infant born with HIV in 2007, compared with 10 in 2005. In addition, 70,000 residents received HIV tests in fiscal year 2008, Fenty said (Fears/Vargas, Washington Post, 3/17).

In 1977, a secret federal virus program produced 15,000 gallons of AIDS. The record reveals the United States was represented by Dr. Robert Gallo and the USSR was represented by Dr. Novakhatsky of the diabolical Ivanosky Institute. On August 21, 1999, the world first saw the flowchart of the plot to thin the Black Population.

The 1971 AIDS flowchart coordinates over 20,000 scientific papers and fifteen years of progress reports of a secret federal virus development program. The epidemiology of AIDS is an identical match to the “research logic” identified in the five section foldout. The flowchart is page 61 of Progress Report #8 (1971) of the Special Virus program of the United States of America. We today, challenge world scientists to discussion of this document find.

We believe there is a daily, growing number of world experts who are all coming to the same conclusion regarding the significance of the flowchart. Dr. Garth Nicolson has examined the flowchart as well as other top experts from around the world. It is time for Dr. Michael Morrissey of Germany to examine the flowchart and report to the world. In addition, we have now examined the 1978 report. It is heresy to continue to further argue the program ended in 1977.

The 1978 report of the development of AIDS leaves no doubt as to the (“narrow result”) candidate virus sought by the United States. The flowchart conclusively proves a secret federal plot to develop a “contagious cancer” that “selectively kills.”

Following the presentation of the flowchart in Canada, the same information was presented to the United States in the rotunda of the Western Reserve Historical Society in Cleveland. Shortly thereafter a major African newspaper called and for four days in a row, this issue was the feature story in an uncensored press. The people of Africa already know about the U.S. virus development program. It is time for the rest of us to know.

In January, the U.S. had no response to my two page abstract submitted to the African American AIDS 2000 conference. In February, the U.S. Congress had no response to the 3000 Americans who signed signature petitions calling for immediate review of the flowchart and progress reports of the secret virus development program. We firmly believe once the dust settles from the current election marathon, reviewing the special virus program will be the single most important pursuit of the 21st Century.

More scientists and doctors must join with Dr. Nicolson, Dr. Strecker, Dr. Cantwell, Dr. Horowitz, Dr. Lee, Dr. Wainwright, Dr. Halstead and Professor Boyle. In any public debate on this issue, we will continue to present the flowchart of the secret virus development program, as the “irrefutable missing link” in the true laboratory origin of AIDS.

We have successfully navigated a federal maze and matrix and found a curtain surrounding the issue of AIDS. The 1999 discovery and presentation of the AIDS flowchart is a “smoke detector” wake up call. Society has an obligation to do more than don masks.

Male Condoms

Several studies have demonstrated that male condoms made of either latex or polyurethane are effective barriers against HIV. The theory behind using condoms is clear: they cover the penis and provide an effective barrier to secretions such as semen and vaginal fluids, thereby blocking sexual transmission of HIV infection. 

Studies have also demonstrated that other common sexually transmitted viral infections, such as herpes simplex virus (HSV) and hepatitis B virus (HBV), can be prevented with the use of latex or polyurethane condoms. While condoms can help prevent the transmission of human papillomavirus (HPV), a virus that can cause cervical and penile warts, lesions and cancer, there is still a risk of infection.

Condoms made of “natural” materials—such as lambskin—are not a consistently effective barrier against many viruses. This is because they contain microscopic holes through which HIV can pass.

The key to effective protection is consistent and correct use of condoms. To learn more about correct condom use, click here.

Incorrect use of condoms can increase the risk of condom slippage or breakage, which diminishes their protective effect. Inconsistent use—for example, failure to use condoms with every act of vaginal or anal intercourse—can lead to HIV transmission.

A word about polyurethane condoms: They are an effective alternative to latex condoms, especially for people with an allergy to latex. However, some studies have found that polyurethane condoms are more likely to break than latex condoms. Still, if used consistently and correctly, they are considered to be a highly effective barrier against the sexual transmission of HIV.

Female Condoms

The female condom, approved in 1993 for use in the United States, is a polyurethane pouch with flexible polyurethane rings at each end. It is inserted deep in the vagina, much like a diaphragm. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vulva (vaginal opening). If inserted properly, it lines the vagina and the cervix, which helps to prevent pregnancy, along with HIV and other sexually transmitted infections.

While female condoms are not approved for use during anal intercourse, some men and women have reported using them for anal sex. However, at least one study has uncovered problems for the receptive partner using the female condom, during anal sex, including difficulty inserting the condom, discomfort and rectal bleeding (removing the inner ring may alleviate some of the problems experienced during anal insertion and removal).

A Word About Lubricants

Only water-based and silicone-based lubricants should be used with latex condoms. K-Y Jelly, Wet and Astroglide are three examples of water-based lubricants that can be used with latex condoms. Examples of silicone-based lubricants include Millennium ID and Eros Bodyglide.

Never use oil-based lubricants, including hand or body lotion, baby oil, vegetable oil or shortening, massage oil, mineral oil, or petroleum jelly (e.g., Vaseline) with latex condoms. Oil-based lubricants can damage latex and cause latex condoms to tear more easily. If you must use an oil-based lubricant, it should only be used with polyurethane condoms.

Some pre-lubricated condoms and separately sold lubricants contain a chemical called nonoxynol-9. While nonoxynol-9 has been shown to kill sperm (and potentially reduce the risk of pregnancy) and various sexually transmitted infections, some men and women are allergic to this chemical. This can cause irritation inside the vagina and anus, which can increase the risk of HIV transmission if the condom breaks.

March 9, 2009

HIV Infections on the Rise Among Bali Sex Workers

In an attempt to tackle the rising rate of HIV/AIDS among Bali’s sex workers and their clients, 36 doctors on the Indonesian island participated in a training session for public health centers and private clinics that treat sexually transmitted infections (STIs), The Jakarta Post reports.

According to the article, the rate of STIs among Bali’s sex workers rose from 3 percent in 2003 to 14 percent in 2008. Yahya Anshori, a program director at the Bali AIDS Commission (KPAD), attributed the increase to the facts that sex workers are highly mobile and that many public clinics and doctors are not able to sufficiently treat STIs.

“Through this training, we hope doctors can extend access [to] treatment,” Anshori said. “The earlier we treat those infected, the better we can defend ourselves from HIV.”

There are an estimated 8,000 sex workers in Bali.