Showing posts with label HIV prevention. Show all posts
Showing posts with label HIV prevention. Show all posts

Over the years, parents have been faced with a sexual health issue right in the early stages of their child’s infancy; circumcision. While proponents tout the wellness benefits of circumcision, opponents argue that the barbaric nature of the procedure does no good to a boy’s wellbeing. Now, the latest to join the fray is an anti-circumcision group in San Francisco, who are pushing for a ban on the practice. Unsurprisingly, those in favour of the procedure disagree with the proposal, citing the procedure’s history as a religious ritual, as well as its sexual health benefits, as some research suggests that circumcision helps prevent the spread of HIV. The debate that rages on is, therefore, “Is circumcision a good idea or not?”


 


We can date the process of circumcision as far back as to the Ancient Egyptians in 2,500BC, but the ritual later became more associated with Jewish people. Reasons for this included marking a boy’s passage into manhood, marking to distinguish those of higher social status, male “menstruation” or sign of the onset of puberty, and a way to discourage masturbation. Now, however, circumcision is not just a Jewish ritual but the most common surgery performed on males in the United States. According to a recent survey by the Centres for Disease Control and Prevention (CDC), between the years of 1999 and 2004, 79% of men reported that they were circumcised.


 


The main health reason to be circumcised is that the process is believed to prevent diseases, such as HIV, and some research suggests that circumcision reduces the risk of male-to-female HIV transfer. This is possibly due to the fact that, when you are circumcised, the Langerhans cells in your foreskin are removed, and these cells are more susceptible to HIV infection. Langerhans cells are equipped with special receptors that may allow HIV access into the body. In 2009, three studies published in the Cochrane Database of Systematic Reviews – which included data from more than 11,000 men in South Africa, Uganda and Kenya between 2002 and 2006 – showed that circumcised men were 54% less likely to get HIV than their uncircumcised counterparts.


 


However, while HIV prevention is becoming a well-supported argument for circumcision in developing countries, it is not as strong of an argument for the United States or for us here in Britain. A report from the CDC notes, ‘A number of important differences from sub-Saharan African settings where the three male circumcision trials were conducted must be considered in determining the possible role for male circumcision in HIV prevention in the United States.’ It continues, ‘Studies to date have demonstrated efficacy only for penile-vaginal sex, the predominant mode of HIV transmission in Africa, whereas the predominant mode of sexual HIV transmission in the United States is by penile-anal sex among [men who have sex with men].’


 


Still, is that a reason to ban the practise, especially considering the fact that there’s a lack of strong evidence showing negative side effects? Proponents of the San Francisco ban have now delivered more than 12,000 signatures to the Department of Elections, and, if enough signatures are deemed to be valid, this ban will appear on the ballot in the November election. Under the ban, circumcision of any male under the age of 18 would carry a fine of up to $1,000 and jail time of up to one year. Lloyd Schofield, the leader of the proposal, comments that circumcision is ‘excruciatingly painful and permanently damaging surgery that’s forced on men when they’re at their weakest and most vulnerable.’ However, Scott Bryan, a spokesperson for the CDC, argues, ‘Data has shown that with anaesthesia, the majority of infants have no objective pain reaction.’

Although the ultimate goal of AIDs therapy is to prevent the HIV affecting anyone’s sexual health in the first place, so far nothing — from vaccines to gels — has proven up to the task. Still, that’s not to say that drugs haven’t controlled the spread of HIV, but now a new exciting study, published in the New England Journal of Medicine, has found a way for antiretroviral drugs to do the job for which they were always intended: guarding the wellbeing of healthy, uninfected individuals against HIV.


 


For the study, the researchers investigated almost 2,500 HIV-negative gay men, across six countries, who were at high risk of contracting HIV. Of those participants, some were given the currently prescribed treatment dose of a combination anti-HIV medication known as Truvada, while others took a placebo. After the study’s longest follow up of nearly three years, the researchers found that those taking the medication had a 44% lower rate of HIV infection than those taking a placebo. The benefit was even greater amongst those participants who took their medications more faithfully on a daily basis, as their risk of acquiring HIV dropped to a 73% lower rate than the placebo group.


 


In a statement, Dr. Kevin Fenton, director of the Centres for Disease Control (CDC) National Centre for HIV-AIDS, Viral Hepatitis, STD and TB Prevention, commented, ‘These results represent a major advance in HIV prevention research. For the first time, we have evidence that a daily pill used to treat HIV is partially effective for preventing HIV among gay and bisexual men at high risk for infection.’ Other wellness experts echoed this excitement, as those in the HIV community have long been pushing for a stronger preventative strategy, especially in the developing world. Dr. Anthony Fauci, director of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, noted, ‘The study is really quite impressive, and the data are very robust, really strong.’


 


The data was particularly encouraging to Fauci, as it represents a closer look at the difference in HIV infection rates among those taking medications, suggesting that varying degrees of exposure to anti-HIV medications can help to thwart infection. Even the volunteers who weren’t on-the-ball with taking their medications had a 13-fold lower rate of HIV infection than those who showed no measurable level of drug in their system. Fauci explained, ‘This is really huge; this is a very impressive result. As with any new treatment strategy, it’s all about whether you adhere to the regimen.’ Fauci added that he suspects many doctors already prescribe antiretroviral medications for this reason; heading off in uninfected but high-risk individuals. Even though government health officials are yet decide whether the results are robust enough to justify recommending anti-HIV drugs as a prevention strategy, Fauci believes these findings should bolster that practice.


 


Still, that is not to say that the findings give you an excuse to abandon safe sex with condoms. The drugs don’t alter your immune system or prime your body in the same way that a vaccine would against HIV; they act only when the infection is present, and block its ability to infect and replicate in your body’s healthy cells. Therefore, this prevention strategy only ensures that the drugs are on the front lines, ready to act at the first encounter with the virus. As Fenton concluded, ‘[The] results are exciting, but it is not time for anyone to stop using condoms or stop following proven prevention methods. [The study] cannot be seen as the first line of defence against HIV.’

How Oral Medications Can Benefit Your Type 2 DiabetesUsing a vaginal gel that contains HIV medication before and after sex has been shown to reduce the number of cases of infection of the virus. This is one of the strategies used to prevent HIV infection through unprotected sex in sub-Saharan Africa.


However, a project analysing the use of the vaginal gels along with daily tablets has shown that this particular strategy has failed because the women involved did not take the medication when they were supposed to. The results of the study reveal the importance of individual’s behaviour in dictating the spread of the disease.


More than 5,000 women in Zimbabwe, South Africa and Uganda were given the gel and two different types of anti-HIV drugs in the three-year study carried out by the University of Washington called Vaginal and Oral Interventions to Control the Epidemic (VOICE).


Blood tests at the end of the study revealed that more than 70% failed to use the medication in the way it was prescribed. Unmarried women, who are the group most at risk of contracting HIV, were shown to be the most likely to not use of any of the medication.


Truvada, the daily tablet tested during the study, has now given approval for use in HIV prevention by the US Food and Drug Administration because tests have shown its effectiveness in reducing the risk of HIV.


The results of the University of Washington study were revealed at a conference on retroviruses and opportunistic infections in Atlanta. Experts in HIV and AIDS believe the study confirms that, alongside medication, encouraging a change in people’s behaviour so they take the drugs is the only way that infection rates will be reduced.


HIV rates in eastern and southern Africa are the highest anywhere in the world and so the focus for experts on the disease has been on finding drug treatments that can be administered simply and effectively to a destitute population.



Medication Halts Spread of HIV But Women Failing to Use it