When microorganisms invade the body, immune mechanisms kick in to fight them off. The infected tissues typically show depleted oxygen levels, and a protein called HIF-1 alpha regulates this. Interestingly, the cells responsible for destroying the foreign pathogens are effective in this low-oxygen environment. In a new study appearing in the July 1 print issue of The Journal of Clinical Investigation, Randall Johnson and collegues from UCSD show for the first time that induction of the HIF-1 pathway can act as a “super-antibiotic”, accelerating the killing of bacteria in conditions typical of those found during bacterial infection and sepsis.

The authors show that regulation of HIF-1 is required for immune defense against bacterial infection. They also show that bacteria killing is increased under conditions of low oxygen due to HIF-1 upregulation, and that bacterial infection upregulates HIF-1. In fact, upregulation of HIF-1 enhances expression of bactericidal agents and killing of bacteria.

This reveals that a novel approach to treating bacterial infection is by increasing the killing capacity of cells of the innate immune system. In a related commentary, Kol Zarember and Harry Melach write, “By dissecting the role of HIF-1 in innate immune defenses, the study…introduces new targets for therapeutic immunomodulation.”

View the PDF of this article at: https://www.the-jci/article.php?id=25740

Journal of Clinical Investigation
https://www.the-jci Continue reading →

When individuals infected with HIV become infected with a second strain of the virus, the two viral strains can exchange genetic information, creating a third, recombinant strain of the virus. It is known that the presence of multiple viral strains, called superinfection, frequently leads to a loss of immune control of viral levels. Now a study from the Partners AIDS Research Center at Massachusetts General Hospital (PARC/MGH) shows that how and where viral strains swap DNA may be determined by the immune response against the original infecting strain. Their report will appear in the Journal of Experimental Medicine and has been released online.

“The implication that recombination events are selected by immune responses identifies a new mechanism for the virus to escape the patient’s immune system, which would present additional challenges to vaccine design,” says Hendrik Streeck, MD, PhD, of PARC/MGH, one of the paper’s lead authors. “This finding also has worldwide implications for the development of more complex strains of HIV.”

Part of the immune system’s response against HIV is carried out by HIV-specific CD8 T cells, also called cytotoxic T lymphocytes (CTLs), which can identify and kill virus-infected cells. Previous PARC/MGH research showed that the effectiveness of the CTL response varies depending on which version or allele of an immune system molecule called HLA Class I an individual has inherited. The current study was undertaken to investigate why an HIV-positive research participant known to have a powerfully protective Class I allele called HLA-B27 began to experience rapid increases in viral levels much sooner than would have been expected.

An examination of blood samples from this individual revealed that his immune response against HIV had predictably controlled the virus for about a year and a half after he was first diagnosed. The effective CTL response was primarily directed against a short segment of the Gag protein typically targeted in HLA-B27 patients.

Analysis after the abrupt increase in viral levels showed that the patient had become infected with a second strain of HIV, and two months later it was found that the two strains had exchanged portions of their Gag sequences initially targeted by his CTLs, allowing the virus to escape from that immune response. The patient’s viral loads stabilized for a while but rose again several months later, when it was found that a second HIV mutation that more effectively evades control by HLA-B27 had developed, possibly in response to a second recombination of viral sequences.

“The first Gag recombination event facilitated escape from the primary immune response, shortly after which the immune response recovered to recognize this mutant strain,” Streeck explains. “After the second recombination event and emergence of a more potent mutation, there was a dramatic reduction in the CTL response against both versions, leading to a significant increase in viral loads.”

Todd Allen, PhD, of PARC-MGH, the study’s senior author adds that, while recombination itself appears to be a random event, recombinant strains that are better able to evade the immune system are likely to become dominant through natural selection. He also stresses that even patients whose immune systems can partially control HIV should avoid a secondary infection that could lead to the development of an uncontrollable, recombinant viral strain.

Streeck notes, “Given the growing frequency of recombinant HIV strains worldwide, we need to better understand how immune system pressures may be driving their development and also determine how frequently patients exposed to a second strain of HIV become superinfected.” He is a research fellow in Medicine at Harvard Medical School, where Allen is an associate professor of Medicine.

###

Additional co-authors of the report are co-lead author Bin Li, PhD, Arne Schneidewind, MD, Adrienne Gladden, Karen Power, Suzane Bazner, RN, Christian Brander, PhD, Eric Rosenberg, MD, and Marcus Altfeld, MD, PhD, of PARC-MGH; Art Poon, PhD, and Simon Frost, PhD, University of California at San Diego; Demetre Daskalakis, MD, New York University School of Medicine; and Rosario Zuniga, PhD, Asociacion Civil IMPACTA Salud y Educacion, Lima, Peru. The study was supported by grants from the National Institutes of Health.

Massachusetts General Hospital (massgeneral/), established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.

Source: Sue McGreevey

Massachusetts General Hospital Continue reading →

Children with asthma are at increased risk of developing pneumonia as a complication of influenza, reports a study in the July issue of The Pediatric Infectious Disease Journal. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Infants and children less than five years old are also at higher risk of developing pneumonia while hospitalized for influenza, according to the new study, led by Dr Fatimah S. Dawood of the Centers for Disease Control and Prevention (CDC).

Findings May Help in Targeting Children at Highest Risk

Using the CDC’s Emerging Infections Program (EIP) Network database, the researchers identified nearly 3,000 children who were hospitalized for influenza over five consecutive flu seasons-2003 to 2008. Based on a review of chest x-rays, 27 percent of the children had influenza-related pneumonia. Children with pneumonia were more likely to be admitted to the intensive care unit, 21 versus 11 percent; and to require mechanical ventilation, 11 versus three percent. Although the overall risk of death was low, it was three times higher in children with pneumonia: 0.9 versus 0.3 percent.

Children with asthma were more likely to develop pneumonia-40 percent more likely, after adjustment for other factors. Children less than five years old were also at higher risk of pneumonia. Risk was twice as high in infants between six months and two years old, and 70 percent higher in children aged two to four.

Pneumonia is a common and serious complication of influenza in children. Previous studies have identified risk factors for pneumonia in adults with influenza, but not in children.

The new study finds that asthma is a risk factor for pneumonia in children hospitalized for influenza. This is especially important since children with asthma are more likely to develop influenza in the first place. In the study, asthma was the most common pre-existing condition, present in nearly one-fourth of children.

The results also show that children with pneumonia have a more severe clinical course, including higher rates of mechanical ventilation and death. The authors note that most of the children in the study did not receive antiviral medications such as oseltamivir (Tamiflu), which can improve influenza outcomes if given early enough.

Dr. Dawood and co-authors also point out that less than half of children in the study had received yearly influenza vaccinations, which are recommended for most children over six months old. The researchers hope their results “will help to identify children who might benefit most from early antiviral treatment and inform the development of prevention strategies that target children at risk for severe influenza complications.”

Source:

Wolters Kluwer Health: Lippincott Williams & Wilkins

View drug information on Tamiflu capsule. Continue reading →

Despite national guidelines aimed at improving sexual health services for teenagers, most sexually active boys – even those who report high-risk sexual behaviors – still get too little counseling about HIV and other sexually transmitted infections (STIs) during their visits to the doctor, according to a study led by researchers at Johns Hopkins Children’s Center.

The study, published online ahead of print in the Journal of Adolescent Health, analyzed data from the 1995 National Survey of Adolescent Males and the 2002 National Survey of Family Growth, found that only 26 percent of teens who reported high-risk sex – such as having sex with a prostitute or an HIV-infected person or having sex while high or drunk – said they received HIV/STI counseling at the doctor’s office in the year preceding the survey. Twenty-one percent of all sexually active boys, regardless of risk, said they discussed HIV and other STIs with their doctors.

The study also found no improvement in how well teenage males were screened for STIs and HIV between 1995 and 2002, even though in the early 1990s, the American Medical Association and the American Academy of Pediatrics both issued guidelines urging physicians to make sexual health counseling and related services part of the regular exam for teenagers.

The researchers say their findings signal the need for better STI counseling of young male patients in order to minimize risky behaviors.

“If guidelines alone can’t change what is being done at the doctor’s office, then the million-dollar question becomes how to get doctors and nurses to talk with their patients about sexual health,” says lead investigator Arik Marcell, M.D., M.P.H., a pediatrician and adolescent medicine specialist at Hopkins Children’s.

Marcell and colleagues say the first step to better counseling is the use of evidence-based, uniform guidelines to reduce confusion among providers. And, they say, it is critical to understand what prevents providers from counseling and devise ways to eliminate any such barriers.

In the meantime, pediatricians on the frontlines should ACT: ask, counsel, test. “Ask the patient if he is sexually active, counsel him about risk and test accordingly,” Marcell says.

Other findings in the current study:

- In 1995, less than one-fourth of male teens said they had discussed STIs and HIV with a doctor or a nurse, compared to less than 22 percent in 2002.
- In 2002, less than 18 percent of males reported ever discussing birth control with their doctors. The 1995 survey did not include birth control questions.

The research was funded with support from the National Institutes of Health and the Ford Foundation.

Co-investigators included David Bell, M.D. M.P.H., of Columbia University Medical Center; Laura Duberstein Lindberg, Ph.D., of the Guttmacher Institute; and Adel Takruri, from the Johns Hopkins Bloomberg School of Public Health.

Related on the Web:
HIV Antibody Tests Unreliable For Early Infections In Teens
HIV Treatment Lagging Behind for Many Infected Youth
Myths About Manhood Keep Teen Boys from Sexual Health Care
CDC data on STDs

Source
Johns Hopkins Medicine Continue reading →

Many people who know their sexual partners well consider themselves to be at a low risk of sexually transmitted infections, including HIV, according to a study published in the June issue of Sexually Transmitted Diseases, Reuters reports.

For the study, Cindy Masaro of the University of British Columbia and colleagues distributed questionnaires to 317 men and women who were attending an STI clinic for the first time and had not yet been diagnosed with an STI. The questionnaire asked whether people could be “pretty sure” a sex partner was “safe” in certain circumstances, such as if they knew the partner well, knew the partner’s friends or believed they could trust the partner.

The study found that people often considered subjective measures in determining whether a sex partner would put them at increased risk for HIV and other STIs. Many people determined their partner’s “safety” based on how long they had known the partner or on how intelligent or well-educated the partner was. In addition, 70% of participants said they probably would consider a partner “safe” if the partner generally was trustworthy.

According to the researchers, earlier studies have found that although many people are “confident in their assessments of their partner’s character,” their knowledge of their partner’s STI risk often is inaccurate. The researchers said that interventions that “target assumptions of safety and dispel incorrect beliefs about the selection of safe partners [are] needed to promote safer-sexual behavior” and reduce the risk of STI transmission (Reuters, 6/25).

An abstract of the study is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Despite current media reports about CDC’s estimates of new HIV infections in the USA, Dr. Kevin Fenton, Director, , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC (Centers for Disease Control and Prevention) stresses the new estimates are not yet final.

Dr. Fenton said “In recent years, CDC has worked to develop an innovative system designed to estimate the number of new HIV infections in a given year. As a result of new technology that can distinguish recent from longstanding infections, the new system will provide the clearest picture to date of new HIV infections in the United States. Given the importance of the new estimates in guiding HIV prevention policy and programs, CDC’s public health responsibility is to ensure accurate information. The estimates have been submitted for further analysis and rigorous scientific review to ensure the accuracy of the complex new methods and of the estimates themselves.”

Fenton went on the explain that the new estimates use complex methods based on several statistical assumptions. Any kind of alteration to those assumptions during the scientific review process will have an impact on the final estimates. “It would not be responsible for CDC to discuss specific data before we are certain that the new estimates are reliable.”

The CDC takes seriously its commitment to providing an accurate and timely picture of the HIV epidemic at home (in the USA), he added. Fenton said the CDC is moving as quickly as possible to complete, confirm, and release these important new estimates.

The new estimates are expected to be released at the beginning of next year, Fenton said.

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Continue reading →

A Ugandan drug trial’s findings that the AIDS medication nevirapine is effective and safe in preventing HIV transmission
from mother to unborn child during birth were well-supported, according to a new, independent analysis by the Institute of
Medicine of the National Academies. The IOM’s analysis of the design and methodology of the 1997 drug study in Uganda, called
HIVNET 012, determined that policy-makers and other scientists can rely on the resulting data and conclusions, despite some
flaws in record keeping and procedural issues.

“The data from the HIVNET 012 study, which showed that nevirapine effectively prevents many infants from contracting HIV from
their infected mothers, are sound and reliable,” said James Ware, chair of the committee that wrote the report, and professor
of biostatistics, Harvard School of Public Health, Boston. “None of the shortcomings that we discovered upon reviewing the
data and conducting our own original analysis of source documents indicates a need to retract or discount the study’s
findings. Our confidence in the trial’s data and findings is based on several factors, including evidence that the study’s
design was both scientifically sound and ethically implemented, that participants adhered well to the treatment regimens, and
that a high percentage of participants remained in the study so that the effectiveness and safety of the drug could be
thoroughly assessed.”

Previous evaluations of HIVNET 012 left lingering uncertainties about the trial’s results, suggesting the need for a
definitive, objective review. The IOM focused on the scientific validity of the study’s conclusions based on a close
examination of how researchers from Johns Hopkins University and Uganda’s Makerere University conducted the trial. This
independent review was requested and funded by the National Institutes of Health, which also funded the original trial in
Uganda.

The committee did not evaluate the trial’s oversight by the National Institutes of Health. It also did not examine the impact
of other recent studies of potential toxicity or resistance buildup associated with the use of nevirapine either in short- or
long-term treatment of HIV-infected individuals.

Because of inconsistencies in and challenges to previous audits, the committee undertook its own assessment of the accuracy
and completeness of the trial’s reporting through a review of medical records and other primary source documents for a subset
of 49 infants involved in the trial. In addition, the committee reviewed information provided by NIH, the original
investigators, previous audits of the trial, and other information brought to its attention. The findings of the HIVNET 012
study previously underwent audits by Westat Corp. and by NIH’s Division of AIDS (DAIDS).

The Hopkins and Makerere researchers’ conclusion that nevirapine is effective is supported by data on rates of survival and
HIV infection among newborns in the study, the committee determined, noting that the trial researchers accurately recorded
that information in the database created for the study. No evidence was found that the trial researchers either failed to
report or mistakenly reported the deaths of any of the infants.

Regarding the trial researchers’ findings on nevirapine’s safety, the committee’s review of source documents for the subset
of 49 infants found that deaths, hospitalizations, and serious adverse events observed during clinic visits also were
recorded accurately in the trial database. In some instances, however, not all serious adverse events that occurred
simultaneously were reported, and some less-serious adverse events were underreported.

However, there was no evidence of a difference in the level of underreporting of adverse events among patients receiving
nevirapine versus those receiving zidovudine, a second AIDS drug that also was studied in HIVNET 012. The trial
investigators’ comparative findings on safety are valid, the committee said.

Questions in previous audits about whether any adverse events had been missed stemmed from the trial investigators’ use of a
narrow but acceptable interpretation of what counted as “serious.” The Hopkins and Makerere researchers used hospitalization
as the principal — but not sole — determinant to classify clinical events as “serious” to take into account the high
prevalence of malaria, tuberculosis, and other concurrent health problems in Uganda. The IOM report finds that the
investigators’ use of a narrow interpretation was reasonable, but it means that other researchers may not be able to
generalize the study’s total rate of adverse events to all settings. Other settings — such as countries with lower rates of
endemic diseases — may have different thresholds for hospitalization and interpretations of what counts as “serious.”

Another concern about HIVNET 012 focused on whether cases of jaundice — or hyperbilirubinemia — among infants in the study
were underreported. While the study investigators reported only one infant with abnormal levels of bilirubin, a subsequent
safety report issued by DAIDS initially stated that there were 63 cases of elevated bilirubin. DAIDS later retracted the
safety report as incorrect. The IOM committee, based on its own analysis, determined that the DAIDS safety report initially
used an incorrect upper limit of the normal range for bilirubin levels in newborns. When the correct upper limit is applied,
the trial data confirm the original HIVNET 012 investigators’ findings and the subsequent DAIDS retraction.

Overall, the Hopkins and Makerere researchers conducted the trial ethically and in accordance with U.S. and international
standards for research and management of patient care, the IOM report says. Although there were some problems with full
documentation of compliance with all the requirements for the trial, the committee determined that the HIVNET 012 study was
designed and implemented with approval from the boards that oversaw the trial’s design and protocols; that the researchers
enrolled women only after they gave free and informed consent; and that fathers were involved in the consent process when
they were reasonably available.

Blood tests that detected the presence of nevirapine in mothers and infants and other data showed that trial participants
received the right drug and there was a high level of adherence to the treatment regimens, the committee found. It also noted
that trial investigators achieved high rates of retention and follow-up among participants.

The committee found no reason that medical journals should revise or retract articles that reported on the efficacy and
safety of nevirapine for reducing mother-to-child transmission of HIV based on the HIVNET 012 trial.

The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional
charter granted to the National Academy of Sciences. A committee roster follows.

A pre-publication version of Review of the HIVNET 012 Perinatal HIV Prevention Study is available from the National Academies
Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at nap.edu. Reporters may obtain a pre-publication copy from the Office of News and Public
Information (contacts listed above).

[ This news release and report are available at national-academies]

INSTITUTE OF MEDICINE
Board on Population Health and Public Health Practice

Committee on Reviewing the HIVNET 012 Clinical Trial
James H. Ware, Ph.D. (chair)
Dean for Academic Affairs, and
Frederick Mosteller Professor of Biostatistics
School of Public Health
Harvard University
Boston

R. Alta Charo, J.D.
Elizabeth S. Wilson Professor of Law and Bioethics
University of Wisconsin Law School and Medica1 School, and
Associate Dean
University of Wisconsin Law School
Madison

Ezra C. Davidson Jr., M.D.
Associate Dean of Primary Care, and
Professor of Obstetrics and Gynecology
Charles R. Drew University of Medicine and Science
Los Angeles

Wafaa El-Sadr, M.D., M.P.H., M.P.A.
Director
Center for Infectious Diseases Epidemiologic Research, and
Professor of Clinical Medicine and Epidemiology
Mailman School of Public Health
Columbia University
New York City

Mark W. Kline, M.D.
Professor of Pediatrics;
Chief of Retrovirology;
Director, AIDS International Training and Research Program;
Director, Baylor-CDC Global AIDS Technical Assistance Project; and
Associate Director of General Clinical Research Center
Baylor College of Medicine
Houston

Stephen W. Lagakos, Ph.D.
Henry Pickering Walcott Professor of Biostatistics and Chair
Department of Biostatistics
School of Public Health
Harvard University
Boston

J. Richard Landis, Ph.D.
Professor of Biostatistics, and
Director, Division of Biostatistics
Department of Biostatistics and Epidemiology
School of Medicine
University of Pennsylvania
Philadelphia

George W. Rutherford III, M.D.
Salvatore Pablo Lucia Professor of Preventive Medicine;
Professor-in-Residence of Epidemiology, Preventive Medicine, Pediatrics, and Family and Community Medicine;
Head, Division of Preventive Medicine and Public Health; and
Interim Director of Institute for Global Health
University of California
San Francisco

Charles van der Horst, M.D.
Professor of Medicine and Associate Chief
Division of Infectious Diseases
School of Medicine
University of North Carolina
Chapel Hill, and
Visiting Professor
University of the Witwatersrand
Johannesburg, South Africa

INSTITUTE STAFF

Alicia R. Gable, M.P.H.
Study Director

Rose Marie Martinez, Sc.D.
Director, Board on Population Health and Public Health Practice

Contact: Christine Stencel
newsnas.edu
202-334-2138
The National Academies
nas.edu Continue reading →

1. Current Stool DNA Tests Not Effective, Cost-Effective for Colorectal Cancer Screening

Questions about test accuracy and cost make the role of a stool DNA test screening for colorectal cancer uncertain. The Centers for Medicare & Medicaid Services (CMS) initiated a National Coverage Determination process to assess under which conditions a stool DNA test would be a cost-effective option for colorectal cancer screening among average-risk Medicare patients. Using a computer model with assumptions based on best available data, researchers concluded that stool DNA testing every three to five years was both more costly and less effective than yearly screening with a sensitive fecal occult blood test, an older test for colorectal bleeding. According to the study authors, even if the test sensitivity were improved, stool DNA testing still would not be cost-effective unless the price was reduced from about $350 to about $50 per test and it was used by a large proportion of the population who might not otherwise be screened.

2. Using Proton Pump Inhibitors and Clopidogrel Together Does Not Increase Risk for Adverse Cardiovascular Outcomes Following First Heart Attack

Due to concerns about risk for adverse cardiovascular reactions such as heart attack, the U.S. Food and Drug Administration and the European Medicines Agency recently discouraged the combined use of proton pump Inhibitors (PPIs) and clopidogrel unless patients had a very strong indication for simultaneous use of these drugs. Using data from hospitals in Denmark, researchers sought to determine the risk for adverse cardiovascular outcomes in patients who simultaneously used the two agents compared with patients who used only PPIs. The researchers found that patients who received clopidogrel and PPIs had similar risks for adverse cardiovascular events as those of patients who received PPIs alone. These results refute concerns about increased risk for ischemic events when using these therapies together.

3. HIV Study Shows More Work Needed to Recruit and Retain Women for Clinical Trials

Women, especially women of color, have been underrepresented in clinical trials of HIV treatment. However, some studies suggest that women with HIV infection are less likely to respond to HICV treatments than their male counterparts. The current study assesses sex-based differences in efficacy of HIV treatments and evaluates the incidence of adverse events among HIV-positive patients taking darunavir-ritonavir-based therapy. The study, which purposefully enrolled a high proportion of treatment-experienced North American women, found no statistically significant differences between women and men in either treatment efficacy or occurrence of clinically relevant adverse events after 48 weeks. However, women were more likely to discontinue study participation for a variety of reasons other than virologic failure. The researchers conclude that any numeric differences in response rates between men and women in the study were probably not driven by differences in true virologic response to therapy, but rather by higher discontinuation rates in women for other reasons.

4. Evidence Review Reaffirms USPSTF Recommendation Against Screening for Testicular Cancer

In 2004, the U.S. Preventive Services Task Force (USPSTF) recommended against screening for testicular cancer due to its relative rarity, the lack of evidence showing the accuracy of clinical or self-examination, and highly favorable outcomes from treatment of cancers identified when patients developed testicular symptoms. Instead, the USPSTF encouraged clinicians to consider testicular cancer when patients present with testicular symptoms. This review searched for new research published since 2004 to inform an updated USPSTF recommendation and found no new evidence on the benefits or harms of screening for testicular cancer that would alter the previous recommendation against screening.

Early Release:

5.Thigh-Length Compression Stockings More Effective than Knee-Length for Preventing DVT After Stroke

Graduated compression stockings are widely used to prevent deep venous thrombosis (DVT) in patients who have limited mobility from conditions such as stroke. However many questions remain about the effectiveness of these stockings including whether below-knee or thigh-length stockings are more effective at preventing DVT. Researchers randomly assigned 3,114 patients admitted to the hospital with acute stroke between 2002 and 2009 to wear either thigh-length stockings or knee-length stockings while in the hospital. Ultrasonography in 1,406 patients in each treatment group between 7 and 10 days after enrollment and a second scan in 643 patients in the thigh-length group and 639 in the below-knee group at 25 to 30 days showed that DVT occurred more often in patients with stroke who wore below-knee stockings than in those who wore thigh-length stockings.

Source:
Angela Collom
American College of Physicians Continue reading →

More than 200 HIV advocates, people living with HIV/AIDS and commercial sex workers rallied in the Indian city of Pune on Thursday, calling for the passage of a bill that aims to reduce HIV/AIDS-related stigma and discrimination, India’s Daily News & Analysis reports (Daily News & Analysis, 5/23).

The bill, which is under consideration by India’s Ministry of Law and Justice, would appoint health officials in all districts in the country to address HIV/AIDS-related stigma and discrimination. The bill in its current form includes measures such as the right to equality, autonomy, privacy, health, safe working environments and information. According to Anand Grover, director of the HIV/AIDS unit at the Lawyers Collective, the bill calls for an official, or ombudsperson, to be appointed in every district of the country to hear cases of HIV/AIDS-related discrimination and ask for audits. Individuals also would be permitted to approach courts directly without contacting an ombudsperson, according to the bill. The bill already has been accepted by the Ministry of Health and Family Welfare (Kaiser Daily HIV/AIDS Report, 2/22).

The advocates raised slogans, such as “Discrimination Kills, Pass the HIV Bill.” They also met with Pune’s Municipal Commissioner Pravinsinh Pardeshi, who said their concerns would be forwarded to the state government, and other health officials. The rally, which was organized by sex workers, drew representatives from the Soudamini Network of Positive Women, the Deep Griha Society and other nongovernmental organizations.

Ujwala Kadam of SNPW said the protesters “wanted to reach out to the civic body and the district health machinery, sensitize them to our cause and seek their support for the bill.” HIV advocate Pankaj Bedi said the bill “ensures a legal framework in place for protecting the right to quality health care and right to information,” adding that its passage is “imperative.” A sex worker attending the rally added that the bill is “empowering” and will help sex workers and people living with HIV/AIDS “seek medical services without any discrimination” (Daily News & Analysis, 5/23).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

Lisa Power, Head of Policy at Terrence Higgins Trust said: “Multi-drug-resistant HIV is known, both in the US and in
Canada. It is the result of treatment, which fails, either because the drug is not strong enough, or because it is not taken
at the right time. Multi-drug-resistant strains of HIV can be passed on.

“This case is certainly worrying, but it is important to bare in mind that complete drug resistance is still very rare, and
that people with the same strain of HIV can progress at very different speeds to AIDS symptoms.”

Oliver Wright
Terrence Higgins Trust
Terrence Higgins Trust
52-54 Grays Inn Road
London
WC1X 8JU
United Kingdom
Tel: 020 7831 0330
Fax : 020 7242 0121
Email : infotht
Open: Mon to Fri 9.30am – 5.30pm

Tube: Chancery Lane Continue reading →