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August 9, 2010
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Message from the Editor
Welcome to e-HAP FYI—one of a series of new communication products that expands the Division of HIV/AIDS Prevention’s (DHAP) ability to reach you with timely, targeted information critical to our collective prevention efforts.
We have designed e-HAP FYI as a monthly digest—with a built-in flexibility that will allow us to share important HIV prevention information as it becomes available. You can expect to receive e-HAP FYI at least once a month—and more often, when warranted. As we strive to make these new communication products valuable and informative, we welcome and encourage suggestions and feedback. We need to hear from you to ensure that we are conveying the most relevant and useful HIV prevention information possible. To provide feedback, you can contact the Office of Communications at DHAPCommunications@cdc.gov. Go to top
What’s New in HIV Prevention?
NHAS Provides Roadmap for Reducing HIV Infection
On July 13, Health and Human Services Secretary Kathleen Sebelius, White House Domestic Policy Council Director Melody Barnes, Office of National AIDS Policy Director Jeffrey Crowley, and HHS Assistant Secretary for Health Dr. Howard Koh unveiled the National HIV/AIDS Strategy (NHAS) and discussed its goals and details. Reflected in NHAS are
many of the approaches CDC agrees will have the most impact in reducing HIV infections, including
- Expanding prevention and treatment services for persons living with HIV disease;
- Targeting prevention interventions to persons at the very highest risk
for HIV infection;
- Strengthening HIV prevention strategies and combination approaches in communities disproportionately affected by HIV/AIDS, specifically gay, bisexual and other men who have sex with men, African Americans, Latinos, and injection drug users; and
- Intensifying efforts in geographic areas where HIV disease is most heavily concentrated.
NHAS gives us an opportunity to redefine our nation’s approach to HIV prevention and calls for shared responsibility—across agencies, across sectors and communities, and among all Americans—to end the epidemic.
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XVIII International AIDS Conference
Leaders and scientists from DHAP and the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention (NCHHSTP) joined the federal delegation attending the
International AIDS Conference in Vienna, Austria, July 18–July 23. DHAP had 55 scientific submissions
accepted to the conference program, including oral presentations, oral posters, and poster sessions.
Additionally, NCHHSTP Director
Dr. Kevin Fenton participated in a satellite session held in Vienna on the NHAS. Highlights of three key
presentations—one from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and two
from CDC—follow.
- Ground-breaking results from a much-anticipated HIV prevention study among women in South Africa showed that use of a tenofovir-based vaginal gel, called a microbicide,
when applied before and after sex, reduced HIV infection by 39%—and by 54%
for women who used it consistently. The study, led by CAPRISA, a South African multi-institutional AIDS
research organization, also showed that women who
used the gel had a 51% reduced risk of developing genital herpes—a lifelong, incurable
infection that also facilitates HIV transmission. For more details,
see CDC Statement on
CAPRISA Microbicide Study Results.
- CDC released a first-of-its-kind analysis showing that 2.1% of heterosexuals
living in high-poverty areas of 23 major U.S. cities are infected with HIV—more
than four times the national average (0.45%). Data also showed an inverse correlation
between income and HIV prevalence among heterosexuals living in these poor urban areas:
the lower the income, the higher the prevalence of HIV. More heterosexuals whose household
income was below the poverty line were infected with HIV (2.4%) than those whose income was
above it (1.2%). These findings support NHAS recommendations to move beyond individual focus to
better understand and address the larger landscape in which people live. For more information, see
New CDC Analysis Reveals
Strong Link Between Poverty and HIV Infection and the
poster presented at IAC.
- Preliminary findings from the first CDC study to examine the clinical and behavioral safety of tenofovir taken daily for HIV prevention among men who have sex with men (MSM) identified no significant safety concerns in this population—and suggest no increase in risk behavior associated with pill taking. The approach of taking a daily antiretroviral drug to try to prevent HIV infection is known as pre-exposure prophylaxis, or PrEP, and studies around the world are currently underway to determine if it is effective at reducing HIV infection among persons at high risk, including MSM, injection drug users, and heterosexual men and women. While results from the efficacy trials are not anticipated until early 2011, this safety study suggests that the strategy may be well-tolerated in MSM, should it prove effective. Get more information
about this study.
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Estimated Future HIV Prevalence, Incidence, and Potential Infections Averted in the United States: A Multiple Scenario Analysis
In a
new analysis published online in the Journal of Acquired Immune Deficiency Syndromes
(JAIDS), researchers from CDC and the Johns Hopkins Bloomberg School of Public Health modeled future HIV incidence, prevalence, and infections averted over the next 10 years in 5 scenarios: 3 base-case scenarios (steady incidence, steady transmission rate, declining transmission rate) and 2 intensified HIV intervention scenarios (50% reduction in transmission rate within 10 and 5 years).
Maintaining HIV prevention efforts at the current level would substantially increase
the number of persons living with HIV disease—and associated health care costs
to provide treatment and care to those who become
infected within the next decade. The JAIDS study shows that the faster we act, the more lives and
money we can save. Intensifying the nation’s HIV prevention efforts would significantly
reduce the number of annual new infections and potentially save hundreds of thousands of lives.
If we can scale up prevention in 5 years, annual HIV incidence would decrease 46%—from 55,400
to 30,200—saving an
additional 306,000 persons from becoming infected and over $100 billion in health care costs.
Read
the CDC Factsheet: Projecting Possible Future Courses of the HIV Epidemic in the United States
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U.S. Department of Health and Human Services (HHS) Releases Implementation Guidance for Syringe Services Programs
On July 7, HHS released guidance for state health departments interested in implementing, with FY 2010 appropriated dollars, syringe services programs (SSPs) for injection drug users (IDUs) as part of a comprehensive HIV prevention program. The term SSP is inclusive of syringe access, disposal, and needle exchange programs, as well as referral and linkage to HIV prevention services, substance abuse treatment, and medical and mental health care.
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National Institutes of Health (NIH)-Led Scientists Find Antibodies That Prevent 90% of HIV Strains from Infecting Human Cells
According to the scientists, these antibodies could be used to design improved HIV vaccines, or could be further developed to prevent or treat HIV infection. The method used to find these antibodies could also be applied to isolate therapeutic antibodies for other infectious diseases. Read the press release from the National Institute of Allergy and Infectious Diseases and the full text of the report in Sciencexpress.
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HHS Reallocates $25 Million to Extend Care to People on ADAP Waiting List
On July 9, HHS Secretary Kathleen Sebelius announced the reallocation of $25 million for AIDS drug assistance to states that have AIDS Drug Assistance Program (ADAP) waiting lists or have implemented strategies to contain costs and delay or prevent a waiting list. This action will provide states with additional resources to improve access to critical HIV/AIDS prescription drugs. For more information, see the fact sheet and a post by Mary Wakefield, Administrator, Health Resources and Services Administration (HRSA).
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HIV/AIDS Treatment Curbs Spread of HIV Among Drug Users
On July 18, Lancet published an article supported by the National Institute on Drug Abuse, which shows that highly active antiretroviral therapy (HAART) curbs the spread of HIV among persons with a history of injection drug use. Additionally, the findings point to a correlation between increased HAART coverage and a reduction in the spread of HIV in the general population. HAART—a combination of drugs that target HIV at different points in its lifecycle—suppresses the virus, stopping disease progression and prolonging survival in persons diagnosed with HIV disease and AIDS. In this study, Canadian researchers found that increasing levels of HAART coverage in British Columbia were strongly associated with decreases in viral load and new HIV diagnoses on a population level. This study, although focused on a population with free access to HIV care, has important implications for combining biomedical, behavioral, and structural approaches to preventing HIV infection in communities across the United States. See the press release.
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Act Against AIDS Phase Released
On June 17, CDC launched HIV Screening. Standard Care. (HSSC), a phase of the Act Against AIDS national communication campaign designed to help physicians make HIV testing a routine part of medical care. The HSSC program provides tools and resources to primary care providers for incorporating HIV testing into primary care settings, including an annotated physician’s guide with CDC’s testing recommendations and underlying rationale for them, a patient brochure and poster explaining the need for HIV screening, and a new webpage where physicians can get more information. For more details, read the press release.
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Resources
July/August Public Health Reports supplement, Social Determinants of Health
Act Against AIDS (AAA) First Year-End Report
HIV/AIDS Prevention and Service Provider Locator
View upcoming conferences and observances.
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