News from aidsmap

Approximately 4.2 million over 50s are now living with HIV

Persuasive new data showing the ageing of the global HIV epidemic have been published in the online edition of AIDS. Using UNAIDS prevalence figures, investigators estimated that 4.2 million people aged 50 years or older were living with HIV in 2013. Prevalence among older people has more than doubled since 1995. Comparison with alternative data sources suggested that the UNAIDS figure was generally reliable.

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Counselling during routine HIV care reduces rates of risky sex among people on ART in South Africa

HIV prevention counselling delivered during routine care reduces sexual risk behaviour in people receiving antiretroviral therapy (ART) in South Africa, according to research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes. Approximately 2000 people were randomised to receive risk-reduction counselling or standard of care. Over 18 months of follow-up, people in the intervention arm were less likely to report any recent unprotected sex and also recent unprotected sex with a partner who was HIV negative or of unknown HIV status.

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The treatment cascade in the United States – good in Ryan White programmes, but overall picture for gay men is poor

People living with HIV in the United States who receive their care through the Ryan White HIV/AIDS Program have good rates of retention and virological suppression, investigators report in the online edition of Clinical Infectious Diseases. Of the patients seen at least once in 2011, some 82% were retained in care and 73% achieved virological suppression.

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People with hepatitis B who have cirrhosis should be prioritised for liver cancer screening

Liver cancer screening for people with hepatitis B virus (HBV) infection should be targeted at those with cirrhosis, according to the results of a systematic review and meta-analysis published in PLOS ONE. The risk of hepatocellular carcinoma (HCC) and death were 31- and 44- times higher, respectively, in people with liver cirrhosis compared to people who did not have cirrhosis. Moreover, incidence among people without cirrhosis was well below the threshold of screening cost effectiveness.

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PrEP will need high adherence, high effectiveness and high coverage in specific populations to be affordable in the US, New York study finds

A study based on New York City that modelled pre-exposure prophylaxis (PrEP) uptake there has found that, in order to be affordable, PrEP would need to be tightly targeted at gay men at higher risk of HIV infection. Within this target population, it would need high levels of usage.

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Nearly half of HIV-positive gay men could benefit from being vaccinated against HPV, say Irish researchers

A study of gay men in Ireland that has investigated the prevalence of infection with human papillomavirus (HPV), some types of which cause genital warts and cervical, anal and oral cancers, concludes that 47% of HIV-positive and 64% of HIV-negative gay men would benefit from being given one of the HPV vaccines against the two most common cancer-causing types.

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Treatment of worm infections leads to increases in CD4 counts and haemoglobin and fall in viral load for HIV-positive women taking ART

De-worming is associated with falls in viral load and increases in CD4 count and haemoglobin, in pregnant women living with HIV and receiving antiretroviral therapy (ART), according to the results of a study conducted in Rwanda and published in the online edition of Clinical Infectious Diseases. Albendazole – a cheap treatment for helminth infections – was provided to 980 women.

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London gay men: 2% of the population, a quarter of the sexually transmitted infections and half of HIV infections

Men who have sex with men (MSM) living in London have particularly poor sexual health and this is worsening, Public Health England warn in a report published yesterday. The report calls on commissioners and providers of sexual health services to focus on the needs of this group: “Improving sexual health in MSM should be made the highest sexual health priority in London,” they recommend.

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HIV infection associated with an increased risk of the diseases of ageing

HIV infection is associated with an increased risk of several diseases of old age, according to Dutch research published in the online edition of Clinical Infectious Diseases. Researchers compared the risk of cardiovascular, renal (kidney) and bone disease between older people living with HIV and matched HIV-negative controls. All diseases of ageing were more prevalent in people living with HIV, cardiovascular disease and renal dysfunction significantly so. Traditional risk factors were associated with an increased risk of these morbidities, but so too was infection with HIV, as well as longer duration of immune suppression and systemic inflammation.

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HCV antibody testing may miss recent infections in gay men living with HIV

Nucleic acid testing should be used to diagnose acute hepatitis C virus (HCV) infections in gay men living with HIV, Dutch research published in the online edition of Clinical Infectious Diseases shows. HCV antibodies only developed a median of 74 days after infection with the virus. Over half of people who had a successful response to HCV therapy lost their HCV antibodies during follow-up. However, there was a high rate of re-infection, and these could be reliably diagnosed using antibody testing.

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Editors' picks from other sources

Selling the end of AIDS

from Poz

As slogans anticipating an end to the AIDS epidemic gain popularity, skeptics worry that such promises are hollow and unrealistically ambitious, and that failure to deliver will ultimately set back efforts to combat HIV.

Choosing to love poz guys

from Betablog

Jake Sobo writes: "The serodivide is crumbling. Hookup sites that used to allow only two options for HIV status now offer endless choices, from undetectable to on PrEP. Recent life expectancy projections suggest that gay men who test HIV-positive today and start treatment quickly will live longer than those who do not...Unlearning decades of stigma and fear will not happen overnight. It will take time and learning. That’s okay. But the cost of staying in place is too great, both for poz guys who face that stigma and fear on a daily basis, and to our communities which remain divided."

Treatment Action Campaign faces closure

from Health-e

After almost two decades spent fighting for HIV treatment and access to medicines, the Treatment Action Campaign (TAC) may close its doors due to a severe funding shortage.

Early HIV drugs are 'not a cure'

from BBC Health

Giving drugs within hours of HIV infection is not a cure for HIV, according to doctors treating a baby in Milan.

Is a study of HIV treatment for mothers in Africa unethical?

from Health Affairs (blog)

A global health controversy erupted this summer when the prominent scientific journal Nature ran an article entitled “HIV trial attacked.” Within, commentators squared off over whether a huge ongoing study provides suboptimal and thus unethical treatment options to mothers with HIV in the developing world.

Countries ready to “Fast Track” response to end the AIDS epidemic by 2030

from UNAIDS

High-level panel emphasises fragile five-year window for rapid and massive acceleration of HIV treatment and prevention services. New agreement to reduce cost of viral load tests for HIV to below US$10 will improve the quality of life for millions of people on HIV treatment