Kaisernetwork.org (Washington, DC)
1 May 2008
Science & Medicine
Specific Adverse Effects of Antiretroviral Therapy Vary Depending on Race, Gender, Study Says
Global Challenges
Two PEPFAR-Funded Methadone Clinics Open in Vietnamese Port City
HIV/AIDS Services in Northern Cote d'Ivoire Still Unavailable
Media & Society
mtvU, Kaiser Family Foundation, POZ Magazine Launch Online Game To Confront HIV/AIDS-Related Stereotypes
Public Health & Education
Antigua, Barbuda Government, UNFPA Hold Training Workshop for Groups To Promote Condom Use
Namibia's New Era Examines Increased Risk of HIV Among Fishermen
Science & Medicine
Specific Adverse Effects of Antiretroviral Therapy Vary Depending on Race, Gender, Study Says
[May 01, 2008]
Although the overall rate of adverse events among HIV-positive people initiating antiretroviral treatment does not differ significantly among different races and genders, there are significant differences in the incidence of specific adverse events, according to a study recently published in the Journal of Acquired Immune Deficiency Syndromes, Reuters Health reports. For the study, Ellen Tedaldi of Temple University's School of Medicine and colleagues compared the frequency and types of adverse effects among 1,301 patients who were initiating antiretroviral therapy. The study included 701 black participants, 225 Latinos and 273 women. The study did not find significant differences among races or gender in regard to death from any cause or treatment withdrawal rates because of drug toxicity (Reuters Health, 4/30).
According to the study, several "baseline characteristics" differed based on gender and race -- including age, HIV transmission risk, hepatitis B or C coinfection, viral load, diagnosis of AIDS, body mass index and baseline hypertension (Tedaldi et al., JAIDS, 4/1). Cardiovascular and kidney side effects were 2.64 and 3.83 times more frequent, respectively, among the black participants than among white participants, the study found. This finding was consistent with the increased rates of heart disease, diabetes and kidney disease found among all black men and women, the researchers noted.
Black men experienced 2.45 times higher rates of psychiatric-related adverse events than white men, the study showed. Tedaldi and her team said that it is "likely that grade four psychiatric adverse events represent a constellation of factors that include psychosocial and biologic associations," such as undiagnosed mental illness or the virus' effects on the central nervous system.
The study found 409 grade four adverse events during an average five-year follow-up period, or a rate of 8.9 events per person per 100 years. Grade four events are considered the most severe types based on a scale of one to four. The study found that women were 2.34 times more likely to experience grade four anemia, compared with men, according to the study. This finding was "not unexpected" because most of the women were premenopausal and black, the researchers wrote. Researchers also recorded 176 deaths -- a rate of three per person per 100 years. The study also recorded 523 antiretroviral discontinuations for any toxicity -- a rate of 13 per person per 100 years.
The researchers note that published data on the rate and types of adverse events by gender and race are limited, concluding that the findings "could inform HIV treating clinicians about particular issues to consider in the selection of antiretroviral regimens for diverse populations" (Reuters Health, 4/30).
The study abstract is available online.
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Global Challenges
Two PEPFAR-Funded Methadone Clinics Open in Vietnamese Port City
[May 01, 2008]
The United Nations mission in Vietnam recently announced that two new methadone clinics in the northern port city of Hai Phong, Vietnam, have opened to treat injection drug users and reduce the spread of HIV/AIDS, AFP/Thanhnien News reports. According to the U.N. mission, the clinics will be able to serve about 700 IDUs this year (AFP/Thanhnien News, 4/29). According to the Vietnam News Agency, the clinics are funded by the President's Emergency Plan for AIDS Relief (Vietnam News Agency, 4/29).
Hai Phong is the fist location that the country's Ministry of Health has allowed use of methadone treatment, VietNamNet reports (VietNamNet, 4/29). Methadone clinics are scheduled to open next month in Ho Chi Minh City, which has the highest HIV prevalence among IDUs in the country, according to AFP/Thanhnien News. UNAIDS country chief Eamonn Murphy said the country has "effective harm reduction approaches" that "ensur[e] a comprehensive response to HIV." About 300,000 HIV-positive people are estimated to be living in the country (AFP/Thanhnien News, 4/29).
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HIV/AIDS Services in Northern Cote d'Ivoire Still Unavailable
[May 01, 2008]
Health care services, including HIV/AIDS services, in Cote d'Ivoire's rebel-controlled northern region are still unavailable in spite of an agreement signed between government and rebel leaders in March 2007, PlusNews reports. According to IRIN/PlusNews, a lack of supplies, infrastructure and a shortage of health care workers have suspended many of the services in the northern region since a civil war began in the country in 2002.
N'Dri N'Guessan -- medical director of the University Hospital Center, known as CHU, in Bouake, Cote d'Ivoire -- said the hospital cannot assign doctors or nurses to HIV/AIDS services due to a shortage of staff. CHU officials said about 70 nurses are needed for the hospital to function properly; however, less than 35 are currently employed.
According to data collected by United Nations agencies, only 440 of the 729 nurses who were working in the central, northern and eastern regions of the country before the civil war were still working at the end of 2007. In addition, only one laboratory in Bouake is processing HIV tests. Yapo Felix Boa, director-general of CHU, said since the end of the war, the center has been "working at a slow pace." He added that many of the center's buildings, "which have been left abandoned," need to be repaired.
According to IRIN/PlusNews, CHU has been able to provide emergency courses of post-exposure prophylaxis antiretroviral drugs to survivors of sexual assault through partnerships with U.N. agencies and nongovernmental organizations. The hospital also has been able to treat opportunistic illnesses linked to HIV, IRIN/PlusNews reports. Boa said he hoped to reintroduce other HIV/AIDS services once CHU had "found its feet."
N'Guessan said the hospital also has organized HIV training sessions for physicians in the central, northern and eastern regions, adding that one pharmacist has already been trained in HIV care. In addition, Massagnon Soro, inspector general of the ministry devoted to HIV/AIDS, said the process of recruiting new physicians from a pool of 1,200 applicants has begun. She added that most applicants are young practitioners who have completed HIV/AIDS training (IRIN/PlusNews, 4/28).
Link to this story.
Media & Society
mtvU, Kaiser Family Foundation, POZ Magazine Launch Online Game To Confront HIV/AIDS-Related Stereotypes
[May 01, 2008]
mtvU, MTV's college network, and the Kaiser Family Foundation, in partnership with POZ Magazine, on Wednesday unveiled "Pos or Not," an online game that aims to confront HIV/AIDS stereotypes and overcome obstacles that prevent people from talking openly about the disease, Reuters reports (Reuters, 4/30). In the game, which also seeks to break down barriers that keep people from getting tested for HIV and using protection, players must decide whether a profiled participant is HIV-positive or negative based on a photo and a few personal details. HIV-positive participants share when they first learned their HIV status, and HIV-negative participants talk about how they have been affected by the disease. The game also provides information about HIV prevention, as well as local HIV and sexually transmitted infection resources from CDC (Kaiser Family Foundation release, 4/30).
The "Pos or Not" campaign, which was inspired by a nationwide competition asking college students to create a web-based game on the topic, is supported by several celebrities, including Wyclef Jean, Fall Out Boy, Will.i.am, Alyssa Milano, Say Anything, Perez Hilton, Angels & Airwaves, Atmosphere, The Spill Canvas, 30 Seconds to Mars, Aesop Rock, Motion City Soundtrack, All Time Low and Rise Against (Reuters, 4/30). Representatives from mtvU and the Kaiser Family Foundation will be presenting "Pos or Not" at the fourth annual Games for Health Conference on May 8-9 in Baltimore (Kaiser Family Foundation release, 4/30).
Link to this story.
Public Health & Education
Antigua, Barbuda Government, UNFPA Hold Training Workshop for Groups To Promote Condom Use
[May 01, 2008]
The AIDS Secretariat and the Directorate of Gender Affairs of the Caribbean nation of Antigua and Barbuda, with support from UNFPA, earlier this week hosted a two-day workshop to train representatives from government ministries, and community and social groups to promote condom use, the Antigua Sun reports. The workshop, titled "Behavioral Change Communication Condom Programming," emphasized use of the female condom.
The AIDS Secretariat recently announced that the number of HIV cases among young females in the country is increasing. According to AIDS Program Manager Janet Weston, available data show that more young girls, some as young as age 14, are being diagnosed with HIV. Weston said the rise could be attributed to sexual relationships between young women and older men. The number of HIV cases among men and women ages 25 to 50 is nearly equal, but more men are being diagnosed with HIV in the 50 and older age group, the data showed.
"We need to do something to broaden the scope of our education, so more persons can go out and help us because we at the secretariat have to collaborate with others," Weston said, adding, "HIV can be prevented if people are educated and decide to change their behavior."
UNFPA has pledged to provide no-cost female condoms to national HIV/AIDS programs in the Caribbean in an effort to help governments achieve the United Nation's Millennium Development Goal of reducing HIV/AIDS by 2015. Weston said that the country has received about 5,000 of those condoms. UNFPA representative Dervin Patrick said the agency is pleased to be partnering with Antigua and Barbuda and will work towards enhancing its health programming (Smith, Antigua Sun, 4/29).
Link to this story.
Namibia's New Era Examines Increased Risk of HIV Among Fishermen
[May 01, 2008]
Namibia's New Era on Tuesday examined increased risk of HIV among fishermen in the country. According to New Era, fishermen are among those most vulnerable to HIV in the country, and HIV prevalence among the group has been increasing. According to New Era, heterosexual sex is the main HIV transmission route in Namibia, where an estimated 230,000 people are living with HIV/AIDS. Increased development in harbor towns has increased the number of commercial sex workers and could be fueling the spread of HIV among fishermen, New Era repots.
New Era interviewed several fishermen in the country, finding that inconsistent condom use and infidelity among fishermen and their partners could be contributing to the spread of the epidemic. Richard Mbaha, a fishermen, encourages fishermen and their partners to undergo regular HIV testing to help address the issue. Another fisherman, Sledge Kauapirura, encourages fishermen and their partners to always use condoms to stop the spread of the virus (Tjatindi, New Era, 4/29).
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