Kaisernetwork.org (Washington, DC)
24 June 2008
Science & Medicine
Children, Adolescents Living With HIV Have Higher Rates of Risk Factors for Cardiovascular Issues, Study Finds
[Jun 24, 2008]
Children and adolescents living with HIV have higher rates of risk factors for cardiovascular issues than HIV-negative children and adolescents, according to a study published in the June issue of the Journal of Pediatrics, the Miami Herald reports. In addition, many antiretroviral drugs can increase cardiovascular risk factors, the Herald reports.
Tracie Miller, a professor of pediatrics at the University of Miami Miller School of Medicine, and colleagues in the multi-hospital study followed 42 HIV-positive children from 1998 to 2003 who contracted the disease through mother-to-child transmission. The study found that HIV-positive children had triglyceride levels 50% higher than children not living with the virus. The study also found that among the HIV-positive children, cholesterol levels were 6% higher, and LDL, or "bad cholesterol," was 10% higher. In addition, HDL, or "good" cholesterol, was 13% lower among the HIV-positive children when compared with HIV-negative children. According to the Herald, all four are key risk factors for heart disease. In addition, the antiretroviral zidovudine -- which is given to HIV-positive pregnant women to prevent MTCT -- has been found to increase children's cardiac risks.
Although other antiretrovirals, such as non-nucleoside transcriptase inhibitors, have been associated with lower lipid levels, Miller said people living with the disease often need a combination of antiretrovirals. The increased cardiovascular issues associated with being HIV-positive and taking antiretrovirals is "a double whammy" for children and adolescents, Miller said. She added, "We know that adults with HIV have a seven-to-10-times higher risk of having a heart attack than other adults. The fear is that the same factors are at work in children from birth to 20." According to Miller, it will take decades to determine whether the higher risk factors observed in the study will translate into more heart attacks and higher death rates.
Miller has designed a program for HIV-positive children that includes education, monitoring, diet, lifestyle and exercise, the Herald reports. She said that it is important for children living with the disease to avoid high-fat and sugar-rich foods, as well as alcohol and tobacco. Miller is starting another study to determine if such lifestyle changes help reduce cardiovascular risk, the Herald reports (Tasker, Miami Herald, 6/24).
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Public Health & Education
Florida HIV/AIDS Advocacy Groups, Health Departments To Increase HIV Awareness Among Minorities Ahead of National HIV Testing Day
[Jun 24, 2008]
HIV/AIDS advocacy groups and health departments in Florida are planning several events aimed at increasing awareness about HIV among minorities ahead of National HIV Testing Day, which is scheduled for Friday, the Naples Daily News reports.
According to the Daily News, Florida in 2006 reported the third-highest AIDS rate for blacks and fourth-highest rate for Hispanics nationwide, as well as the highest rate for whites. Amalia Zamot, regional minority HIV/AIDS coordinator for the Florida Department of Health, said that there is a "general disproportion" in HIV/AIDS rates among white and minority communities in the area. She added that the disparity is especially true for the area's black community, in which one in every 72 people is living with HIV/AIDS.
Advocacy groups and county health departments are implementing several programs in an effort to increase awareness and improve testing rates among minorities. The Collier County Health Department is offering on-site testing, treatment, education and support programs, according to Scott Tims, the department's HIV/AIDS program manager. Tims added that department staff also are increasing outreach efforts and are working with local churches and not-for-profit groups to increase testing and establish outreach programs. In addition, the Lee County Health Department has set up several HIV testing centers throughout the region.
Although advocates and health workers are working to improve testing among minorities, Zamot said efforts also need to be made to reduce stigma associated with the virus. "We have to be culturally sensitive and culturally proficient," Zamot said (Batista, Naples Daily News, 6/21).
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One-Third of Status-Aware HIV-Positive MSM in U.K. Still Practicing Risky Sexual Behavior, Study Says
[Jun 24, 2008]
About one-third of HIV-positive men who have sex with men in the United Kingdom who are aware of their status are still engaging in risky sexual behavior, according to a study recently released by the Medical Research Council, BBC News reports. According to the study -- which included 3,500 MSM -- participants who knew that they were HIV-positive were statistically more likely to have unprotected sex than those who did not know or were HIV-negative. The study also found that 40% of the 300 participants who tested HIV-positive did not know their status. Study author Lisa Williamson of MRC said that more risky behavior was being practiced by men who had been living with HIV for a long time, BBC News reports. The researchers are calling for more targeted prevention methods, including promoting condoms among men who are regularly tested for HIV and urging men who report high-risk behavior to be tested more than once annually.
"What we don't necessarily want to see is an across-the-board increase in testing," Will Nutland from the Terrence Higgins Trust said, adding, "We want to see [MSM] who are taking the greatest number of risks testing more often. Of course, on the face of it, it seems perfectly simple, but what we do know is that one-third of young [MSM] leave school without adequate sex education." According to Nutland, the United Kingdom is "not investing the way we ... should be in HIV prevention campaigns across the whole of the U.K. in the communities who are most at risk." Funding for prevention efforts aimed at MSM is insecure, and there is not enough discussion about the issue within the MSM community, according to the Terrence Higgins Trust. About 2,700 MSM were newly diagnosed as HIV-positive in 2006 -- double the number from 10 years earlier. The 2,700 new diagnoses among MSM in 2006 represent about one-third of all new diagnoses for that year (BBC News, 6/20).
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Global Challenges
New HIV/AIDS Threat in India Found Among Youth Working at Call Centers, Researcher Says
[Jun 24, 2008]
Unprotected sex with multiple partners among young staff in India's call centers has emerged as a new HIV/AIDS threat in the country, Suniti Solomon, the researcher who detected the first HIV case in India in 1986, told the International Congress on Infectious Diseases on Saturday, the AP/International Herald Tribune reports.
According to Solomon, such risky behavior among "call center Romeos," who typically work at night to correspond with the daytime working hours of their U.S. and European clients, has become a great concern. Solomon said, "They have all the money. They huddle together in the night. They are young, they are sexually active, so naturally they start."
Solomon, who runs an HIV/AIDS center in the city of Chennai, said at least three or four call center workers visit her clinic weekly to undergo HIV testing because of concerns after engaging in unprotected sex. Solomon said that her patients have told her that groups of young men and women rent apartments along the beach during weekends and have multiple-partner sex. "If they are having sex just among themselves and all are non-infected, it is fine," Solomon said, adding, "But if there is one person who has gone out of this group and brought in the virus, it will spread to everyone." The AP/Herald Tribune reports that there are no figures on how many call center workers are HIV-positive.
According to the AP/Herald Tribune, India's call centers employ about 1.3 million people, mostly youth who have just graduated from schools and colleges. The starting monthly salary for call center workers is 25,000 rupees, or $600, which is more than a government physician's paycheck.
Solomon said that although the call center situation is a reflection of recent liberal values, India's fight against HIV/AIDS has been hampered by co-existing conservatism, including opposition to male circumcision. A recent government study to gauge the acceptance of circumcision generated a backlash by some traditional Hindus, who called the procedure "obnoxious" and "a conspiracy," the AP/Herald Tribune reports. Solomon said, "If you go out into the streets and say, 'I will do this (circumcision) to reduce HIV,' there will be a chaos. Vaccines have failed. Microbicides have failed. This is one tool we have in hand, but we can't use it" (Joshi, AP/International Herald Tribune, 6/22).
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Mozambique Business Association Launches Program That Aims To Address HIV/AIDS in Workplaces
[Jun 24, 2008]
The Confederation of Business Associations in Mozambique recently launched a program called ECOSIDA to address issues related to HIV/AIDS in the workplace, SAPA/iAfrica.com reports. According to Salimo Abdula, president of the confederation, the country's business sector is experiencing the consequences of HIV/AIDS through the increased absence of employees, which has started to affect production.
According to official statistics, at least 16% of the country's population ages 15 to 49 is living with HIV/AIDS, and at least 500 people contract HIV daily. In response to Mozambique's high HIV prevalence, the World Bank has lowered its prediction on life expectancy in the country to 37 years in 2010. In addition, although the country's economy has increased by about 7% annually during the past few years, the World Bank in a recent report estimated that HIV/AIDS could lower economic growth rates in the country by as much as one percent annually, SAPA/iAfrica.com reports.
"HIV/AIDS is not a case for the future," Abdula said, adding that "it is starting to affect companies now through performance of workers, and this is mostly evident in increased cases of absence from work." To address the consequences of the epidemic, ECOSIDA will encourage workers to be tested for HIV. "We believe that if workers know their status and they are HIV-positive, they can receive treatment, and they can continue with their jobs," Abdula said. He added that although the government is participating in many HIV/AIDS programs, it still needs to involve the private sector by providing incentives to companies that are taking action against the disease. "The result (of fighting the pandemic) has not been achieved, and the private sector feels that medium- and small-scale companies need to be self-sufficient in their fight against the pandemic," Abdula said, adding, "This could be achieved if the government gives incentives to companies involved in the fight against HIV/AIDS" (SAPA/iAfrica.com, 6/20).
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