Media outlets continue to follow major HIV/AIDS developments this week

Nov 25 2010

Media outlets continued to track the major developments in HIV/AIDS this week, including: prevention research using an antiretroviral; new UNAIDS estimates of HIV/AIDS around the world; and Pope Benedict XVI's stance on condoms for HIV prevention.

Science Now examines the details of the Pre-Exposure Prophylaxis Initiative, or iPrEx trial, which found a daily dose of oral antiretroviral drug Truvada by men who have sex with men (MSM) can reduce the risk of contracting HIV by an average of 44 percent and by more than 70 percent when the drug regimen is followed closely. The finding, the news service notes, "come[s] on the heels of a widely celebrated positive finding from the so-called CAPRISA 004 trial in South African women, which this summer reported that a vaginal gel laced with tenofovir reduced infection by 39 percent."

The article notes the main differences between the iPrEx and CAPRISA trials - while the gel in the case of CAPRISA was an experimental product, Truvada "is a popular anti-HIV treatment and can be prescribed for 'off-label use' by any physician."

Gilead, the maker of the brandname Truvada, "says it wants to have 'frank' talks with the U.S. Food and Drug Administration and other stakeholders before it decides to seek licensure for Truvada as a preventive. 'We'll have, I imagine, a very interesting discussion about the potential risks and benefits associated with this kind of a modality, and I think that will govern what we choose to do,' says Howard Jaffe, president of the Gilead Foundation, a nonprofit started by the company to help poor communities combat HIV and hepatitis B and C," according to Science Now.

The results of the iPrEx trial also raise "fundamental questions about how to best spend money to thwart the AIDS epidemic," the article continues.

"For a country that has not yet reached the level of care in terms of providing antiretrovirals to save people's lives, I think it's going to be quite a while before we'd start using oral antiretrovirals for prevention," explained Salim Abdool Karim, an epidemiologist a the University of KwaZulu-Natal in South Africa, who co-ran the CAPRISA study. Costs for Truvada "run from $11 per month for a generic version to nearly $1000 per month for product made by Gilead," according to the news service (Cohen, 11/23).

Meanwhile, Agence France-Presse on the progress in the fight against HIV/AIDS in sub-Saharan Africa, as detailed in the UNAIDS global report, writes: "Sub-Saharan Africa saw an estimated 320,000 fewer people die of HIV-related causes in 2009 than in 2004, when the region began to dramatically scale up access to anti-AIDS drugs, according to the report. Additionally, the number of new HIV infections in the region fell by more than 18 percent, from 2.2 million in 2001 to 1.8 million new infections in 2009."

Still, "[a]cross sub-Saharan Africa, 22.5 million people are living with HIV, more than any other region in the world, and 68 percent of the global total of 33.3 million people," the news service writes. "UNAIDS said South Africa continues to have the largest AIDS epidemic in the world, with 5.6 million HIV-positive people. Neighbouring Swaziland has the highest adult [prevalence] rate, 25.9 percent." The article also notes the disproportionate number of women and girls living with HIV/AIDS on the continent.

The piece quotes Sheila Tlou, UNAIDS regional director for sub-Saharan Africa, who when speaking with journalists on the findings of the report, called upon leaders in sub-Saharan Africa to invest more in the region's HIV/AIDS response, according to AFP (11/23).

NPR's "Shots" features an interview with UNAIDS Executive Director Michel Sidibe on the findings of the UNAIDS annual report (Knox, 11/24).

AFP, in a separate article, reports that groups in Africa "have welcomed Pope Benedict XVI's reversal of the church's stance completely outlawing condom use, seeing his words as a breakthrough in fighting AIDS."

The article includes quotes from HIV/AIDS advocates in a variety of African nations, such as Fogue Foguito, president of Positive-Generation, a Cameroonian NGO that works on HIV/AIDS programs, who said of the pope's remarks, "This is a great step ... The church has agreed that the condom is a necessary tool in the fight against AIDS, but we are waiting for this evolution in its discourse to be put into effect."

"The pope's ideas are going to help reduce the pandemic in the framework of prevention," said Youssouf Bamba, an official with Repmasci, a group that works on tackling HIV/AIDS in Ivory Coast. "'We will be more at ease raising the issue in church. Until now, it was difficult for us to develop a combative strategy,' he added, pointing out that 17.77 percent of Africa's population is Roman Catholic, according to Vatican figures," according to AFP.

The article also includes quotes by several leaders of Catholic churches in Africa, who AFP writes "warned against a misinterpretation of the pope's message and declared that it was not a sudden justification of the use of condoms, except in special circumstances" (11/23).