Listserv Provides Forum for HIV
A consortium of organizations specializing in
HIV and infectious diseases has developed a
listserv for clinicians.
The ReproIDHIV listserv is a forum for
discussing clinical cases, finding patient
referrals, sharing protocols, providing
information on upcoming events and networking
with colleagues in the HIV and infectious
The listserv is sponsored by the UCSF
National HIV/AIDS Clinicians’ Consultation
Center, Infectious Disease Society of
Obstetricians and Gynecologists and UCSF
Fellowship in Reproductive Infectious
To be added to the listserv, contact Shannon
Weber at email@example.com.
Issues New Guidance for HIV Testing in Community
The CDC has developed a new resource for HIV
testing in community health centers. The guide
provides information on testing protocols and
To access the guide, visit www.cdc.gov/hiv/topics/testing/resources/guidelines/pdf/routineHIVtesting.pdf.
Produces Fact Sheet on HIV and Women in the
Women in the U.S. contract HIV primarily
through heterosexual contact. The majority of
those women are African-Americans.
These are some of the facts presented in the
recent update on HIV and women produced by The
Henry J. Kaiser Family Foundation.
To view the fact sheet, visit http://www.kff.org/hivaids/upload/6092-09.pdf.
Prevention Bilingual Glossary Widget
The CDC has produced an English/Spanish
widget for its HIV/AIDS Prevention Bilingual
Glossary. The glossary provides linguistic
support to individuals and organizations working
with Spanish-speaking populations in the United
For more information and to access the
widget, go to HIV/AIDS
Prevention Bilingual Glossary Widget - The
Office of Minority Health.
AND RESEARCH UPDATES:
Halted for Pill to Stop HIV in Women
A trial among women taking antiretrovirals
daily to prevent sexually acquired HIV infection
has been stopped early after a review suggested
its data would be inconclusive. The results are
contrast with data from a large, multi-country
study presented last year that showed the
approach - called pre-exposure prophylaxis
(PrEP) - is protective against HIV for men who
have sex with men.
The halted FEM-PrEP trial involved 1,951
women from South Africa, Kenya and Tanzania
randomized to take either Truvada or placebo
daily. Fifty-six acquired HIV: exactly half in
the Truvada arm and half in the placebo group.
Reasons for FEM-PrEP's inconclusive results
remain speculative, but lapses in adherence
could be to blame. Blood samples taken to
measure adherence still must be analyzed, said
For more information, visit http://www.cdc.gov/hiv/prep/femprep.htm.
for Safe Conception Methods Exists for
Approximately half of HIV-discordant
heterosexual couples in the United States want
children, according to a recent study,
indicating demand for pre-exposure prophylaxis
to prevent mother-to-child transmission.
This is according to a recent article in the
American Journal of Obstetrics and Gynecology
authored by perinatal HIV experts from CDC. The
authors state that couples should receive
services to ensure they enter pregnancy in
optimal health and receive education about all
conception methods that reduce the risk of HIV
To view an abstract of the article, visit Achieving safe conception in
HIV-discordant couple... [Am J Obstet Gynecol.
2011] - PubMed result.
Show One-Third of HIV-Infected Women Not Tested
CDC’s recent release of its Enhanced
Perinatal HIV Surveillance data for 2005-2008
show that 30 to 35 percent of HIV-infected women
are not tested for the virus until after they
These data are reported by 15
jurisdictions—health departments in nine states,
five cities and Puerto Rico. In these regions
alone, more than 8,000 HIV-infected women gave
birth during the three-year period.
To access the full report, visit Enhanced Perinatal Surveillance—15
Indicated Need for Specialized Reproductive Care
for HIV-Infected Women
A survey of HIV-infected women in the U.K.,
indicates that three-quarters of them want more
children, and that almost half reported their
HIV diagnoses did not affect their fertility
intentions. These findings, in the April edition
of AIDS Care, highlight the need for specialized
family planning and reproductive health services
targeting the population.
Some 450 women were surveyed in the U.K.,
where the number of pregnancies in HIV-infected
women has increased dramatically in the past
To view an abstract, visit Fertility intentions of
HIV-infected women in the ... [AIDS Care. 2011]
- PubMed result.
Says Fewer Youth Report Having Sex
The largest and most in-depth report on U.S.
sexual behavior, sexual attraction and sexual
identity shows a rising number of young people
are electing to remain abstinent. In 2006-2008,
29 percent of females and 27 percent of males
ages 15-24 reported not having any sexual
contact, compared with 22 percent in 2002, CDC
National Center for Health Statistics
researcher Anjani Chandra, PhD, and colleagues
used data based on computer-assisted interviews
with 13,495 males and females ages 15-44. That
2006-2008 National Survey of Family Growth
(NSFG) data was compared with results from the
2002 NSFG and other national surveys. The team
found few overall changes in the nation’s sexual
patterns compared to the 2002 survey. But for
the first time, they examined certain, specific
behaviors that young people may not always
report as sex because it is not vaginal
Among teenagers ages 15-19, 7 percent of
females and 9 percent of males reported oral sex
with an opposite-sex partner but no vaginal
intercourse. Of sexually active people ages
15-24, almost 63 percent of females and 64
percent of males had oral sex, versus almost 69
percent in 2002.
The report, “Sexual Behavior, Sexual
Attraction, and Sexual Identity in the United
States: Data from the 2006-2008 National Survey
of Family Growth,” was published in National
Health Statistics Reports (2011:36). It can be
found by visiting http://www.cdc.gov/nchs/data/nhsr/nhsr036.pdf.
Condoms Are Gaining Ground
First approved by the Food and Drug
Administration (FDA) in 1993, the female condom
was slow to gain acceptance. Now, however, the
improved version, dubbed FC2, appears to be
making headway, according to a manufacturer.
The number of FC2s distributed in the United
States last year tripled, said Mary Anne Leeper,
founder of its manufacturer, the Female Health
Company. The product now is sold in more than
100 nations, and it even has fans on Facebook.
Whereas the original female condom was made
of polyurethane, the improved version, approved
by FDA in March 2009, is seamless and made of
more comfortable synthetic latex. For more
information, go to http://www.femalehealth.com/.
Therapy No Better than Standard
Increasing the number of antiretrovirals
administered to treat acute and early HIV
infection is not effective, according to a study
presented at the recent Conference on
Retroviruses and Opportunistic Infections.
Forty-eight weeks into the 96-week study,
patients receiving five drugs had equivalent
amounts of HIV RNA in their blood compared to
those receiving the standard three-drug therapy,
and there also was no difference in a range of
other immune system measurements, said Martin
Markowitz, MD, of New York’s Aaron Diamond AIDS
Markowitz and colleagues enrolled 40
early-stage HIV patients and randomly assigned
them, in a one-to-two fashion, to receive either
three or five medications.
Thirty-four patients remained in the study.
Among results at 48 weeks:
- While the five-drug patients achieved
undetectable HIV RNA levels more rapidly than
the three-drug patients, by 24 weeks there was
no significant difference in the proportion with
- In both study arms, patients had strong
recovery of CD4+ cells of about 300 each; there
was no significant difference between the
- No differences were found in levels of
proviral DNA or cell-associated HIV RNA, or
their rates of decay over time.
- No differences were found in levels of naïve
and total CD4 cells or immune system activation
- All three patients who had virological
failure were in the five-drug group.
- No different responses were found between
those who were acutely infected, about
one-quarter of patients, and those in the
For more information, go to 5 Drugs No Better than 3 for
Treatment of Primary HIV Infection.
Warns Against Abbott HIV Drug in Premature
The FDA advised against using Kaletra
(lopinavir/ritonavir) oral solution in premature
babies, which can cause severe or possibly fatal
health problems, and in all babies younger than
14 days. There is no safe, established dose for
babies younger than two weeks, whether premature
or full-term, FDA said.
The Kaletra oral solution contains alcohol
and propylene glycol, and the inability of
premature babies to eliminate propylene glycol
can lead to adverse events, including "serious
heart, kidney or breathing problems," said the
notice to health professionals. FDA has received
reports of serious problems in premature babies
"Because the consequences of using Kaletra
oral solution in babies immediately after birth
can be severe or possibly fatal, the label is
being revised to include the new warning,"
stated the notice. "The use of Kaletra oral
solution should be avoided in premature babies
until 14 days after their due date, or in
full-term babies younger than 14 days of age
unless a health care professional believes that
the benefit of using Kaletra oral solution to
treat HIV infection immediately after birth
outweighs the risks. In such cases, FDA strongly
recommends monitoring for increases in serum
osmolality, serum creatinine, and other signs of
For additional information, visit http://www.fda.gov/Drugs/DrugSafety/ucm246002.htm.
Levels of HIV in Genital Secretions Predict
HIV-1 RNA concentrations in semen and vaginal
secretions can be used as a marker for HIV
transmission risk, suggests a new two-year study
of serodiscordant heterosexual couples in
Africa. The relation was independent of plasma
HIV-1 concentrations, noted Jared Baeten, MD of
the University of Washington.
Researchers for years have known of the link
between HIV concentration in the blood and the
risk of transmission, Baeten said. However, no
studies have been large enough to conclusively
establish the same for HIV in genital
secretions, beyond a working hypothesis, he
In the prospective study, Baeten and
colleagues followed 2,521 serodiscordant
heterosexual couples from seven African
countries, assessing genital HIV-1 RNA quantity
and transmission risk for up to two years.
Couples received HIV prevention counseling, and
viral sequence analysis was used to confirm
subsequent HIV transmissions.
The researchers tested endocervical samples
from 1,805 women, including 46 women who
transmitted HIV to their partner, and semen
samples from 716 men, including 32 who infected
"There was a correlation between genital and
plasma HIV-1 RNA concentrations," wrote the
study authors. Even so, genital HIV-1 RNA
independently predicted transmission risk after
adjusting for plasma HIV quantity, the study
The study, "Genital HIV-1 RNA Predicts Risk
of Heterosexual HIV-1 Transmission," was
published in Science Translational Medicine
Finds Disparities in Diagnoses of HIV Infection
Since early in the HIV epidemic,
blacks/African Americans have been
disproportionately affected, according to the
CDC. Drawing on data from the National HIV
Surveillance System, they estimated numbers,
percentages and rates of HIV diagnoses in
blacks/African Americans during 2005-08 and
described the results of those analyses.
During 2005-08, blacks/African Americans
accounted for 50.3 percent of HIV diagnoses in
37 states with mature HIV surveillance systems,
despite representing just 13.6 percent of the
population in these states. By comparison,
whites accounted for 67.9 percent of the
population and 29.4 percent of diagnoses, while
Hispanics/Latinos accounted for 13.4 percent of
the population and 17.8 percent of
Among males, black/African Americans
represented the largest proportion (44.8
percent) of HIV diagnoses during 2005-08. Among
females, black/African Americans accounted for
most (65.9 percent) diagnoses, including a
majority for the South (70.9 percent), Midwest
(60.9 percent) and Northeast (60.0 percent).
Blacks/African Americans comprised the largest
proportion of HIV diagnoses in every age group.
By transmission category, among
black/African-American males, male-to-male
sexual contact was most frequently reported
(61.1 percent), followed by heterosexual contact
(23.1 percent), injection drug use (11.9
percent) and both IDU and male-to-male (3.6
percent). Among black/African-American females,
most were exposed through heterosexual contact
(85.2 percent), followed by IDU (14
Males ages 13-24 accounted for the largest
proportion (30.9 percent) of HIV diagnoses among
black/African-American males with infection
attributed to male-to-male sexual contact,
followed by males ages 25-34 (28.7 percent) and
35-44 (23.7 percent). Among
black/African-American female diagnoses, the
largest percentages were in those ages
For more information about CDC efforts to
address these disparities, visit: http://www.cdc.gov/hiv/aaa/
Reports Caregivers Who Practice Premastication
Put Children at Risk
Premastication, or chewing foods or medicines
before feeding to a child, is a route of HIV
transmission through blood in saliva and has
been associated with transmission of other
pathogens, according to the CDC.
Approximately 14 percent of caregivers in the
United States report premastication; however,
the frequency of this behavior among
HIV-infected caregivers is unknown.
For more information, visit MMWR: Premastication of Food by
Caregivers of HIV-Exposed Children --- Nine U.S.
Reports New Drug Regimen Cut HIV Spread from
Mother to Infant
A National Institutes of Health study found
that adding one or two drugs to the standard
treatment of infants after delivery from an
HIV-positive woman can prevent mother-to-child
The CDC reports that one fifth of the people
in the United States who have HIV are unaware of
their status. From 100 to 200 infants are born
with HIV in the U.S. each year, many to women
who either were not tested in early pregnancy or
who did not receive treatment during
The study reflects the rates of infection
with infants who were given the standard
zidovudine (ZDV) alone, ZVD and nevirapine (NVP)
and those receiving ZVD plus lamivudine and
nelfanavir. Results showed that treatment with
the two- and three-drug regimens reduced HIV
transmission by more than 50 percent.
For more information, visit New Drug Regimens Cut HIV Spread
From Mother To Infant.
regimen cuts HIV risks for breastfeeding
Giving breastfeeding infants of HIV-infected
mothers a daily dose of nevirapine for six
months halved the risk of HIV transmission to
the infants at age 6 months, compared with
giving infants the drug daily for six week,
according to a study funded by the National
Institutes of Health.
The longer nevirapine regimen achieved a
75-percent reduction in HIV transmission risk
through breast milk for the infants of
HIV-infected mothers with higher T-cell counts
who had not yet begun treatment for HIV.
The primary analysis of the study data found
that 2.4 percent of the infants who received six
weeks of nevirapine had acquired HIV through
breastfeeding by 6 months of age, but only 1.1
percent of the infants who received six months
of nevirapine had acquired HIV through
breastfeeding by that time – a 54-percent
For more information, visit Six-Month Drug Regimen Cuts HIV
Risk for Breastfeeding Infants, NIH Study