HIV and AIDS

April 23, 2007

Man 'deliberately gave partner HIV'

Jamie Michael Richards, 34, of Highgate Hill in inner-city Brisbane, today pleaded not guilty in Brisbane District Court to intending to transmit a serious disease and unlawfully transmitting a serious disease due to sex with a 20-year-old man.

He faces an alternative charge of grievous bodily harm against the man, whom Mr Richards allegedly had a casual sexual relationship with.
Prosecutor Sal Vasta told the court there was a "certain attraction" when Mr Richards and the complainant, who was an apprentice hairdresser, first met at a Brisbane train station in mid to late 2003.

"They were always friends first and foremost ... who did sexual acts together," Mr Vasta said.

"They were never in a relationship."

He said the victim lost his virginity to Mr Richards and during their regular sexual encounters "there were times where they did not use a condom".

"There were a number of conversations about the use of condoms ... Jamie would say it was okay not to wear one because he'd never had a sexually transmitted disease," Mr Vasta told the court.

"He never mentioned anything about HIV or AIDS."

Mr Vasta said the victim also noticed Mr Richards was taking a lot of medication and herbal treatments.

He said Mr Richards' brother, who had moved into his unit to care for his "AIDS-stricken" sibling, broke the news to the victim in December 2004.

The court was told the younger man then cut off the relationship before starting to feel sick in January 2005.

Blood tests confirmed he was HIV-positive.

He then made a complaint to police.

Mr Vasta told the court Mr Richards had known he was HIV-positive since 1995 and had been advised by help services not to expose others to the infection.

The court also heard Mr Richards told police in 2003 that he had "full-blown AIDS and hepatitis C" while questioned over another matter.

Mr Vasta said Mr Richards still denied he had AIDS in a telephone conversation with the victim taped by police.

2007 HIV/AIDS conference set

To heighten awareness of the HIV/AIDS epidemic in Kentucky, public health officials from across the Commonwealth will gather in downtown Lexington May 9-11 for the 2007 Kentucky HIV/AIDS Conference.

The Kentucky Department for Public Health and Heartland CARES of Paducah are co-hosting the event at the Radisson Plaza Hotel.
The conference is for health care and social service professionals involved in planning, providing prevention education or direct delivery of services to people with HIV/AIDS.

Anyone interested in improving the quality of life for those with HIV/AIDS and those who are concerned about the impact of the disease on Kentucky communities are also encouraged to attend.

The cost of registration is $100 until April 30. On site registration if $125.

Approval for continuing education credit is currently pending. There is no additional charge for these credits.

For more conference information, contact Merinda Brown in the Kentucky Department for Public Health,

Concern over future of UMC's HIV-AIDS program

Saving UMC some much needed cash will come at a high cost. But patients of the hospital's HIV-AIDS program hope it doesn't mean cutting them out.

An e-mail is being sent out valley-wide. It asks county commissioners to keep the Wellness Center open. The decades-old facility appeared on a list of suggested closures last week.

By cutting the program out, UMC would save almost $3 million. But one doctor says you'd leave thousands of patients with no place to go. "If this clinic loses money, no private docs are going to say come on down," Dr. Jerry Cade said. "Let me take care of you even if you're going to hurt my bottom line."

County commissioners are urging people to bring up their concerns. They say the public's reaction will be considered when they decide which programs stay and which go.

Not Mandatory For Couples To Test For HIV/Aids Before Marriage

The Pahang state government has not imposed a mandatory requirement for couples to test for HIV/Aids before getting married but encourages them to do so, the state assembly was told Monday.

Chairman of the State Health, Social Welfare and Orang Asli Affairs Committee Datuk Ishak Muhamad said the Pahang Health Department offered the test for free to couples wanting to get married.

"We encourage couples about to get married to take the HIV/Aids test. The programme was started in 2004 and has received encouraging response. Last year, 11,076 couples took the test before marriage," he said.

He was replying to a question from Datuk Chan Choon Fah (BN-Teras) who had wanted to know whether the state government planned to make it mandatory for couples to take the HIV-Aids test before getting married.
Chairman of the State Youth, Sports and Unity Committee Datuk Dr Ahmad Shukri Ismail said that a study by the federal Criminal Investigation Department (CID) indicated that firearms used in criminal cases were smuggled from abroad.

He said the study also showed that there were criminals who used fake or toy firearms when committing crime.

"However, cases of crime with the use of firearms were low in Pahang. For the whole of last year, only eight cases of armed robbery were reported," he said when replying to a question from Datuk Redzwan Harun (BN-Kerdau).

Meanwhile, Menteri Besar Datuk Seri Adnan Yaakob said not all the stalls at the rest areas of the East Coast Expressway opened for business at the same time because of the low volume of traffic along the highway.

"Requiring all the stalls to be in operation would force the operators to incur losses owing to lack of customers," he said when replying to a question from Datuk Abdul Manan Ismail (BN-Panching).

"At the moment, at least two food stalls and one drinks stall are opened by rotation round the clock according to a schedule," he said, adding that the operating hours of stalls not scheduled to operate round the clock were from 8 am to 10 pm.

"Nevertheless, during festival periods and at weekends, more stalls will be opened to cater to the bigger number of users of the highway," he said.

FDA To Consider Approval Of First CCR5 Antagonist Against HIV/AIDS

An advisory panel of the US Food and Drug Administration (FDA) is meeting tomorrow to decide whether to recommend approval of Pfizer's HIV/AIDS drug Maraviroc for patients already taking other drugs. If approved, it will be the first drug available in the class called CCR5 antagonists.

The FDA does not have to follow the panel's recommedations, but it usually does.

Many HIV drugs fight the virus from inside infected white blood cells. CCR5 antagonists stop the virus from getting into cells by blocking the main entry point common to most people who have the infection.
CCR5 stands for chemokine (C-C motif) receptor 5. HIV uses it as a co-receptor to get into target cells: the CD4 T-cells or helper cells, the main coordinators of the immune system.

When the co-receptor "sees" the HIV virus it signals to the main CD4 cell receptor to allow the HIV antigen into the target T-cell.

By blocking the CCR5 co-receptor, CCR5 antagonists stop strains of HIV known as "R5-tropic", an HIV variant that is common in earlier infection. However, as the disease progresses, the virus adapts to use an alternative entry point, the CXR4 receptor.

In February, Pfizer announced that marketing authorization applications for Maraviroc were receiving accelerated review in both the US and Europe.

Accelerated reviews are granted to drugs that may offer significant improvements over current therapies, if approved.

During development Maraviroc was known as UK-427857.

The marketing applications for Maraviroc are supported by efficacy and safety data from two phase 3 trials.

Named MOTIVATE-1 and 2 (Maraviroc plus Optimized Therapy In Viremic Antiretroviral Treatment-Experienced patients), the trials show 24 weeks of data comparing Optimized Background Therapy, with or without Maraviroc, in over 1,000 highly treatment-experienced patients with CCR5-tropic HIV-1.

The HIV virus was suppressed in 45 per cent of the patients, compared with 23 per cent who took a placebo. Maraviroc and the placebos were taken in combination with other drugs.

According to Pfizer, these trial results have been accepted for presentation at a forthcoming HIV conference.

CCR5 antagonists have raised safety concerns in the past. Earlier drugs under development were linked to lymphoma and liver damage.

These risks did not appear to be significant in the Pfizer studies, but according to media reports, the FDA reviewers are concerned about modest increases in liver damage.

When they submitted the marketing application, John LaMattina, president, Pfizer Global Research and Development, said:

"There is a profound global need for new medicines to help HIV/AIDS patients."

"We expect that CCR5 antagonists, like Maraviroc, will become critically important new treatment options for patients who are resistant or intolerant to their current HIV/AIDS therapies," he added.

Other drug companies are also working on CCR5 antagonists.

Nobody knows what the long term effect of using CCR5 antagonists will be. Some have speculated that it will accelerate the development of new strains of HIV that use other entry points.

Early trials have suggested not, but it highlights the importance of keeping an eye on the impact of the drug over the coming years should it pass the FDA and European approval.

According to researchers on the Pfizer trials, the priority now is to get the drug to the people who are running out of options. The longer term effects will not be known until the drug has been used for 5 to 10 years.

April 20, 2007

Why swapping dirt tracks for new roads can be lethal

Road crashes are on course to overtake HIV-Aids by 2015 as the main cause of death and disability for children aged 5-14 in developing countries. Roads built with foreign aid are often so poorly designed that death rates soar, according to a world road safety report.

Britain is among the leading donor nations that have failed to ensure that minimum safety standards are applied to road projects it has helped to fund, says the Commission for Global Road Safety. It forecast that the 1.2 million road deaths worldwide in 2002 will double by 2020 unless action is taken.

More than 90 per cent of the deaths occur in developing countries even though they have much lower car ownerships levels than richer nations.
Africa has the most dangerous road network, with 28.3 road deaths for every 100,000 people each year, compared with 5.6 deaths in Britain. In several African countries a motor vehicle is 100 times more likely to be involved in a fatal road crash than one in Britain.

The World Bank recommended in 1982 that 5-10 per cent of the funding for a road project supported by foreign aid should be spent on safety measures, including proper pavements and crash barriers. But a $1.2 billion (£600 million) fund for roads in Africa, approved by the G8 group of leading countries, has allocated only $20 million for safety, or 1.7 per cent of the total. In Britain, the Department for International Development committed £330,000 for road safety overseas in the year to March 2004 in a total spending of £20 million on road projects.

David Ward, director-general of the FIA Foundation, which promotes road safety and funded the report, said: “New roads can make a bad situation much worse by raising the speed and volume of traffic while doing nothing to protect pedestrians and other vulnerable road users.”

Village markets displaced from dirt tracks often returned to the same place once the tracks became paved roads, he said. Deaths rose sharply because vehicles sped through the markets on the new roads.

The report calls for a UN summit on road safety next year and a commitment from the G8 to devote at least 10 per cent of the development aid for roads to safety measures.

It says that donor countries underestimate the impact of road deaths, which can result in the victim’s family starving to death. In India and Bangladesh half the families that lost somebody in a crash fell below the poverty line.

The World Health Organisation calculates that the health and economic costs of road crashes in developing countries often exceed the total amount they receive in foreign aid.

National Strategic Plan on HIV/AIDS

The National STD/AIDS Control Programme (NSACP) of the Ministry of Health is preparing the National Strategic Plan for 2007-2011, in its continuous efforts to minimise the spread of HIV/ AIDS in Sri Lanka.

As a prerequisite for this process, it has organised a consultative workshop with NGOs and Civil Society Organisations (CSOs) based island-wide and working on HIV/AIDS with their communities, to obtain inputs from grassroots for the proposed Strategic Plan.

This workshop is to be held later this month at the National HIV/AIDS Prevention Project Conference Hall in Colombo. It will be organised by Alliance Lanka in partnership with NSACP, supported by the Commonwealth Foundation UK.
Commonwealth Foundation supported Alliance Lanka to conduct a capacity building workshop on HIV/AIDS for NGOs/CSOs in partnership with the Ministry of Health late last month.

This was the first of a series of capacity building workshops for civil society organisations working on HIV/AIDS prevention. The workshop was aimed at improving NGO skills in key areas identified by civil society during a consultation held in December 2006.

Health Minister Nimal Siripala de Silva while inaugurating the workshop said the Government is committed to fight the AIDS pandemic.

Observing that Governments and politicians had difficulty in broaching the topic with the public he urged civil society organisations to use their position within local communities to help authorities in their battle against HIV/AIDS.

The areas covered during the 3-day workshop, held at the Hector Kobbekaduwa Agrarian Research & Institute in Colombo, included interpersonal communication, advocacy skills, clinical aspects of HIV/AIDS, development of educational and training material, training peer leaders, conducting focus group discussions and monitoring & evaluation.

Dr Sujatha Samarakoon, Consultant Venereologist at the National STD/AIDS Control Programme pointed out that in the past different bodies had worked at cross purposes. She said that the Health and Education Ministries are now working on an effective mechanism to address this issue.

There were 838 reported HIV infections by the end of 2006 in Sri Lanka, and authorities estimate 5,000 people to be carrying the virus. This figure can be much higher since a person infected can generally live with the virus undetected for 10-15 years before any symptoms appear. This period is the danger zone since the person can unknowingly spread the virus.

Mapping out a way forward, participants identified a number of areas for action. These include: Educating parents, Counselling and social/ livelihood support for people with HIV/AIDS, Addressing the shortage of trained counsellors and creating awareness among media personnel.

The Executive Director of Alliance Lanka, Swarna Kodagoda said a co-operative effort is needed by all parties working on HIV/ AIDS prevention in Sri Lanka to ensure a strong and cohesive strategy to combat the pandemic and strengthen the national response.

This initiative is part of the Foundation's commitment to Sri Lanka ahead of the 8th International Congress on AIDS in Asia and the Pacific which will be held in Colombo in August this year.