Male Circumcision, New Antiretrovirals, Genetic Engineering Most Promising HIV Prevention

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Male Circumcision, New Antiretrovirals, Genetic Engineering

The emergence of new antiretroviral drugs, genetic engineering and male circumcision are the latest and most promising HIV/AIDS prevention and treatment methods, delegates attending the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney, Australia, said on Tuesday, Reuters reports (Perry, Reuters, 7/24).

Delegatesattending the conference, which will end on Wednesday, are expected topresent studies and discuss advances in HIV/AIDS prevention andtreatment. The conference aims to improve understanding of HIV/AIDS,treatments for the disease and methods to prevent it from spreadingworldwide (Kaiser Daily HIV/AIDS Report, 7/23).

Robert Bailey, a professor at the University of Illinois-Chicago's School of Public Health, at the conference Tuesday said studies conducted in Uganda and Kenya -- along with other studies in the U.S.,Zambia and Malawi -- have found that male circumcision reducesfemale-to-male transmission of HIV by 60%. According to Bailey, malecircumcision -- which the World Health Organization and UNAIDS have recommendedto help reduce transmission of the virus -- could prevent two millionnew HIV cases and 300,000 AIDS-related deaths in sub-Saharan Africaover 10 years.

"The challenge ahead for us is how to roll outcircumcision safely ... and to persuade leaders in countries that it isgoing to help their populations," Bailey said (Lee, Reuters,7/24). He added, "Circumcision is not just simply a medical procedure,it's tied up in a complex web of cultural and religious practices andbeliefs, so it's not easy for politicians and ministries of health tovery quickly come out in favor of circumcision in countries where it'snot traditionally practiced." Bailey said leaders in developingcountries need to endorse circumcision because international healthauthorities will not impose it because of concerns about appearingculturally insensitive. "But the time to act is right now," he said,adding, "Delaying the roll-out of circumcision could be causing moreharm, not just because more people are getting infected with HIV thannecessary, but also, people are going to unqualified practitioners" (AFP/Yahoo! News, 7/24).

According to Reuters,women in Africa likely will be the driving force behind malecircumcision as an HIV prevention method because traditionally they areassociated with ensuring hygiene in their communities. "Women, morethan men, equate circumcision with improved hygiene," Bailey said (Lee,Reuters, 7/24).

Michel Kazatchkine -- executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria-- said, "I believe that the evidence is overwhelming for the efficacyof circumcision," adding, "And if countries come to us ... I see noreason at all why we wouldn't fund that" (Foley, AP/Forbes, 7/24).

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Emerging Antiretrovirals, Genetic Engineering

Delegates at the conference also discussed emerging antiretrovirals, including integrase inhibitors, and techniques such as genetic engineering to treat HIV/AIDS, Reuters reports.

Joseph Eron, professor of medicine at the University of North Carolina-Chapel Hill,at the conference said recent research has shown that new classes ofantiretrovirals could offer treatment to HIV-positive people who havebecome resistant to first-line drugs. "I think that while it will takesome time, some of these new agents will also be very useful in thedeveloping world where we are seeing the emergence of resistant virus,"Eron said.

According to Reuters, human trials of anew technique of genetically modifying the blood stem cells and CD4+ Tcells of people living with HIV and reintroducing the cells back intothe body are about to begin. John Rossi, head of biological sciences atthe Beckman Research Institute at the City of Hope,said this technique is a "permanent modification of the cells. As longas the cells persist in the patient, they will be resistant to furtherinfection." He added, "We realize that this is not a treatment thatwill be applied universally," but the treatment should allow someHIV-positive people to reduce drug doses.

Rossi and Eron also called on drug companies to make new drugs available to developing countries, Reuters reports (Perry, Reuters, 7/24).

MSM Initiative


The American Foundation for AIDS Researchon Tuesday at the conference announced the launch of a globalinitiative to curb the spread of HIV among men who have sex with men,the Associated Press reports. According to statisticsreleased by amfAR, the number of HIV cases is increasing among MSM inAfrica, Asia and Latin America, and less than 5% of MSM have access toHIV-related health care.

Kevin Frost, CEO of amfAR, said, "It isestimated that one in 20 MSM have access to appropriate HIV prevention,treatment, care and support services." He added, "This is a massivefailure of the HIV/AIDS response globally and I think one that needs tobe addressed."

The initiative aims to raise $300 million duringthe next three years to provide grants for HIV/AIDS education andresearch among MSM in developing countries (Associated Press,7/24). The initiative also will support grassroots MSM organizationsand advocate for increased global attention and funding for HIV/AIDSprograms that are specific to MSM. Funding also will be allocated toepidemiological, demographic and policy research to inform moreeffective HIV prevention efforts (amfAR release, 7/24). "Empowering"MSM and "other marginalized groups to protect themselves from HIV isone of the world's most urgent health priorities," UNAIDS ExecutiveDirector Peter Piot said (Associated Press, 7/24).
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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily HIV/AIDS Report, search the archives, and signup for email delivery at kaisernetwork.org/email. The Kaiser Daily HIV/AIDS Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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