New York, NY May 17, 2010 – For more than a decade, researchers and advocates have marked HIV Vaccine Awareness Day with varying degrees of hope, cynicism and despair. This year, in large part because of the results of the Thai Prime-Boost vaccine study, there is greater cause for hope than ever before and a renewed sense of urgency to transform this hope into a reality.
In September 2009, the world’s largest AIDS vaccine trial to date showed the first evidence that an experimental AIDS vaccine could lower the risk of HIV infection. The results were complex; the observed benefit from the vaccine was modest; and the field is still years away from a highly protective vaccine.
“The caveats to the Thai Prime-Boost study results are important and true. But letting them become the entire story does a severe, even dangerous, disservice to the field, the trial and especially the 16,000 people who participated in the trial,” said Mitchell Warren, Executive Director of AVAC: Global Advocacy for HIV Prevention. “Despite the many perspectives on and interpretations of the trial – and its results – the Thai AIDS vaccine trial provides evidence for the first time that it is possible to reduce the risk of HIV infection with a vaccine. AVAC and others have worked to explain the uncertainty of the results and the need for follow-up research. We will continue to do this because the science is complicated, and the future is unknown.”
But for HIV Vaccine Awareness Day, AVAC’s loud and clear message is that the Thai Prime-Boost trial changed the game for AIDS vaccines. A preventive AIDS vaccine is possible. The results were surprising to many and prompted some skepticism. But it is potentially disastrous if all that advocates, potential donors and future HIV vaccine trial volunteers and researchers think about the trial is that it gave a murky result, that it failed or that it left us no closer to an AIDS vaccine than we had been before.
“In fact, there’s renewed energy in the AIDS vaccine field today, even as we grapple with what these results mean and where we go from here,” said Warren. “The next steps for the field must involve more not less: more trials, more community volunteerism, more political will and sustained funding. One way to help ensure this is to celebrate what’s happened to date, even as we prepare for everything that still needs to be done.”
AVAC proposes three key steps for the AIDS vaccine field:
· Work aggressively to see what information can be gleaned from further analysis of the biological samples from more than 16,000 Thai men and women who participated in the trial and hope that we might learn why this vaccine combination worked at all.
· Build on this result, testing similar vaccines and combinations in different populations.
· Ensure that there is an increasingly diverse scientific portfolio to develop and test entirely different approaches.
There is no question that more resources are needed for existing AIDS treatment and prevention programs. People living with HIV deserve treatment and care, not waiting lists and death. But people who are at risk of HIV infection also deserve new ways to protect themselves.
Fully funding HIV treatment and prevention programs and HIV research would require only a fraction of the trillions of dollars governments have spent on bailing out big companies, and it would be a wise investment for the long-term economic stability of families, communities and nations.
“It’s easy to call for all of these things, but it is much, much harder to achieve them,” said Warren. “We hope that the next chapter of AIDS vaccine research shows the field capable of greater efficiency and prioritization: triaging current projects, jettisoning some, cutting costs within others, scaling up still others, and developing a clear strategy for collaborative action on key goals. We need a fully funded comprehensive approach to AIDS prevention and treatment, which includes finding new HIV prevention options, such as AIDS vaccines and antiretroviral-based HIV prevention, including pre-exposure prophylaxis (PrEP) and microbicide gels that could be used by women and men to protect themselves from HIV infection.”
The Thai Way Forward: A New Report from the Ground
To mark this HIV Vaccine Awareness Day, AVAC is launching The Thai Way Forward, which tells the story of the world’s largest AIDS vaccine trial using the voices of the people on the ground who made the trial happen.
“Every clinical trial, especially a large HIV prevention efficacy trial, is a complex story with fascinating characters, complex science and many perspectives. Success depends on a combination of coordination, communication, urgency and patience,” said Warren. “With this report, we wanted to delve into what actually happened in Thailand both during and after the trial and to see what the critical lessons are, not just for researchers and funders, but also for advocates and communities who are continuing the work of finding new ways to end the AIDS epidemic.”
Award-winning journalist Tom Paulson traveled to Thailand where he interviewed community leaders, government officials, researchers, trial participants, clinic staff and AIDS activists about what went right and what went wrong with the trial. The resulting report provides lessons about community engagement and approaches to international collaboration as well as important insights for developing trial protocols and planning for follow-up research once a trial is complete.
The Thai Way Forward is an excerpt from AVAC’s annual state of the field report, Turning the Page, which will be released in July ahead of the International AIDS Conference.
As this report from Thailand makes clear, the search for an AIDS vaccine has been tumultuous and often divisive, much like the overall response to the AIDS epidemic.
“The global response to AIDS is in trouble. There are yawning gaps in funding for proven prevention and treatment and a crisis in political will for continued support of AIDS programs.” Warren said. “We face skepticism about whether responding to AIDS is cost effective and whether limited funds for AIDS should include funding for AIDS prevention research. We have to meet this skepticism with honesty about what we know and clarity about the cause for hope that exists today in a way that it never has before.”
The Thai Way Forward is available online at www.avac.org/avacreport.
Monday, May 17, 2010
Monday, May 3, 2010
A Case for New HIV Prevention Technologies
I bring to your attention the following extract from a story that I posted previously on this blog:
" HARARE, 14 April 2010 (Plus News) - A new report by Zimbabwe's National AIDS Council (NAC), showing a dramatic rise in sexually transmitted infections (STIs) among people aged 15 to 24 in the capital, Harare, has health experts worried that the country's success in reducing HIV could be unravelling.
STIs heighten vulnerability to HIV infection, and this age group is one of the hardest hit. According to the NAC report, more than 24,000 people were treated for STIs in 2009, compared to 8,500 cases recorded in 2008; over 60 percent of the cases were women."
The bigger problem that most of us may have overlooked is that "60% of the cases were women." Women continue to be at the receiving end of the consequences of bad sexual decisions. No matter how much we can argue about women having been empowered, it is evident from the above statistic that women are still being subjected to unsafe sex.
The sad scenario being painted here is even made worse by the revelation that these are women between the 15-24 year age group. One would have thought that this generation of women is more empowered than those of the 25+ generation.
It therefore goes without argument that there is an urgent need for new alternative HIV prevention technologies that will empower women to protect themselves against STIs and HIV.
Microbicides and Pre-Exposure Prophylaxis (PrEP) trials underway are key biomedical developments that hold a lot of hope for women all over the world who cannot negotiate for safe sex. It is my hope that these clinical researches will yield the desired results and put women in a position to access SAFE & SATISFYING sex.
" HARARE, 14 April 2010 (Plus News) - A new report by Zimbabwe's National AIDS Council (NAC), showing a dramatic rise in sexually transmitted infections (STIs) among people aged 15 to 24 in the capital, Harare, has health experts worried that the country's success in reducing HIV could be unravelling.
STIs heighten vulnerability to HIV infection, and this age group is one of the hardest hit. According to the NAC report, more than 24,000 people were treated for STIs in 2009, compared to 8,500 cases recorded in 2008; over 60 percent of the cases were women."
The bigger problem that most of us may have overlooked is that "60% of the cases were women." Women continue to be at the receiving end of the consequences of bad sexual decisions. No matter how much we can argue about women having been empowered, it is evident from the above statistic that women are still being subjected to unsafe sex.
The sad scenario being painted here is even made worse by the revelation that these are women between the 15-24 year age group. One would have thought that this generation of women is more empowered than those of the 25+ generation.
It therefore goes without argument that there is an urgent need for new alternative HIV prevention technologies that will empower women to protect themselves against STIs and HIV.
Microbicides and Pre-Exposure Prophylaxis (PrEP) trials underway are key biomedical developments that hold a lot of hope for women all over the world who cannot negotiate for safe sex. It is my hope that these clinical researches will yield the desired results and put women in a position to access SAFE & SATISFYING sex.
Friday, April 23, 2010
CAPRISA 004
Phase IIb Trial to Assess the Safety and Effectiveness of the Vaginal Microbicide 1% Tenofovir Gel for the Prevention of HIV Infection in Women.
Conducted in South Africa this phase IIb, two-arm, double-blinded, randomised, placebo controlled trial comparing 1% Tenofovir gel with a placebo gel was an expanded safety and effectiveness trial involving 900 young women at risk of sexually transmitted HIV infection. Participants were provided with a supply of single-use, pre-filled applicators according to their randomisation. While in the study, participants were asked to apply a first dose of the assigned study gel within 12 hours prior to coitus and insert a second dose as soon as possible within 12 hours after coitus. All participants received HIV risk reduction counselling, condoms, and syndromic treatment of sexually transmitted infections, if required.
Further study details as provided by Centre for the AIDS Programme of Research in South Africa:
Primary Outcome Measures:
•Comparison of HIV incidence rates in 2 arms (tenofovir vs placebo) [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
Secondary Outcome Measures:
•To assess the impact, if any, of tenofovir gel on the incidence rate of deep epithelial disruption [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess the impact, if any, of tenofovir gel on viral load in women who become infected with HIV during the trial. [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess tenofovir resistance in HIV seroconvertors in the trial [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To ascertain the impact, if any, of tenofovir gel on pregnancy rates and outcomes [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess the impact, if any, of product hold at study exit on HIV infection and tenofovir resistance [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
Enrollment: 900
Study Start Date: May 2007
Study Completion Date: March 2010
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Results are anticipated in July 2010 and their outcome has a bearing on ongoing trials in Zimbabwe.
Source: http://clinicaltrials.gov
Conducted in South Africa this phase IIb, two-arm, double-blinded, randomised, placebo controlled trial comparing 1% Tenofovir gel with a placebo gel was an expanded safety and effectiveness trial involving 900 young women at risk of sexually transmitted HIV infection. Participants were provided with a supply of single-use, pre-filled applicators according to their randomisation. While in the study, participants were asked to apply a first dose of the assigned study gel within 12 hours prior to coitus and insert a second dose as soon as possible within 12 hours after coitus. All participants received HIV risk reduction counselling, condoms, and syndromic treatment of sexually transmitted infections, if required.
Further study details as provided by Centre for the AIDS Programme of Research in South Africa:
Primary Outcome Measures:
•Comparison of HIV incidence rates in 2 arms (tenofovir vs placebo) [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
Secondary Outcome Measures:
•To assess the impact, if any, of tenofovir gel on the incidence rate of deep epithelial disruption [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess the impact, if any, of tenofovir gel on viral load in women who become infected with HIV during the trial. [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess tenofovir resistance in HIV seroconvertors in the trial [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To ascertain the impact, if any, of tenofovir gel on pregnancy rates and outcomes [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
•To assess the impact, if any, of product hold at study exit on HIV infection and tenofovir resistance [ Time Frame: April 2010 ] [ Designated as safety issue: Yes ]
Enrollment: 900
Study Start Date: May 2007
Study Completion Date: March 2010
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Results are anticipated in July 2010 and their outcome has a bearing on ongoing trials in Zimbabwe.
Source: http://clinicaltrials.gov
Tuesday, April 20, 2010
Civil society and media have shared responsibility to ensure accurate, non-stigmatising reporting on HIV
News: SAfAIDS Media Desk
16 April 2010
************
PRETORIA - The fight against HIV needs to be multi-sectoral and inclusive, and the media should remain a strategic partner in interventions. This was said by Mr. Jason Wessenaar, Project Director of the Siyasi Counselling and Testing Project in response to assertions that the language used by media practitioners when talking about HIV and AIDS issues often stigmatises and has done a lot of harm to, and compromised the fight against the epidemic.
The discussion followed his presentation titled using culture to address HIV and discrimination among people living with HIV' where he spoke about the importance of being careful of the language stakeholders use, as it may further stigma; terms including HIV/AIDS as opposed to HIV and AIDS, AIDS orphans as opposed to orphans and being clear to distinguish between people living with HIV and those who have AIDS were discussed.
Mr. Wessenaar explained that in South Africa, non-stigma guidelines for use in work with media practitioners - both journalists and editors - to inform reporting on HIV and gender issues have been developed. These guidelines can also be used in the workplace, and with faith based organisations. Further, a National Stigma Framework has also been developed for use by all sectors.
Media practitioners attending the Conference asserted that in their studies, journalists are not afforded the opportunity to specialise, in HIV and gender reporting for instance. Specialisation comes through the information and training that journalists receive in workshops, trainings and conferences; so civil society organisations and activists need to take some responsibility for the information that the media takes forward and circulates.
The meeting agreed that the fight against HIV must be a collective effort which includes all relevant sectors; there should be no exclusion.
Both the non-stigma guidelines and the National Stigma Framework were developed by the Siyam'kela Stigma Project at the Centre for the Study of AIDS at the University of Pretoria.
---------
This article covers the recently ended Changing the River's Flow Conference held at Birchwood Hotel, Johannesburg, South Africa from the 12th to the 13th of April 2010.
16 April 2010
************
PRETORIA - The fight against HIV needs to be multi-sectoral and inclusive, and the media should remain a strategic partner in interventions. This was said by Mr. Jason Wessenaar, Project Director of the Siyasi Counselling and Testing Project in response to assertions that the language used by media practitioners when talking about HIV and AIDS issues often stigmatises and has done a lot of harm to, and compromised the fight against the epidemic.
The discussion followed his presentation titled using culture to address HIV and discrimination among people living with HIV' where he spoke about the importance of being careful of the language stakeholders use, as it may further stigma; terms including HIV/AIDS as opposed to HIV and AIDS, AIDS orphans as opposed to orphans and being clear to distinguish between people living with HIV and those who have AIDS were discussed.
Mr. Wessenaar explained that in South Africa, non-stigma guidelines for use in work with media practitioners - both journalists and editors - to inform reporting on HIV and gender issues have been developed. These guidelines can also be used in the workplace, and with faith based organisations. Further, a National Stigma Framework has also been developed for use by all sectors.
Media practitioners attending the Conference asserted that in their studies, journalists are not afforded the opportunity to specialise, in HIV and gender reporting for instance. Specialisation comes through the information and training that journalists receive in workshops, trainings and conferences; so civil society organisations and activists need to take some responsibility for the information that the media takes forward and circulates.
The meeting agreed that the fight against HIV must be a collective effort which includes all relevant sectors; there should be no exclusion.
Both the non-stigma guidelines and the National Stigma Framework were developed by the Siyam'kela Stigma Project at the Centre for the Study of AIDS at the University of Pretoria.
---------
This article covers the recently ended Changing the River's Flow Conference held at Birchwood Hotel, Johannesburg, South Africa from the 12th to the 13th of April 2010.
Friday, April 16, 2010
Worrying rise in STIs among young people
News:14 April 2010
************
HARARE, 14 April 2010 (PlusNews) - A new report by Zimbabwe's National AIDS Council (NAC), showing a dramatic rise in sexually transmitted infections (STIs) among people aged 15 to 24 in the capital, Harare, has health experts worried that the country's success in reducing HIV could be unravelling.
STIs heighten vulnerability to HIV infection, and this age group is one of the hardest hit. According to the NAC report, more than 24,000 people were treated for STIs in 2009, compared to 8,500 cases recorded in 2008; over 60 percent of the cases were women.
During this time almost 900,000 male condoms and over 155,000 female condoms were distributed in Harare. Itai Rusike, executive director of the Community Working Group on Health (CWGH), a network of civic groups that promote health awareness, blamed the rise in STIs on a too narrow focus on HIV and AIDS treatment.
"In the last two to four years we have concentrated our focus on access to treatment, especially access to ARVs (antiretrovirals), at the expense of preventive services," he told IRIN/PlusNews.
"Right now the bulk of our AIDS levy money [a 3 percent tax on income] is going towards procurement of ARVs, to the detriment of health education awareness campaigns, especially for the young adults who are supposed to be our hope for the future."
Zimbabwe's adult HIV prevalence has been on a downward trend, dropping from 14.1 percent in 2008 to 13.7 percent in 2009.
Young people neglected
In 2009 the CWGH conducted an assessment of young people's needs for sexual reproductive health and HIV and AIDS interventions, which indicated that sex work, intergenerational relationships, early marriage, early sexual debut and unplanned pregnancy were among the challenges they faced.
In its recently published 2009 annual report the CWGH noted that young people had limited access to reproductive health information and services. "If we do not invest in preventive services, all the gains we have scored so far in HIV prevalence rate will be eroded," Rusike warned.
''If we do not invest in preventive services, all the gains we have scored so far in HIV prevalence rate will be eroded''
"Youth-led peer education activities need to be well co-ordinated and supported with financial resources, education materials, mentoring and capacity building, in order for them to be sustainable," he pointed out.
Orirando Manwere, a National AIDS Council (NAC) information officer, agreed that the rise in STI infections was an urgent call to action. "There is a need to carry out a study on why this is the trend, but generally this could be attributed to early sexual debut among the youth, unprotected sex, abuse by older men - particularly among the women and girls."
Manwere said Zimbabwe's current policy on sex education did not allow HIV and AIDS organizations to go into schools and teach young people about issues like condom use, but discussions between non-governmental organisations and government were ongoing. "It is clear that the youth are indeed sexually active and need to be empowered on sexual and reproductive health issues."
Political disruptions
AIDS activist Martha Tholanah attributed the STI increase to the violence that occurred in the aftermath of the March 2008 election.
"Youths were used to target other youths - we had reported cases of a sexual violence, which I do not think were followed up adequately, as many actors were very fearful of the repercussions if they dealt with these issues."
Many organizations, especially those working with young people, are still struggling to get on their feet after the economic and political disruptions of 2008 and beyond.
"I do not think many organisations working on sexual and reproductive health have regained the impetus they had before political and economic disruptions," Tholanah commented. "I believe we will still see more negative health effects resulting from that era."
Online at: http://www.plusnews.org/report.aspx?ReportID=88810
************
HARARE, 14 April 2010 (PlusNews) - A new report by Zimbabwe's National AIDS Council (NAC), showing a dramatic rise in sexually transmitted infections (STIs) among people aged 15 to 24 in the capital, Harare, has health experts worried that the country's success in reducing HIV could be unravelling.
STIs heighten vulnerability to HIV infection, and this age group is one of the hardest hit. According to the NAC report, more than 24,000 people were treated for STIs in 2009, compared to 8,500 cases recorded in 2008; over 60 percent of the cases were women.
During this time almost 900,000 male condoms and over 155,000 female condoms were distributed in Harare. Itai Rusike, executive director of the Community Working Group on Health (CWGH), a network of civic groups that promote health awareness, blamed the rise in STIs on a too narrow focus on HIV and AIDS treatment.
"In the last two to four years we have concentrated our focus on access to treatment, especially access to ARVs (antiretrovirals), at the expense of preventive services," he told IRIN/PlusNews.
"Right now the bulk of our AIDS levy money [a 3 percent tax on income] is going towards procurement of ARVs, to the detriment of health education awareness campaigns, especially for the young adults who are supposed to be our hope for the future."
Zimbabwe's adult HIV prevalence has been on a downward trend, dropping from 14.1 percent in 2008 to 13.7 percent in 2009.
Young people neglected
In 2009 the CWGH conducted an assessment of young people's needs for sexual reproductive health and HIV and AIDS interventions, which indicated that sex work, intergenerational relationships, early marriage, early sexual debut and unplanned pregnancy were among the challenges they faced.
In its recently published 2009 annual report the CWGH noted that young people had limited access to reproductive health information and services. "If we do not invest in preventive services, all the gains we have scored so far in HIV prevalence rate will be eroded," Rusike warned.
''If we do not invest in preventive services, all the gains we have scored so far in HIV prevalence rate will be eroded''
"Youth-led peer education activities need to be well co-ordinated and supported with financial resources, education materials, mentoring and capacity building, in order for them to be sustainable," he pointed out.
Orirando Manwere, a National AIDS Council (NAC) information officer, agreed that the rise in STI infections was an urgent call to action. "There is a need to carry out a study on why this is the trend, but generally this could be attributed to early sexual debut among the youth, unprotected sex, abuse by older men - particularly among the women and girls."
Manwere said Zimbabwe's current policy on sex education did not allow HIV and AIDS organizations to go into schools and teach young people about issues like condom use, but discussions between non-governmental organisations and government were ongoing. "It is clear that the youth are indeed sexually active and need to be empowered on sexual and reproductive health issues."
Political disruptions
AIDS activist Martha Tholanah attributed the STI increase to the violence that occurred in the aftermath of the March 2008 election.
"Youths were used to target other youths - we had reported cases of a sexual violence, which I do not think were followed up adequately, as many actors were very fearful of the repercussions if they dealt with these issues."
Many organizations, especially those working with young people, are still struggling to get on their feet after the economic and political disruptions of 2008 and beyond.
"I do not think many organisations working on sexual and reproductive health have regained the impetus they had before political and economic disruptions," Tholanah commented. "I believe we will still see more negative health effects resulting from that era."
Online at: http://www.plusnews.org/report.aspx?ReportID=88810
Wednesday, April 14, 2010
THE IMPACT OF MEDIA ON ADOLESCENTS' SEXUAL BEHAVIOUR
The effects of media consumption on young people's attitudes and behaviour
regarding sex should be of increasing interest to policy makers and program planners.
One concern is the extent to which frequent consumption of media with high levels of sexual content and low levels of portrayal of responsible sexual conduct is a causal influence on young people's subsequent sexual behaviour, including the responsible use of protection from pregnancy and disease.
Three basic areas for concern:
(1) What sexual content do youth pay attention to, and how they interpret what
they see and hear;
(2) Effect of media content on adolescents’ sexual beliefs and behaviour; and
(3) How the mass media can be used to promote responsible sexual behavior among
youth
The effects, if any, of growing up in an environment saturated by media that focuses on sexual behavior.
Frequent consumption of media with high levels of sexual content and low levels of portrayal of responsible sexual conduct is a causal influence on young people's subsequent sexual behaviour and young people's understanding of the dynamics and risks of sexual intercourse and its consequences are improved via their use of media. The content of various forms of media affects young people's attitudes and behaviour with regard to sexual intercourse.
Young people are heavy consumers of sexually-oriented media including TV, broadcast and satellite channels, videos, movies, magazines, and, more recently, the Internet. Content analysis has also demonstrated that broadcast satellite television contains a high, growing and increasingly explicit dose of sexual messages, and that a low proportion of such messages display or model either restraint or contraceptive use.
Forms of media are changing constantly, so that media "diets" may be changing in
unknown, and as yet, uncharted ways. Developmentally, young people gain more
control over their media use as they mature. Individuals may selectively use and
change their use of media, in ways not clearly understood. Age, gender,
race/ethnicity and social class may influence what media individuals have access
to and choose to pay attention to. There are also suggestions that self-definition as a member of a particular clique or crowd may influence young people's choice of media. No one form of media use predominates in adolescence.
For the purposes of this article, "media" are taken to mean information and images
delivered via: printed matter, such as newspapers, magazines, and comic books;
radio, both music and talk; TV, broadcast, satellite and video, including music
videos; movies, tapes and compact discs and the games and information accessible
through computers on the Internet and World Wide Web. Program content and
advertising are both included. Unlimited access to the Internet and to the wide
range of services available on the World Wide Web is of growing interest. The
number of individuals who have ready access to computers is growing daily.
Mass media are to a great extent fueled by commercial enterprises which have as
their goals influencing individuals' purchasing decisions. While messages may
be targeted to one or another group of individuals, there is limited or no
control over who actually listens to or understands or acts upon the information
or images disseminated.
There is therefore a need for policy makers and programme planners to recognise the role played by the mass media in modelling the sexual orientation and behaviour of adolescents.
regarding sex should be of increasing interest to policy makers and program planners.
One concern is the extent to which frequent consumption of media with high levels of sexual content and low levels of portrayal of responsible sexual conduct is a causal influence on young people's subsequent sexual behaviour, including the responsible use of protection from pregnancy and disease.
Three basic areas for concern:
(1) What sexual content do youth pay attention to, and how they interpret what
they see and hear;
(2) Effect of media content on adolescents’ sexual beliefs and behaviour; and
(3) How the mass media can be used to promote responsible sexual behavior among
youth
The effects, if any, of growing up in an environment saturated by media that focuses on sexual behavior.
Frequent consumption of media with high levels of sexual content and low levels of portrayal of responsible sexual conduct is a causal influence on young people's subsequent sexual behaviour and young people's understanding of the dynamics and risks of sexual intercourse and its consequences are improved via their use of media. The content of various forms of media affects young people's attitudes and behaviour with regard to sexual intercourse.
Young people are heavy consumers of sexually-oriented media including TV, broadcast and satellite channels, videos, movies, magazines, and, more recently, the Internet. Content analysis has also demonstrated that broadcast satellite television contains a high, growing and increasingly explicit dose of sexual messages, and that a low proportion of such messages display or model either restraint or contraceptive use.
Forms of media are changing constantly, so that media "diets" may be changing in
unknown, and as yet, uncharted ways. Developmentally, young people gain more
control over their media use as they mature. Individuals may selectively use and
change their use of media, in ways not clearly understood. Age, gender,
race/ethnicity and social class may influence what media individuals have access
to and choose to pay attention to. There are also suggestions that self-definition as a member of a particular clique or crowd may influence young people's choice of media. No one form of media use predominates in adolescence.
For the purposes of this article, "media" are taken to mean information and images
delivered via: printed matter, such as newspapers, magazines, and comic books;
radio, both music and talk; TV, broadcast, satellite and video, including music
videos; movies, tapes and compact discs and the games and information accessible
through computers on the Internet and World Wide Web. Program content and
advertising are both included. Unlimited access to the Internet and to the wide
range of services available on the World Wide Web is of growing interest. The
number of individuals who have ready access to computers is growing daily.
Mass media are to a great extent fueled by commercial enterprises which have as
their goals influencing individuals' purchasing decisions. While messages may
be targeted to one or another group of individuals, there is limited or no
control over who actually listens to or understands or acts upon the information
or images disseminated.
There is therefore a need for policy makers and programme planners to recognise the role played by the mass media in modelling the sexual orientation and behaviour of adolescents.
Tuesday, April 13, 2010
Microbicides, vaccines may need to repel HIV contact at mucosa
http://www.aidsmap.com/en/news/5B7B6E24-E8DE-4E40-86A9-3BB6E18F043C.asp
April 9, 2010
*****************************
Found in today’s AIDSmap news. Informs ecology between HIV and mucosa; also enlightens an increasingly prevalent topic in AIDS pathology studies, the phenomena – and implications – of chronic inflammation within GI tract:
Keith Alcorn, Friday, April 09, 2010
HIV can damage the walls of cells in the mucous membranes in the genital tract and the intestines, permitting the virus to pass across these barriers and infect vulnerable cells below, even when the tissue is undamaged, Canadian researchers report this week in the journal PLoS Pathogens.
The findings suggest that microbicides and vaccines may have the greatest chance of success if they can limit or prevent completely contacts between HIV's gp120 surface protein and cells in the mucous membranes of the genital tract and the intestines.
The events taking place when HIV comes into contact with mucous membranes and the immune reactions that occur within the mucosa are a critical area of research for scientists hoping to develop new methods of preventing HIV infection. All sexual transmission of HIV occurs through mucous membranes.
In their research the group from McMaster University, Ontario, with colleagues from the University of Toronto and Laval University found that in the test tube HIV’s envelope protein gp120 stimulated production of inflammatory cytokines in mucous membrane cells which made the membrane more permeable.
The authors say that this mechanism could allow HIV to enter cells below the mucous membrane surface even when it is undamaged, and may also explain why bacteria `translocate` across the intestinal wall in people with HIV more frequently than in uninfected people.
This translocation of bacteria is responsible for immune activation in people with HIV, in the view of some researchers, and may drive not only HIV disease progression but also the development of serious conditions such as atherosclerosis which are promoted by the inflammatory state that exists in people with highly activated immune systems.
Previously researchers into HIV transmission had thought that transmission was most likely to occur either when the mucous membrane was damaged (for example through trauma or ulceration) or when many activated immune cells were present (such as during a sexually transmitted infection like gonorrhoea).
But the McMaster University group found that HIV can weaken the integrity of surface cells, even when they are undamaged.
"What it does is that it makes the electrical barrier resistance of epithelial cells decrease. By doing that, the virus can cross the barrier," said lead researcher Charu Kaushic, associate professor in the Centre for Gene Therapeutics at McMaster University.
Scientists have been faced with the question of how HIV actually gets underneath epithelial cells to infect other cells that are susceptible to HIV. "It's not the cells on top," Kaushic said. "It is the immune cells underneath that have all the receptors that HIV likes to latch on to and that allow the virus to replicate and establish infection. But it has to cross the epithelial barrier first!"
The McMaster researchers grew purified primary epithelial cells in the laboratory from small pieces of tissues that were removed from women's uterus during hysterectomies, with their consent. Then, they began to study how HIV actually interacts with these cells. The electrical resistance in these cultures is used to monitor how well the epithelial cell cultures are growing and functioning.
Aisha Nazli, a researcher in Kaushic's laboratory, noticed every time she put HIV on epithelial cells their resistance went down significantly. Repeated tests confirmed this.
Kaushic said the surface protein of the virus causes the epithelial barrier to break. "The surface protein signals to the inside of the epithelial cells by binding to it", she said. "The epithelial cells start making inflammatory proteins which cause these cells to go on their self-destructive pathway."
The researchers say that providing viral load and exposure time are sufficient, HIV can probably disrupt any mucosal barrier in the body, although infection may not necessarily occur every time.
"This is a significant step forward in defining where prevention strategies, such as microbicides and vaccine, need to focus. Instead of trying to stop HIV from infecting the target cells underneath the epithelium, we need to think about ways to stop the virus from attaching to epithelial cells themselves," said Charu Kaushic.
Reference
Nazli A et al. Exposure to HIV-1 directly impairs mucosal epithelial barrier integrity allowing microbial translocation. PLoS Pathogens 6 (4): e1000852, 2010.
April 9, 2010
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Found in today’s AIDSmap news. Informs ecology between HIV and mucosa; also enlightens an increasingly prevalent topic in AIDS pathology studies, the phenomena – and implications – of chronic inflammation within GI tract:
Keith Alcorn, Friday, April 09, 2010
HIV can damage the walls of cells in the mucous membranes in the genital tract and the intestines, permitting the virus to pass across these barriers and infect vulnerable cells below, even when the tissue is undamaged, Canadian researchers report this week in the journal PLoS Pathogens.
The findings suggest that microbicides and vaccines may have the greatest chance of success if they can limit or prevent completely contacts between HIV's gp120 surface protein and cells in the mucous membranes of the genital tract and the intestines.
The events taking place when HIV comes into contact with mucous membranes and the immune reactions that occur within the mucosa are a critical area of research for scientists hoping to develop new methods of preventing HIV infection. All sexual transmission of HIV occurs through mucous membranes.
In their research the group from McMaster University, Ontario, with colleagues from the University of Toronto and Laval University found that in the test tube HIV’s envelope protein gp120 stimulated production of inflammatory cytokines in mucous membrane cells which made the membrane more permeable.
The authors say that this mechanism could allow HIV to enter cells below the mucous membrane surface even when it is undamaged, and may also explain why bacteria `translocate` across the intestinal wall in people with HIV more frequently than in uninfected people.
This translocation of bacteria is responsible for immune activation in people with HIV, in the view of some researchers, and may drive not only HIV disease progression but also the development of serious conditions such as atherosclerosis which are promoted by the inflammatory state that exists in people with highly activated immune systems.
Previously researchers into HIV transmission had thought that transmission was most likely to occur either when the mucous membrane was damaged (for example through trauma or ulceration) or when many activated immune cells were present (such as during a sexually transmitted infection like gonorrhoea).
But the McMaster University group found that HIV can weaken the integrity of surface cells, even when they are undamaged.
"What it does is that it makes the electrical barrier resistance of epithelial cells decrease. By doing that, the virus can cross the barrier," said lead researcher Charu Kaushic, associate professor in the Centre for Gene Therapeutics at McMaster University.
Scientists have been faced with the question of how HIV actually gets underneath epithelial cells to infect other cells that are susceptible to HIV. "It's not the cells on top," Kaushic said. "It is the immune cells underneath that have all the receptors that HIV likes to latch on to and that allow the virus to replicate and establish infection. But it has to cross the epithelial barrier first!"
The McMaster researchers grew purified primary epithelial cells in the laboratory from small pieces of tissues that were removed from women's uterus during hysterectomies, with their consent. Then, they began to study how HIV actually interacts with these cells. The electrical resistance in these cultures is used to monitor how well the epithelial cell cultures are growing and functioning.
Aisha Nazli, a researcher in Kaushic's laboratory, noticed every time she put HIV on epithelial cells their resistance went down significantly. Repeated tests confirmed this.
Kaushic said the surface protein of the virus causes the epithelial barrier to break. "The surface protein signals to the inside of the epithelial cells by binding to it", she said. "The epithelial cells start making inflammatory proteins which cause these cells to go on their self-destructive pathway."
The researchers say that providing viral load and exposure time are sufficient, HIV can probably disrupt any mucosal barrier in the body, although infection may not necessarily occur every time.
"This is a significant step forward in defining where prevention strategies, such as microbicides and vaccine, need to focus. Instead of trying to stop HIV from infecting the target cells underneath the epithelium, we need to think about ways to stop the virus from attaching to epithelial cells themselves," said Charu Kaushic.
Reference
Nazli A et al. Exposure to HIV-1 directly impairs mucosal epithelial barrier integrity allowing microbial translocation. PLoS Pathogens 6 (4): e1000852, 2010.
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