HIV, AIDS, PEPFAR, International AIDS Conference

************************ IPREX STUDY ON AIDS PREVENTION**********************

According to this study, an anti-retroviral pill--Truvada, a combination of two drugs, tenofovir and emtricitabine--helps prevent AIDS. The study, nicknamed iPrEx, included nearly 2,500 men in six countries and was co-ordinated by the Gladstone Institutes of the University of California, San Francisco. The results are better than the results made public in the summer of 2010 that a vaginal microbicide had protected 39% of all the women testing it and 54% of those who had used it faithfully.

Source: The Dallas Morning News (November 24, 2010)

************************ IPREX STUDY ON AIDS PREVENTION**********************

The biennial world conference on AIDS returned this year to Washington as approximately 20,000 scientists, doctors, policy-makers and patients gathered for a week-long discussion and debate on the latest curse on mankind. The International AIDS Society-organized conference began on July 22, 2012. The fight against HIV has taken a backseat in recent years because of global financial distrait and complacency. Last year (2011), $16.8 billion  was spent on HIV prevention in poor countries that had enabled eight million HIV patients to be accepted for treatment. An additional $7 billion funding is needed to provide access to 15 million people who will need the most by 2015. At present, 34.2 million live with HIV, and the International AIDS Society President Dr. Elly Katabira promised on the opening day (July 22, 2012) of the International AIDS Conference that the world "must resolve together never to go backwards". Even in the USA, 50,000 new cases of HIV are reported every year over the past several years, and 1.2 million people live with HIV with one-fifth not knowing about it.

Dallas to Join Fast-Track Cities Initiative
Dallas and surrounding cities will announce on August 26, 2019 that they are joining the Fast-Track Cities, an international campaign to end the HIV epidemic by 2030, according to an August 24, 2019, published report carried by The Dallas Morning News. The trio of tenets of the Fast-Track Cities are 90-90-90 rules, implying 90% of the people with HIV to be diagnosed and 90% of the diagnosed to be treated with anti-retroviral therapy to suppress the disease for 90% of the patients under therapy. After years of dramatic improvement, fight against HIV infection had stalled in recent years, according to a 2013 CDC report. Community activists in Dallas County are trying to reach out to the target population to urge them to take PrEP, or Pre-Exposure Prophylaxis, if they are at risk of infecting HIV and PEP, or Post-Exposure Prophylaxis, within 72 hours of infecting. 

************************** PEPFAR

Renewal of PEPFAR at Crosshairs of Partisan Battle

A successful program that had saved millions of people's lives in more than 50 nations across the globe and brought so much of political goodwill for the U.S. recently fell victim to partisan political bickering and GOP blackmail. The program, President's Emergency Plan for AIDS Relief, or PEPFAR, according to the July 31, 2023, edition of The Dallas Morning News, has invested more than $100 billion since its inception in 2003 and has been renewed three times with a five-year mandate each time. The current five-year term will expire on September 30, 2023, and the Congress is not even close to opening a meaningful negotiation to extend the program for another five years. The main contention is related to the Republican allegation--many health experts and PEPFAR groups call that sham at best and cynical at its worst--that PEPFAR funding is being diverted to fund abortions overseas. A New Jersey Republican member of the House, Rep. Christopher Smith, a key House panel chairman, shifted his stance over PEPFAR after a May 2023 Heritage Foundation report alleged abortion connection to PEPFAR funding and anti-abortion groups such as Heritage, Susan B. Anthony Pro-Life America and Family Research Council subsequently began to put pressure on Republican members not to renew the PEPFAR funding. A middle-ground of extending the PEPFAR funding for one year is being discussed too, but the White House insists that a clean bill of five-year extension is the one that it is looking forward to from the Congress. 

************************** PEPFAR

Daily Aspirin May Cut Cancer Risks

According to two new studies published March 20, 2012, taking aspirins every day may significantly reduce the risks of cancers and prevent tumors from spreading. One of the studies focused on tens of thousands of men and women from dozens of large, long-term Randomized Controlled trials conducted by the University of Oxford. As part of the study, the researchers, led by Dr. Peter Rothwell, found that three years after taking daily aspirin, the risk of developing cancers was reduced by almost 25 percent when compared to the control group of not taking aspirin. The same study found that the risk of dying of cancer after five years was 37 lower among those taking daily aspirin.

A second paper led by the same group of University of Oxford researchers found from five large RC trials that over the 6-and-1/2 years, the risk of metastatic cancer such as colorectal cancer was 36 percent lowers among the daily aspirin users when compared to nonusers. The risk of adenocarcinimas cancers such as colon, lung and prostate cancers was 46 percent lower among the daily aspirin users.

Both papers were published in the journal The Lancet.

A third paper, authored by Dr. Rothwell and his colleagues and published in the The Lancet Oncology, compared the findings of observational studies and randomized controlled studies of aspirin.

One of the concerns about the RC studies performed by the Oxford researchers is that they were not focused on cancer prevention. Instead they were focused on the effects of aspirin on prevention of heart disease. The Oxford researchers excluded two major U.S. studies, which could not prove the benefit of aspirin, as they involved taking aspirin every other day, instead of taking daily.

Revoking the Advanced Breast Cancer Drug

The Food and Drug Administration on November 18, 2011 ruled that Avastin should no longer be used to treat advanced breast cancer patients as the risks such as severe high blood pressure, bleeding, heart attack, or heart failure, perforations in kidney outweigh the benefits for the metastatic breast cancer patients. FDA Commissioner Dr. Margaret Hamburg said that she had arrived at the decision after much thought and with heavy heart. Avastin is world's best-selling cancer drug, and also is used to treat colon, kidney, lung and brain cancers. The FDA gave Genentech, the manufacturer of Avastin and part of the Swiss conglomerate Roche Group, in 2008 to market the drug under a special permit while the advanced studies and trial were continuing.

However, two new studies published in the January 26, 2012, New England Journal of Medicine, show that Avastin may be helpful for the early-stage cancer-stricken women. In one study, about one-third of women given Avastin plus chemotherapy for few months prior to surgery  have no cancer vs. 28 percent of the women in the control group given chemotherapy alone. In the second study, tumors disappeared for the 18 percent of the women in the experimental group (Avastin plus Chemo) vs. 15 percent of the women in the control group. The true test is whether Avastin helps improve survival. Women in Control and Experimental Groups in both studies are under continuing watch for that pattern to emerge.

HPV Vaccination Recommended for Boys

The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention on October 25, 2011 recommended HPV (human papillomavirus) vaccination for:

** Boys ages 11 and 12

** Males ages 13 through 21 if all three shots have not already be given

The HPV vaccination for boys were recommended against anal and throat cancers.

The same committee in 2006 recommended that all girls ages 11 to 26 should be vaccinated.

PSTF (PREVENTIVE SERVICES TASK FORCE) RECOMMENDATIONS

Avoid Prostate Cancer Test

The US Preventive Services Task Force on October 6, 2011 advised men to avoid PSA blood test as Prostate Specific Antigen (PSA) test leads to other needless tests and results in unnecessary treatments, causing incontinence, impotence, or both. PSA test is pretty common to screen cancer risks among males over 50. Two years ago, the panel created a huge national controversy as it had recommended, at that time, women in their 40s to forego routine mammogram screening. The panel opined that between 1986 and 2005, 1 million men received surgery, radiation therapy or both who would not have been treated without PSA test. Among them at least 5,000 died soon after the surgery, and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered incontinence, impotence, or both. As a result of these complications, the man who had discovered the test, Dr. Richard J. Abilin, called its widespread use a "public health disaster".

Anxiety Screening Recommended for non-elderly Adults

The U.S. Prevention Services Task Force on September 20, 2022 recommended screening for anxiety for adults younger than 65 years, highlighting a growing epidemic that had worsened during pandemic.