Emerging Issues on HIV/AIDS - December 25, 2024 Update: Well this briefing document is my Christmas present to everyone, particularly as it circulates on December 25/98! We are at the end of 1998 and looking ahead to 1999, hopefully it will be another year of scientific discoveries and effective treatments. Merry Christmas and Happy New Year. Laurie Morning After Pill for HIV Prevention? Recently much attention has been focused on a project taking place in San Francisco, which has raised many questions about HIV prevention and transmission. In the past few months, there has been much media focus on vaccines being tested for HIV, such as the new AIDSVAX. Although these are essential strides in our fight against HIV, many people may have overlooked a new form of possible HIV prevention which will be described in the following section. Most people are aware of the morning after pill available to women which is effective, up to 72 following intercourse, in preventing pregnancy. Now there is information emerging on a so-called morning after pill which is currently being studied, which has demonstrated strong results in the realm of HIV prevention. What is this new treatment? According to Gala (1998) the morning after pill is known as "post-exposure prophylaxis or PEP" (p. 7). PEP is the anti-HIV treatment which has been made available recently to health-care workers and victims of sexual assault who may have been exposed to HIV (Gala, 1998). Over the past year, PEP has been offered (free of charge) through a project in San Francisco in an effort to target high risk groups who are at risk for HIV infection.
According to the article, PEP was a project initiated by the city
of San Francisco and the AIDS Research Institute at the University of California. This
project was started in 1997 and provides patients who are at high risk for HIV infection
immediately following possible exposure: The hope of this PEP project is to eliminate and stop the virus before it enters into the bodys immune system. Current participants received a 28 day regiment of the treatment prophylaxis in a controlled environment, as well as a minimum of two anti-HIV drugs. The counseling program is focused on identifying high risk behaviors and outlining ways to reduce and/ or eliminate the risk of HIV infection for participants in the future. Through this intensive intervention, if PEP demonstrates positive results, the benefits could provide some well needed options for people today. One benefit from this project is that it will increase awareness of participants in order to prevent a future incident(s) of high risk behavior, and to educate participants of safer alternatives, thereby reducing the need for PEP. Study Supporting this Initiative: Health Care Workers: One recent study found that when PEP was administered to health care workers at risk for HIV infections through occupational hazards:
How was this program publicized? This project has been kept fairly quiet, with advertisement only originally occurring through word of mouth &/or publications directed at gay communities. Present-Day San Francisco Project: This project currently has an enrolment list of 215 participants, who are primarily Caucasian gay men who have been exposed through unsafe sexual practices (Gala, 1998). Since the initiation of this project no participants have tested positive for HIV infection. Future Plans: PEP project coordinators are hoping to expand the project in the future to provide services to more diverse populations including the following:
Costs: The current program is accompanied by an initially high price. According to PEPs public health director, Dr. Katz, the costs are broken down as follows: $500 - $1, 000 per patient for four weeks of drug therapy Yet how can we compare the costs of this preventative treatment, when we are aware that the cost for drug-treatment therapy for people living with HIV/ AIDS is nearly $15,000/mth for an indefinite amount of time. Gala (1998) estimated that for a person living with HIV/AIDS on drug-therapy can cost "between $150,000 to $200,000 for a person with HIV for a lifetime of care" (p. 7). Conclusion: According to oragnizers of PEP, they feel that this product should be available to everyone who is at risk for HIV infection, particularly if it can be effective. The director of the AIDS Reseach Institute in San Fransico, Dr. Coates, stated that "this is an elegant and important way of targeting those individuals who are exposing themselves, or exposing others, to HIV . . . if there is an opportunity to avoid infection, it should be offered to everyone" (Gala, 1998, p. 7). Fears:
Source: Gala (1998). You have 72 hours: morning after pill stirs controversy. The Gala Occasion, 7, 3, November, p. 7. International Information In the last briefing document, I gave an overview of what issues are of major concern globally. I feel that it is important to get a better sense of the distribution of HIV internationally.
Africa: (ICAD, 1998, p. 1).
Asia and the Pacific: (ICAD, 1998, p. 1).
Latin America and the Caribbean: (ICAD, 1998, p. 1).
Industrialized Countries of North America, Europe, Australia, and New Zealand: (ICAD, 1998, p. 1).
Eastern Europe and the Commonwealth of Independent States: (ICAD, 1998, p. 1). Source: Interagency Coalition on AIDS and Development (1998). AIDS in the World. Ottawa, ON. Available at: [email protected][Online]. STDs - How they affect HIV infection rates In a recent article from the Globe and Mail, research demonstrating the increased risk for HIV infection for people who have STDs was highlighted. The research outlined the following risk factors:
In Canada last year, 21.7% of new HIV infections were found among heterosexuals. However, people with STD have a two- to fivefold increased risk for HIV infection. The risk is the highest with herpes or syphilis that cause ulceration. If STDs are treated, the risk of HIV infection is reduced. Study: A randomized, controlled trial in Tanzania found that:
Study results:
Source: Silversides, A. (1998). People with STDs face higher risk of AIDS. The Globe and Mail, December 1, p. A23. |
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