HIV Testing for Everyone? Experts Say Yes

ABC News Radio(WASHINGTON) -- About 1.2 million people in the U.S. are HIV-positive. And about one in five of them doesn't know it.

In an effort to broaden the front in the war on AIDS, experts now says almost everyone should be tested for the AIDS virus -- probably including you.
 
Those who don't know they are infected are believed to transmit about 20,000 new cases of AIDS each year.
 
The U.S. Preventive Services task force now recommends that all people ages 15 to 65 get tested for AIDS. Those younger or older who have increased risk factors should also be screened, according to the task force's new recommendations.
 
Risk factors include:

• unprotected sex with multiple partners
• any partner with HIV
• any injection drug use, and
• exchanging sex for money

The task force also says that all pregnant women should be tested for the HIV virus.
 
Earlier diagnosis means earlier treatment, and that means sharp reductions in the spread of AIDS and in AIDS-related deaths.
 
Copyright 2012 ABC News Radio

AIDS Conference Turns Focus to the Future

Alex Wong/Getty Images(WASHINGTON) -- After stirring up enthusiasm and hope that the end of the AIDS epidemic may finally be possible, scientists, policymakers and others at the International AIDS Conference on Tuesday turned their focus to the challenges -- and potential solutions -- that lie ahead in the fight against HIV.

There remain more than 50,000 new HIV infections each year in the United States, and new data from the HIV Prevention Trials Network presented this week showed that the rate of HIV among black gay men under age 30 is nearly 6 percent -- a rate as high as that in Sub-Saharan countries in Africa most affected by the virus.

"In the U.S., the burden of HIV is not shared equally by population or region," said assistant Health and Human Services (HHS) secretary Dr. Howard Koh.

Addressing HIV-related health disparities is one of three overarching goals of the the U.S. National HIV/AIDS Strategy, along with reducing new infections and increasing access to HIV care.  Such a strategic national approach is critical in addressing the HIV epidemic, Koh said.

Launched in 2010, the strategy outlines a list of specific goals, including decreasing the number of yearly HIV infections by 25 percent by the year 2015.

"We are making important progress," Koh said.  For example, he noted, among the more than 8,000 publicly funded community health centers in the United States there has been a 13 percent increase in people tested for HIV in the past year.

He also cited a national campaign to decrease HIV-related stigma, as well as nearly $80 million in new grants to expand HIV care announced by HHS Secretary Kathleen Sebelius earlier this week.  New data, however, is not yet available to assess the impact of these initial steps.

As policymakers grappled with how best to stem the spread of HIV, scientists considered the progress in a search for an HIV cure.

"The field is quickly advancing," said AIDS researcher Dr. Javier Martinez-Picado, senior investigator at the IrsiC-aixa AIDS Research Institute in Spain.  Yet, Martinez-Picado said he foresees several more years of laboratory research to advance basic science knowledge before considering clinical trials.

But as the world waits for science to progress in research labs, doctors need to use the tools available now in the most efficient way possible, said Dr. Nelly Mugo of the University of Nairobi and Kenyatta Hospital in Kenya.

Mugo stressed that with the advent of a new set of proven prevention strategies -- antiretroviral therapy early in the course of disease, pre-exposure prophylaxis and voluntary male circumcision -- it is critical to tailor packages of HIV interventions to specific populations.

"The interventions and the things that work for men who have sex with men in Cambodia may be very different for heterosexual individuals in Africa," she said, adding that the world needs to "be ready to get rid of those policies and approaches that do not work," in order to "focus resources and efforts on what is proven and impactful."

Copyright 2012 ABC News Radio

Sex Workers, Drug Users, Protest Stigma During AIDS Conference

Alex Wong/Getty Images(WASHINGTON) -- A crimson wall made its way across Washington D.C., Tuesday as more than 1,000 sex workers, drug users and AIDS activists -- many of them carrying red umbrellas to fend off the rain -- marched toward the White House to protest the stigma associated with their activities, a stigma they believe contributes to the spread of HIV/AIDS.

Protesters held up signs reading "Fight AIDS! No More Drug War!" and "Stop the Witch Hunt against Sex Workers."

"Sex work is work," the group chanted, responding to demonstration leaders holding megaphones.

The demonstrators were calling for the decriminalization of drugs and sex work, which they argue would encourage people to practice safer sex.

The march was one of five protests that joined -- in front of the White House -- different groups affected by HIV and AIDS. The demonstrations coincided with the 19th International AIDS Conference, which is taking place in the nation's capital this week, the first time the U.S. has hosted it in 22 years. Until 2009, a U.S. travel ban denied visas to people who had HIV.

Most protesters delivered their message on posters and in chants, but a group of Canadian AIDS activists wore only underwear that bore the message, "I party, I bareback, I'm positive, I'm responsible."

"Bareback" refers to the practice of engaging in sex without condoms.

"People who are positive have sex," said activist Jessica Whitbread. "They should be able to negotiate the kind of sex they want to have. Putting the responsibility of prevention on them creates stigma, and only continues the spread of the disease."

Bryan Floury also opted for a more eye-catching display, wearing a hat littered with different condom brands while holding a sign reading, "Teach Condom Sense."

"Everybody likes looking at the guy in condoms," Floury joked, but later, on a more serious note, compared sex education to basic training.

"We need to train students like soldiers, train them to protect themselves," he said.

Copyright 2012 ABC News Radio

Man Cured of HIV Says He's Still HIV-Free

T.J. Kirkpatrick/Getty Images(WASHINGTON) -- Timothy Ray Brown, who is believed to be the first person to have ever been cured of HIV, had a message for the room of scientists, advocates and journalists who'd gathered to hear him speak at the International AIDS conference in Washington, D.C., Tuesday.

His message: He is still free of the virus that causes AIDS.

"Let me be clear. I am HIV-negative," Brown told a news conference.

Brown, famously known as "the Berlin Patient," responded directly to a controversy that arose recently when tissue samples from his blood cells, plasma and rectum showed evidence of HIV when tested.

Steven Yuki at the University of California, San Francisco, and one of the scientists who'd tested Brown's samples, expressed doubts during a June 8 talk at the International Workshop on HIV and Hepatitis Virus in Sitges, Spain.

"There are some signals of the virus, and we don't know if they are real or contamination," Yuki said in June, "and, at this point, we can't say for sure whether there's been complete eradication of HIV."

Nevertheless, Brown said he had been off anti-retrovirals now for five years, and was doing well.

Brown's story -- arguably one of the most followed in the realm of HIV research -- began in 1995 when he was diagnosed with HIV while attending school in Berlin. For the next 11 years, doctors treated him with anti-retroviral therapy, to which he responded positively.

In 2006, however, Brown's health deteriorated. He was diagnosed with acute myeloid leukemia -- and underwent chemotherapy. While the first round of treatment appeared to work, it also made him more susceptible to infections. Brown developed pneumonia early on in his treatment, and he battled sepsis halfway through his third round of chemo. His doctors realized they would have to try a different approach.

His oncologist, Dr. Gero Hutter of the Charite Hospital in Berlin, opted to give Brown a stem cell transplant to treat his leukemia. But rather than choosing a matched donor, he used the stem cells of a donor he found who had what is known as a CCR5 mutation -- a mutation that makes cells immune to the HIV. In results later published in the New England Journal of Medicine, Hutter and his colleagues reported that the transplant not only treated Brown's leukemia but had also eliminated the HIV from his system.

Brown stopped taking his anti-retrovirals three months later, and he said he has never needed them since. The only drawback of his treatment is that he has endured some neurological damage. "There was a period after my transplant when I couldn't even walk," he said.

Brown's stem cell procedure was so difficult and expensive that most agree it is unlikely that it will be used as a way to cure HIV for the millions of others who are infected.

Still, the hope that Brown's case could pave the way for a widely used cure remains. During his talk, Brown announced that he would be starting a foundation, the Timothy Ray Brown Foundation, in conjunction with the World AIDS Institute. This foundation, he said, would be the only one in the country dedicated solely to finding a cure for HIV.

Brown also urged leaders and other members of the scientific community to focus more funding and efforts specifically toward finding a cure.

Copyright 2012 ABC News Radio 

Big Names Call for More AIDS Funds

Alex Wong/Getty Images(WASHINGTON) -- Researchers may be turning the corner on the AIDS epidemic, but eliminating the disease completely will take more research and more money.

Such was the message of a series of high-profile talks at the International AIDS Conference in Washington, D.C.

More than 20,000 scientists, activists, politicians and people living with HIV are gathering this week at the conference, which has returned to the United States for the first time in 22 years around the theme "Turning the Tide Together."

"The U.S. is committed and will remain committed to achieving an AIDS-free generation," Secretary of State Hillary Clinton declared during a speech Monday morning.

From 1990 to 2009, such a gathering would have been impossible in this country, as people who were HIV positive were not allowed to enter the U.S. during this time -- making it the only medical condition explicitly listed under immigration as a reason to not be let into the country.

AIDS has claimed the lives of more than 30 million people since the epidemic began more than three decades ago.  But there have been substantial signs of progress in recent years.

There were 500,000 fewer new HIV infections in 2011, compared to 2001.  Additionally, the number of people in low- and middle-income countries receiving antiretroviral therapy increased from 400,000 people in 2003 to more than eight million people in 2011.

And now, scientists believe they finally have the scientific tools at hand to end the epidemic.  The cornerstone of these tools is antiretroviral medications used in combination to both save the lives of those infected with HIV and prevent transmission.  More advances recently proven effective include male circumcision and "pre-exposure prophylaxis," a daily pill to prevent HIV infection.

"We have a historic opportunity to -- with science on our side -- to make the achievement of an AIDS-free generation a reality," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.  Now, Fauci urged, "we must enhance what works and eliminate what does not, overcome legal and political barriers, and remove the stigma attached to HIV."

But what all of these solutions have in common is that they will cost money, and in the current fiscal climate, garnering the additional funds necessary to scale up these innovations is a challenge.  Technology magnate and philanthropist Bill Gates used his time at the meeting to call for improved efficiency in the use of our resources.

"The funding environment is very tough.  Some days it feels like we are going to have to fight just to keep the funding at the levels it's at now," Gates said.  "It's a human imperative that we be able to increase that number [of people treated] even if the dollars aren't going up as fast as we'd like."

In order to put these proven tools into action, Clinton pledged more than $150 million in new funding to fight AIDS.  Of that, $80 million will be dedicated towards preventing mother-to-child transmission abroad, with the goal of eliminating it by the year 2015.  Another $40 million is allotted for voluntary male circumcision in Africa to decrease risk of transmission of the virus.

Clinton pledged an additional $15 million to fund research on interventions, $20 million to bolster country-led efforts to expand HIV-related services, and $2 million towards civil society groups to reach key populations affected by HIV.

Copyright 2012 ABC News Radio

Clinton Says US Is Committed to an AIDS-Free Generation

Alex Wong/Getty Images(WASHINGTON) -- Secretary of State Hillary Clinton’s only public event of the day was a speech to the 2012 International AIDS Conference being held Monday in Washington D.C.; it's the first time in two decades that the conference is being held in the U.S. The conference had stayed away from the U.S. to protest the longtime ban on people with the virus entering the country. That ban was lifted two years ago.

Like other administration speakers at Monday’s conference Clinton spoke of America’s goal for an AIDS-free generation.  An energetic Clinton said, “I’ve heard a few voices from people raising questions about America’s commitment to an AIDS-free generation, wondering whether we are really serious about achieving it. Well, I am here today to make it absolutely clear:  The United States is committed and will remain committed to achieving an AIDS-free generation. We will not back off, we will not back down, we will fight for the resources necessary to achieve this historic milestone. ”

Although she said she was preaching to the choir, she said it was needed. “We need the choir and the congregation to keep singing, lifting up their voices, and spreading the message to everyone who is still standing outside. So while I want to reaffirm my government’s commitment, I’m also here to boost yours. This is a fight we can win. We have already come so far -- too far to stop now.”

“If we’re going to beat AIDS, we can’t afford to avoid sensitive conversations, and we can’t afford not to reach the people who are at the highest risk,” she said. Clinton spoke about new U.S. funding totaling $150 million to fund programs dealing with some of those sensitive conversations.

She spoke about the feasibility of eliminating the transmission of HIV from infected pregnant women to their babies by 2015 and how this can be achieved by getting mothers onto anti-AIDS drugs.  Currently 370,000 women globally are being treated this way and PEPFAR’s on target to reach an additional 1.5 million women by next year.  The U.S. will provide an additional $80 million to bridge the gap so pregnant women who are identified as being HIV-positive get the medical assistance they need. She also announced an additional $40 million in U.S. funding to support efforts in South Africa to boost voluntary medical circumcisions for males.

Clinton cited statistics that show how women in Africa are an at-risk population for HIV.  She said that in Sub-Saharan Africa today, women account for 60 percent of those living with HIV and that about 12 percent of female sex workers were HIV-positive.

Copyright 2012 ABC News Radio

End to AIDS Epidemic: Is It Near?

ABC News Radio(NEW YORK) -- “I was 3 years old when my parents found out I had AIDS, and the doctors told my adoptive parents that I wouldn’t live to be 5 years old,” says Hydeia Broadbent, 28.

In the 1980s, few treatment options were available for children like Broadbent, so her parents took her to the National Institute of Health for experimental treatment.  Nearly three decades later, as a testament to this treatment, she is still alive.

“The blueprint for the treatment we have now was tested on me and my friends with AIDS, and I’ve been on treatment ever since,” she says.

Broadbent, who is part of the Centers for Disease Control and Prevention’s Let’s Stop HIV Together campaign, is one of 34 million people worldwide and 1.2 million people in the United States who are living with HIV.  She started speaking out about having AIDS when she was 6 years old, and hasn’t stopped since.

“If I can use my voice, my name and my life to be a positive example for living with AIDS, then that’s what I’m going to do,” she said.  “I pray that a cure will happen.  I believe that it can.”

Broadbent is not alone.  According to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, “We are at a point in the HIV pandemic where we have the scientific basis to be able to say with a degree of certainty that if we implement properly and aggressively on a global scale what science has given us, we can appreciate the reality at some time in the reasonable future -- what we call the end of the AIDS pandemic or an AIDS-free generation.”

In this week’s Journal of the American Medical Association, Fauci and his colleague Gregory Folkers outline recent scientific advances in AIDS research, and the way forward for implementing these tools in working towards an AIDS-free generation.

Among the tools proven effective against AIDS are, first, effective combination antiretroviral therapy.  These medications can save the lives of people living with HIV, as well as prevent transmission to sexual partners and from mother to child.  Second, male circumcision has been shown to decrease the risk of a heterosexual man contracting HIV.  And finally, a daily medication can now be used to prevent contracting HIV, termed “pre-exposure prophylaxis” and recently approved by the Food and Drug Administration.

But there is more work to be done.  While these interventions are effective, delivering them remains a challenge.  For example, an estimated eight million people in need of HIV treatment still do not have access to it.

Scaling up and refining these interventions will require more than just science, according to Fauci.

“We now have no excuse scientifically to say ‘we cannot do it.’  We can do it.  The real issue is, will we do it?” he said.  “[It will] require a global commitment, political will, organizational will and individual will.”

What is next on the horizon for scientists?  Currently, scientists are focusing on developing an HIV vaccine and potentially a cure.  This past week, the International AIDS Society released the first-ever strategy for finding a cure for AIDS, identifying specific steps needed to advance the research in this field.

Fauci will be joined by others on Monday who share his optimism.  Returning to the United States for the first time in 22 years, the International AIDS Conference convenes in Washington, D.C., on Monday under the theme “Turning the Tide Together.”  There, scientists from around the world are gathering for a week to present the latest research advances.

Copyright 2012 ABC News Radio

FDA Approves Truvada for HIV Prevention

Justin Sullivan/Getty Images(WASHINGTON) -- The Food and Drug Adminstration Monday announced the approval of the first drug for use in people who are not infected with the human immunodeficiency virus (HIV), to prevent its transmission, which some are calling a landmark in the fight against AIDS.

The drug, Truvada, is actually a combination of two medicines and is manufactured by Gilead Sciences, Inc. of Foster City, Calif. While Truvada has been approved since 2004 as a treatment for those already infected with the HIV virus, this is the first time any drug has been approved for pre-exposure prophylaxis, or PrEP.

The study that led to the drug's approval found the risk of transmission among men who have sex with men decreased more than 40 percent. Furthermore, it showed a decrease of more than 70 percent in risk of transmission among heterosexual couples in which one partner was infected with HIV but the other was not.

"Truvada should not be used alone for preventing infections," cautioned Dr. Debra Birnkrant, director of the Division of Antiviral Products at the FDA's Center for Drug Evaluation and Research. "However, when used in combination with other prevention methods, such as safer sex practices, counseling, and regular testing to determine infection status, Truvada is effective in reducing the risk of transmission."

Other experts in the field agreed with this assessment.

"The approval of Truvada to prevent HIV infection in uninfected individuals who are at high risk of sexually acquired HIV infection is a significant development, providing an important addition to our toolkit of HIV prevention interventions," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease. "However, it is critical to stress that Truvada as 'pre-exposure prophylaxis' should not be considered a stand-alone method, but should be used in conjunction with other proven HIV prevention strategies."

Not everyone was in favor of the approval. The AIDS Healthcare Foundation, a global organization involved in providing treatment to AIDS/HIV patients, strongly criticized the move, calling it irresponsible and saying Truvada's approval for this use would undermine current prevention efforts.

AHF president Michael Weinstein questioned whether the fact that support provided to study participants -- such as monthly HIV testing and intensive counseling -- would not be available to the general population would lead to decreased adherence to the drug regimen, and thus to the development of drug-resistant strains. Weinstein further cautioned that the drug's side effects on the kidneys and bones might be worth accepting in patients who needed to be treated for HIV, but were not worth the risk on otherwise healthy individuals.

"Today marks a catastrophe in the history of AIDS in America," he said.

While the AHF criticized the approval, a number of experts said there are many high risk individuals who won't use condoms but might take a daily pill.

"It's argued that PrEP is far more expensive than condoms, but it's a lot cheaper than a lifetime of HIV treatment," said Dr. Joel Gallant of the Johns Hopkins Center for Global Health. "If we can target PrEP to those at highest risk, PrEP is likely to be cost-effective."

Copyright 2012 ABC News Radio

FDA Approves Over-the-Counter HIV Test

OraSure Technologies, Inc./Getty Images(WASHINGTON) -- In what could be a breakthrough in preventing the transmission of HIV, the U.S. Food and Drug Administration on Tuesday approved a new over-the-counter test kit called OraQuick that the government says could help identify hundreds of thousands of previously undiagnosed cases of the infection.

“This is the first home-diagnostic HIV test that allows the consumer to obtain a sample by swabbing the upper and lower gum, putting it into a developing vial and waiting for test results to determine – in the privacy of their home – their HIV status,” FDA spokesperson Rita Chappelle said Tuesday.

The test offers a result in approximately 20 to 30 minutes.

There are an estimated 1.2 million people living with HIV in the U.S., and the Centers for Disease Control and Prevention says 1 in 5 cases are undiagnosed.

“This test has the potential to identify large numbers of previously undiagnosed HIV infections, especially if used by people who typically would not seek out standard screening methods,” Chappelle said.

The test has been more than 99 percent accurate in diagnosing negative results -- but one in every 12 tests gave a false positive. Chappelle says consumers should still exercise caution when using OraQuick: infections from within the past three months may not be detected.

“Regardless of the results, they should still follow up in a medical setting to get a confirmatory test.”

Copyright 2012 ABC News Radio

AIDS Quilt Returns to Washington Amid Anger, Mourning

Daniel C. Britt/The Washington Post(WASHINGTON) -- The AIDS Memorial Quilt has returned to Washington, D.C., for the first time in 16 years, marking the 25th anniversary of The NAMES Project and thirty years in the struggle to stop the spread of HIV and AIDS around the world.

Every morning volunteers take on the laborious process of unfolding the panels of the quilt on the National Mall and then packing them up in the evening, a process that can only be described as a labor of love.

The quilt has over 94,000 names of AIDS sufferers on it and has been seen by over 18 million people worldwide. Through tours and special events, the quilt has raised over $4 million for direct services for people living with AIDS.

For the quilt's creators, this patch of green lawn in the heart of the nation's capital holds special significance -- the quilt was first displayed there in October of 1987 during the National March on Washington for Lesbian and Gay Rights, a time when many felt the federal government was turning its back on the AIDS epidemic. For Gert McMullin, the quilt production coordinator, it's a place of anger.

"I'm here to throw [the quilt] in front of my government and lay down my dead friends and hope that somebody will start caring and do something about it," said McMullin.

McMullin said she was close to losing her mind in the early 1980s, when many of her friends were dying of AIDS during the height of the epidemic in San Francisco.

"I had to find something I could do that I could talk about them," McMullin said, fighting back tears.

That "something" was the NAMES Project: for 25 years she has been sewing, stitching and displaying thousands of quilt panels dedicated to those who lost their lives to the AIDS virus.

The quilt is the brainchild of San Francisco gay-rights activist Cleve Jones, who in 1987, helped found The NAMES Project. Today, the quilt consists of 48,000 panels and takes up 1.3 million square feet, making it impossible to view in its entirety at any one time. If a visitor were to spend one minute to view each panel, it would take over 33 days to see the entire quilt.

Joan Juster is the Reader Coordinator at NAMES Project AIDS Memorial Quilt. She oversees the reading of the names, where volunteers memorialize those who have lost their lives to HIV.

For Juster, working with The NAMES Project is her way of doing something about an issue that is close to her heart.

"You know, I remember when I was a kid asking my Daddy, 'What did you do during World War II, Daddy,' and he told me that everybody had to help," Juster said. "Well, when AIDS came along in the early '80s, I was living in San Francisco. It was our war. Our community was decimated. I had to help, I had to help somehow."

"People did see the quilt, and they got it. They got that they had to do something about AIDS," Juster said. "They got that it was about real people and real individuals, they saw the love sewn into the quilt and it changed their minds about, about gay people, because it was all about gay people in those early days, and about the quilt itself, and about AIDS."

The quilt is on display from June 27 to July 1, and July 4 through July 8, as part of the Smithsonian Folklife Festival on the National Mall. A full list of display times and locations can be found at http://quilt2012.org/quilt-display-locations/.

Copyright 2012 ABC News Radio