News (Updated December 2,
2007)
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Thu Nov 29, 2007 10:30 PM GMT
By Will Dunham
WASHINGTON (Reuters) - A program backed by U.S. health authorities brought HIV tests to about 24,000 people at high risk for infection who otherwise might have been missed by AIDS prevention efforts, officials said on Thursday.
The Centers for Disease Control and Prevention described the results of a program it funded from 2004 to 2006 in which eight private community-based AIDS outreach organizations offered rapid HIV tests in seven big cities.
The program was intended to bring testing to injection drug users, homosexual and bisexual men and other people at high risk for infection by the human immunodeficiency virus that causes AIDS rather than wait for them to come in for testing.
"We actually went to a variety of venues -- and those included places like parks, shelters, night clubs, health fairs, syringe exchange sites (giving clean needles to injection drug users). The idea here was to find places where people at high risk might congregate or might seek services," said Dr. Patrick Sullivan, a CDC AIDS prevention official.
"The demonstration project has ended and we hope to be able to integrate the best parts of this into ongoing prevention programs," Sullivan said.
The project was run in Boston, Chicago, Detroit, Los Angeles, San Francisco, Washington and Kansas City, Missouri.
About 23,900 people were given a rapid HIV test for which results are ready in 20 to 40 minutes rather than the couple of weeks typically needed for the conventional blood test. In all, 267 of them, about 1 percent, turned out to be HIV infected.
The accuracy of the quick test is comparable to conventional tests but it costs more. Representatives of the eight organizations, not CDC staffers, performed the testing.
About 39 percent of those getting the tests were black, 31 percent Hispanic and 21 percent white, the CDC said.
Half reported having no health insurance and 9 percent were homeless, the CDC said. Of those tested, about 17 percent were men who have sex with men, a comparatively low proportion compared to the overall population of HIV-infected Americans.
Sullivan said more than 1 million Americans are currently infected with HIV and about a quarter of those are unaware they are infected.
The CDC estimates that up to 70 percent of the new sexually transmitted infections in the United States are caused by these 25 percent of infected people unaware of their HIV status.
"The problem of undiagnosed HIV infection is one of the things that we see as important in confronting the HIV epidemic in the U.S.," Sullivan said in a telephone interview.
"We felt like based on this experience, this kind of HIV testing in outreach settings really can help reach people at high risk of infection, including racial and ethnic minorities, and is a good complement to the kind of testing in health care settings that's already being implemented," Sullivan said.
More than 33 million people globally are infected with HIV. There is no cure although a cocktail of drugs can keep the infection suppressed and patients healthy.
(Editing by Maggie Fox and Todd Eastham)
Thu Nov 29, 2007 10:05 PM GMT
By Will Boggs, MD
NEW YORK (Reuters Health) - Many volunteers who take part in clinical trials of experimental HIV vaccines report negative social consequences because of their participation in the studies, according to a new report.
"Since a majority of the negative social impact events were due to negative reactions from friends and family who misinterpreted what a preventive HIV vaccine trial entails, trial sites need to continue their educational efforts with both study participants and with local communities emphasizing that you cannot become HIV-infected from the vaccine itself and that these trials seek HIV-negative individuals to participate," Dr. Jonathan Fuchs told Reuters Health.
Fuchs, from the San Francisco Department of Public Health, and his associates evaluated the negative social impacts reported by 5417 mostly male volunteers in an HIV vaccine efficacy trial.
Just under 1000 volunteers reported negative social events during 36 months of follow-up.
Most such events were negative reactions from friends, family, and partners, the authors report in the Journal of Acquired Immune Deficiency Syndromes. These reactions were primarily attributed to a misunderstanding of the volunteer's HIV status or risk of infection.
Less than 1 percent of the group reported problems with disability or life insurance, employment, medical or dental care, health insurance, government agencies, or housing.
Among the 368 participants who became infected with HIV after enrollment in the trial, only 12 reported a negative social incident, the investigators say. Most involved personal relationships, such as friends or family members asserting that the vaccine caused the individual to become HIV-infected or more susceptible to infection.
Although the vaccine could affect HIV test results, none of the HIV antibody-related negative social events reported by 29 volunteers were attributed to vaccine-induced antibody results, the researchers note.
"A substantial proportion of vaccinees may test 'false-positive' on a standard HIV antibody screening test," Fuchs explained. "Providers should remember to first ask whether their patients have participated in an HIV vaccine trial before they perform HIV testing, to avoid potential misinterpretation of antibody results and possible social harm."
SOURCE: Journal of Acquired Immune Deficiency Syndromes, November 1, 2007.
Mon Nov 26, 4:42 PM ET
Early, routine HIV testing might help stem the spread of the infection among teenagers, according to researchers.
In a study of more than 1,200 sexually active 15- to 21-year-olds, the researchers found that key HIV risk factors -- like having unprotected sex or having a high-risk partner -- had no bearing on whether the study participants sought HIV testing over the next three months.
Instead, the single most important factor was whether they had ever been tested before. Those who had were about three times more likely to seek testing during the study period, the researchers report in the Journal of Adolescent Health.
"These findings were a bit surprising, since we thought teens would be more likely to get an HIV test if they engaged in risky behaviors, such as substance use during sex, or attended an HIV prevention workshop," Dr. Larry K. Brown, the senior researcher on the study, said in a statement.
Since a history of HIV testing was so important, the implication is that early, universal testing might encourage more teenagers to get tested as they grow older, according to Brown and his colleagues at the Brown University Medical School in Providence, Rhode Island.
Widespread testing of younger adolescents could have a "dramatic effect" on HIV infection rates, the researchers write, given that one-quarter of Americans with HIV are unaware of it -- and could be passing it on to others.
The study included 1,222 teenagers and young adults from three U.S. cities who were considered to be at high risk of HIV because they admitted to having unprotected sex. They were randomly assigned to either attend a 3-hour HIV-prevention workshop or go on a wait-list; the researchers then tracked their rates of HIV testing over the next three months.
They found that the prevention workshop seemed to make no difference in the odds of participants getting tested for HIV; one-quarter in each group said they gotten a test during the three-month study period.
Instead, the teenagers' history of HIV testing emerged as the primary factor.
The findings suggest that getting kids into the habit of HIV testing early on may affect their behavior down the road, according to Brown's team. They suggest that routine testing could be offered not only in doctors' offices, but in non-traditional settings like schools and community centers as well.
SOURCE: Journal of Adolescent Health, December 2007