Archive for the ‘Research’ Category

Find out about research concerning health issues of men who have sex with men

HIV study: 96% reduction in HIV transmission

Posted by administrator on May 13, 2011

Press release from HIV Prevention Trials Network:

Thursday, 12 May 2011, 11 am EST
Washington, DC

Initiation of Antiretroviral Treatment Protects Uninfected Sexual Partners from HIV Infection (HPTN Study 052)

Men and women infected with HIV reduced the risk of transmitting the virus to their sexual partners through initiation of oral antiretroviral therapy (ART), according to findings from a large multinational clinical study conducted by the HIV Prevention Trials Network (HPTN), a global partnership dedicated to reducing the transmission of HIV through cutting-edge biomedical, behavioral, and structural interventions.

The study, known as HPTN 052, was designed to evaluate whether immediate versus delayed use of ART by HIV-infected individuals would reduce transmission of HIV to their HIV-uninfected partners and potentially benefit the HIV-infected individual as well. Findings from the study were reviewed by an independent Data and Safety Monitoring Board (DSMB).The DSMB recommended that the results be released as soon as possible and that the findings be shared with study participants and investigators. The DSMB concluded that initiation of ART by HIV-infected individuals substantially protected their HIV-uninfected sexual partners from acquiring HIV infection, with a 96 percent reduction in risk of HIV transmission. HPTN 052 is the first randomized clinical trial to show that treating an HIV-infected individual with ART can reduce the risk of sexual transmission of HIV to an uninfected partner.

“This is excellent news,” said Dr. Myron Cohen, HPTN 052 Principal Investigator and Associate Vice Chancellor for Global Health and Director of the Institute of Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill. “The study was designed to evaluate the benefit to the sexual partner as well as the benefit to the HIV-infected person. This is the first randomized clinical trial to definitively indicate that an HIV-infected individual can reduce sexual transmission of HIV to an uninfected partner by beginning antiretroviral therapy sooner. HPTN recognizes the significant contribution that this study’s participants have made to furthering the progress in HIV treatment and prevention. We are very grateful for their participation.”

Media inquiries:

Matt Matassa
703.647.1909
mmatassa@fhi.org

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Institute of Medicine releases long-awaited report on LGBT health

Posted by administrator on March 31, 2011

From the Gay and Lesbian Medical Association

Washington, DC – The Institute of Medicine today released its long-awaited report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. The National Institutes of Health commissioned this groundbreaking report, and a distinguished panel of experts dedicated more than a year to evaluating the state of LGBT health research and crafting recommendations for improving the health of the LGBT community.

Read the full report at The National Academies Press Website.

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Health implications of DADT

Posted by administrator on December 9, 2010

By Michael Smith, North American Correspondent, MedPage Today
Published: December 01, 2010
 

The military “don’t ask, don’t tell” policy for gay, lesbian, and bisexual service members is not only a constitutional and legal issue — it also has serious health implications, an epidemiologist claims.

The policy often means that sexually transmitted infections go undiagnosed and service members and their partners are untreated, Kenneth Katz, MD, of San Diego State University, wrote in a Perspective piece published online by the New England Journal of Medicine.

And messages aimed at preventing HIV and other sexually transmitted diseases — and tailored for gay, lesbian, and bisexual service members — are not transmitted, Katz argued.

“In very real ways,” Katz wrote, the policy threatens the health of service members as well as the community at large, and may even have an impact on the ability of the service as a whole to respond to combat missions.

Katz cited the case of a gay serviceman who came to his municipal STD clinic in San Diego County complaining of rectal pain and discharge. The diagnosis was rectal gonorrhea, which was treated according to CDC guidelines with an intramuscular injection of 125 mg of ceftriaxone (Rocephin) along with one gram of oral azithromycin (Zithromax) for empirical treatment of chlamydia.

But, Katz noted, the man had had ready access — for free — to military clinics. He said he chose the municipal clinic because he would have felt uncomfortable discussing his sexual behavior with a military doctor.

Katz reported that, in 2002, nearly one in 10 clients of a gay men’s health clinic in San Diego were sailors on active duty, which is consistent with his own experience.

But there are an estimated 66,000 gays, lesbians, and bisexuals in the military, or about 2.2% of the total, he noted. “How many of them have no access to nonmilitary medical care?” Katz wrote. “How many simply don’t seek it?”

The policy also may have effects on the use of public health resources, he argued.

Katz cited the case of gay man diagnosed with an STD at a service clinic. Rather than providing the name of his actual sexual partners for follow-up, he gave the name of a female friend who in due time got a phone call advising her she had been exposed to an STD. Meanwhile, the man notified his partners on his own.

The policy also may have adverse effects on the military as a whole, Katz argued. The illnesses caused by STDs can compromise troop readiness and increase the chance of acquiring HIV, which in most cases bars a service member from combat missions.

And the substantial costs of treating HIV are borne by the military.

“We can do better for our service members, our military, and our country,” Katz concluded.

Primary source: New England Journal of Medicine
Source reference: Katz KA “Health hazards of ‘Don’t ask, don’t tell’” N Engl J Med 2010; DOI: 10.1056

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Speaking of lubes, UCLA researchers found 4 out of 6 most used lubes are toxic to rectal lining

Posted by administrator on September 9, 2010

This bit of information was pointed out by a Facebook subscriber in Texas. One of the studies mentioned in the article is actually right here at the University of Pittsburgh – The Microbicides Trials Network. You can find out more about it under our “Get Involved in Research” tab. 

As the article notes: “Subjects who used lubricants during anal sex were three times more likely to contract rectal sexually transmitted infections than those who had anal sex without lubricant, found UCLA researchers. This and one other study examining the effects of sexual lubricants used in anal sex were presented last month at the International Microbicides Conference.” The bottom line is two of the lubes tested were found to be nontoxic – Wet Platinum and PRÉ.

To read the full article, go to 365gay.

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Researchers Identify Two FDA Approved Drugs That May Fight HIV

Posted by administrator on August 24, 2010

“Researchers at the University of Minnesota Academic Health Center have identified two drugs that, when combined, may serve as an effective treatment for HIV. The two drugs, decitabine and gemcitabine — both FDA approved and currently used in pre-cancer and cancer therapy — were found to eliminate HIV infection in the mouse model by causing the virus to mutate itself to death — an outcome researchers dubbed lethal mutagenesis.”

Find out more on ScienceDaily

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Canadian Research Shows Substantive Drop in HIV Transmission

Posted by administrator on July 19, 2010

A study published in Lancet, on the same day as the 2010 AIDS Conference kicked off in Vienna, proves the treatment of HIV/AIDS with a cocktail of drugs not only benefits individual patients but also lowers the transmission rate of new infections. Read the full article in the Los Angeles Times online.

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Pitt Men’s Study Director Creates Anal Dysplasia Clinic

Posted by administrator on May 5, 2010

Dr. Ross Cranston was recruited to Pittsburgh in 2007 to create an Anal Dysplasia Clinic at the Pittsburgh AIDS Center for Treatment (PACT). The focus of the clinic, which is also open to non-PACT patients, is to address the high incidence of human papillomavirus (HPV or wart virus).  HPV has been associated with anal cancer in gay men – particularly those living with HIV. 

 “As gay men, we run the risk of serious health issues because we don’t pay enough attention to our butts.”  Dr. Cranston states. “So, one of my goals is to promote an ‘anal agenda’ that increases awareness of the medical conditions gay men are more likely to experience.” Putting the issue into perspective, he adds: “Anal health has yet to emerge as an area to which it is deemed appropriate to direct our attention. As a result, gay men in particular are unaware of their increased risk of many anal diagnoses including those related to sex or sexually transmitted infections, such as the development of anal cancer.”   

Patients with an abnormal anal cytology (a test of anal cells that is used to detect abnormalities) are referred to Dr. Cranston for high-resolution anoscopy (HRA). This office procedure involves examining the anal canal using magnification.  If there is evidence of high-grade dysplasia – the precursor to anal cancer – a biopsy may be performed. If high-grade dysplasia is confirmed, Dr. Cranston can then remove the lesion in order to prevent its potential progression to cancer.

“We are currently diagnosing about one case of anal cancer every 2 weeks,” says Dr. Cranston, “which is why I suggest that gay men who are HIV-positive talk to their clinician about anal dysplasia screening and have an annual anal Pap smear.” Although there are no national screening guidelines, Dr. Cranston notes, it is also suggested that HIV-negative men over 40 get tested every two to three years.

Dr. Cranston is an Assistant Professor in the Division of Infectious Disease and the Medical Director of the Pitt Men’s Study.  He began his studies at the University of Edinburgh before moving to London, where he completed a fellowship in HIV and Sexually Transmitted Infection. He moved to the U.S. to conduct doctoral research at the University of California—San Francisco and then spent five years working at the UCLA Center for AIDS Research and Education in Los Angeles, where he established and ran the UCLA Anal Dysplasia Clinic. 

For many years, Dr. Cranston has used his knowledge of anal dysplasia, HPV, and HIV to help countless HIV-positive men. He moved to Pittsburgh in September 2007 with his partner of 11 years, Ian McGowan, who is also employed by the University as a Professor in the School of Medicine, and is Co-Principal Investigator of the Pittsburgh-based Microbicide Trials Network. 

For more information about the anal dysplasia clinic, you can call  412-647-0996 .

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Testing Microbicides to Combat HIV

Posted by administrator on May 5, 2010

The development of safe and effective prevention strategies against HIV infection is a critical component of the HIV research agenda and, in recent years, the University of Pittsburgh School of Medicine has emerged as a global leader in microbicide development. Ongoing microbicide research is based both in Pittsburgh and at international sites in Africa and India.

A microbicide is a substance designed to prevent transmission of HIV and other sexually transmitted diseases in men and women. It can come in the form of a gel, cream, suppository, film, sponge or ring that releases an active ingredient over time.

The Microbicide Trials Network (MTN) is led by Dr. Sharon Hillier and headquartered at Magee-Womens Research Institute & Foundation in Pittsburgh. The MTN is funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health specifically to conduct clinical trials to evaluate the safety and effectiveness of topical microbicides. Several microbicides are being tested in clinical trials and the present network includes a total of 17 sites located in seven countries.

The concept for a microbicide-like product was developed more than 15 years ago by reproductive health specialists and advocates who recognized the need for female-controlled HIV prevention methods. Beyond being effective, microbicides for HIV prevention must be safe and easy to use.

Microbicides first undergo rigorous testing in the laboratory before testing in humans can occur. Phase I trials evaluate safety in a small number of people exposed to study products for brief periods such as one to two weeks. If those study results suggest the product is safe, investigation then progresses to a Phase II trial. Researchers then track safety of the product over greater periods of time.

Finally, Phase III trials are performed to establish the product’s effectiveness. This type of study is conducted in a large number of participants, and usually involves multiple centers. Studies may be designed to compare one product’s effectiveness with another’s and/or with an inactive agent, or placebo. The data resulting from a Phase III trial are often used by regulatory agencies to determine if a product should be approved for widespread use.

Public health experts estimate microbicides that are even 60 percent effective against HIV could prevent upwards of 2.5 million infections over a three-year period.  More research is focusing on the development of rectal microbicides. One current trial involves assessment of rectal safety of microbicide products originally formulated for the vagina, as it is assumed that once vaginal microbicides are licensed they will also be used in the rectum. In addition, a team lead by Dr. Ian McGowan are developing microbicide products formulated specifically for rectal use.

For information about microbicides, the following websites offer a variety of views and news including research and advocacy efforts. They are:  http://www.mtnstopshiv.org/; http://www.ipm-microbicides.org/; http://www.global-campaign.org/; and http://www.microbicide.org/.

Persons interested in participating in upcoming local microbicide research studies at the University of Pittsburgh are encouraged to call Anne Davis at  412-641-3381  .

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