Condom Homework Increases Compliance, Comfort and Consistency

A new and successful strategy for combating the spread of sexually transmitted diseases such as HIV was revealed today at the American Public Health Association’s annual meeting in Boston.

The idea is based upon the decades old premise that practice makes perfect!.

In the study entitled “A novel, self-guided, home-based intervention to improve condom use among young men who have sex with men.  The men were given a “ditty bag” full of eight different types of condoms and five different types of  lubricants, taught how to apply the condoms correctly, and then assigned homework. The men were expected to try out at least six condoms solo, paying particular attention to their own pleasure and which condoms they liked best.

The purpose of this study was to test of feasibility and efficacy of this intervention and to promote positive condom attitudes and to reduce risk behaviors.

30 volunteer subjects were recruited from a Midwestern University and its surrounding community. A pre-test questionnaire was administered.  A post-test questionnaire was given at Day 15 and an additional follow-up questionnaire at Day 45.

It’s such a simple idea, but nobody has every structured an approach like this,” said William L. Yarber, professor in the Indiana University School of Public-Health. “These are pilot studies. But even with small samples, the results are really good. Men become more motivated to use condoms; they use them more correctly and consistently. They also appreciate learning that there are different condoms available.”

A pilot study, published in the Journal of Men’s Health in 2011, focused on heterosexual men. The new study, focuses on young men who have sex with men, or MSM.  It will be published in the Journal of American College Health, MSM aged 18 – 29 are diagnosed with HIV more than any other group, according to the Centers for Disease Control and Prevention. In fact, half of all new HIV infections in the U.S. are among MSM between the ages of 13 and 24 years. College-aged MSM are more likely than older MSM and men who only have sex with women to be infected with HIV.

“This is an important group of men to reach,” says  Roberta Emetu, who coordinated the research project.  “The men who experienced this intervention became better in their condom use. They not only used them more often but used them correctly. We saw an increase in motivation to use them.”

When pre-test and post-test responses were compared, significant post-intervention improvements were found for beliefs and application of condoms, self-efficacy, condom attitude, motivation to use condoms, and consistency of condom use for insertive penile-anal intercourse.

Yarber and his colleagues have documented for more than 10 years how merely wearing a condom is not enough to provide effective protection against STDs and unwanted pregnancies. Condoms need to be used correctly, yet fit-and-feel issues can result in erection difficulty, loss of sensation, removal of condoms before the intercourse episode ends, and other problems that can interfere with their correct use.

These findings suggest that this intervention could be applicable to college-aged MSM, and could be a great resource or model for other public health condom interventions.

Scientific Breakthrough of the Year

Happy New Year!

Earlier this month Hollywood announced it’s nominations for the 69^th Golden Globe Awards. Among the movies in the running for best motion picture are The Descendants, The Help and War Horse.

While we will have to wait until January 15^th to learn the actual winner, we already know who won the 2011 Science “Breakthrough of the Year”.   This title went to a team of researchers, who demonstrated that HIV treatment with antiretroviral drugs  can actually prevent transmission of the virus from an infected person to his or her uninfected partner.

Their clinical research showed that early initiation of antiretroviral  therapy in people infected with HIV reduces transmission of the virus to their partners by 96%. The findings end a longstanding debate over whether treatment of HIV-infected individuals can provide a double benefit by treating the virus in individual patients while simultaneously cutting transmission rates.

The results were called “astounding” by Anthony Fauci, the government’s top HIV researcher. Others have called them a “game changer” because of the near 100 percent efficacy of the intervention.

“It’s wonderful for this trial to be recognized,” says Susan H. Eshleman, M.D., Ph.D., a professor of pathology at the Johns Hopkins University School of Medicine and head of the HIV Prevention Trials Network, which supported the trial. “This research moves the field of HIV prevention science forward, leading us on a path toward curbing the HIV epidemic. It provides a new direction for HIV prevention research and is beginning to shape public health policy.”

SRxA’s Word on Health is delighted to bring you such great news to start the New Year. If you have any health related stories you’d like to share, we’d love to hear from you.

Debunking Myths About HIV Vaccine

In honor of World AIDS Day tomorrow, SRxA’s Word on Health wants to share with our readers the top 10 myths about HIV vaccine research.

With the help of our friends at the HIV Vaccine Trials Network (HVTN), we’d like to set the record straight.

Myth # 1: HIV vaccines can give people HIV

HIV vaccines do not contain HIV and therefore a person cannot get HIV from the vaccine. Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Think of it like a photocopy: It might look similar, but it isn’t the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has been infected with HIV by any of the vaccines tested.

Myth #2: An HIV vaccine already exists

There is no licensed vaccine against HIV or AIDS, but scientists are getting closer than ever before.  In 2009, a large-scale vaccine study conducted in Thailand showed that a vaccine combination could prevent about 32% of new infections. Researchers around the world continue to search for an HIV vaccine that is even more effective. Leading this effort is the HVTN.

Myth #3: Joining an HIV-vaccine study is like being a guinea pig

Unlike guinea pigs, people can say yes or no to participating in research. All study volunteers undergo informed consent to ensure that they fully understand all of the risks and benefits of being in a study and those volunteers are reminded that they may leave a study at any time without losing rights or benefits.

Myth #4: A person must be HIV positive to be in an HIV vaccine study

Not so. While some research groups are conducting studies of vaccines that might be used in people who are already infected with HIV, the vaccines being tested by the HVTN are preventive vaccines which are tested on volunteers who are not infected with HIV.

Myth #5: Vaccine researchers want study participants to practice unsafe behaviors so they can see whether the vaccine really works

Not true. The safety of study participants is the No. 1 priority of HIV vaccine researchers and study site staff. Trained counselors work with study participants to help them develop an individual plan on how to keep from contracting HIV.

Myth #6: Now that there are pills that can prevent HIV infection, an HIV vaccine is no longer necessary

Although high risk, HIV-negative people can take antiretroviral medication to lower their chances of becoming infected if they are exposed to the virus, it has not yet been recommended for widespread use. This type of therapy known as  PreExposure Prophylaxis is unlikely to be an option for everyone because the pills are expensive, are not always covered by insurance, may cause side effects, and not everyone has access to them.

Myth #7: An HIV vaccine is unnecessary because AIDS is easily treated and controlled

While treatment for AIDS has dramatically improved over the last 30 years, it is no substitute for prevention.

Myth #8: The search for an HIV vaccine has been going on for a long time and it’s just not possible to find one that works

The science of HIV-vaccine development is challenging, but scientific understanding continues to improve all the time. Science has come a long way in the 30 years since AIDS was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; the polio vaccine took 47 years to develop.

Myth #9: Vaccines cause autism and just aren’t safe

This is not true. Numerous studies in the past decade have found this claim to be false. The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data.

Myth #10: People who aren’t at risk don’t need an HIV vaccine

Not true either. A person may not currently be at risk for HIV, but life situations can change along with disease risk.

So now you know!  By correcting these myths we hope in some small way to be able to help in the mission of this World AIDS campaign – bringing the number of AIDS deaths to zero.

A Big “Clap” for the FDA

Sexually transmitted diseases (STDs) have always been a bit of a taboo subject.  Especially it seems among the FDA.   In a joint initiative with the Federal Trade Commission (FTC), the Agency has just sent warning letters to more than a dozen companies selling non-prescription products that claim to treat STD’s such as herpes, chlamydia, genital warts, HIV, and AIDS.

Despite names such as Medavir, Herpaflor, Never An Outbreak and C-Cure, the FDA says that none of the products have been proven to prevent, treat or cure any disease.  In fact, say FDA scientists, the products are a public health hazard because patients could waste time taking them and delay seeking medical care.

A full list of the companies and products involved can be found here.

These products, sold both online and in retail outlets, often claim to be supported by research. A website for Medavir, made claims the product “has been proven effective in several official university research studies, including an official FDA trial.”

Similarly, Arenvy Laboratories’ website for ImmuneGlory touts the product as “the ultimate herpes outbreak solution” and claims the product “strengthens your immune system so that herpes or cold sores have nowhere to hide.”

However, the Agency says that is has never approved any non-prescription products for sexually transmitted diseases.  Drugs are available for herpes, chlamydia, HIV and other diseases, but only via prescription.

“These products are dangerous because they are targeted to patients with serious conditions, where treatment options proven to be safe and effective are available,” said Deborah Autor, FDA Director of Drug Compliance.

Companies cited by the FDA will have 15 days to take their products off the market. If they do not, the agency can take legal action, including seizing products and taking company officials to court.

Additionally, under the FTC Act it is illegal to make such unsubstantiated treatment claims.

“These companies are on notice that advertising health benefits that are not supported by rigorous scientific evidence violates the FTC Act,” said David Vladeck, Director of the FTC’s Bureau of Consumer Protection. “They also should know that health scams that endanger public health will not be tolerated.”

While we wait with baited breath to see if the companies will comply, Word on Health cautions its readers that appropriate treatment of STDs can only occur under the supervision of a health care professional.

Nonprofits Calls on America to Expand Health Research

Policymakers and public health experts from across the globe gathered on Capitol Hill this week to call on the United States to bolster its commitment to fighting the deadly diseases that afflict the developing world.

Organized by the Global Health Technologies Coalition, the briefing featured a panel discussion in which participants explained how vaccines, drugs, diagnostics, and devices can catalyze improvements in a country’s health infrastructure. Panelists also examined how the U.S. can assure that residents of the developing world have a voice in the development and use of new health tools.

“Thanks to U.S. investment and innovation, undeniable progress has been made in preventing, diagnosing, and treating conditions like HIV/AIDS, malaria, tuberculosis, and other neglected tropical diseases,” said Jana Armstrong, Executive Director of the Drugs for Neglected Diseases initiative North America, “But the fight against infectious disease is by no means won. American leaders in both the public and private sectors must recommit to this fight.”

Word on Health agrees, but wonders why the pharmaceutical and biotech industry wasn’t invited to the party. The Global Business Coalition on HIV/AIDs, Malaria and Tuberculosis (GBC) was created to turn business assets into disease-fighting assets and has been pivotal in joining the corporate sector, governments and civil society together in common cause. Many pharmaceutical and biotech companies are members of GBC and have done outstanding work in this area. If you work for one of them, we’d love to hear from you.

A banana a day keeps HIV away?

Yes, you read that right, and no, this isn’t our attempt at an early April Fool’s day story.  Your favorite fruit really might be even healthier for you than you thought.

Scientists have discovered that bananas may hold the key to preventing sexual transmission of HIV. Researchers from the University of Michigan Medical School have shown that a chemical found in bananas is better at preventing HIV than two current synthetic anti-HIV drugs.

The miracle substance is called BanLec, a type of lectin.

BanLec, works by binding to the sugar-rich envelope that encases the HIV virus and blocks its entry into the body.  BanLec could therefore be incorporated into a vaginal ointment and could be self-applied before sexual contact.  Researchers believe it would be much cheaper to produce and distribute than most current anti-retroviral medications which require the production of synthetic components.

One thing’s for sure: new ways of stopping the transmission of HIV are desperately needed. “HIV is still rampant in the U.S. and the explosion in poorer countries continues to be a problem” said study senior author Professor David Marvovitz, M.D.

Condoms are effective, but they are often used incorrectly or inconsistently.

Although clinical use of BanLec is probably years away, researchers believe that even modest success could save millions of lives. They estimate that if as little as 20% of the “at risk” population used a drug that is only 60 percent effective against HIV, it could still prevent up to 2.5 million infections over the course of three years.

It’s been more than two decades since HIV and AIDS began sweeping the globe, during which time hundreds of billions of dollars have been spent on research and the elusive hunt for a vaccine or a cure.  Who’d have thought  that the answer may have been literally hanging in front of us all this time?