Making Strides: Highlights of Research Unveiled at AIDS Conference

Head delegates (L-R) Chris Beyrer, Francoise Barre-Sinoussi, Michael Sidibe, Brent Allan, Ayu Oktariani, Sharon Lewin and Michael Kirby, attend the opening press conference for Aids 2014 conference in Melbourne, Australia, 20 July 2014.
Head delegates (L-R) Chris Beyrer, Francoise Barre-Sinoussi, Michael Sidibe, Brent Allan, Ayu Oktariani, Sharon Lewin and Michael Kirby, attend the opening press conference for Aids 2014 conference in Melbourne, Australia, 20 July 2014. –EPA/DAVID CROSLING AUSTRALIA AND NEW ZEALAND OUT

Coinciding with the 2014 International AIDS Conference, the Journal of the American Medical Association (JAMA) released a special theme issue this month that highlights the major research and studies presented.

The International Aids Conference is an annual conference in which leading HIV and AIDS researchers, policy makers and HIV patients gather to discuss new scientific research and strategy toward ending the pandemic.

Here we highlight some of the ground-breaking research presented at the conference:

Overall HIV Diagnosis Down in U.S., Up for Some Groups

Key Findings:

•From 2002-2011, the HIV diagnosis rate decreased by 30 percent.

•From 2002-2011, the HIV diagnosis rate increased among some grops of men who have sex with men (increased by 133 percent among gay men ages 13-24).


•From 2002-2011, HIV diagnoses attributed to drug injection decreased.

The annual overall HIV diagnosis rate in the United States has decreased by more than 30 percent over the last decade, an analysis of data from the National HIV Surveillance System of the Centers for Disease Control and Protection (CDC) shows. However, the diagnosis rate increased among key groups, particularly young men who have sex with men (MSM).

Researchers from the Division of HIV/AIDS Prevention at the CDC analyzed the 493,400 HIV diagnoses made in the United States from 2002-2011 to expose demographic trends. The analysis shows that the overall diagnosis rate for the virus dropped by more than 33 percent over the decade, down from 24 diagnoses per 100,000 persons in 2002 to 16.1 per 100,000 in 2011.

However, while the overall diagnoses rate decreased, certain susceptible groups saw an increase. The diagnosis rate increased among MSMs ages 13-24, 45-54, and 55 years or older. The largest increase was seen among young men ages 13-24, for whom the diagnosis rate increased by 133 percent. However, the overall number of diagnoses among MSMs remained stable due to a decrease among men ages 35 to 44 years.

“Among men who have sex with men, unprotected risk behaviors in the presence of high prevalence and unsuppressed viral load may continue to drive HIV transmission,’’ the authors wrote in the study. “Disparities in rates of HIV among young men who have sex with men present prevention challenges and warrant expanded efforts.’’


The analysis also found that the number of HIV diagnoses due to drug use and heterosexual contact decreased. The greatest decline in HIV diagnoses was seen in women ages 35 to 44 years and people of multiple races.

Combination Treatment Benefits Patients Co-Infected with HIV and Hepatitis C

Key Findings:

•Combination therapy for HIV/HCV co-infected patients is associated with high HCV cure rate.

Patients infected with both HIV and Hepatitis C Virus (HCV) who received combination treatment for the infections showed favorable responses, a new study conducted by Johns Hopkins University researchers shows.

An analysis of 223 patients infected with both HIV and HCV who received a combination of sofosbuvir and ribavirin shows that the combination therapy is associated with a high HCV cure rate. The study analyzed the sustained HCV virologic reponse (a.k.a. cure) and relapse rates of 223 co-infected patients from 34 treatment centers in the United States and Puerto Rico.

Treatment of the HIV/HCV co-infection has previously been limited due to bad reactions between the medicines typically used to fight the two infections. However, the new combination therapy is interferon-free (interferon is the protein that was causing the bad reaction). Approximately 7 million people worldwide are infected by both viruses.

“In this open-label, nonrandomized, uncontrolled study, HIV-infected patients with HCV genotypes 1, 2, or 3 coinfection who received an oral combination of sofosbuvir plus ribavirin for 12 or 24 weeks had high rates of sustained HCV virologic response 12 weeks after cessation of therapy,’’ the authors wrote in the study.

While the sample size was relatively small, the findings are optimistic in curing. HCV in co-infected patients.


Economic Incentives Improve Male Circumcision Rates in Kenya, Reduce Risks of HIV

Key Findings:

•Compensation in the form of food vouchers has led to a modest increase in male circumcision rates in Kenya.

Providing economic incentives, such as food vouchers, results in a modest increase in male circumcision rates, a new study conducted by University of North Carolina at Chapel Hill researchers shows. Circumcision can decrease a man’s risk of HIV infection by 50 to 60 percent, according to the study.

The researchers studied 1,500 men at three voluntary medical male circumcision (VMMC) programs in Kenya to see if economic incentives could increase circumcision rates. Each program recieved a different amount of compensation, either $2.50, $8.75, or $15 in the form of food vouchers. The results found that the higher the economic incentive, the higher the rate of circumcision.

Two months after the introduction of the incentive programs, VMMC rates had increased by 7.4 percent among the $15 group, by 6 percent among the $8.75 group, and by 0.3 percent among the $2.50 group, compared with men who received no compensation.

The incentive program also lead to an increase in VMMC rates among married and older men, groups that have had particularly low circumcision rates previously.

“There was also a significant increase in VMMC uptake among married and older participants, groups that have been harder to reach previously,’’ the authors wrote in the study. “The interventions also significantly increased the likelihood of circumcision uptake among participants at higher risk of acquiring HIV. This latter result is especially promising from an HIVprevention standpoint.’’

The Kenyan VMCC economic incentive program may serve as a model for other countries hoping to increase circumcision rates. The authors noted that these results come after just two months, and the program may be more successful in the long-term.

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