Monday, November 04, 2013

#AIDSFreeWorld: Global HIV Dropped 33% Since 2001

Today was the second day of the joint Cell and Lancet conference titled What Will it Take to Achieve an AIDS Free World, and I attended the afternoon sessions on prevention related issues. Overnight, I glanced at the posters and one in particular caught my attention, from New York City's Department of Health titled What proportion of patients need to be tested to realize test and treat goals. Trend analysis of patients screened for HIV within the New York City municipal health-care system. Excerpted findings state:

Between 2006 and 2012, 7,381,847 patients aged 13 years and older were seen at 17 HHC facilities. 1,157,830 unique patients were tested, and 11,781 HIV-positive diagnoses were made, 4,963 of them new. 

Rates of concurrent HIV/AIDS diagnosis for newly diagnosed patients went from 32·26% (190 of 589) in 2006, to 25·27% (94 of 372) in 2012. 

First finding: I want to learn the number of tests and their results broken down over the six year period. The cumulative annual stats need breaking out by year, at minimum, and by other categories such as by borough and race.

Second finding: If I'm reading this right, the rates of concurrent HIV/AIDS diagnosis decreased by 6.99% and also that the figures for newly diagnosed patients dropped from 589 down to 372.

I'm trying to chat with the NYC researchers before the conference ends tomorrow.

Connie Celum from the University of Washington explained various prevention trials and theories, and lots of relevant findings, a good portion of which I was able to follow and understand.

In this slide of hers, Connie echoed what NIAID's Dr. Anthony Fauci presented yesterday about the global decline in new HIV infections. I failed to capture his slide with such a figure as a photo and don't recall what number or period he cited. Connie reports a 33% decline of new infections since 2001. From New York City's decline to San Francisco's endemic phase to a worldwide decrease, there is good news on number of new infections. Let's connect more of the epi dots about declines, please. It's out there.

News to me that there's a Tenofovir gel for rectal use, and during the Q&A I told Connie hearing her speak those words was beautiful music to my ears. I asked if patients were instructed to insert the gel several hours before or immediately prior to sex, and what about irritation for either the top or the bottom partners.

She said the rectal gel was not ready for prime time and her colleague Dr. Craig Hendrix of Johns Hopkins University explained that the research is at the very early stages, but that they had observed irritation due to inflammation from the Tenofovir. There's no definitive answer of when to apply the gel, but it gets absorbed within minutes of application.

Yes, I know it's far-off into the future before we're going to see this, but one day I believe there will be lubes containing safe but effective amounts of HIV and STD killing properties, and the lubes will be widely accepted and used by gay men into buttsex.

Say hello to Leonardo Bastida Aguilar of Letre S Sida, Cultura y Vida Cotidiana, which is based in Mexico. We exchange pleasantries during the snack break. He's attending the conference thanks to a grant to his AIDS and cultural agency from the Ford Foundation.

This is Dr. Obinna Excellence Oleribe who is the executive director of E&F Management Care Center, which is based in Nigeria. He told me about a health care clinic that must perform all HIV/AIDS services, from testing to prevention counseling to providing treatment to clients only Mondays because of limited resources, and to deal with other healthcare needs the other days of the week.

Since everyone knows Monday is the one day to receive any sort of HIV service, many folks in need of testing or drugs avoid the clinic because of the stigma heaped upon those entering or leaving the place. The entrance is on public and busy street, Obinna said. He worries how to provide access to services without burdening clients with the rampant stigma associated with people living with HIV and AIDS.

Allow me to introduce Richard Horton, the editor of the Lancet. He made opening remarks yesterday that included mention of addressing the neglect of key populations to create a world free of AIDS, and he mentioned men who have sex with man and sex workers at the top of his list. Today he thanked me for coming to the meeting and said he heard my plea for more engagement of people with AIDS in conferences.

I requested to be put on tomorrow morning's panel titled What’s the biggest risk for long term survivors of HIV? No PWA is on the panel but Richard is not in charge of it, however, he supports me getting on it and said I need to speak with Dr. Jay Levy of UCSF. Jay has organized the panel and I've emailed him my request. Keep your fingers crossed I get a few minutes on the panel.

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