Closer Than Ever To an AIDS-Free Generation

December 1, 2013 • 0 comments • By Thomas Frieden, M.D., M.P.H., Director, Centers for Disease Control and Prevention
Cross-posted from Huffington Post

Dr. Tom Frieden, Director of the CDC

As CDC Director, I’ve had the privilege of meeting with nurses, doctors, outreach workers, and people living with HIV in communities across the U.S. and around the world.

As an infectious disease doctor who trained in New York City before treatment for HIV was available, these meetings are always deeply moving. Together we’ve made enormous progress addressing the suffering and death caused by this fearsomely deadly virus.

Today is World AIDS Day, the worldwide reminder that we must all continue the fight against HIV.

This year’s theme, “Shared Responsibility: Strengthening Results for an AIDS-Free Generation,” reflects our global commitment to achieving President Obama’s vision of an AIDS-free generation.

We’ve made remarkable progress since the launch of the U.S. President’s Emergency Plan for AIDS Relief – PEPFAR – in 2003.

In June, CDC, together with our sister PEPFAR implementing agencies, achieved a dramatic milestone: the prevention of HIV infection in one million babies globally over the past ten years.

I will never forget the woman I met in Nigeria holding twin babies in her arms. She said to me, “I’m HIV positive, but my babies are HIV negative because of PEPFAR. Please thank the American people for me.”

New HIV infections are declining globally and life expectancy is rebounding in many countries. Because of PEPFAR, more than 5 million HIV-positive people are working, studying, teaching, learning – contributing to their communities – who would otherwise be dead or dying.

More people than ever are aware of their HIV infection status, and that means more people living with HIV can take steps to stay healthy and protect their partners, including by taking antiretroviral treatment.

The heart of what CDC brings to the fight is our ability to share our science and innovation to build capacity across the globe.

From Atlanta and field offices in more than 50 countries, we work alongside our host country and international partners. We have 1,800 people working in the field, the vast majority hired from the local communities. They provide technical assistance, consultation, mentoring, and training in Asia, South America, Africa, and the Caribbean. It’s a huge footprint that makes a real difference across the globe.

We’re helping build systems with the essential components of public health: laboratories, surveillance systems, trained staff, and data systems that can monitor projects and programs, not only for progress, but to ensure maximum impact.

It’s building capacity from the inside out.

In the United States, efforts to curb the HIV/AIDS pandemic through testing, education, prevention, care, and treatment are bolstered by new evidence that antiviral treatment greatly reduces risk of spread of HIV.

On this World AIDS Day, CDC continues to bring the best prevention and treatment tools at our disposal to the communities that need them most.

We’re closer today than ever to reaching the goal of an AIDS-free generation, and that’s reason to celebrate. But more importantly, it’s reason to dedicate ourselves even more to scaling up what works to stop the HIV/AIDS pandemic.

Follow Tom Frieden, MD, MPH on Twitter: www.twitter.com/@DrFriedenCDC

Related posts:

1. On the Road to an AIDS-Free Generation
2. Moving Towards an AIDS-free Generation
3. An AIDS-Free Generation
4. Continuing Our March to an AIDS-Free Generation and Improved Global Health
5. Commentary Discusses “On-the-Ground” Details Necessary to Achieve an AIDS-Free Generation

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World AIDS Day 2013—Addiction Treatment Supports AIDS Treatment

December 1, 2013 • 0 comments • By Nora Volkow, M.D., Director, National Institute on Drug Abuse (NIDA), NIH
Cross-posted from National Institute on Drug Abuse - Nora's Blog

NIDA displays panels from the AIDS Memorial Quilt

December 1 is World AIDS Day. At NIDA, we always stress the principle that drug abuse treatment is AIDS prevention, because of the close links that exist between drug abuse and the spread of HIV.  Injection drug use alone contributed to more than 7% of new infections in 2011, although the population of people who use drugs by any route who are also HIV-positive is much higher. Drug use goes hand-in-hand with various behaviors besides needle-sharing that place individuals at risk for HIV infection, such as unprotected sex.

A new study  by researchers in Vancouver, British Columbia shows that, beyond the benefits of drug addiction treatment in HIV prevention, it also supports HIV treatment. Drug users face numerous unique challenges that contribute to poorer outcomes from HIV infection. The Canadian study found that, in the absence of financial and other barriers preventing access to antiretroviral therapy (ART) regimens, opioid-dependent individuals engaged in methadone maintenance therapy (MMT) were less likely to discontinue ART than those not engaged in MMT and were more likely to achieve suppressed viral loads.

This study shows that investment in drug treatment improves a crucial step in the HIV Care Continuum: helping people stay in care—since HIV treatment is a lifelong process until a cure is found. By treating drug dependence, a person is benefiting not only from a lifestyle free of illicit drug use but from one that is less compromised by HIV because remaining on ART will be more likely. The benefits of delivering addiction treatment to HIV-positive drug users could also extend to the community, by reducing the likelihood of HIV transmission to others.

We have done much to reduce the spread of HIV, but there are still approximately 50,000 new HIV infections each year, and at the end of 2010, an estimated 872,990 people in the United States were living with an HIV diagnosis. World AIDS Day is an occasion to renew our commitment to reducing the scourge of AIDS and curbing the spread of HIV. The Canadian study is a reminder that drug addiction treatment is an intrinsic part of those goals.

Related posts:

1. Increasing HIV Testing, Including Rapid Testing, in Substance Abuse Treatment Programs
2. President’s FY 2013 Budget Supports Implementation of the National HIV/AIDS Strategy
3. Presidential Proclamation — World Hepatitis Day, 2013
4. NIH Statement on World AIDS Day 2013
5. SAMHSA Announces New Funding Announcement for Rapid Hepatitis C Screening in Drug Treatment Programs

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Join the Fight Against HIV/AIDS by Getting Tested

Quinn Tivey Photographer

Posted: 12/01/2013 11:51 am

At the 1992 Freddie Mercury Tribute Concert, my grandmother, Elizabeth Taylor, gave some simple and on-point sexual advice: "Straight sex, gay sex, bisexual sex: use a condom -- whoever you are."

It might seem a bit unusual to hear your grandma reminding you (and a packed stadium) that if you're getting laid, use a condom. But she was always blunt -- and someone who spoke straight from her heart.

Since her death, I've been striving to continue on the path that my grandmother helped to establish in the fight against HIV/AIDS. Last year I helped to start a Los Angeles branch of genCURE, a youth-oriented division of amfAR (which she helped to form in 1985), and over the last few months, I have been working closely with the support-based Elizabeth Taylor AIDS Foundation (ETAF) that she started in 1991.

At 27 years old, I've noticed that many of my friends don't seem to regard HIV/AIDS as a major concern in their lives. This is bewildering considering that here in the U.S. the CDC counts 20-24 year olds as the largest group of new infections and young adults and teens between 13 and 29 as comprising over 35 percent of new infections across all age groups. Of course, my age group is not uniquely at risk of infection. Persons of every age, background, sexuality, everywhere in the world, can be at risk. There are approximately 35 million people living with HIV around the world (WHO), with over a million here in the U.S., a fifth of whom do not realize they are positive (aids.gov).

So now, 25 years after the first World AIDS Day in 1988, I'm writing to reiterate the same fundamental call to awareness and action that World AIDS Day was founded upon and to which my grandmother was dedicated. I'm asking my friends and peers, young and old, gay and straight -- anyone who is reading this -- to engage in the individual responsibilities that we all share in the global fight against HIV/AIDS.

In 1986 the US Surgeon General C Everett Koop released a report on AIDS in which he recommended condom use, testing to know one's HIV status and avoiding sharing needles as individual ways of stopping transmission of the virus. These basic principles aren't new but they are worth repeating year after year and generation after generation.

Get tested if you could have been exposed to anything that puts you at risk of HIV infection. The importance of getting tested is eloquently summarized in this brief video produced by Portland, Oregon-based Cascade AIDS Project, which is funded in part by ETAF. As the video clearly states: "one in five people who have HIV don't know they have it, but when they do know, they are 70 percent less likely to pass HIV to their partners, and if they take medication, use protection, and stay in care, then transmission rates can drop by up to 96 percent."

To expand upon that: If you are in an exclusive and trusting relationship and don't want to use protection, get tested together. I have friends who entered into exclusive relationships and began having unprotected sex because both parties thought (or claimed) themselves to be negative. They later learned, too late, that one of the partners had actually been positive and had transmitted the virus.

At the Freddie Mercury tribute concert I mentioned earlier, my grandma went on to give some more good advice: "If you share drugs, don't share a needle." She stood behind that advice by personally funding 59 syringe exchange programs since 1992. According to the Lower East Side Harm Reduction Center in Manhattan, to which ETAF has been providing funding since 1999, the transmission rate among injection drug users in New York State has plummeted from over 50 percent in 1992 to about 5 percent as of 2008. That exceptional drop in transmission speaks volumes to the importance of using clean syringes if you are using injection drugs.

ETAF and amfAR have helped to save countless lives around the world. Such organizations are imperative in our communal response to HIV/AIDS. Our individual actions are too.

If you engage in sexual or drug-related activities, it doesn't matter whether you identify them as being "high risk" or "low risk," because either way, you can be at risk. So, I'm writing now to simply say: please be careful. Demonstrate responsibility to yourself and those with whom you might share yourself. It is through such individual responsibility that we can each participate in the international fight against HIV/AIDS, and work towards ending the pandemic one step at a time.

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NIH Statement on World AIDS Day 2013 — December 1, 2013

Embargoed for Release: Wednesday, November 27, 2013, 1 p.m. EST

Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases
Jack Whitescarver, Ph.D., Director, NIH Office of AIDS Research
Francis S. Collins, M.D., Ph.D., NIH Director

In the 25 years that have passed since the first annual commemoration of World AIDS Day, extraordinary scientific progress has been made in the fight against HIV/AIDS. That progress has turned an HIV diagnosis from an almost-certain death sentence to what is now for many, a manageable medical condition and nearly normal lifespan. We have come far, yet not far enough.

In 2012, more than 2 million new HIV infections and 1.6 million AIDS-related deaths occurred globally. Although these numbers represent a decline from previous years, they also reflect a grim reality: far too many people become HIV-infected and die from the effects of the disease. On World AIDS Day, the National Institutes of Health (NIH) reaffirms its commitment to finding improved HIV treatments and tools for preventing infection (including a vaccine), addressing the conditions and diseases associated with long-term HIV infection, and, ultimately, finding a cure.

Over the years since HIV was established as the cause of AIDS, NIH-funded researchers—in partnership with academia and the biotechnology and pharmaceutical industries—have developed more than 30 life-saving antiretroviral drugs and drug combinations for treating HIV infection. Moreover, as the landmark HPTN 052 clinical trial proved, antiretroviral treatment can also effectively prevent HIV transmission by lowering the amount of virus in infected individuals, thereby making them less able to transmit the virus to their sexual partners. Today, we are working to improve upon these medicines by developing drugs that are longer-acting, simpler to use, and with fewer side effects. Further, NIH scientists and grantees are exploring the administration of anti-HIV antibodies as a way to treat infection. This approach was recently shown to be effective when used in monkeys infected with a genetically engineered version of simian HIV.  Additionally, NIH researchers have begun early stage human testing of a monoclonal antibody (called VRC01), which in the laboratory, protected human cells against infection by more than 90 percent of known HIV strains.

However, advances in antiretroviral therapy or the discovery of new treatments are of little value if HIV-infected individuals do not know they are infected, do not have adequate access to HIV treatment and the necessary medical care to control their virus levels, or do not adhere to their treatment regimen. For example, of the 1.1 million people living with HIV infection in the United States, only 25 percent receive ongoing medical care and have virus levels that are adequately controlled by taking antiretroviral medications as prescribed. The NIH is funding studies in the United States and internationally to explore new approaches to addressing this problem. The HPTN 065 study (also known as TLC-Plus), is assessing the feasibility of conducting widespread voluntary HIV testing, linking HIV-infected individuals to care and antiretroviral treatment, and providing incentives to individuals to adhere to treatment. The study is being conducted in New York City, and Washington, D.C.—both of which have communities at greater than average risk of HIV infection. Internationally, the recently launched HPTN 071 study, also called PopART, is examining whether offering expanded voluntary HIV testing along with enhanced delivery of antiretroviral treatment and prevention services can substantially reduce the number of new infections in South Africa and Zambia. The study will involve 21 communities and 1.2 million people in those countries. 

NIH-funded research has proven the effectiveness of such HIV prevention strategies as voluntary medical adult male circumcision and pre-exposure prophylaxis, or PrEP (taking a daily antiretroviral pill to prevent HIV acquisition). In order to be effective, these strategies must be used consistently under strict guidelines. NIH supports behavioral and social science research designed to better understand how to foster adherence to medications, promote acceptance and overcome barriers to the use of effective HIV prevention tools.

The NIH also continues to investigate new HIV prevention tools for those groups most at risk for HIV infection, including women and men who have sex with men. The multinational ASPIRE clinical trial, launched in 2012, is testing whether a vaginal ring containing the experimental antiretroviral drug dapivirine can prevent HIV infection in women. The recently launched MTN 017 clinical trial is examining the safety of a rectally applied gel containing the antiretroviral drug tenofovir for men who have sex with men.

A cornerstone of our HIV prevention efforts continues to be the search for a safe and effective vaccine. The pathway to an effective HIV vaccine has been challenging and marked by disappointments; however, basic research advances this year are charting the course for a new generation of investigational HIV vaccines. Through the work of NIH scientists and grantees, we have gained insights into how HIV and a strong antibody response to the virus co-evolve in an infected person and improved our understanding of how B-cells create potentially protective immune system responses. Further, NIH-funded researchers have developed a new tool for identifying broadly neutralizing antibodies against HIV that could help speed vaccine research and illuminated in exquisite detail the protein largely responsible for enabling HIV to enter human immune cells and cause infection.

Additionally, ongoing analyses of the landmark RV 144 HIV vaccine trial conducted in Thailand are providing important information about human immune responses and other factors that may explain why the investigational vaccine regimen reduced the risk of HIV acquisition by 31 percent. Large-scale investigational clinical trials to build on the RV 144 results are being planned for South Africa and Thailand.

We have reached the point when the thought of an HIV cure is not unrealistic. Several cases, including that of a toddler, have demonstrated the possibility of sustained remission, in which patients control or perhaps even eliminate HIV without the need for a lifetime of daily antiretroviral therapy. NIH continues to focus on the important area of research toward a cure through basic science and clinical testing that is underway or in development.

On this World AIDS Day, we take stock of what has been achieved and look forward to what can be accomplished in the near future toward the universally shared goal of ending the HIV/AIDS pandemic.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

The Office of the Director, the central office at NIH, is responsible for setting policy for NIH, which includes 27 Institutes and Centers. This involves planning, managing, and coordinating the programs and activities of all NIH components. The Office of the Director also includes program offices which are responsible for stimulating specific areas of research throughout NIH. Additional information is available at http://www.nih.gov/icd/od/.

The Office of AIDS Research, part of the Office of the Director, plans and coordinates the scientific, budgetary, legislative and policy elements of the NIH AIDS research program. Additional information, including the trans-NIH strategic plan and budget, is available at http://www.oar.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visitwww.nih.gov.

NIH...Turning Discovery Into Health^®

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AbbVie Partners with HIV Community to Launch International Awareness Campaign Focused on Women Living with HIV

PRESS RELEASE

Nov. 26, 2013, 9:21 a.m. EST

Nearly Half of Adults Living with HIV Are Women Who Face Unique Challenges Throughout Every Stage of Life

NORTH CHICAGO, Ill., Nov. 26, 2013 /PRNewswire via COMTEX/ -- In advance of World AIDS Day on December 1, 2013, AbbVie ABBV +0.85% today announced the launch of See Us: Women Take a Stand on HIV, an international awareness campaign focused on helping to address the unique challenges faced by women living with HIV. The campaign is being launched in collaboration with an expert steering committee, which includes representation from women living with and affected by HIV, the medical community, the International Association of Providers in AIDS Care (IAPAC), and NAM/aidsmap, the HIV information charity.

Women are the fastest-growing group within the population of people living with HIV globally.1 They face many challenges as a consequence of the compounding effects of HIV status, its associated stigmas and the status of women. These challenges range from lack of access to care to the experience of violence and discrimination.2 In addition, at each stage of life, from childhood through childbearing years to post-menopause, women living with HIV are confronted with unique care considerations, which include maternal and emotional health issues, and an increased risk for multiple disease complications.3

"As we recognize World AIDS Day this year, it is important to acknowledge and work to address the unique needs of women living with HIV, who make up nearly half of the global population of people living with HIV," said Jose M. Zuniga, PhD, MPH, President of IAPAC. "Because women living with HIV can face challenges around accessing health care resources, and as HIV prevalence increases among women, there is an urgent need for initiatives to raise awareness and respond to the unique needs of women living with HIV throughout all phases of their lives."

In the coming months, AbbVie and the See Us: Women Take a Stand on HIV steering committee will develop and launch an informational tool as a resource for women living with HIV and will continue to contribute to building a broader sense of community by helping to gain support from national and international organizations focused on both women and HIV.

"As a global leader in HIV, AbbVie has a long-standing commitment to providing support to people living with HIV through global initiatives that seek to increase knowledge and understanding of the effects of HIV on people living with the disease," said Marisol Martinez-Tristani, MD, Medical Director, Global Medical Affairs, AbbVie. "It's important that we recognize specifically the plight of women living with HIV. Through this campaign we will engage in efforts to reach the HIV community to collectively improve both emotional support and long-term care for these women."

About See Us: Women Take a Stand on HIV See Us: Women Take a Stand on HIV is an international awareness campaign created by AbbVie and the steering committee with representation from women living with and affected by HIV, the medical community, IAPAC, and NAM/aidsmap. The campaign seeks to assist in breaking down barriers, improving overall care and support, and ultimately helping encourage women living with HIV to create a cohesive community and advocate for their own needs. The campaign is made possible through funding provided by AbbVie and involves the participation of HIV community representatives from around the world.

Women: The New Face of HIVWomen are the fastest-growing group within the population of people living with HIV worldwide.1 Every minute, one woman is infected by HIV, mainly through sexual transmission.2 Globally, some 49 percent of all adults living with HIV are female.2 Infection rates among women aged 15-24 are twice as high as in young men.2 Women have different care considerations from men, including pregnancy, increased risk for cervical cancer, and premature menopause and osteoporosis.3 HIV is the leading cause of death in women of reproductive age around the world4, many of whom are diagnosed when they become pregnant.5

About AbbVieAbbVie is a global, research-based biopharmaceutical company formed in 2013 following separation from Abbott. The company's mission is to use its expertise, dedicated people and unique approach to innovation to develop and market advanced therapies that address some of the world's most complex and serious diseases. In 2013, AbbVie employs approximately 21,000 people worldwide and markets medicines in more than 170 countries. For further information on the company and its people, portfolio and commitments, please visit www.abbvie.com. Follow @abbvie on Twitter or view careers on our Facebook or LinkedIn page.

References1 AIDS Epidemic Update December 2004. UNAIDS and WHO. Accessed September 26, 20132 Women Out Loud. UNAIDS. Accessed September 26, 20133 Guide for HIV/AIDS Clinical Care, Health Care of HIV Infected Women through the Life Cycle. US Department of Health and Human Services. Accessed September 26, 20134 Women and Health. WHO. Accessed September 26, 20135 Global HIV/AIDS Response Epidemic Update and Health Sector Progress Towards Universal Access. Accessed September 26, 2013

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