Women 'may face greater HIV risk'- BBC
HIV virus (red) slips between loosely connected skin cells to reach its immune cell targets such as the Langerhans cells (orange), macrophages (purple), dendritic cells (green) and CD4 positive T cells (blue)
Women having unsafe sex may be at more risk of HIV than thought after tests revealed the virus could breach even healthy vaginal tissue.
It had been believed that only damaged skin inside the vagina could provide a route to infection.
However, US-based researchers say HIV can get past this intact barrier within hours.
UK HIV charities said it reinforced the need for women to avoid unprotected sex unless their partner's health is known.
The lining of the vagina - the squamous epithelium - had been believed by many to be capable of keeping HIV at bay.
While transmission of the virus from men to women through unprotected sex is commonplace in many parts of the world, it was thought that HIV was most likely travelling through cuts or sores in the vaginal tract, or penetrating a much thinner layer of skin further up the reproductive tract.
The scientists from Northwestern University in Chicago found that, far from this being the truth, HIV could move quickly between the skin cells themselves.
This is an important and unexpected result - we have a new understanding of how HIV can invade the female vaginal tract
Professor Thomas Hope
Northwestern University
The weak point, they said, occurs when skin cells are about to be shed, as the cells are no longer as tightly bound together.
Using HIV "tagged" with a marker which gives off light, they observed that, within four hours, the virus had reached a fraction of a millimetre below the surface.
At this depth, according to the researchers, it could encounter the immune cells it needed to invade to establish itself in the body.
Professor Thomas Hope, leading the research, said: "This is an important and unexpected result - we have a new understanding of how HIV can invade the female vaginal tract."
"We urgently need new prevention strategies or therapeutics to block the entry of HIV through a woman's genital skin."
Condom call
He said that while condoms were highly effective in blocking the virus, people often rejected them for cultural and other reasons.
Lisa Power, from the Terrence Higgins Trust said: "This is sadly not surprising, though it is an important finding.
"We have long known that it is easier for a man to transmit HIV sexually to a woman than for a woman to transmit it to a man and this helps us understand why.
"This will help in developing better prevention mechanisms - but until then, it's more clear than ever that a condom is a vital part of safer sex."
The charity AVERT echoed this advice, adding: "While there is evidence given by scientists that unprotected heterosexual sex is not as risky as other routes of HIV transmission, AVERT would still advocate the need for the use of condoms in all sexual encounters unless the HIV status of those involved was known.
"This study serves to strengthen that argument and will hopefully give weight to the need for safer heterosexual sex to be advocated further by governments and practitioners worldwide."
Showing posts with label AIDS. Show all posts
Showing posts with label AIDS. Show all posts
Wednesday, December 17, 2008
Tuesday, September 2, 2008
H.I.V. Is Spreading in New York City at Three Times the National Rate, a Study Finds
The virus that causes AIDS is spreading in New York City at three times the national rate — an incidence of 72 new infections for every 100,000 people, compared with 23 per 100,000 nationally — according to a study released on Wednesday by the city’s Department of Health and Mental Hygiene.
The findings, based on a new formula developed by the federal Centers for Disease Control and Prevention, estimated that 4,762 New Yorkers contracted H.I.V. in 2006, the most precise estimate the city had ever offered.
But the city stressed that because the method of estimating infections was new, it could not be said definitively whether the number of new infections in the city had increased or decreased from previous years.
Blacks, and men who have sex with other men, are the groups at greatest risk of contracting H.I.V., the study found. A summary of the new data:
¶Men accounted for 76 percent of new H.I.V. infections and women for 25 percent. (The figures exceed 100 percent because of rounding.)
¶Blacks made up 46 percent of the newly infected; Hispanics, 32 percent; and whites, 21 percent. (Figures for other racial or ethnic groups were not provided.)
¶Those under age 20 made up 4 percent of the newly infected; those 20 to 29 years old, 24 percent; those 30 to 39 years old, 29 percent; those 40 to 49 years old, 29 percent; and those 50 and older, 15 percent.
¶Sex between men was the main cause in 50 percent of new infections; high-risk heterosexual sex in 22 percent; intravenous drug use in 8 percent; and unknown or uncertain causes in 18 percent.
Manhattan accounted for 35 percent of new infections; Brooklyn, 26 percent; the Bronx, 19 percent; and Queens, 17 percent.
As the health department has repeatedly noted, gay minority men were particularly at risk. For example, of new H.I.V. infections among men under age 30 who have sex with men, 77 percent were in black or Hispanic men, as were 59 percent of new H.I.V. infections among men ages 30 to 50 who have sex with men.
Over all, the study found some interesting differences between national and local rates of new H.I.V. infections.
Nearly two-thirds of the city’s new infections occurred in people 30 to 50 years old. Nationally, people under 30 accounted for 41 percent of new infections, compared with 28 percent in New York City.
Also, within New York City, whites were infected at four times the national rate, Hispanics at three times the national rate, and blacks at almost twice the national rate.
The health department said in a news release:
“The analytic technique is new, and the estimates may be imprecise, but even a rough gauge of H.I.V. incidence is a valuable tool for understanding — and combating — the spread of H.I.V. The health department’s new estimate includes 2006 incidence figures for different age groups, racial groups and both genders. By repeating the exercise for subsequent years, researchers may be able to discern increases and decreases over time, and target their prevention efforts accordingly.”
Over the past year, the health department has warned that H.I.V. infections among young gay men have risen and that unsafe sex remains common.
The findings, based on a new formula developed by the federal Centers for Disease Control and Prevention, estimated that 4,762 New Yorkers contracted H.I.V. in 2006, the most precise estimate the city had ever offered.
But the city stressed that because the method of estimating infections was new, it could not be said definitively whether the number of new infections in the city had increased or decreased from previous years.
Blacks, and men who have sex with other men, are the groups at greatest risk of contracting H.I.V., the study found. A summary of the new data:
¶Men accounted for 76 percent of new H.I.V. infections and women for 25 percent. (The figures exceed 100 percent because of rounding.)
¶Blacks made up 46 percent of the newly infected; Hispanics, 32 percent; and whites, 21 percent. (Figures for other racial or ethnic groups were not provided.)
¶Those under age 20 made up 4 percent of the newly infected; those 20 to 29 years old, 24 percent; those 30 to 39 years old, 29 percent; those 40 to 49 years old, 29 percent; and those 50 and older, 15 percent.
¶Sex between men was the main cause in 50 percent of new infections; high-risk heterosexual sex in 22 percent; intravenous drug use in 8 percent; and unknown or uncertain causes in 18 percent.
Manhattan accounted for 35 percent of new infections; Brooklyn, 26 percent; the Bronx, 19 percent; and Queens, 17 percent.
As the health department has repeatedly noted, gay minority men were particularly at risk. For example, of new H.I.V. infections among men under age 30 who have sex with men, 77 percent were in black or Hispanic men, as were 59 percent of new H.I.V. infections among men ages 30 to 50 who have sex with men.
Over all, the study found some interesting differences between national and local rates of new H.I.V. infections.
Nearly two-thirds of the city’s new infections occurred in people 30 to 50 years old. Nationally, people under 30 accounted for 41 percent of new infections, compared with 28 percent in New York City.
Also, within New York City, whites were infected at four times the national rate, Hispanics at three times the national rate, and blacks at almost twice the national rate.
The health department said in a news release:
“The analytic technique is new, and the estimates may be imprecise, but even a rough gauge of H.I.V. incidence is a valuable tool for understanding — and combating — the spread of H.I.V. The health department’s new estimate includes 2006 incidence figures for different age groups, racial groups and both genders. By repeating the exercise for subsequent years, researchers may be able to discern increases and decreases over time, and target their prevention efforts accordingly.”
Over the past year, the health department has warned that H.I.V. infections among young gay men have risen and that unsafe sex remains common.
Saturday, July 26, 2008
Meditation slows AIDS progression
WASHINGTON: Meditation may slow the worsening of AIDS in just a few weeks, perhaps by affecting the immune system, US researchers reported.
If the findings are borne out in larger studies, it could offer a cheap and pleasant way to help people battle the incurable and often fatal condition, the team at the University of California Los Angeles said on Thursday.
They tested a stress-lowering program called mindfulness meditation, defined as practicing an open and receptive awareness of the present moment, avoiding thinking of the past or worrying about the future. The more often the volunteers meditated, the higher their CD4 T-cell counts - a standard measure of how well the immune system is fighting the AIDS virus. The CD4 counts were measured before and after the two-month programme.
"This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said David Creswell, who led the study.
His team tested 67 HIV-positive adults from the Los Angeles area, 48 of whom did some or all of the meditation. Most were likely to have highly stressful lives, Creswell said.
"The average participant in the study was male, African American, homosexual, unemployed and not on ARV (antiretroviral) medication," they wrote in the journal Brain, Behavior, and Immunity.
The meditation classes included eight weekly two-hour sessions, a day-long retreat and daily home practice. "The people that were in this class really responded and just really enjoyed the program," Creswell said.
"The mindfulness program is a group-based and low-cost treatment, and if this initial finding is replicated in larger samples, it’s possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications," he added.
He said it was unclear how the stress-reducing effects of meditation work. It may directly boost CD4 T-cell levels, or suppress the virus, he said.
If the findings are borne out in larger studies, it could offer a cheap and pleasant way to help people battle the incurable and often fatal condition, the team at the University of California Los Angeles said on Thursday.
They tested a stress-lowering program called mindfulness meditation, defined as practicing an open and receptive awareness of the present moment, avoiding thinking of the past or worrying about the future. The more often the volunteers meditated, the higher their CD4 T-cell counts - a standard measure of how well the immune system is fighting the AIDS virus. The CD4 counts were measured before and after the two-month programme.
"This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said David Creswell, who led the study.
His team tested 67 HIV-positive adults from the Los Angeles area, 48 of whom did some or all of the meditation. Most were likely to have highly stressful lives, Creswell said.
"The average participant in the study was male, African American, homosexual, unemployed and not on ARV (antiretroviral) medication," they wrote in the journal Brain, Behavior, and Immunity.
The meditation classes included eight weekly two-hour sessions, a day-long retreat and daily home practice. "The people that were in this class really responded and just really enjoyed the program," Creswell said.
"The mindfulness program is a group-based and low-cost treatment, and if this initial finding is replicated in larger samples, it’s possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications," he added.
He said it was unclear how the stress-reducing effects of meditation work. It may directly boost CD4 T-cell levels, or suppress the virus, he said.
Monday, June 30, 2008
Unsafe sex Asia’s undoing: report
Sanchita Sharma, Hindustan Times
New Delhi, July 01, 2008
Up to 10 million women in Asia sell sex and at least 75 million men pay for it regularly. With an estimated 10 male clients for every sex worker in Asia, men who go for unprotected commercial sex are probably the single most important determinant of the size of HIV epidemics in most of Asia, followed by sharing of contaminated needles and syringes and unprotected sex between men.
These were the findings of the Independent Commission on AIDS in Asia in its report, Redefining AIDS in Asia: Crafting an Effective Response, which was released by Prime Minister Manmohan Sigh on Monday. According to UNAIDS, an estimated 4.9 million Asians are currently infected with HIV. In 2007, 440,000 people were infected with HIV and 300,000 died of AIDS-related infections and diseases.
By pragmatically focusing prevention programmes to the sex trade and on drug use, the commission suggests that governments would make considerable progress in halting and reversing the epidemic. In most Asian countries, an increase in casual and premarital sex among women is unlikely to lead to a net increase in new infections, notes the commission, which is supported by UNAIDS.
India as had some successes. Though the country has 2.5 million people infected with HIV, which is over half of Asia's 4.9 million HIV population, effective initiatives such as condom promotion among sex workers, raising awareness, lowering stigma and making treatment accessible has slowed down new infections in some states such as Tamil Nadu.
Other Asian countries, however, are lagging behind in their response to AIDS. If countries do not change policies, HIV would infect 10 million Asians and claim 500,000 lives annually by 2020.
"Countries at the early stages of the epidemic needed to spend an average of 50 cents per capita to reverse the epidemic. Every dollar spent on early prevention would save $8 in treatment costs later. Yet, the money spent on HIV programmes from national budgets decreased over the past decade in the 23 countries surveyed, the only exceptions being India and China," said C Rangarajan, chairman of the nine-member commission and chairman of the Economic Advisory Council to the PM.
New Delhi, July 01, 2008
Up to 10 million women in Asia sell sex and at least 75 million men pay for it regularly. With an estimated 10 male clients for every sex worker in Asia, men who go for unprotected commercial sex are probably the single most important determinant of the size of HIV epidemics in most of Asia, followed by sharing of contaminated needles and syringes and unprotected sex between men.
These were the findings of the Independent Commission on AIDS in Asia in its report, Redefining AIDS in Asia: Crafting an Effective Response, which was released by Prime Minister Manmohan Sigh on Monday. According to UNAIDS, an estimated 4.9 million Asians are currently infected with HIV. In 2007, 440,000 people were infected with HIV and 300,000 died of AIDS-related infections and diseases.
By pragmatically focusing prevention programmes to the sex trade and on drug use, the commission suggests that governments would make considerable progress in halting and reversing the epidemic. In most Asian countries, an increase in casual and premarital sex among women is unlikely to lead to a net increase in new infections, notes the commission, which is supported by UNAIDS.
India as had some successes. Though the country has 2.5 million people infected with HIV, which is over half of Asia's 4.9 million HIV population, effective initiatives such as condom promotion among sex workers, raising awareness, lowering stigma and making treatment accessible has slowed down new infections in some states such as Tamil Nadu.
Other Asian countries, however, are lagging behind in their response to AIDS. If countries do not change policies, HIV would infect 10 million Asians and claim 500,000 lives annually by 2020.
"Countries at the early stages of the epidemic needed to spend an average of 50 cents per capita to reverse the epidemic. Every dollar spent on early prevention would save $8 in treatment costs later. Yet, the money spent on HIV programmes from national budgets decreased over the past decade in the 23 countries surveyed, the only exceptions being India and China," said C Rangarajan, chairman of the nine-member commission and chairman of the Economic Advisory Council to the PM.
Friday, June 27, 2008
Majority of Drug Addicts in India Are HIV Positive
Written by Sapna Mhatre
Friday, 27 June 2008
THURSDAY, June 26, (News Locale) - One of the major risk factors for developing HIV/AIDS infection is drug addiction. A recent study by United Nations Office on Drugs and Crime (UNODC) finds that a majority of drug addicts in the Indian subcontinent are in fact HIV positive.
The report says that these drug users are also not aware that sharing needles could lead to HIV. Furthermore these individuals are also more likely to have unsafe sexual habits thus exposing them to the risk of contracting HIV.
The rapid situation and response assessment (RSRA) survey of drugs and HIV in India involved some 6,000 drug addicts in the country. The survey found more than 1400 drug users had lent their used syringes to fellow addicts and another 1279 had borrowed syringes from fellow addicts.
The report added that most drug users fell in the age group of 21 to 30 years and that just 20 percent of them used a condom before having sexual intercourse. A majority of them had multiple sexual partners as well.
Other startling statistics from the report are that just 23 percent of them used condom while having casual sex although 72.7 percent of them knew that condom protects against HIV.
"HIV infection is often associated with unsafe injecting drug practices - the use of contaminated injecting equipment is a major route of HIV transmission," UNODC says on its website."Once the virus is introduced into an injecting drug user community, prevalence can rise up to 90 percent in a short space of time."
Friday, 27 June 2008
THURSDAY, June 26, (News Locale) - One of the major risk factors for developing HIV/AIDS infection is drug addiction. A recent study by United Nations Office on Drugs and Crime (UNODC) finds that a majority of drug addicts in the Indian subcontinent are in fact HIV positive.
The report says that these drug users are also not aware that sharing needles could lead to HIV. Furthermore these individuals are also more likely to have unsafe sexual habits thus exposing them to the risk of contracting HIV.
The rapid situation and response assessment (RSRA) survey of drugs and HIV in India involved some 6,000 drug addicts in the country. The survey found more than 1400 drug users had lent their used syringes to fellow addicts and another 1279 had borrowed syringes from fellow addicts.
The report added that most drug users fell in the age group of 21 to 30 years and that just 20 percent of them used a condom before having sexual intercourse. A majority of them had multiple sexual partners as well.
Other startling statistics from the report are that just 23 percent of them used condom while having casual sex although 72.7 percent of them knew that condom protects against HIV.
"HIV infection is often associated with unsafe injecting drug practices - the use of contaminated injecting equipment is a major route of HIV transmission," UNODC says on its website."Once the virus is introduced into an injecting drug user community, prevalence can rise up to 90 percent in a short space of time."
Tuesday, June 24, 2008
'India is considered to be a 'next wave' country for HIV/AIDS'
With increasing prevalence and rising incidence of HIV in India, how well equipped are Indian drug manufacturers to handle the same. T Vijayakumar, Senior Manager-Export Formulations, Aurobindo Pharma discusses the antiretrovirals (ARV) market, in conversation with Arshiya Khan. Excerpts
What has been the growth rate of HIV/AIDS and the incidence of the disease in India?
The world's second most populous country, India, is experiencing a highly varied HIV epidemic, which appears to be stable or diminishing in some parts while growing at modest rates in others. Approximately 6 million people are suffering with AIDS in India. Today, the world's largest democracy has entered a critical period in its fight against the HIV/AIDS pandemic.
The first case of HIV disease was documented in India in 1986. India accounts for 75 percent of HIV/AIDS prevalent in South, South East Asia and 15 percent of global prevalence. Majority of people living with HIV/AIDS in India are from rural areas (57 percent in 2005). By comparison, India represents 20 percent of the world's population. With an estimated 5.7 million people living with HIV/AIDS, India has the highest HIV/AIDS prevalence in the world, according to UNAIDS. Among 15-49 year olds, an estimated 5.2 million are living with the disease, according to India's National AIDS Control Organisation (NACO).
Still, India's prevalence rate (the percent of the adult population estimated to be infected with HIV) is relatively low. However, India is considered to be a 'next wave' country; that is, it stands at a critical point in its epidemic, with HIV poised to expand, but where large scale prevention and other interventions today could help to contain a more serious epidemic in the future. As the second most populous nation in the world, even a small increase in India's HIV/ AIDS prevalence rate would represent a significant component of the world's HIV/AIDS burden.
AIDS being a non curable disease, tell us about the developments, availability, accessibility and affordability of ARV medicines, with respect to the contemporary market situation.
Promising developments have been seen in recent years in global efforts to address AIDS epidemic, including increased access to effective treatment and preventive programmes. However, the number of people living with HIV is growing as the number of deaths due to AIDS. A total of 40 million are living with HIV today. In many regions of the world, new HIV infections are heavily concentrated among young people.
Access to treatment and care has greatly increased in recent years. The expanded provision of antiretroviral treatment is reached by 2 million lives per year in recent years with the help of organisations worldwide.
Making drugs affordable to those who need them is a formidable challenge. Availability of HIV/AIDS drugs, like others, depends on sustainable financing for drug procurement at the national level, national and local health infrastructure for delivering drugs and monitoring patient compliance and affordable drug prices.
What are the characteristics of the ARV market?
Currently the ARV markets in the regions where HIV is grown up to epidemic levels is funded by two major funding agencies, namely, President's Emergency Plan for AIDS Relief (PEPFAR) and Global Funds. These are availed by various underdeveloped and developing countries to combat the growing menace of AIDS.
India is fortunate to have a vibrant domestic pharma industry that can play a crucial role in the fight against the pandemic by providing ARV drugs at low cost to the government. Several Indian pharma companies are manufacturing generic drugs at competitive prices.
Since the number of people living with HIV is increasing, what opportunities does the ARV segment offer to the manufacturers of the same?
There are two sides to this. Firstly, increasing resistance to existing drugs drives innovations in drug therapy. Estimates show that up to 78 percent of patients are now failing to respond to antiretroviral drugs. Research indicates that patients are developing resistance to more than one class of drugs that are in general use. There is an increased level of drug resistance even in drug-naive patients. In 1999, eight percent hike in resistance was recorded in treatment-naive individuals and the figure has now alarmingly risen to 20 percent. This can lead to a condition where patients are less likely to reach suppressed levels of HIV due to undetectable levels when they start treatment.
Using a resistant test prior to starting the treatment regimen ensures that patients with primary resistance will receive a good response from the antiretroviral treatment similar to those who lack it. According to various analysts, the need for newer and more effective therapies grows as treated patients increasingly develop resistance to currently available antiretrovirals. These older generation drugs are being replaced by products with lower pill burdens, enhanced potency, and reduced side effects. Compounds that are effective against multi-drug resistant strains currently dominate the clinical development scene and are likely to drive the future growth of this industry.
There were speculations about the quality of drugs in India by WHO what has been the impact and the outcome of the same on the market?
Indian medical experts see the hand of powerful Western drug manufacturers in the World Health Organisation's withdrawals of its recommendations, for some of India's cheap and popular combination drugs against HIV/AIDS using generic 'copycats.' Generic 'copycats' are alternatives to brand name drugs and according to WHO requirements they must show pharmaceutical equivalents -- which means that the amount of active ingredient, the dosage form, and the strength are identical to those of a comparable brand. The generic must also be bio-equivalent, meaning the drug must be absorbed into the blood stream at roughly the same rate and extent as the pharmaceutically equivalent brand.
With one in four new HIV cases being reported from Asia, the sprawling continent is on the verge of being felled by an AIDS epidemic that would dwarf the devastation wrought by the killer disease in Africa, the Joint United Nations Programme on HIV/ AIDS (UNAIDS) warned.
The WHO decision seemed to be in line with repeated claims made by Western drug manufacturers and US government officials that generic drugs do not have the same quality standards as the patented ones.
The outcome for this situation is that WHO's pre-qualification list was created to guide procurement by aid agencies that are fighting the HIV/AIDS epidemic and includes more than 60 anti-retroviral drugs made by both patented and generic drug manufacturers. To be fair to WHO, the organisation made clear that its target was not the generic combinations themselves but the contract research organisations (CRO) hired by the Indian manufacturers and their questionable standards.
What are the market drivers and market restraints of the ARV segment?
Regulatory and patent uncertainties constrain development of generic and biogeneric drugs in developed countries. With end users of prescription drugs seeking to pay less for medication, generic and biogeneric products are poised for strong growth, especially in the developing nations. In India, for example, drug manufacturers may patent a process but not a compound, thus, generic drug makers are able to synthesize the compound through another process and may legally introduce another version of the drug. In this manner, they can benefit from the original manufacturer's ongoing advertising and promotion of the drug while eliminating the need to depend on the American and European generics producers. In an endeavor to avoid the stringent patent processes, generic manufacturers may lose some quality in the process of reengineering drugs. Several Asian and ROW generics producers have faced similar difficulties and one recent example is the removal of two generic HIV drugs produced by a prominent Indian pharma company from the WHO list of approved medications meant specifically for patients in Africa.
Though generics and biogeneric drugs are emerging as strong contenders to branded medications, a number of consumers in developed nations have a perception that branded products are more effective than unbranded ones. Certain patient populations tend to view healthcare benefits as entitlements rather than privileges and resist shifting from more expensive to less expensive options. Even when they are compelled to switch drugs, they shift from one brand to another - popularly known as a 'brand name shift' - despite the availability of low-cost generics. This is one challenge that generic drug manufacturers are likely to find hard to overcome in their quest to extend market reach.
How can these problems be tackled?
Even more fundamental to combating the emerging HIV/AIDS pandemic in India, than drug treatment, plans and funding is to create a sense of national urgency about the pandemic. India must urgently ramp up its communication campaign to make its citizens aware of the disease as well as the dangers they face from the virus. Overcoming consumer belief in branded products, which restricts use of generics.
arshiya.khan@expressindia.com
What has been the growth rate of HIV/AIDS and the incidence of the disease in India?
The world's second most populous country, India, is experiencing a highly varied HIV epidemic, which appears to be stable or diminishing in some parts while growing at modest rates in others. Approximately 6 million people are suffering with AIDS in India. Today, the world's largest democracy has entered a critical period in its fight against the HIV/AIDS pandemic.
The first case of HIV disease was documented in India in 1986. India accounts for 75 percent of HIV/AIDS prevalent in South, South East Asia and 15 percent of global prevalence. Majority of people living with HIV/AIDS in India are from rural areas (57 percent in 2005). By comparison, India represents 20 percent of the world's population. With an estimated 5.7 million people living with HIV/AIDS, India has the highest HIV/AIDS prevalence in the world, according to UNAIDS. Among 15-49 year olds, an estimated 5.2 million are living with the disease, according to India's National AIDS Control Organisation (NACO).
Still, India's prevalence rate (the percent of the adult population estimated to be infected with HIV) is relatively low. However, India is considered to be a 'next wave' country; that is, it stands at a critical point in its epidemic, with HIV poised to expand, but where large scale prevention and other interventions today could help to contain a more serious epidemic in the future. As the second most populous nation in the world, even a small increase in India's HIV/ AIDS prevalence rate would represent a significant component of the world's HIV/AIDS burden.
AIDS being a non curable disease, tell us about the developments, availability, accessibility and affordability of ARV medicines, with respect to the contemporary market situation.
Promising developments have been seen in recent years in global efforts to address AIDS epidemic, including increased access to effective treatment and preventive programmes. However, the number of people living with HIV is growing as the number of deaths due to AIDS. A total of 40 million are living with HIV today. In many regions of the world, new HIV infections are heavily concentrated among young people.
Access to treatment and care has greatly increased in recent years. The expanded provision of antiretroviral treatment is reached by 2 million lives per year in recent years with the help of organisations worldwide.
Making drugs affordable to those who need them is a formidable challenge. Availability of HIV/AIDS drugs, like others, depends on sustainable financing for drug procurement at the national level, national and local health infrastructure for delivering drugs and monitoring patient compliance and affordable drug prices.
What are the characteristics of the ARV market?
Currently the ARV markets in the regions where HIV is grown up to epidemic levels is funded by two major funding agencies, namely, President's Emergency Plan for AIDS Relief (PEPFAR) and Global Funds. These are availed by various underdeveloped and developing countries to combat the growing menace of AIDS.
India is fortunate to have a vibrant domestic pharma industry that can play a crucial role in the fight against the pandemic by providing ARV drugs at low cost to the government. Several Indian pharma companies are manufacturing generic drugs at competitive prices.
Since the number of people living with HIV is increasing, what opportunities does the ARV segment offer to the manufacturers of the same?
There are two sides to this. Firstly, increasing resistance to existing drugs drives innovations in drug therapy. Estimates show that up to 78 percent of patients are now failing to respond to antiretroviral drugs. Research indicates that patients are developing resistance to more than one class of drugs that are in general use. There is an increased level of drug resistance even in drug-naive patients. In 1999, eight percent hike in resistance was recorded in treatment-naive individuals and the figure has now alarmingly risen to 20 percent. This can lead to a condition where patients are less likely to reach suppressed levels of HIV due to undetectable levels when they start treatment.
Using a resistant test prior to starting the treatment regimen ensures that patients with primary resistance will receive a good response from the antiretroviral treatment similar to those who lack it. According to various analysts, the need for newer and more effective therapies grows as treated patients increasingly develop resistance to currently available antiretrovirals. These older generation drugs are being replaced by products with lower pill burdens, enhanced potency, and reduced side effects. Compounds that are effective against multi-drug resistant strains currently dominate the clinical development scene and are likely to drive the future growth of this industry.
There were speculations about the quality of drugs in India by WHO what has been the impact and the outcome of the same on the market?
Indian medical experts see the hand of powerful Western drug manufacturers in the World Health Organisation's withdrawals of its recommendations, for some of India's cheap and popular combination drugs against HIV/AIDS using generic 'copycats.' Generic 'copycats' are alternatives to brand name drugs and according to WHO requirements they must show pharmaceutical equivalents -- which means that the amount of active ingredient, the dosage form, and the strength are identical to those of a comparable brand. The generic must also be bio-equivalent, meaning the drug must be absorbed into the blood stream at roughly the same rate and extent as the pharmaceutically equivalent brand.
With one in four new HIV cases being reported from Asia, the sprawling continent is on the verge of being felled by an AIDS epidemic that would dwarf the devastation wrought by the killer disease in Africa, the Joint United Nations Programme on HIV/ AIDS (UNAIDS) warned.
The WHO decision seemed to be in line with repeated claims made by Western drug manufacturers and US government officials that generic drugs do not have the same quality standards as the patented ones.
The outcome for this situation is that WHO's pre-qualification list was created to guide procurement by aid agencies that are fighting the HIV/AIDS epidemic and includes more than 60 anti-retroviral drugs made by both patented and generic drug manufacturers. To be fair to WHO, the organisation made clear that its target was not the generic combinations themselves but the contract research organisations (CRO) hired by the Indian manufacturers and their questionable standards.
What are the market drivers and market restraints of the ARV segment?
Regulatory and patent uncertainties constrain development of generic and biogeneric drugs in developed countries. With end users of prescription drugs seeking to pay less for medication, generic and biogeneric products are poised for strong growth, especially in the developing nations. In India, for example, drug manufacturers may patent a process but not a compound, thus, generic drug makers are able to synthesize the compound through another process and may legally introduce another version of the drug. In this manner, they can benefit from the original manufacturer's ongoing advertising and promotion of the drug while eliminating the need to depend on the American and European generics producers. In an endeavor to avoid the stringent patent processes, generic manufacturers may lose some quality in the process of reengineering drugs. Several Asian and ROW generics producers have faced similar difficulties and one recent example is the removal of two generic HIV drugs produced by a prominent Indian pharma company from the WHO list of approved medications meant specifically for patients in Africa.
Though generics and biogeneric drugs are emerging as strong contenders to branded medications, a number of consumers in developed nations have a perception that branded products are more effective than unbranded ones. Certain patient populations tend to view healthcare benefits as entitlements rather than privileges and resist shifting from more expensive to less expensive options. Even when they are compelled to switch drugs, they shift from one brand to another - popularly known as a 'brand name shift' - despite the availability of low-cost generics. This is one challenge that generic drug manufacturers are likely to find hard to overcome in their quest to extend market reach.
How can these problems be tackled?
Even more fundamental to combating the emerging HIV/AIDS pandemic in India, than drug treatment, plans and funding is to create a sense of national urgency about the pandemic. India must urgently ramp up its communication campaign to make its citizens aware of the disease as well as the dangers they face from the virus. Overcoming consumer belief in branded products, which restricts use of generics.
arshiya.khan@expressindia.com
Sunday, June 22, 2008
Expert: New AIDS threat emerging in India among 'call center Romeos'
Sun, Jun 22 11:18 AM
KUALA LUMPUR, Malaysia (AP) _ A new AIDS threat is rising in India's numerous call centers, where young staff are increasingly having unprotected sex with multiple partners in affairs developed during night shifts, a top AIDS expert has warned. While India has made great strides in bringing down its HIV infection rate, the promiscuity among "call center Romeos" is a great concern, Dr.
Suniti Solomon, who detected the first HIV case in India in 1986, told an international medical conference Saturday. The United Nations, however, still estimates there are some 2.5 million Indians living with HIV and AIDS now.
"India has reached a plateau of the infections," Solomon told the International Congress on Infectious Diseases, which ends Sunday. Her concern now is the call centers, where many of the young staff work at night to correspond with the daytime working hours of their American and European clients.
"They have all the money. They huddle together in the night.
They are young, they are sexually active, so naturally they start," Solomon, who runs an AIDS center in the southern city of Chennai, told The Associated Press in a separate interview. She said at least three or four call center workers visit her clinic every week to get tested for HIV because they are worried after having unprotected sex.
It is estimated that India's call centers employ some 1.3 million people, mostly youths fresh out of school and colleges, earning a starting salary of 25,000 rupees (US$600) a month, more than a government doctor's paycheck. "You will see call center Romeos are a major high risk for HIV," Solomon said.
There are no figures for how many call center workers are infected with HIV. Citing confessions by the visitors to her center, Solomon said groups of young men and women rent apartments along the beach during the weekends and end up having multiple-partner sex. "If they are having sex just among themselves, and all are non-infected it is fine.
But if there is one person who has gone out of this group and brought in the virus, it will spread to everyone," she said. While the "call center Romeo" situation is a reflection of recent liberal values, India's anti-AIDS fight is also hampered by society's coexisting conservatism, Solomon told the conference.
She said this is evident in Hindu activists' opposition to circumcision which is proven to help inhibit HIV transmission on the grounds that it is against tradition and religion of Hindu-majority India. Solomon said she does not expect India to accept circumcision for preventing HIV infections.
A recent government study to gauge the acceptance for circumcision triggered a massive backlash by Hindu fundamentalists, who called it "obnoxious" and "a conspiracy." "If you go out into the streets and say I will do this (circumcision) to reduce HIV, there will be a chaos," she said.
"Vaccines have failed. Microbicides have failed.
This is one tool we have in hand but we can't use it.".
KUALA LUMPUR, Malaysia (AP) _ A new AIDS threat is rising in India's numerous call centers, where young staff are increasingly having unprotected sex with multiple partners in affairs developed during night shifts, a top AIDS expert has warned. While India has made great strides in bringing down its HIV infection rate, the promiscuity among "call center Romeos" is a great concern, Dr.
Suniti Solomon, who detected the first HIV case in India in 1986, told an international medical conference Saturday. The United Nations, however, still estimates there are some 2.5 million Indians living with HIV and AIDS now.
"India has reached a plateau of the infections," Solomon told the International Congress on Infectious Diseases, which ends Sunday. Her concern now is the call centers, where many of the young staff work at night to correspond with the daytime working hours of their American and European clients.
"They have all the money. They huddle together in the night.
They are young, they are sexually active, so naturally they start," Solomon, who runs an AIDS center in the southern city of Chennai, told The Associated Press in a separate interview. She said at least three or four call center workers visit her clinic every week to get tested for HIV because they are worried after having unprotected sex.
It is estimated that India's call centers employ some 1.3 million people, mostly youths fresh out of school and colleges, earning a starting salary of 25,000 rupees (US$600) a month, more than a government doctor's paycheck. "You will see call center Romeos are a major high risk for HIV," Solomon said.
There are no figures for how many call center workers are infected with HIV. Citing confessions by the visitors to her center, Solomon said groups of young men and women rent apartments along the beach during the weekends and end up having multiple-partner sex. "If they are having sex just among themselves, and all are non-infected it is fine.
But if there is one person who has gone out of this group and brought in the virus, it will spread to everyone," she said. While the "call center Romeo" situation is a reflection of recent liberal values, India's anti-AIDS fight is also hampered by society's coexisting conservatism, Solomon told the conference.
She said this is evident in Hindu activists' opposition to circumcision which is proven to help inhibit HIV transmission on the grounds that it is against tradition and religion of Hindu-majority India. Solomon said she does not expect India to accept circumcision for preventing HIV infections.
A recent government study to gauge the acceptance for circumcision triggered a massive backlash by Hindu fundamentalists, who called it "obnoxious" and "a conspiracy." "If you go out into the streets and say I will do this (circumcision) to reduce HIV, there will be a chaos," she said.
"Vaccines have failed. Microbicides have failed.
This is one tool we have in hand but we can't use it.".
Saturday, June 21, 2008
Tirupati-Tirumala hills grapple with rising AIDS cases
Shwetal Rai / CNN-IBN
TimePublished on Sat, Jun 21, 2008 at 01:35, Updated at Sat, Jun 21, 2008 in Nation section
TagsTags: Tirupati, Tirumala , Hyderabad
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SCARY STATS: AP AIDS Control Society says there are over 200 sex workers in the Tiruptai-Tirumala hills area.
SCARY STATS: AP AIDS Control Society says there are over 200 sex workers in the Tiruptai-Tirumala hills area.
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Hyderabad: There has been a steep rise in the number of HIV/AIDS cases in one of India’s holiest Hindu pilgrimage sites, the Tirupati-Tirumala hills.
Andhra Pradesh AIDS Control Society has found out that over 200 commercial sex workers operate in the area.
“We have come across this information through unofficial sources that there is commercial sex activity even in Tirumala. There are about 200-300 sex workers there,” Project Director, AP AIDS Control Society, K Chandravadan said.
The discovery reveal that sex workers clandestinely operate in about 15 secluded spots in the hills.
Chittoor — another district known for its pilgrimage sites — has also been identified as a high-risk zone. Incidentally, smoking, drinking and non-vegetarian food are banned in the Tirupati-Tirumala hills.
TimePublished on Sat, Jun 21, 2008 at 01:35, Updated at Sat, Jun 21, 2008 in Nation section
TagsTags: Tirupati, Tirumala , Hyderabad
E-mail this report | Print this report
SCARY STATS: AP AIDS Control Society says there are over 200 sex workers in the Tiruptai-Tirumala hills area.
SCARY STATS: AP AIDS Control Society says there are over 200 sex workers in the Tiruptai-Tirumala hills area.
Featured Blog
Global Warming.
Featured Slideshows
Save your precious time : Jet Airways takes the least time to reach India. Book your ticket now!
Discount Hearing Aids : Save on Major Hearing Aid Brands Free PDF Download - Buyer's Guide
Your New HIV Regimen : Get info and tips for side effects. Sign up for this support program.
Digital Hearing Aids : Top 5 Websites For Digital Hearing Aids
Ads by Google
Hyderabad: There has been a steep rise in the number of HIV/AIDS cases in one of India’s holiest Hindu pilgrimage sites, the Tirupati-Tirumala hills.
Andhra Pradesh AIDS Control Society has found out that over 200 commercial sex workers operate in the area.
“We have come across this information through unofficial sources that there is commercial sex activity even in Tirumala. There are about 200-300 sex workers there,” Project Director, AP AIDS Control Society, K Chandravadan said.
The discovery reveal that sex workers clandestinely operate in about 15 secluded spots in the hills.
Chittoor — another district known for its pilgrimage sites — has also been identified as a high-risk zone. Incidentally, smoking, drinking and non-vegetarian food are banned in the Tirupati-Tirumala hills.
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