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Sex Workers In Pakistan Give Recommendations On HIV Prevention To Health Officials
Although the recorded HIV prevalence in Pakistan is relatively low, health officials are concerned that a concentrated epidemic of the virus among injection drug users could carry over to commercial sex workers and other high risk groups in the country, IRIN/PlusNews reports. To address the issue, the National AIDS Control Program and the United Nations Population Fund recently held a meeting, called the National Consultation on HIV and Sex Work, in an effort to improve HIV prevention efforts targeted at sex workers by consulting with workers in the field.Sex workers at the meeting made various recommendations, including HIV testing, referrals and increased efforts to decrease stigma. The Ministry of Health reports that from 2006 to 2007, female sex workers were at a high risk of HIV in 12 cities across Pakistan. A survey of 4,639 female sex workers found that less than 25% reported condom use; 10% had a partner that had used injection drugs during the past six months; and that illiterate sex workers were less likely to use condoms than those with a higher level of education. A female sex worker at the meeting said, "It is very hard for us to convince [partners] to put on a condom, but I feel that a female condom would put us in a position where we can protect ourselves against HIV and sexually transmitted infections." She added that female condoms are not widely available. Legalizing sex work would make it easier for sex workers to protect their rights, another female sex worker at the conference said. She added that often, outreach workers face barriers from police forces. Daniel Baker, UNFPA"s country representative for Pakistan, said that sex workers should have greater involvement in creating and implementing HIV programs. He added, "The female sex workers have to be in there as managers, workers and leaders to benefit in the long run." Safdar Kamal Pasha with UNFPA agreed that the recommendations from sex workers are critical points to address in future programming. "The female sex workers agreed that there should be vocational training and the means for alternative work opportunities for those who want to move out of sex work, as well as those who are past their prime and do not find sustainability in sex work," Pasha said (IRIN/PlusNews, 5/14).
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Potent Inhibitor Blocks Tumors From Metastasizing
Researchers at Children"s Hospital Boston have isolated a potent inhibitor of tumor metastasis made by tumor cells, one that could potentially be harnessed as a cancer treatment. Their findings were published in the online Early Edition of the Proceedings of the National Academy of Sciences during the week of June 22.
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New Cognitive Screening Test For Detecting Early Dementia
Researchers at Addenbrook"s Hospital in Cambridge published a study on bmj.com in which they explain their design and evaluation of a new cognitive test for detecting Alzeimer" disease called TYM ("test your memory") which is considered quicker and more precise than many existing tests, and which can also help diagnose early dementia.
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HAART Is 'Optimal Treatment' For Reducing Mother-to-Child HIV Transmission

Highly active antiretroviral therapy (HAART) should be the new standard treatment for prevention of mother-to-child transmission of HIV in poor countries, according to an editorial in response to a research study in the August 15 issue of JAIDS: Journal of Acquired Immune Deficiency Syndromes. JAIDS is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. At this point in the HIV epidemic, the ethical imperative to offer the most effective treatment for preventing HIV transmission to infants trumps economic rationales, according the editorial by Dr. Arthur J. Ammann of the University of California San Francisco Medical Center and President of Global Strategies for HIV Prevention. HAART Reduces Drug-Resistant HIV, New Study Shows In the new research study, HIV-positive pregnant women in Nairobi, Kenya, were randomly assigned to one of two treatments to prevent HIV transmission to their infant. One group received the standard treatment for poor countries: treatment of the mother with the antiviral drug zidovudine starting six weeks before delivery, plus a single dose of the drug nevirapine for the infant after birth (ZDV/sdNVP). Another group received a three-drug HAART combination. This "triple therapy" combination-the standard treatment for HIV-infected pregnant women in wealthier countries-also started six weeks before delivery. HAART then continued for six months after birth, with the goal of preventing HIV transmission during breast-feeding. The two groups were compared for measures of HIV resistance to antiretroviral drugs. Drug resistance has been a problem after short-term preventive approaches like ZDV/sdNVP. The lead author was Dara A. Lehman, M.H.S., Ph.D., and the senior author Julie Overbaugh, Ph.D., of Fred Hutchinson Cancer Research Center, Seattle. Three months after treatment, sophisticated gene studies found that HAART reduced drug resistance, though did not eliminate it completely. Low levels of resistant virus were detected in 75 percent of women receiving ZDV/sdNVP, compared to just 18 percent of those receiving HAART. The study "provides strong evidence that short-course HAART results in lower rates of antiretroviral resistance compared with the standard ZDV/sdNVP regimen," according to the researchers. Research Should Focus on Effectiveness, Not Economics Dr. Ammann comments on research progress in preventing mother-to-child transmission-specifically on what should be considered "standard treatment" in poor countries. Since ZDV was introduced in 1994, major progress has been made in preventing HIV transmission from mothers to infants. However, because of economic and infrastructure constraints, many studies have sought to define the minimum duration of treatment necessary for effective prevention. In Dr. Ammann"s view, these studies have placed too many HIV-infected mothers and infants in poor countries in Africa and elsewhere at risk for disease progression. "At this point in the epidemic, there is consensus on the principles that define optimal treatment and prophylaxis of HIV infection," Dr. Ammann writes. Now that anti-HIV drugs are more widely available, he believes that treatment to prevent mother-to-child transmission "should include early initiation of HAART for all HIV-infected pregnant women, and continuation of HAART during and after breastfeeding has ceased." This should be a requirement for all current and future clinical research studies. Shorter courses or treatments using fewer drugs "should be considered suboptimal treatment and prophylaxis." Rather than looking for a quicker or cheaper way, research should focus on further increasing safety and enhancing access, with HAART as the new standard treatment, Dr. Ammann believes. He concludes, "To do less, provides an unintentional signal to international organizations and National Ministries of Health that HIV-infected pregnant women and their infants need not receive the same level of treatment and prophylaxis as other HIV-infected or HIV-exposed individuals." Dr. Overbaugh comments, "While the data support the use of HAART to minimize resistance that could complicate future treatment options for the mother, the issue is certainly more complex." Drs. Lehman and Overbaugh emphasize that access to HAART is still limited and that optimal adherence to HAART would be critical to achieve such low levels of resistance. "Thus programs to provide HAART for prevention of mother-to-child transmission must include ways to maximize adherence to see benefit in terms of antiviral resistance," adds Dr. Overbaugh. About JAIDS JAIDS: Journal of Acquired Immune Deficiency Syndromes (www.JAIDS.com) is the trusted, interdisciplinary re for HIV- and AIDS-related information with a strong focus on basic science, clinical science, and epidemiology. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world. About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Wolters Kluwer Health is a division of Wolters Kluwer, a leading global information services and publishing company. The company provides products and services for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer had 2008 annual revenues of €3.4 billion ($4.9 billion), employs approximately 20,000 people worldwide, and maintains operations in over 35 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Visit http://www.wolterskluwer.com for information about our market positions, customers, brands, and organization. Lippincott Williams & Wilkins


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