CDC HIV/Hepatitis/STD/TB Prevention News Update (120203)

The CDC National Center for HIV/AIDS, Viral Hepatitis, STDs and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHHSTP Daily News Summary should be cited as the source of the information. Copyright © 2012, Information Inc., Bethesda, MD.

NATIONAL NEWS

UNITED STATES: New Vaccine Recommendations for Boys and Diabetics

New York Times (02.02.12) - Friday, February 03, 2012

CDC on Thursday released a new immunization schedule that recommends routine vaccination against human papillomavirus for boys ages 11-12, and catch-up HPV vaccination for males ages 13-21.

Since 2006, HPV vaccination has been recommended for girls and young women to prevent cervical cancer. Federal health officials previously had said boys "could" receive the quadrivalent HPV vaccine to help prevent genital warts, certain cancers, and the spread of HPV. The new immunization schedule now explicitly recommends it.

In addition to the HPV recommendation, health officials adopted the recommendation that people with Type 1 or 2 diabetes be vaccinated against hepatitis B. The vaccine has been recommended for years for people at risk of blood exposure, such as health care workers, injection drug users, and people with end-stage renal disease who are undergoing dialysis, said Carolyn Bridges, associate director for adult immunizations at CDC's National Center for Immunization and Respiratory Diseases.

Diabetics have twice the risk of getting hepatitis B as others, and officials have recorded hepatitis outbreaks at nursing homes linked to the sharing of blood-sugar testing equipment, Bridges said.

UNITED STATES: Coming Soon: Over-the-Counter Oral AIDS Test

Crain's New York Business (02.01.12) - Friday, February 03, 2012

In January, Bethlehem, Pa.-based OraSure Technologies submitted a final module of clinical test results supporting its application to sell the OraQuick rapid HIV test to the public. Food and Drug Administration approval could come this year. The test uses oral fluid or blood; it currently is used widely in clinical settings.

To assess issues regarding at-home rapid HIV testing, Columbia University researchers conducted a study in which they offered the OraQuick test in an office setting to men who have sex with men, then interviewed them about their attitudes toward it. More than 80 percent said they would use the kit to test themselves or their sexual partners, according to Alex Carballo-Dieguez, Timothy Frasca, and colleagues at the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute.

In general, however, there was little agreement about how to raise the subject with a partner or how to handle an unexpected positive result. Some men talked about making the test a condition of forgoing condom use; others said the test might be a signal that a relationship had advanced beyond casual status.

Opponents of at-home testing worry about how users would react if the test is positive. "There's a lot of potential opposition, and clinics might not be crazy about direct access in a private setting with no personnel with them if they get a positive result," Carballo-Dieguez said. The study's participants gave different reactions to this scenario: Some said they would offer sympathy; a minority said they would leave at once.

In a follow-up study to the paper they published this week in the Journal of Sex Research, the authors are distributing rapid test kits for use at home and asking testers to report on their experiences.

MEDICAL NEWS

CANADA: Head-to-Head Comparison of Accuracy of a Rapid Point-of-Care HIV Test with Oral Versus Whole-Blood Specimens: A Systematic Review and Meta-Analysis

Lancet Infectious Diseases doi:10.1016/S1473-3099(11)70368-1 (01.24.12) - Friday, February 03, 2012

In the current study, the researchers sought to establish whether a convenient, non-invasive HIV test that uses oral fluid was accurate compared with using the same test with blood-based specimens.

The systematic review and meta-analysis compared the accuracy of OraQuick Advance Rapid HIV-1/2 test using oral fluid versus blood-based specimens among adults at risk of HIV. The study authors searched five databases of published work and databases of five key HIV conferences. Diagnostic accuracy was assessed with bivariate regression analysis, and positive predictive values (PPVs) in high- and low-prevalence settings were computed with Bayesian methods.

In a direct comparison of studies, the researchers identified a pooled sensitivity about 2 percent lower in oral (98.03 percent, 95 percent CI 95.85-99.08) than in blood-based specimens (99.68 percent, 97.31-99.96), but similar specificity (oral 99.74 percent, 99.47-99.88; blood 99.91 percent, 99.84-99.95). Negative likelihood ratios were small and similar (oral 0.019, 0.009-0.040; blood 0.003, 0.001-0.034), but positive likelihood ratios differed (oral 383.37, 183.87-799.31; blood 1105.16, 633.14-2004.37). Although in high- prevalence settings PPVs were similar (oral 98.65 percent, 95 credible interval 85.71-99.94; blood 98.50, 93.10-99.79), in low-prevalence settings PPVs were lower for oral (88.55 percent, 77.31-95.87) than blood (97.65 percent, 95.48-99.09) specimens.

"Although OraQuick had a high PPV in high-prevalence settings in oral specimens, the slightly lower sensitivity and PPV in low-prevalence settings in oral specimens should be carefully reviewed when planning worldwide expanded initiatives with this popular test," concluded Pant Pai and colleagues.

LOCAL AND COMMUNITY NEWS

CALIFORNIA: Curtains Up on STDs: Medical Group Gets Info About Sensitive Issues Out Through Theater

Daily News of Los Angeles (01.30.12) - Friday, February 03, 2012

For 25 years, Kaiser Permanente's theater troupe has raised the curtain on health concerns such as STDs and sexual health for high school audiences. "We're one of the largest theatrical organizations that do this public-based, public health theater," said Gerry Farrell, director of Kaiser Permanente Southern California's Educational Theater. "This is such a better way of presenting information about health, especially for this age group."

For example, the play "What Goes Around" deals with STDs, including HIV. In the production, actors - who also are health educators - play the roles of boyfriend and girlfriend Eli and Alicia. Eli cheats on Alicia with an old girlfriend, thinking he is protected from disease because the girl is on birth control.

Eli soon discovers his ex has left him a "downtown souvenir" - in this case, chlamydia and human papillomavirus infection. Much of the rest of the play focuses on how Eli plans to explain this to Alicia.

Following a recent performance for continuing students at John Wooden High School in Reseda, the actors led a question-and-answer session. These days, youths' wired worlds lead to a host of questions, from different types of sexual behavior to alleged household cures for STDs.

"They have some of the same questions I had when I was in high school," said performer Ray Auxais. "The only difference now is technology. We're constantly having to evolve the show."

NEW YORK: AIDS Care Recognized for Patient Care

Rochester Democrat and Chronicle (01.31.12) - Friday, February 03, 2012

The designation makes AIDS Care eligible for Medicaid reimbursement incentives of up to $16 per office visit, allowing the agency to expand programs and services, said Jay Rudman, president and CEO. AIDS Care serves approximately 700 patients, but not all are on Medicaid.

AIDS Care is among 39 Rochester-area practices and more than 3,000 nationwide to receive the designation from NCQA, which issues report cards based on outcome and accountability measures.

"The idea is about putting the patient in the center of the process," said Rudman. Ninety-eight percent of AIDS Care's clients receive their primary and specialty care at the facility.

The aim is to provide coordinated care attending to the whole person, improving quality and controlling costs by addressing problems before they escalate. NCQA reports that medical homes have helped North Carolina save $1 billion in Medicaid spending; the medical home movement is part of health care reform.

"Nationally, it's becoming evident that primary care practices that have transformed into medical homes are having an impact on the health and experience of the patients," said Peggy Reineking, NCQA's director of recognition operations.

FLORIDA: 'Silence Is Death' Highlights Link Between Churches and Rise in Local African-American HIV Rates

South Florida Gay News (Wilton Manors, Fla.) (01.31.12) - Friday, February 03, 2012

The 2009 documentary "Silence Is Death: Unheard Voices" was commissioned by Palm Beach County in response to a report showing the disproportionate toll HIV/AIDS is having on Florida's black residents. Made on a $5,000 budget, the film examines homophobia and the role of the black church in the epidemic. It was produced by Lorenzo Robertson, an outreach coordinator with the Florida Department of Health.

Black men who have sex with men are especially at risk, and their life experiences are captured in the documentary. "I was raised in the church where they said if you were gay you were going to hell," recalled "Abdul," who feared he would lose his loved ones and sense of community by coming out.

According to Robertson, state officials understand they must engage black churches if they are to successfully tackle HIV/AIDS. But gay black men also must assume responsibility for their health, he said. "You can't make sure anyone else is protected, but you can protect yourself," he said.

The film, which premiered in 2010, will be screened Feb. 12 at the Wolfsonian Museum at Florida International University. Tickets are free but an RSVP is required. For more information, telephone 305-751-7283 or visit http://tinyurl.com/DefendingOurIdentities.

NEWS BRIEFS

SOUTH DAKOTA: South Dakota House Panel OKs AIDS Testing of Prostitutes

Associated Press (02.03.12) - Friday, February 03, 2012

The House Health and Human Services Committee gave unanimous approval Thursday to a measure that would require persons convicted of prostitution or soliciting prostitutes to be tested for HIV. The bill would also give anyone who has had sex with a convicted sex worker access to the test results. The legislation now advances to the full House for additional debate.

FLORIDA: Afternoon Ceremony, Evening Candle Lighting Highlight National Black HIV/AIDS Awareness Day Feb. 7 in Broward

Miami Herald (02.02.12) - Friday, February 03, 2012

The Broward County Health Department, the Community Access Center, and other partners will mark National Black HIV/AIDS Awareness Day, Feb. 7, with a special gathering in downtown Fort Lauderdale. The commemoration and candle lighting ceremony will take place from 3 p.m. to 7 p.m. at the Broward County Main Bus Terminal at Northwest 2nd Street and 1st Avenue. Free rapid HIV testing will be available. For more sites offering free testing, visit www.browardchd.org, or www.preventhivflorida.org/counseling_testing_team.html.

NEW YORK: Late-Night Soccer to Promote AIDS Awareness

Rochester Democrat and Chronicle (02.02.12) - Friday, February 03, 2012

Grassroot Rochester, a University of Rochester student organization that works to encourage and create opportunities for the underserved youths of Monroe County, is hosting a late-night soccer event to raise AIDS awareness. The YellowJacket Cup, a three-on-three tournament, will begin at 11 p.m. Friday night and run though approximately 3 a.m. Saturday at Brighton Sports Zone. Grassroot Rochester works with the River Flow Soccer Club to provide positive role models for youths toward the goals of promoting equal access to health and education and creating an HIV-free generation. Admission is free for spectators.

CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

For Friday, February 03, 2012