Dutch Study: Most New HIV Infections Could Be Prevented With Pill

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The pill that prevents HIV is not widely available in Europe. If it were, it would probably drop infections considerably, researchers say.

The pill that prevents HIV is not widely available in Europe. If it were, it would probably drop infections considerably, researchers say.

Nearly two-thirds of new HIV infections in gay and bisexual men in the Netherlands could be prevented with antiretroviral treatment, according to a study published on Wednesday.

This treatment — also known as pre-exposure prophylaxis, or PrEP — is not widely available in Europe. It’s not clear whether it would lead to a similar drop in infections in the U.S., where a growing number of gay and bisexual men are already getting PrEP as Truvada, the once-a-day blue pill.

Still, the researchers say that the new study adds to other research showing the public health benefits of PrEP, especially when combined with frequent HIV testing.

“I hope that this study contributes to making the case for making PrEP available to as many individuals as possible,” Oliver Ratmann, an epidemiologist at Imperial College London and leader of the new study, told BuzzFeed News.

Ratmann and his colleagues looked at the medical records of 617 Dutch men who were diagnosed with HIV between July 1996 and December 2010.

The Netherlands, like several other countries in northern Europe, is famous among medical researchers because the government routinely collects health and demographic data on citizens, and then makes the anonymized data available for scientific research. “All hospitals have to comply, which is why we have such a comprehensive dataset,” Ratmann said. “Almost everyone with HIV is in it.”
                           Ratmann’s team looked in particular at the specific genetic code of HIV in each of the 617 men. The virus’s DNA sequence mutates rapidly as it spreads from person to person. By comparing these sequences, “you can say that patient A did not infect patient B, because sequences are so dissimilar.”
                          With this approach, it’s not possible to determine for certain who infected who. But for each infected man, the researchers were able to identify three or four other men who could have infected him. By weighing these various probabilities, the researchers found that an estimated 71% of HIV transmissions came from men who had not been diagnosed, and 43% from men in their first year of infection, underscoring the importance of regular HIV testing.
                           The scientists’ mathematical modeling also found that 66% of the infections could have been prevented if: half of all men at risk of HIV were tested annually; those who tested positive were immediately put on treatment; and half of those who tested negative were put on PrEP.

                            The results are particularly exciting, Ratmann said, because the Netherlands already has a high level of HIV treatment once a person tests positive. These results suggest that proactively treating men before the infection could drop infection rates even more.That high level of treatment, however, also makes the Netherlands quite different from the U.S., noted Dawn Smith of the CDC’s Division of HIV/AIDS Prevention.

“The underlying analysis methods are convincing, and findings are in the ballpark of what I would expect,” Smith told BuzzFeed News by email. Still, “this study’s direct applicability to the United States would be a bit different in that we don’t have the high coverage of antiretroviral treatment or retention in care rates here that are present in the Netherlands.”

Although PrEP awareness in the U.S. is on the rise, Smith added, there are still two notable barriers to making it more common. Too few gay and bisexual men know about it (or where to get it), and too few doctors know about it or know which of their patients would benefit from it.

Link of original article: http://realhealthtreatments.info/dutch-study-most-new-hiv-infections-could-be-prevented-with-pill

Medical Apartheid:The Dark History Of Medical Experimentation On Black Americans

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From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations.

It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities.

Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed,Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit.

At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.

The author

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Harriet Washington is the author of Deadly Monopolies: The Shocking Corporate Takeover of Life Itself and of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, which won the 2007 National Book Critics’ Circle Award and was named one of the year’s Best Books by Publishers’ Weekly.
                            She has won many other awards for her work on medicine and ethics and has been a Research Fellow in Ethics at Harvard Medical School, a fellow at the Harvard School of Public Health, a Knight Fellow at Stanford University, a senior research scholar at the National Center for Bioethics at Tuskegee University and a Visiting Scholar at the DePaul University College of Law.

http://www.amazon.com/Harriet-Washington-Medical-Apartheid-Experimentation/dp/B008GQ24UE