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Majority Of HIV-Positive Pregnant Women In Developing World Lack Access To PMTCT Services, Report Says
Two-thirds of HIV-positive pregnant women in the developing world do not have access to treatment to prevent mother-to-child HIV transmission, which could lead to 370,000 new HIV cases annually among infants, according to a study released Thursday by the International Treatment Preparedness Coalition, Bloomberg reports (Chase, Bloomberg, 5/21). Of the 1.5 million HIV-positive pregnant women each year in the developing world, about one-third receive any kind of drug therapy at all, the report said, adding that most of the treatment is inadequate and fails to prevent MTCT. According to the report, eight years after world governments pledged to cut the number HIV cases among infants in half by 2010, only about 8% of pregnant women in developing countries are receiving the complete triple-dose combination therapy widely used in wealthy nations (York, Globe and Mail, 5/22). The report cited poor government and donor coordination, as well as funding gaps, as the main reasons many women do not obtain the treatment, Stephen Lewis, founder of AIDS-Free World and a co-author of the report, said (Bloomberg, 5/21). According to the report, there is a "shocking lack of consistency and coordination" between governments and agencies, and about 18% of pregnant women worldwide were offered HIV tests in 2007. In addition, there is an acute shortage of prevention and counseling services for women, the report said. It added that one of the largest issues is a lack of counseling on infant feeding, as most women are not properly counseled and advice sometimes can lead to a bias toward using formula over breastfeeding. Lewis also criticized United Nations health agencies for claims that an increasing number of pregnant women in developing countries are gaining treatment access. He added that the large majority of such women do not have access to the complete triple-dose treatment. "It makes the access a simple mockery," Lewis said.The report found that in 61 countries -- such as Cameroon, Ethiopia, India and Nigeria -- more than three-quarters of HIV-positive pregnant women do not receive any drug treatment for PMTCT. It said that the world is tolerating a "shameful example of double standards" because MTCT has been virtually eliminated in wealthy nations, where most HIV-positive pregnant women have access to the complete drug regimen (Globe and Mail, 5/22).According to Bloomberg, most HIV-positive pregnant women who do have access to prevention services in developing countries receive nevirapine for PMTCT, which is 40% effective at reducing transmission. Nevirapine can so lead to drug-resistant strains of HIV from developing, Bloomberg reports. Boehringer Ingelheim, which manufactures nevirapine, provides the drug at no-cost to pregnant HIV-positive women in developing countries, according to Bloomberg. According to CDC, the availability of PMTCT services in the U.S. has reduced the number of HIV cases in infants by more than 90%.Officials from UNAIDS, the World Health Organization and 20 international groups are expected to meet this week in Nairobi, Kenya, to launch a campaign aimed at improving access to PMTCT services, UNAIDS Executive Director Michel Sidibe said. Gregg Gonsalves, head of ITPC, said, "For millions of women, maternal and child health is about HIV/AIDS and we have failed them" (Bloomberg, 5/21). He added, "Our failure to prevent HIV transmission to babies is truly a failure to prevent disease progression in women living with HIV. If we treat mothers properly, if we treat women properly for their own health, we would have few or no HIV infections in babies" (VOA News, 5/21). Sidibe said, "There has been some progress" in PMTCT services, but added, "Overall coverage is still very low for this proven, inexpensive and effective intervention." Sidibe said that UNAIDS "agree[s] with the report that the combination of stigma, fragmented health services, inadequate knowledge within the community and insufficient political leadership are root causes of low coverage" (Bloomberg, 5/21). UNAIDS also has called for the
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Editorial Discusses Removal Of Needle Exchange Funding Ban
A Wilmington News Journal editorial discussed the potential lifting of the ban on using federal funding for needle exchange programs. The editorial notes recent Congressional action and the restrictions in a House bill that prohibit needle exchanges to operate "within a 1,000 feet of day care centers, schools, parks, playgrounds, pools and youth centers." According to the News Journal, "This rule wipes out much of the flexibility many cities need in their fight to prevent the spread of HIV among intravenous drug users. The nation"s capital, where the rates of HIV and AIDS cases are considered epidemic, would be hit the hardest because no part of the District of Columbia would be eligible for the funding according to AIDS Action." The editorial adds, "Vans patrolling near vulnerable populations - specifically young, impressionable children - are an issue that must be addressed. But well-intentioned limits should not be allowed to hold up the rest of the program," according to the News Journal (8/1).
News of the day
Do Prevention Programs Save Money? CBO Says 'No'
The Congressional Budget Office has so far "failed to attribute any savings to increased efforts to provide preventive efforts like stop-smoking programs," challenging the notion that preventive care saves money for the health care system, NPR reports. "Former CBO health analyst Joe Antos, now at the American Enterprise Institute, says preventive services often cost more than they save. In screening people for cancer, for example, he says, "you screen literally millions of people, sometimes at fairly high cost per screen. You"ll pick up some true positives, people who really have the disease. You"ll pick up some false positives." Then all those people have to be followed up by the medical system, which costs even more money."
Cardiovascular

Women Show More Pronounced Health Benefits From Physical Activity

Many experimental studies have found that physical exercise can improve cholesterol levels and subsequently decrease the risks of cardiovascular disease; however, few of these studies have included enough participant diversity to provide ethnic breakdowns. Now, a long-term study of over 8,700 middle-aged men and women provides race- and gender- specific data on the cholesterol effects of physical activity, with the interesting result that women, particularly African-American women, experience greater benefits as a result of exercise than men. The analysis of this large Atherosclerosis Risk in Communities (ARIC) Study, which appears in the August issue of Journal of Lipid Research, was carried out by Keri Monda and colleagues at North Carolina and Baylor. They found that over a 12 year period, all individuals who increased their exercise by about 180 metabolic units per week (equivalent to an additional hour of mild or 30 minutes of moderate activity per week) displayed decreased levels of triglycerides and increased levels of the "good" HDL cholesterol. However, statistically significant decreases in the "bad" LDL cholesterol were only observed in women, with particularly strong effects in menopausal women and African-American women. And total cholesterol levels were only significantly decreased in African-American women. The authors speculate that these novel differences may arise from hormonal differences between the sexes, especially considering the extra effects seen post-menopause. The racial differences observed may stem from genetic variations that require further exploration. The authors do also note that their exercise data was assessed by questionnaire and this was non-scientific, though the particular methodology used has been extremely reliable in other studies. They also note that all evaluated participants were healthy, so these results cannot be generalized to individuals with diabetes or those on cholesterol-lowering medications. From the article: Longitudinal impact of physical activity on lipid profiles in middle-aged adults: the Atherosclerosis Risk in Communities Study, by Keri L. Monda, Christie M. Ballantyne and Kari North Nick Zagorski American Society for Biochemistry and Molecular Biology


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