/ 2 April 2004

HIV/Aids barometer – April 2004

Estimated worldwide HIV infections: 57 078 569 at 11:05am on Thursday April 29

Safe: Breastfeeding is not detrimental to the health of HIV-positive mothers, according to a study published in the latest edition of Aids.

Investigators in Tanzania conducted a study involving 698 HIV-positive mothers between 1995 and 1997. The study was undertaken because earlier studies had produced conflicting evidence about the risk of maternal HIV disease progression after breastfeeding.

The investigators assessed whether breastfeeding was associated with maternal HIV disease progression by looking at the risk of death, low CD4 cell count, anaemia, and weight loss.

”Our findings indicate that breastfeeding is not detrimental to the health of HIV-1-infected women,” the investigators said.

They added that their study suggests ‘that HIV-positive women should continue to base their decisions about breastfeeding on their assessment of the health and nutritional benefits of breastfeeding and the risk of vertical transmission to their children.”

Source: aidsmap

Estimated worldwide HIV infections: 56 864 079 at 12.35pm on Wednesday April 14

Cutting back: There ‘would be no global Aids pandemic were it not for multiple sexual partnerships”, and more should be done to encourage people to reduce their number of sexual partners, according to an article written by officials from several organisations and published recently in the British Medical Journal.

The article says the ‘key to preventing the spread of HIV, especially in epidemics driven mainly by heterosexual transmission, is through changing sexual behaviour”.

According to the authors, ‘most of the often polarised discussion surrounding Aids prevention” has focused on abstinence and condom use, while partner reduction ‘has been the neglected middle child of the ABC [abstain, be faithful and condomise] approach”. The authors say that it is ‘imperative to begin including (and rigorously evaluating) messages about mutual fidelity and partner reduction in ongoing activities to change sexual behaviour”. The authors conclude: ‘Rather than arguing over the merits of abstinence versus condoms, it is time for the international community to unite around a balanced, evidence-based ABC approach.”

In an accompanying editorial, David Wilson, senior monitoring and evaluation specialist for the World Bank’s Global HIV/Aids Programme, writes that it is a ‘simple truth” that without multiple sex partnerships the HIV/Aids pandemic would not occur and adds that partner reduction ‘is good epidemiology, not good ideology, and we must ensure that the ABC approach remains sufficiently scientifically grounded to withstand shifting ideological sands”.

Source: kaisernetwork.org

Estimated worldwide HIV infections: 567 48 574 as at noon on April 6 2004

Pregnancy problems: HIV-positive women are less likely to get pregnant and more likely to have a miscarriage, according to a study conducted in Uganda and published in the March 26 edition of AIDS.

The study involved a total of 191 women, aged between 15 and 49, who were enrolled in the Natural History Cohort, which recruited women from 15 neighbouring villages in south-west Uganda between 1990 and 2001.

Women were seen every three months, when they were asked to complete a questionnaire about their recent sexual behaviour, fluctuation in menstrual cycles, pregnancy, miscarriage, births and illnesses.

The women also underwent a physical examination at these visits. No anti-HIV medication was provided to any of the women in the study.

A total of 92 women were HIV-positive, and 99 women were HIV-negative. Investigators found that the frequency of sexual intercourse was lower in HIV-positive women and that the frequency of sex diminished further with HIV-disease progression.

HIV-positive women in all age groups, except 15 to 19, experienced fewer pregnancies. Pregnancies in HIV-positive women were also associated with an increased risk of miscarriage.

Pregnancy was less likely to result in live births in HIV-positive women than in HIV-negative women, even in those women with asymptomatic HIV infection. The rate of live births diminished even further as HIV infection progressed.

Source: www.aidsmap.com

Estimated worldwide HIV infections: 56 661 891 at 11.35am on March 31

Rapid testing: The United States Food and Drug Administration has approved the use of oral fluid samples with a rapid HIV diagnostic test kit that provides screening results with more than 99% accuracy in as little as 20 minutes. Until now, all rapid HIV tests required the use of blood.

‘Before the approval of this rapid test — many people being tested for HIV in public clinics did not return for the results of standard tests,” said Department of Health and Human Services Secretary Tommy G Thompson. ‘Where the rapid test is available, those tested get their results within minutes.”

To perform the test the device, which has an exposed absorbent pad at one end, is swabbed around the gums. The device is then inserted into a vial containing a solution. In as little as 20 minutes, the device will indicate if HIV-1 antibodies are present in the solution by displaying two reddish-purple lines in a small window.

Source: Embassy of the United States of America 30 March 2004