IAPAC Releases Consensus Statement on TasP and PrEP Implementation at AIDS 2012
“Let us allow hope to guide the way, but action to ensure millions of new HIV infections are averted,” says José M. Zuniga President of IAPAC.
WASHINGTON, DC – The International Association of Physicians in AIDS Care (IAPAC) announced its full embrace of two biobehavioral HIV prevention interventionstreatment as prevention (TasP) and pre-exposure prophylaxis (PrEP) – around which there has been emerging science, and called for immediate integration of these interventions into the existing HIV armamentarium as a means of significantly impacting HIV incidence worldwide. The announcement was made during a press conference at AIDS 2012 during which two key opinion leaders in the field of TasP and PrEP unveiled a Consensus Statement entitled, “Controlling the HIV Epidemic with Antiretrovirals.”

The Consensus Statement, which was developed by an international Advisory Committee that analyzed and synthesized TasP and PrEP data presented and discussed at an IAPAC evidence summit held last month in London, identifies key challenges and opportunities to the integration of the interventions in resourced and resource-limited countries. The Consensus Statement is available in PDF format at www.iapac.org.

Integration must be guided by implementation science, said Kenneth Mayer, MD, Visiting Professor of Medicine at Harvard University in Boston; Medical Research Director at the Fenway Institute in Boston; and Chair of the IAPAC TasP/PrEP Advisory Committee.
“The way forward needs to be met with very careful implementation science studies, so called demonstration projects, around the world so that we know how best to roll out these interventions for key populations in different settings. This will not be a one-size-fits-all scenario,” explained Mayer.

Julio Montaner, MD, Director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada; and a Member of the IAPAC TasP/PrEP Advisory Committee, argued that with efficacy concerns allayed by the emerging evidence, wide-scale implementation of interventions such as TasP should be viewed as a global health priority.

“In view of the evidence that we [have in hand], the return on investment [if biomedical prevention is implemented] has now been increased so dramatically that we can no longer afford not to implement this approach. It is not a matter of whether we want to or whether we can, it is a matter of a responsibility to do so,” Montaner said.

IAPAC President José M. Zuniga, PhD, MPH, added that where fear may have driven an accelerated pace to scale up access to a new treatment intervention – highly active antiretroviral therapy (HAART) – in the mid-1990s, hope that is justified by robust evidence must drive the world to move forward with TasP, and where appropriate PrEP, implementation without delay.

“We stand a solid chance of further bending the HIV incidence and AIDS-related mortality curves in a way only imagined years ago and, perhaps – as many have advocated – of welcoming an AIDS-free generation within our lifetimes. Let us allow hope to guide the way, but action to ensure millions of new HIV infections are averted,” Zuniga said.

The International Association of Physicians in AIDS Care (IAPAC) represents more than 17,000 physicians and allied health care professionals in over 100 countries. Its mission is to improve the quality of prevention, care, treatment, and support services provided to men, women, and children living with HIV/AIDS. Visit www.iapac.org for more information about IAPAC and its global activities.

by Chad S. Johnson, Co-Founder, World AIDS Institute

Timothy Ray Brown (The Berlin Patient) Reacts To Breaking News That Two More Men Hopefully Cured Of AIDS

Washington, D.C. – With breaking news out of the 19th International AIDS Conference that two men at Brigham and Women’s Hospital in Boston may have been cured of HIV through bone marrow transplants, Timothy Brown – The Berlin Patient – today reacted by releasing the following statement:
“Words cannot begin to express my joy that two other men may have been cured of HIV.  This reinforces my determination and belief that we must fulfill my Foundation’s central mission of investing in cutting-edge therapies and treatments to advance AIDS cure research. As I have said many times before, I want everyone to be cured of this disease.  We can only hope that this case and today’s development represents the beginning of the end of this plague.“
Timothy Brown was meeting with Democratic Leader, Nancy Pelosi, his hometown Congresswoman, when the breakthrough was announced. Earlier this week, Timothy Brown, the only person to be cured of HIV, announced the establishment of The Timothy Ray Brown Foundation with the World AIDS Institute. As the only Foundation created with the sole mission of finding a cure that leads to the end of AIDS, its central tenant is to secure funding and support cutting-edge therapies.
Services and Advocacy for GLBT Elders (SAGE) and HRC Applaud the Obama Administration for Taking Steps to Improve the Health of all Older Americans

The Administration on Aging announces it will issue guidance to the Aging Network allowing them to define populations of greatest social need based on sexual orientation and gender identity.

[Washington, DC] The Administration on Aging (AoA) today announced that it would release important new guidance that empowers AoA-funded aging providers to consider lesbian, gay, bisexual and transgender (LGBT) older adults as a population of “greatest social need”—paving the way for increased services that can significantly improve their health and well-being. The Human Rights Campaign and Services and Advocacy for GLBT Elders (SAGE) partnered to urge AoA to provide this guidance.

"SAGE applauds this critically important step taken by the Administration on Aging to recognize that LGBT older people have acute needs and to ensure that services are available to meet those needs," said Michael Adams, Executive Director of SAGE. "We look forward to working with the Administration on Aging to continue to improve the availability of appropriate services to LGBT elders across the country."

“This step brings much-needed attention to the unique needs of LGBT older adults, and the urgent actions we must all take to preserve their dignity,” said HRC President Chad Griffin.  “AoA’s actions today are a crucial step toward ensuring that this generation has equal access to the services and resources that they deserve.  HRC applauds AoA for its leadership, and we will look forward to working with them through implementation.”

The FAQ guidance clarifies that the current definition of “greatest social need” in the Older Americans Act—the country's leading vehicle for funding and delivering services to older people nationwide—allows communities to identify populations in their service area that experience isolation for cultural, social or geographic reasons.  The guidance provides specific examples of these populations, including increased need based on sexual orientation and gender identity. 

LGBT older adults are at an increased risk for social isolation, experience poor health and health access, and face higher poverty rates than other seniors. Despite this increased need, this group is less likely to seek federal assistance and healthcare due to actual and perceived discrimination.  This FAQ guidance allows the aging networks that serve LGBT older adults and receive AoA funding to consider this vulnerable population as one with a “greatest social need.”  This designation will encourage Area Agencies on Aging (AAAs) to include LGBT older adults when prioritizing funding, engaging in outreach, evaluating unmet needs and collecting data.

This announcement is the latest action taken by the AoA to address LGBT elders’ unique needs. In January 2010, SAGE received a historic grant from the Administration on Aging to establish the National Resource Center on LGBT Aging (lgbtagingcenter.org), the country’s only technical assistance resource center aimed at improving the quality of services and supports offered to LGBT older adults. With a wealth of multimedia resources for aging providers, the National Resource Center will be a key resource for AAAs as they implement the guidance.

To learn more about the Older Americans Act and LGBT older adults go to www.sageusa.org/oaapolicybrief
To read HRC’s Issue Brief on aging issues go to www.hrc.org/resources/entry/hrc-issue-brief-aging
Hundreds of thousands of American women suffering from Vulvodynia, a painful disorder that causes inflammation and intense burning in the vulvar area. Vulvodynia can make sitting, walking, or even wearing tight clothing a torturous experience. Sexual intercourse is often impossible.

Because so many women afflicted with vulvodynia are misdiagnosed or never diagnosed, the condition remains undocumented and only few statistics are available. 
According to researcher-author Elizabeth G. Stewart from Harvard University in Boston, 16 percent of women in the U.S. suffer from some form of vulvodynia in their lifetime, and genital pain was considered to be psychosexual, as opposed to physiological.

Howard Glazer, Ph.D., a clinical professor of psychology and obstetrics and gynecology at Cornell University Medical College in New York City, uses biofeedback to treat vulvodynia. He explained that many women with this disorder also have unstable pelvic floor muscles, which can cause the vulvar area to become hypersensitive, inflamed, and painful.

Biofeedback treatment for vulvodynia allows women to heal themselves by strengthening and stabilizing these muscles as they monitor their own progress. Glazer's method involves inserting a sensor, which is attached to a biofeedback instrument, into the vagina. The instrument then directs patients when to vaginally squeeze and release the sensor, and provides feedback about the strength of each contraction and the amount of tension in the muscle when it is relaxed. This exercise, performed daily, stabilizes pelvic floor muscles and diminishes pain. After nine months, all women using this method improved to some degree, and half are pain-free.

Now in Chicagoland a research study The Treatment of Vulvodynia with Acupuncture is in progress. Women ages 18 and older are invited to join study. This confidential study will measure the effectiveness of acupuncture in treating the pain and discomfort associated with this illness. Women who qualify will receive ten free acupuncture treatments over the course of a five-week period.

“Women are suffering in silence,” comments Judith M. Schlaeger, CNM, LAc, who developed the study.  A certified nurse midwife and licensed acupuncturist who describes vulvodynia as a disease of epidemic proportions.  “Western medicine is at best ‘hit or miss’ in treating vulvodynia,” she explains, referring to treatments such as botox injections, estrogen and lidocaine creams, antidepressants, and even surgery. 

The promising results of an earlier study convinced Schlaeger that acupuncture can successfully treat vulvodynia.  However, studies with larger groups are required to quantify these findings.  Traditional Chinese Medicine considers a blocked qi to be the source of chronic pain, and it is the block in the genitals.  "Placing needles in certain acupuncture points of the body helps to unblock the qi, allowing it to flow smoothly” says Schlaeger who trained in both Western and Eastern medicine. With a unique approach to treat vulvodynia, Schlaeger feels that her perspective is unique, and it is her duty to perform this study. 

To join or learn more about the study contact Schlaeger at (708) 334-1097, or the National Vulvodynia Association in Silver Spring, MD, telephone 301-299-0775.