Faculty Bibliography

In a keynote address, Stephen Lewis, the United Nations' ambassador to Africa for AIDS, said South Africa 'is the only country in Africa whose government continues to propound theories more worthy of a lunatic fringe than of a concerned and compassionate state.' South Africa has the largest number of HIV-infected people in the world. South Africa's President Thabo Mbeki has continually expressed skepticism that HIV causes AIDS, and the country has questioned anti-retroviral treatment and delayed providing it to pregnant women and AIDS patients. Nurses and others involved in the care of AIDS patients often work in unsafe or dangerous conditions, said Dr. Pedro Cahn, the new president of the International AIDS Society, the main organizer of the AIDS conferences. This conference was the largest ever, drawing 26,057 participants. The next AIDS conference will be held in Mexico City in August 2008

The official, Dr. Kevin De Cock, who directs the organization's AIDS program, said Wednesday that around the world an estimated 2.3 million children 15 and under are infected with HIV, the virus that causes AIDS, and that 800,000 of them needed anti-retroviral drugs to stay alive. Of the 800,000, only 60,000 to 100,000 are receiving therapy. At the same time, De Cock said, fewer than 10 percent of pregnant women with HIV in poor and middle-income countries are receiving the simple regimen of pills that can prevent the transmission of the AIDS virus to their newborns. By contrast, rich countries have virtually eliminated pediatric AIDS. Many critics also said that HIV would develop a resistance to the drugs if people in poor countries did not take them as prescribed. De Cock said the World Health Organization was watching for drug resistance among patients receiving anti-retroviral therapy and that the information would start to become available later this year

The patients, who were also infected with the virus that causes AIDS, were resistant to all first- and second-line drugs for tuberculosis, Dr. Neel R. Gandhi told the 16th International Conference on AIDS. Dr. [Gerald Friedland] estimated that half the patients had picked up their infections at hospitals or clinics. Most of those who died were in the advanced stages of AIDS, he said. Many were relatively young -- the median age was 35 -- and had never been treated for tuberculosis, so they presumably had not developed resistance slowly in themselves, but had caught the extremely resistant strains from someone else. Tuberculosis and infection with the AIDS virus have long been known to be closely intertwined. This year, the Centers for Disease Control and Prevention in Atlanta reported a total of 347 cases worldwide in which the agency found tuberculosis bacteria resistant to all first- and second-line drugs, including isoniazid, rifampin, ethambutol, streptomycin, kanamycin and ciprofloxacin

The official, Dr. Kevin M. De Cock, who directs the organization's AIDS program, said that an estimated 2.3 million children 15 and under around the world are infected with H.I.V., the virus that causes AIDS, and that 800,000 of them needed antiretroviral drugs to stay alive. Of the 800,000, only 60,000 to 100,000 are receiving therapy. While the children account for 14 percent of AIDS deaths, they make up only 6 percent of recipients of antiretroviral drug therapy. Many of the children are orphans. At the same time, Dr. De Cock said, fewer than 10 percent of pregnant women with H.I.V. in poor and middle-income countries are receiving the simple regimen of pills that can prevent the transmission of the AIDS virus to their newborns. By contrast, rich countries have virtually eliminated pediatric AIDS. Dr. De Cock also described an inequity in antiretroviral treatment for injecting drug users, particularly in Eastern Europe and Central Asia. There, these users account for more than 70 percent of people infected with H.I.V. but about a quarter of those receiving treatment

The studies are complex, the methods will not offer a magic bullet to prevent the disease and whatever preventive techniques are found to be effective will probably be combined with existing prevention strategies, the panel of 50 experts cautioned. The experts also urged the world to address the practical and ethical challenges that they said threaten to slow or derail critical research projects on many prevention measures. More donor financing will be needed to introduce and deliver the new methods, the panel, known as the Global HIV Prevention Working Group, concluded. The panel members made a number of recommendations, including finding ways to help poor countries train enough health workers to carry out male circumcision safely. Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than noncircumcised men to be infected with HIV by female sex partners. By 2007, the results should begin to come in from three studies under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of HIV transmission from men to women

The official, Dr. Kevin De Cock, who directs the organization's AIDS program, said that an estimated 800,000 children worldwide under the age of 16 needed antiretroviral drugs to stay alive. Yet while they account for 14 percent of AIDS deaths, they make up only 6 percent of recipients of antiretroviral drug therapy. At the same time, less than 10 percent of pregnant women with HIV in poor- and middle-income countries are receiving the simple regimen of pills that can prevent the transmission of the AIDS virus to their newborns. This contrasts to the rich countries that have virtually eliminated pediatric AIDS, De Cock said

Large studies of an array of promising new ways to prevent HIV are nearing completion, but the world is unprepared to make them widely available to the hundreds of millions of people at risk of becoming infected, an international panel of experts reported here Tuesday. Findings from some studies, like those assessing the effectiveness of microbicides and male circumcision, are expected within the next five years, some possibly in about a year, the panel said at the 16th International Conference on AIDS. At the same time, a significant number of practical and ethical challenges threaten to slow or derail critical research on many prevention measures, the panel of international experts said

Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than non-circumcised men to be infected with HIV by female sex partners. In 2007, the findings should begin to come in from three under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of HIV transmission from men to women

An array of promising new methods to prevent the spread of H.I.V. may become reality in the near future, but most countries are unprepared to provide them to the hundreds of millions of people at risk of becoming infected, an international panel of experts reported here on Tuesday. The studies are complex, the methods will not offer a magic bullet to prevent the disease, and whatever preventive techniques are found to be effective will probably be combined with existing prevention strategies, the panel of 50 experts cautioned. The experts also urged the world to address the practical and ethical challenges that they said threatened to slow or derail critical research projects on many prevention measures. Last year, a study conducted in South Africa found that circumcised men were 60 percent less likely than noncircumcised men to be infected with H.I.V. by women who are sex partners. In 2007, the findings should begin to come in from three studies under way in Kenya and Uganda. The studies are aimed at confirming the South African study and determining whether male circumcision also reduces the risk of H.I.V. transmission from men to women