Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 20 May 2012 – 0:00 PDT

email to a friend   printer friendly   opinions  

<!–   rate article

Patient / Public:
Healthcare Prof:

A change in the formulation of tenofovir gel, an anti-HIV gel developed for vaginal use, may make it safer to use in the rectum, suggests a study published online this week in the Journal of Antimicrobial Chemotherapy. In laboratory tests of rectal tissue, researchers from the Microbicide Trials Network (MTN) found that the reformulated gel was less harmful to the lining of the rectum than the original vaginal formulation, and just as effective in protecting cells against HIV.

“The lining of the rectum is much more fragile than the vaginal epithelium, so we can’t be certain a product like tenofovir gel that is safe for vaginal use will be completely safe to use in the rectum,” said lead study author Charlene Dezzutti, Ph.D., associate professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine and principal investigator of the MTN Network Laboratory. “We are very encouraged by our laboratory data that suggest the reformulated gel could be safer for rectal use, and serve as a dual compartment gel for use in both the vagina and rectum.”

Tenofovir gel has shown some promise in reducing HIV risk in women through vaginal sex. But because the rectal epithelium – the lining of the rectum that serves as the first line of defense against HIV – is much thinner than the vaginal lining, the gel may not be safe or effective to use rectally. Indeed, unprotected anal sex is 10 to 20 times more likely to result in HIV infection than unprotected vaginal intercourse. By its nature, tenofovir gel is hyperosmolar – contains a higher concentration of sugars and salts relative to cells. This quality could have a harmful effect on the rectal lining by causing epithelial cells to shrink as they purge water to achieve balance. Weakened in this manner, the rectal epithelium may be less able to protect against HIV.

To make tenofovir gel safe and more amenable to rectal use, researchers from CONRAD, a research organization which holds the rights to develop the gel, reformulated it with a reduced amount of glycerin, a common additive found in many gel-like products. In laboratory tests conducted by MTN researchers, the reformulated gel was three times less likely to cause cells in rectal tissue to release water, and equally effective against HIV as the vaginal formulation.

Data from an early phase clinical trial of the reduced glycerin gel presented in March 2012 at the 19th Conference on Retroviruses and Opportunistic Infections (CROI), suggested it was safe and acceptable in 65 HIV-negative men and women who used it rectally once a day for one week. Results from this study, called MTN-007, and future studies will have important implications for the development of a rectal microbicide that could help protect against HIV or other sexually transmitted infections during anal sex.

As follow-up to MTN-007, researchers are now planning a Phase II, multi-site trial called MTN-017 that will involve 186 men who have sex with men, and transgender women at clinical sites in Peru, South Africa, Thailand, and the U.S. Participants will cycle through three study regimens: reduced glycerin tenofovir gel used daily, reduced glycerin tenofovir gel used before and after anal sex, and daily use of the antiretroviral tablet Truvada®. MTN-017 will allow researchers to collect additional information

Tenofovir gel contains the antiretroviral tenofovir, which is commonly used in the treatment of HIV. The vaginal formulation of tenofovir gel was found safe and effective in reducing the risk of HIV in women who used it before and after vaginal sex in a study called CAPRISA 004. More recently, however, MTN researchers conducting the VOICE Study closed the tenofovir gel arm of the trial after a routine review of study data determined that the gel, while safe, was not effective in preventing HIV among the women in that study group, who were asked to apply it vaginally every day. In the meantime, a Phase III trial called FACTS 001 is currently evaluating the vaginal formulation of tenofovir gel using the same regimen as CAPRISA 004, with results expected in 2014.

• Additional
• References
• Citations

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

back to top | home |
privacy policy

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

Editor’s Choice
Main Category: Pregnancy / Obstetrics
Also Included In: Sexual Health / STDs;  Tropical Diseases;  Urology / Nephrology
Article Date: 16 May 2012 – 12:00 PDT

email to a friend   printer friendly   opinions  

<!–   rate article

Patient / Public:
Healthcare Prof:

A review and meta-analysis of studies published in the May 16 theme issue of Global Health in JAMA reveals a significant burden of malaria and STIs/RTIs amongst pregnant women who attend antenatal facilities in sub-Saharan Africa. The findings were discovered after a review of studies reporting estimates of the prevalence of sexually transmitted infections/reproductive tract infections (STIs/RTIs) and malaria over the past 2 decades.

The article’s background information states:

“There are 880,000 stillbirths and 1.2 million neonatal deaths each year in sub-Saharan Africa. Low birth weight (

Sexually transmitted infections and reproductive tract infections and malaria are associated with adverse birth outcomes, but both may be mitigated with preventive or presumptive treatment or by repeated screening and treatment throughout the antenatal period. The extent to which either approach may be beneficial depends on the underlying prevalence of STIs/RTIs and malaria in pregnancy.”

R. Matthew Chico, M.P.H., from the London School of Hygiene and Tropical Medicine and his team performed a systematic review and meta-analysis to provide estimates for the dual prevalence of STIs/RTIs and malaria in pregnant women in sub-Saharan Africa. Their search criteria included reports on malaria, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, or bacterial vaginosis amongst pregnant women who attended antenatal care facilities in sub-Saharan Africa.

From 1990 to 2011, the team found a total of 171 eligible studies including 340,904 women. The combined prevalence estimates of Eastern & Southern Africa and of West & Central Africa was:

The researchers conclude:

“The dual prevalence of malaria and STIs/RTIs is evident among pregnant women who attend antenatal facilities in sub-Saharan Africa. As malaria control and elimination efforts are brought to scale, the relative contribution of STIs/RTIs to adverse birth outcomes most likely will increase proportionately. Coinfection prevalence estimates for malaria and STIs/RTIs need to be established and routinely reported. Rigorous studies using molecular diagnostic methods are needed to characterize more accurately the prevalence of these infections and their clinical consequences.

Clinical trials are needed to compare birth outcomes, operational feasibility/acceptability, and cost-effectiveness of intermittent preventive treatment during pregnancy (IPTp) with azithromycin-based combination therapy against an approach of integrated screening and treatment for malaria and STIs/RTIs.”

Written By Petra Rattue

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

back to top | home |
privacy policy

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

Editor’s Choice
Main Category: Sexual Health / STDs

Also Included In: Women’s Health / Gynecology

Article Date: 15 May 2012 – 6:00 PDT

email to a friend   printer friendly   opinions  

Patient / Public:		4 (1 votes)
Healthcare Prof:

Some non-oral hormonal contraceptives, such as vaginal rings, implants and skin patches carry a higher risk of venous thromboembolism – blood clots – when compared to oral contraceptive pills, researchers from the University of Copenhagen revealed in the BMJ (British Medical Journal). The authors wrote that some patients should change over to oral, hormonal contraceptives to reduce their risk of developing clots.

Venous thrombosis is a collective term for DVT (deep vein thrombosis) and pulmonary embolism. The researchers explained that most studies have focused on the clot risk for females on oral contraceptive pills. There are very few studies that focus on other contraceptives; referred to as non-oral hormonal contraceptives.

Non-oral hormonal contraceptives release hormones into the body more continuously.

Professor Øjvind Lidegaard and colleagues set out to determine what health effects, specifically venous thrombosis, non-oral hormonal contraceptives have on Danish females aged between 15 and 49 years, dating from 2001 to 2010. None of the women in the study were pregnant or had any medical history of cancer or blood clots before the study started.

They took into account a number of factors which could distort the findings, including the women’s education level and their age.

Non-oral hormonal contraceptives, such as the vaginal ring, are linked to a higher risk of developing blood clots, compared to oral contraceptive pills

Over a period of 9,429,128 observation years, a total of 3,434 diagnoses of first-time venous thrombosis were made.
The authors reported the following findings for females aged from 15 to 49 years:

• 2 venous thrombosis events per 10,000 exposure years for those not using any type of hormonal contraception




• 6.2 venous thrombosis events per 10,000 exposure years for those on a levonorgestrel-containing combined oral contraceptive pill




• 9.7 venous thrombosis events per 10,000 exposure years for those using a contraceptive skin (transdermal) patch




• 7.8 venous thrombosis events per 10,000 for those using a vaginal ring




• Women using a progestogen-only subcutaneous implant were found to have a slightly higher chance of blood clots




• Women using a progestogen-only intrauterine device either had no higher risk at all, or possibly a lower risk

Women who used a patch or vaginal ring for a long time did not experience any reduced risk later on.

The researchers worked out that of the women they studied, 2,000 of the vaginal ring users and 1,250 of the skin patch users should switch over to a combined levonorgestrel-containing oral pill to reduce the risk of a venous thrombosis event in one year.

Written by Sarah Glynn B.A. (Psych)

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.


Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

back to top | home |
privacy policy

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

Main Category: Urology / Nephrology

Also Included In: Sexual Health / STDs;  Men’s Health

Article Date: 15 May 2012 – 1:00 PDT

email to a friend   printer friendly   opinions  

Patient / Public:
Healthcare Prof:

The first study using cultivation independent sequencing of the microorganisms in the adolescent male urinary tract has revealed that the composition of microbial communities colonizing the penis in young men depends upon their circumcision status and patterns of sexual activity.

This study, published in the online journal PLoS One, is the first by Indiana University researchers working with a four-year, $7 million grant from the National Institutes of Health’s Human Microbiome Project. It is also the first to reveal that urogenital bacterial communities of young men are surprisingly stable and that some of these bacteria are similar to species that colonize and protect healthy young women from sexually transmitted infections.

The research contradicts the accepted wisdom that pre-sexual men did not have bacteria in their urinary tracts.

“Young men had bacteria that looked similar to those of young healthy women,” said David E. Nelson, Ph.D., an assistant professor of biology at Indiana University Bloomington and the principal investigator of the research. “We think that these bacteria may promote genitourinary health in men, just as they do in women. This contradicts previous dogma that only sexually transmitted pathogens colonize the male urethra.”

The findings open doors for additional research that will lead to a deeper understand of men’s health.

“This is the first real investigator of the normal microbiology of men before they begin sexual activity,” Dr. Nelson said. “There are parallels between normal bacteria in young men and those in young women that are known to be protective.”

This discovery was not possible before the mapping of the human genome and the development of powerful sequencing tools, said J. Dennis Fortenberry, M.D., M.S., principal investigator of the NIH grant and professor of pediatrics in the Division of Adolescent Medicine at the IU School of Medicine.

The investigators used the advanced sequencing techniques to evaluate bacteria on the head of the penis as well as in the urethra in 18 adolescents younger than 18 years, he said. The researchers will follow these adolescents, along with dozens of others, for several years to determine how the types and amounts of bacteria present in and on the penis changes over time.

This study reports that the types of bacteria found on the penis were different than what was found in the urethra, and the bacteria found in circumcised adolescents differed from the bacteria found in the uncircumcised adolescents. These differences may be important in understanding why circumcision helps prevent HIV and other sexually transmitted infections in men.

They also discovered changes in the bacteria after sexual activity began.

“We have some sense that some of the bacteria in the urethra are essential to keeping men healthy,” Dr. Fortenberry said. “This research and the new technology will open doors to explore what is good about the bacteria, what they do and how.”

“At this point in the research, we are asking ‘chicken and egg’ questions,” Dr. Nelson said. “What comes first, the loss of normal bacteria, making a person more susceptible to sexually transmitted infections or, do you get colonized with other bacteria for some reason and that puts a person more at risk of contracting an STI.”

This research, like other longitudinal studies, should shed light on the sequence of events that leads to STIs and other urinary tract diseases such as a common male condition called non-gonococcal urethritis, whose cause is unknown.

Drs. Fortenberry and Nelson said they decided that looking at the microbiome of a cohort of young, non-sexually active males was the only way to determine what bacteria was normal for men. Without that information, researchers can’t determine the difference between healthy and unhealthy bacteria and know how to treat disease.

• Additional
• References
• Citations

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.


Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

back to top | home |
privacy policy

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

Main Category: Sexual Health / STDs

Also Included In: HIV / AIDS;  Women’s Health / Gynecology

Article Date: 11 May 2012 – 1:00 PDT

email to a friend   printer friendly   opinions  

Patient / Public:		1 (1 votes)
Healthcare Prof:

Safer indoor sex work spaces provide important and potentially life-saving benefits to sex workers including reduced exposure to violence and HIV and improved relationships with police, according to a study published by the Gender and Sexual Health Initiative of the BC Centre for Excellence in HIV/AIDS (BC-CfE) and the University of British Columbia (UBC).

The qualitative evaluation study published in the America Journal of Public Health interviewed 39 women living in low-threshold, supportive housing programs for sex workers in poverty and using drugs. These programs, operated by Atira Women’s Resource Society and RainCity Housing and Support Society in Vancouver, Canada, offer an innovative harm reduction model that promotes the health and safety of the most marginalized sex workers.

Security measures include women-only buildings (residents, staff), supportive guest policies (clients sign-in at front desk), video cameras onsite, staff available to call police in case of violence, and health and safety resources onsite, including bad date sheets and condoms. Based on the success of the programs to date, these models have now been extended to reach more sex workers across a number of housing programs in Vancouver.

Sex workers interviewed in the study had all previously worked on the street and described how supportive housing programs increased their control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use and avoid violent predators. Women’s accounts contrast the safety afforded by these environments with their very limited options to controlling their safety when seeing clients in cars, alleys and clients’ homes.

“This research shows that safer indoor sex work spaces dramatically reduce the risks to the health and safety of sex workers,” says Dr. Kate Shannon, senior author of the study, director of BC-CfE’s Gender and Sexual Health Initiative and assistant professor of medicine at UBC. “We have previously shown that displacement and lack of safer indoor options for street-based sex workers are directly associated with elevated rates of violence and HIV risk. The evidence is clear: We need to scale up access to safer sex work spaces and remove legal barriers to their formal implementation and evaluation.”

The publication of the study follows the landmark decision by the Ontario Court of Appeal that allows sex workers to legally work in safer indoor spaces starting next year. The court concluded that laws preventing sex workers from working together under one roof or hiring security staff fail to protect sex workers and exacerbate harms. While the decision is not currently binding outside Ontario, if upheld by the Supreme Court of Canada the government will be forced to ensure the laws are brought in line with the evidence.

“We have created policies and practices that support women’s choice and ensure their health and safety are protected,” says Amelia Ridgway, Manager of RainCity Housing. “Women have the right to govern their own bodies. We believe that housing is a human right and this is about providing women with the most basic human rights around protection from violence within a harm reduction framework.”

“This is about promoting and protecting the basic rights of women who do sex work and live in poverty,” adds Janice Abbott, CEO of Atira Women’s Resource Society. “The contradictory nature of Canada’s criminalized prostitution laws is that sex workers in higher-end neighbourhoods can operate largely free of persecution out of their own apartments, but the most marginalized women in sex work continue to be criminalized and victimized by restrictive and arbitrary policies and enforcement.”

The women interviewed said safer sex work spaces reduce some of the anonymity and isolation that mark street-level transactions, allowing onsite staff and workers to identify violent predators. They added that safer spaces where sex workers can bring clients indoors support increased solidarity between sex workers and promotes their ability to self-regulate safer industry standards.

Improved relationship between sex workers and police

An important finding of the study is improved relations between sex workers and police. “As evidence has shown time and time again, current criminalized laws and enforcement of these laws create an adversarial relationship between sex workers and police,” says Dr. Shannon. “These findings align with the new guidelines by Vancouver Police Department to not harass or arrest sex workers.”

As one sex worker in the study explains: “On the corner, doing it in the car, I used to be scared all the time, paranoid about cops, scared of getting charged. It is a lot easier now. I can come and go [to this safer space], and cops actually say hi to me. It is different.” Another sex worker adds, “Now police just check me out and help me be safe.”

“We need to view safer sex work spaces as an evidence-based public health imperative,” concludes Dr. Perry Kendall, BC’s Provincial Health Officer. “This research clearly demonstrates that safer sex work models bring street-based sex workers indoors and away from violent predators, and support their access to health, security and safety.”

“Safer sex work spaces support better health and safety, period,” said Dr. Patricia Daly, Chief Medical Health Officer, Vancouver Coastal Health. “We need to ensure that evidence-based safer sex work models are supported, and where possible expanded, to reach marginalized individuals.”

• Additional
• References
• Citations

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.


Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

Privacy Policy |
Terms and Conditions

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.

back to top | home |
privacy policy

MediLexicon International Ltd

Bexhill-on-Sea, United Kingdom

MediLexicon International Ltd © 2004-2012 All rights reserved.

MNT (logo) is the registered EU trade mark of MediLexicon Int. Limited.