HPV Infection is an Independent Risk Factor for HIV
STD Chlamydia Very Common in the USA
Swaziland: Lower Teenage HIV by Promoting Abstinence
IAS: HPV INFECTION IS AN INDEPENDENT RISK FACTOR FOR HIV — Infection with one subtype of the human papilloma virus (HPV) doubles the risk of becoming infected with HIV, and infection with several subtypes more than triples it, the third IAS conference heard on July 26th.
Dr. Peter Chin Hong from San Francisco told the conference that the EXPLORE trial of HIV-negative [homosexual] men in four US cities (Boston, Denver, New York and San Francisco) found that 81% of men who seroconverted (became HIV-positive) during a three-year period from January 2001 to January 2004 had HPV infection, as opposed to 50% of those who did not seroconvert.
Forty-three percent (43%) of seroconverters had abnormal squamous cells in the anus, as opposed to 24% of non-seroconverters. The abnormal cells were extracted on swabs. Anal cytoscopy, which would have been able to detect the patches of anal intraepthelial neoplasia (AIN – abnormal and potentially precancerous skin) these cells came from, was not performed, which probably weakened the association between HIV infection and AIN, as swabs would not have detected every person with AIN.
The average number of HPV subtypes present in those infected was two. In univariate analysis, infection with one HPV subtype multiplied the risk of HIV infection by 2.0; with two subtypes by 2.4; and with three or more by 3.7.
However HPV infection was also associated with both [outercourse] and crystal meth use. Once these factors were adjusted for in multivariate analysis, the association of HPV seroconversion with infection with three or more subtypes of HPV remained statistically significant, multiplying the risk of HIV acquisition by 3.3. The presence of abnormal squamous cells multiplied the HIV risk by 2.8.
The study underlined the strong association between HIV acquisition and crystal meth use. [Outercourse] multiplied the likelihood of HIV acquisition by 7.2 but crystal meth use was almost as much a risk factor, multiplying the likelihood of acquisition by 6.8.
The EXPLORE trial followed up 1,409 HIV negative sexually active [homosexual] men between January 2001 and October 2002. There were 51 HIV infections in the group during the average three years of follow-up, an incidence of 1.2% a year. The median age of the group was 36; 78 percent were white; the median number of sexual partners over the follow-up period was six; and 40% said they always used condoms during sex.
Dr. Chin Hong said that in studies of cervical cancer, there was an increased density of CD4 cells in patches of CIN (cervical intraepithelial neoplasia) compared with normal tissue, which suggests how the presence of HPV-associated skin lesions increases vulnerability to HIV infection. [Aidsmap, 08/01/05; Abstinence Clearinghouse 1Aug05]
CHLAMYDIA COMMON IN USA – As many as 1 in 20 teenage girls/women & over than 2% of the general population in the USA are infected with the STD Chlamydia [CDC research survey 12July05].
Pregnant women attending publicly funded clinics and economically disadvantaged youth are especially at risk of the bacterial infection, which can cause serious problems including infertility if untreated.
Dr. John Douglas [dir, CDC’s STD prevention programs]: “STDs often have no symptoms and therefore frequently go unrecognized and undiagnosed. Stepping up screening and prevention efforts is critical to ensuring that young people do not suffer the long-term effects of untreated Chlamydia, including infertility.
CDC researchers found 2.2 percent of U.S. adults aged 14 to 39 had Chlamydia. Nearly 1 in 20 women between the ages of 14 and 19 — 4.6 percent — were infected.
Chlamydia is easily cured with antibiotics, but is often undiagnosed because of its causes few symptoms. Besides infertility, the infection can cause pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain. [Reuters Health, 07/13/05; Abstinence Clearinghouse E-Mail Update, 06/20/05]
HEALTH-SWAZILAND:A MESSAGE TO TEENAGERS – TAKE CHARGE! A new advertising campaign aimed at curtailing teenage HIV rates by promoting abstinence is using a combination of traditional and modern values in its appeal to Swazi youth.
The SiSwati phrase “Ngoba likusasa nelami” — “Because tomorrow is mine” — has been chosen as the theme of the initiative, which got underway with full-page advertisements in Swaziland’s two national newspapers. Because of the limited circulation of the Swazi press, radio adverts are also running. In addition, billboards bearing the images and messages used in the printed adverts began appearing this month.
The pictures show young people with quotes such as “I want to finish my education. Sex can wait.” (used with the image of a girl holding schoolbooks). Another shows a boy with a determined gaze, saying “I am thinking of my future. Sex can wait.”
“We are telling teenagers to take charge of their own lives, for the sake of both their own personal survival and for the future of the Swazi nation,” creative designer Tshepo Motlhala, who developed the campaign for the National Emergency Response Committee on HIV/AIDS (NERCHA), told IPS.
“The new ad campaign aimed at young people is the first time all health stakeholders came together on a single project. From initial meetings with government and NGOs, to research with teenagers, to coming up with the images and message of the campaign, all parties were involved,” NERCHA’s communications director, Nana Mdluli.
“In the ads, we are showing young people who have taken charge of their lives. Because of AIDS [and cervical cancer], sex can be deadly. Abstinence can assure a future for teenagers.”
Swaziland currently has the unenviable distinction of having the world’s highest AIDS infection rate, with the latest official figures showing 42.6 percent of sexually active adults to be HIV-positive.
However, the infection rate among teens is currently 15 percent for sexually-active young people 18 years and younger, is stable, and may be diminishing. [IPS; Allafrica.com, 07/15/05; Abstinence Clearinghouse E-Mail Update, 06/20/05]