AIDS - State of the Battle

"Despite advances, lingering challenges in the global fight against AIDS" PBS NewsHour 12/1/2016

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SUMMARY:  On World AIDS Day, we take a look at efforts being made to improve prevention and treatment of the virus.  While encouraging advancements have been achieved, AIDS is still the number one killer of women ages 18 to 55.  William Brangham speaks with Jon Cohen of Science magazine about recent developments, why adolescents present a particular challenge and securing global funding to fight the disease.

JUDY WOODRUFF (NewsHour):  Today is World AIDS Day.  While the death toll from AIDS has dropped dramatically, the virus still claims over a million people every year, and nearly 40 million remain infected.

William Brangham has an update.

WILLIAM BRANGHAM (NewsHour):  With the growing use of medications to treat and prevent the spread of HIV, some say ending the AIDS epidemic is actually within reach.  But AIDS is still the number one killer of reproductive-age women, and in many places, those lifesaving drugs are barely available.

Scientists are also seeking a vaccine.  A new trial is under way right now in South Africa.  But many remain skeptical.

I'm joined now by Science magazine's Jon Cohen, who's covered this epidemic for nearly 30 years and was a collaborator with us on our recent series about HIV and AIDS.

Jon Cohen, welcome back to the NewsHour.

Let's start off by talking about this vaccine trial in South Africa.  As you well know, you wrote a book about the hunt for an HIV vaccine.  What is happening in South Africa right now?  Is this as promising as some think it is?

JON COHEN, “Science” magazine:  Well, the AIDS vaccine is the Holy Grail.

People can come in, get a few shots, be protected for life.  That's the dream.  In Thailand in 2009, it was revealed that a vaccine being studied there protected people with about a 31 percent reduction in risk.

That's not very good.  That's extremely low, but it was something.  It was the first glimmer of hope.  The vaccine trial in South Africa is building off that Thai trial.  The results from the Thai trial were extremely controversial.  There are people who wonder why that vaccine strategy has moved forward in South Africa, and there are South Africans who argue very strongly that this is a great hope for them, and even if they get some protection, in addition to other protective measures, it could make a big difference.

WILLIAM BRANGHAM:  OK.  Now let's talk a little bit more broadly

Where are the successes currently in the fight against HIV?  And where are those happening?

JON COHEN:  Well, clearly, preventing mother-to-child transmission has been a huge success all around the world.  It's one of the easiest things to do in terms of prevention.

And some countries like South Africa have reduced it to below 2 percent of pregnant women who are infected passing on the virus.  That's a great success.  Treatment now has scaled up from basically being zero in poor countries around the world in the year 2000 to 18.2 million of the 36.7 million infected people.  Phenomenal success story.

People who are treated and stay on treatment fully suppress the virus and they rarely transmit to others.  So that is leading to hope that epidemics can stop petering out.

THE END OF AIDS - An Island in Kenya

"Why a Kenyan island may teach the world how to beat AIDS" PBS NewsHour 7/20/2016

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SUMMARY:  A massive HIV test-and-treat study is underway in Kenya and Uganda.  Migratory men in the fishing industry there have been hit especially hard, and researchers are trying creative ways to encourage them to get tested.  William Brangham reports from Mfangano Island with support from the Pulitzer Center on Crisis Reporting for our series, “The End of AIDS?”

HARI SREENIVASAN (NewsHour):  Finally, as the International AIDS Conference convenes in Durban, South Africa, this week, we continue our End of AIDS series. 

As we have been reporting, public health officials believe that getting the overwhelming majority of HIV-positive people tested and consistently treated is a crucial step to ending the epidemic.  But that's proven a difficult goal. 

But in Western Kenya, on the border with Uganda, there's a small island where researchers are finding remarkable success with even the hardest-to-reach groups. 

Correspondent William Brangham and producer Jason Kane continue our series, with support from the Pulitzer Center on Crisis Reporting. 

WILLIAM BRANGHAM (NewsHour):  It's late on a Monday night. 

Fisherman Kevin Opiyo and his crew are heading out onto Lake Victoria on the very western edge of Kenya.  They throw out their lines and stretch out their nets, hoping the tiny omena fish are schooling below. 

Fishing these waters is long, grueling, dangerous work.  It's also become one of the main pathways for the growth of the HIV epidemic in this part of Kenya. 

Opiyo himself is infected. 

KEVIN OPIYO, Fisherman (through translator):  I'm confident that I got it through sexual intercourse and can say it was the time I was working in Remba. 

WILLIAM BRANGHAM:  Fishing crews often have to travel long distances to other islands on the lake, and into neighboring Uganda. 

DR.  MOSES KAMYA, Makerere University/SEARCH Co-Principal Investigator:  I think there's a mentality among fishermen that life is not as important.  Therefore, you can enjoy it and have as much sex as you can. 

WILLIAM BRANGHAM:  Dr.  Moses Kamya is an HIV researcher who's been working with fishermen in the region for years. 

DR.  MOSES KAMYA:  You know, fishermen tend to have a lot of disposable income, and, you know, they can buy sex very easily.  And, of course, where fishermen are, there are, you know, sex workers who hang around them. 

WILLIAM BRANGHAM:  The fishermen live on Mfangano Island here on Lake Victoria, near the border with Uganda.  The island's 25,000 residents live clustered in homes near the water, and fishing is the main industry. 

Largely because of this migratory fishing, it's estimated that nearly one out of every three adults here is infected with HIV. 

"How South Africa, the nation hardest-hit by HIV, plans to ‘end AIDS’" PBS NewsHour 7/21/2016

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SUMMARY:  Nearly one in five people infected with HIV globally lives in South Africa, and only half of those individuals are on treatment.  But the nation has made major strides against the virus in recent years and now is aggressively moving to implement a plan to "end" the epidemic.  William Brangham reports in the final installment of our series "The End of AIDS?"

HIV - Getting to Zero?

"How San Francisco plans to ‘get to zero’ new infections of HIV" PBS NewsHour 4/11/2015

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SUMMARY:  An ambitious new plan in San Francisco aims to completely end the transmission of HIV, which infects about 50,000 people every year nationwide.  In a city where huge strides have already been made in battling the epidemic, public health officials, doctors and activists are increasing their efforts to bring the number of new HIV infections down to zero.  NewsHour's John Carlos Frey reports.

JOHN CARLOS FREY (NewsHour):  At Ward 86, a bustling outpatient HIV clinic at San Francisco General Hospital, nurse Diane Jones drops everything when this pager goes off.

It means that someone in the city just tested HIV positive.

DIANE JONES:  So, I’m going to make him an appointment.

Jones is following a protocol called ‘RAPID’ which is designed to get new HIV positive individuals into treatment immediately.

DIANE JONES:  Just got diagnosed today, last negative was June.

JOHN CARLOS FREY:  Jones scrambles to make plans for the new patient who is seen just hours later.

It’s part of an ambitious plan in San Francisco to completely end new HIV infections.

Each year about 50,000 people in the United States are infected with HIV.  And while the disease has moved off the front pages as treatment has made infection more of a manageable chronic condition, an estimated 13,700 people still die from AIDS in the U.S. each year.

Globally, an estimated 1.5 million people are killed.  It’s the 6th leading cause of death.

In San Francisco there are relatively few new HIV infections — 359 in 2013 and overwhelmingly found in gay men.  It’s a number that has been falling over the past eight years.  But new infections haven’t gone away.

Today, public health officials, doctors, and activists are increasing their efforts to bring that number all the way down to zero.

HEALTH - Setback, 'Cured Child' HIV Returns

"HIV rebound in young child is ‘another step’ in long process of AIDS research" PBS NewsHour 7/11/2014

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JEFFREY BROWN (NewsHour):  It was in March of last year that doctors thought they might have made a breakthrough in the goal of finding a cure for AIDS, treating a baby girl in Mississippi with early and unusually aggressive drug therapy.

The mother had HIV and had not been treated during pregnancy.  But the girl was treated within 30 hours of her birth and was free of the virus for two years.  Doctors allowed her to stay off therapy and, still, there were no signs of HIV returning.

But, yesterday, officials announced that the girl, now almost 4, had tested positive for HIV during a follow-up visit last week.

Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases joins me now.

And welcome back to you.

This is something that you and I talked about when the news came out last year.  So, remind us first why this seemed so hopeful, how this early and aggressive treatment promised such a difference.

HEALTH - Three Weapons Raise Hope in AIDS Battle

"Injections, gene therapy and treatment for infants raise hope for fighting AIDS" PBS Newshour 3/6/2014

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GWEN IFILL (Newshour):  For all of the progress made in the fight against AIDS, it still takes a terrible toll.  More than 35 million people are infected with HIV around the world.  More than two million people are newly infected each year.  And well over a million die from it annually.

But research released at an AIDS conference this week is raising hope about new inroads into treating it and preventing infections.

Jeffrey Brown has the story.

JEFFREY BROWN (Newshour):  Three reports attracted attention.  One involved injections of drugs into monkeys that helped stop infections.  A second revealed promising news of a baby born with the virus and given aggressive treatment.  A third concerned so-called gene editing, altering cells to resist HIV.

The NIH’s Institute of Allergy and Infectious Diseases has been funding much of this work.  Dr. Anthony Fauci is its longtime director, and he joins me now.

AIDS - Infant Functionally Cured of AIDS

"Mississippi Doctors See Child-Size Breakthrough in the Global Fight Against AIDS" PBS Newshour 3/4/2013

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RAY SUAREZ (Newshour):  Researchers confirmed a two-year-old girl born with HIV has been functionally cured and remains virus-free even after treatment months ago.

It marks the first time HIV has been essentially eradicated in a child, making her just the second person ever said to be cured of HIV.  Doctors at a Mississippi hospital say they gave the girl an especially intensive three-drug regimen within 30 hours of birth, before tests confirmed she was infected and wasn't merely at higher risk from her mother.

The findings were announced at a major AIDS conference in Atlanta and are stirring much discussion about what it could mean for more than 300,000 babies born with HIV each year, mostly in Africa.

We talk to two experts now watching this closely, Dr. Anthony Fauci of the National Institutes of Health, and Rowena Johnston, vice president and director of research at the American Foundation for AIDS Research, amfAR.

AIDS - As 'World "AIDS Day' 2012 Approaches

"2012 World AIDS Day: Strides Taken Towards Cure, But Daunting Hurdles Remain" PBS Newshour 11/30/2012

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MARGARET WARNER (Newshour): Countries around the globe will mark World AIDS Day this weekend. The toll of the disease is still enormous. More than 30 million have died since the epidemic broke out. And AIDS accounted for 1.7 million deaths last year.

But there is growing optimism about curbing and perhaps ending the epidemic for the next generation, even as daunting hurdles remain.

Ray Suarez has the story.

RAY SUAREZ (Newshour): The numbers are still staggering. Some number 34 million are live well HIV, almost 5 million more than a decade ago. The U.S. substantially increased its commitment to fighting AIDS under President George W. Bush.

Yesterday, Secretary of State Hillary Clinton unveiled the Obama administration's road map to increase access to treatment and eliminate new infections in children by 2015.

HEALTH - 2012 AIDS Conference, Sir Elton John

"Elton John on AIDS: Compassion Is Part of the Cure" PBS Newshour 7/24/2012

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GWEN IFILL (Newshour): Next, advocates from around the globe are in Washington this week for the 19th International AIDS Conference. This year's keynote speaker was musician, songwriter, and performer Sir Elton John, whose 20-year-old foundation has raised more than $275 million to fight the disease.

In his speech and in his new book, "Love Is the Cure," Sir Elton told the story of how Ryan White, the young Indiana boy who contracted HIV through a blood transfusion, inspired him to create the foundation. White's death in 1990 also spurred passage of the Ryan White Care Act, the nation's largest domestic program for people living with HIV/AIDS.

I sat down with Sir Elton this morning after he spoke at the Russell Senate Office Building.

HEALTH - 2012 AIDS Conference

"AIDS Conference Returns to U.S. For First Time Since 1990" PBS Newshour 7/20/2012

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SUMMARY: Ray Suarez talks to Dr. Diane Havlir, U.S. Co-Chair of AIDS 2012 and Professor of Medicine at the University of California, San Francisco and Joseph Elias, Global Village Coordinator, about the AIDS Conference being held in Washington D.C. and how the gathering hopes they can 'begin to end the AIDS epidemic.'

HEALTH - At-Home HIV Testing

"Now Approved By FDA, At-Home Testing for HIV Virus May Save Lives" PBS Newshour 7/4/2012

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GWEN IFILL (Newshour): The spread of HIV -- that scientists hope will save lives, it all comes down to testing.

Of the 1.2 million Americans who carry the virus which causes AIDS, 20 percent don't even know they have it. After diagnosis, the chance that a patient treated with antiretroviral drug will transmit the disease drops by as much as 96 percent.

The Food and Drug Administration has now approved the first at-home test to detect HIV infection.

To explain how it will work, we're joined by Dr. Anthony Fauci, the director of National Institute of Allergy and Infectious Diseases.

HEALTH - Rapid HIV Test Approved

"Rapid H.I.V. Home Test Wins Federal Approval" by DONALD G. McNEIL Jr., New York Times 7/3/2012

After decades of controversy, the Food and Drug Administration approved a new H.I.V. test on Tuesday that for the first time makes it possible for Americans to learn in the privacy of their homes whether they are infected.

The availability of an H.I.V. test as easy to use as a home-pregnancy kit is yet another step in the normalization of a disease that was once seen as a mark of shame and a death sentence.

The OraQuick test, by OraSure Technologies, uses a mouth swab and gives results in 20 to 40 minutes. A previous test sold over the counter required a user to prick a finger and mail a drop of dried blood to a lab.

Dr. Anthony S. Fauci, the longtime AIDS researcher and director of the National Institute of Allergy and Infectious Diseases, called the new test a “positive step forward” and one that could help bring the 30-year-old epidemic under control.

Getting an infected person onto antiretroviral drugs lowers by as much as 96 percent the chance that he or she will transmit the virus to someone else, so testing and treatment have become crucial to prevention. About 20 percent of the 1.2 million infected Americans do not know they have the disease, the Centers for Disease Control and Prevention estimates, and about 50,000 more get infected each year.

Dr. Robert Gallo, who headed the National Institutes of Health lab that developed the first American blood test for the virus in 1984, called the F.D.A. approval “wonderful because it will get more people into care.”

The idea of a home test has long been mired in controversy. The first application for one was made in 1987, and the F.D.A. has been considering OraSure’s simple mouth-swab test since 2005.

But the history of AIDS and the human immunodeficiency virus that causes it are unique. AIDS emerged in the 1980s wrapped in a shroud of stigma. It was spread by sex, drug injections and blood transfusions. Along with hemophiliacs, heroin users and Haitians, the most vocal group of early victims was gay men, who were then in the throes of a loud and defiant liberation movement.

Because merely being tested for H.I.V. was seen as tantamount to being publicly revealed as gay or addicted to drugs, and because an H.I.V.-positive result was a death sentence, groups like the Gay Men’s Health Crisis and newspapers like The New York Native advised their members and readers to shun testing until ironclad guarantees of anonymity were put in place.

Alarmists predicted a wave of suicides if home tests were made available. At hearings, advocates for AIDS patients handed out copies of an obituary of a San Francisco man who jumped off the Golden Gate Bridge after learning he was infected. C.D.C. officials warned their F.D.A. counterparts that home testing could lead to a surge of new patients that would swamp overburdened health clinics, according to an F.D.A. document.

So, even as tests for other stigmatized diseases like syphilis were once part of getting a marriage license and home pregnancy kits became available at every corner pharmacy, H.I.V. tests lived in a special limbo, usually requiring a counseling session and the signing of a consent form, adding to the air of dread.

Even when antiretroviral drugs emerged in the mid-1990s, states were slow to rewrite laws governing testing.

Mark Harrington, the executive director of the Treatment Action Group, an AIDS advocacy organization, said in an interview that he thought such fears were “a thing of the past” now that it is clear that early treatment saves lives. “Any tool that speeds up diagnosis is really needed,” he said.

The new test has some drawbacks. While it is extremely accurate when administered by medical professionals, it is less so when used by consumers. Researchers found the home test accurate 99.98 percent of the time for people who do not have the virus. By comparison, they found it to be accurate 92 percent of the time in detecting people who do. One concern is the “window period” between the time someone gets the virus and begins to develop the antibodies to it, which the test detects. That can take up to three months.

So, while only about one person in 5,000 would get a false negative test, about one person in 12 could get a false positive.

Any positive test needs confirmation in a doctor’s office, the F.D.A. said, and people engaged in high-risk sex should test themselves regularly.

The agency does not intend for the home test to replace medical testing, but instead to provide another way for people to find out their H.I.V. status, said Dr. Karen Midthun, director of the F.D.A.’s Center for Biologics Evaluation and Research.

The home test should be available in 30,000 pharmacies, grocery stores and online retailers by October, said Douglas Michels, OraSure’s chief executive. The price has not yet been set. But he said it would be higher than the $17.50 now charged to medical professionals because the company will do more complicated packaging for the home kit, open a 24-hour question line, and advertise to high-risk groups, including gay men, blacks and Hispanics, and sexually active adults. Still, he said, it will be kept inexpensive enough to appeal to people who might want to buy several a year.

Because the F.D.A. approved the home test only for people 17 and older, retail stores may ask customers to show ID, he said. The restriction is not for medical reasons, but because only a few subjects age 14 to 16 were tested, he said, “so that was the deal we worked out with the F.D.A.”

Whether having to show identification would deter teenagers or young-looking people from buying a test is unclear. Mr. Harrington said he thought it might.

In contrast, teenage girls are not legally required to show identification to buy pregnancy tests.

HEALTH - History, AIDS After 30yrs

"AIDS at 30: Who's at Greatest Risk of Infection Now?"
PBS Newshour 6/7/2011