AVAC Report: HIV Prevention in Horizon

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AIDS vaccine, the combination of prevention, condoms, Male and Female, Cure, General, hormonal contraceptives and HIV, microbicides, Prevention with multidisciplinary technologies, PrEP, treatment as prevention, male circumcision in voluntary means clinics.

The annual report of the HVAC field, next CROI meeting will show why the year is the best and the worst of all time for the prevention and fight against HIV

Next week, scientists, lawyers and doctors will meet in Seattle for the Conference on Retroviruses and Opportunistic Infections (CROI), a venerable HIV meeting that often triggers the media coverage of the AIDS epidemic and the potential to reduce it and preserve the health of people living with HIV.

Use earth, horizon and moon

A series of data is expected from CROI including summaries "last minute" that will show the data IPERGAY and PROUD two trials of oral PrEP using TDF / FTC in gay men and other men who have sex with men in Europe and in Canada, and another study of the microbicide with a concentration 1% tenofovir vaginal gel in a South African women. There will also be data from a PrEP "demonstration project" that provided the strategy in a real life context to Kenyans and Ugandans couples couples, with the important detail that all couples were serodiscordant. We do not know what will be the specific headlines, but we can confidently say that a kind of jingle may be this: The future of HIV prevention is on the horizon.

In our last report, AVAC Report 2014 / 15: Prevention on the horizon, we provide a clear agenda for what should happen, what is missing, and why it is important now more than ever.

Specifically, we argue that:

  • Ambitious prevention goals are important. They can galvanize new shares, in part, by expanding our notion of what is possible.
  • But these goals will only work if they are viable, well-defined, measurable, and supported by financial resources and political will and support. Prevention targets issued so far are inspiring, but they still do not meet these requirements.
  • As UNAIDS created an "expressway" to set aspirational targets for 2020, short-term clear targets are also urgently needed. We can not wait for five years to see if the world is on track to end the AIDS epidemic.
  • The global response to AIDS is running with a large financial deficit and we need new contributions. New targets will not be met and may even become irrelevant if we are not able to close a gap in the non-growing global funding at this time.

campsite of refugeesRecent advances in HIV research have become able to reduce new infections, making it possible to contemplate the end of the global AIDS epidemic. But prevention can be left behind if the global leadership help make this a top priority.

Recently, UNAIDS sending big goals for HIV testing, providing ART and virological suppression over the next five years. According to the agency, the realization of these goals "90-90-90" would put the world on track to end up effectively with the AIDS epidemic, at the latest 2030.

In front of prevention, UNAIDS aims to reduce new infections worldwide from 2,1 million in 2013 to 500.000 in 2020, and to eliminate stigma and discrimination. These goals are ambitious and worth aspiring for them. But something important is missing from the outlined goals of intervention with specificity, the strategy and the resources to meet expectations. The goal is great. What is missing is how to get there.

In the future, in a 20 years we will have a broad retrospect whether the targets today, the 2015 year, imported in the quest to end AIDS

History, if it still exists someone to interpret it, the judge

skyline of the city

But now, foresight and focus are urgently needed. We are concerned with whether the goals that have been set are the right ones, how far goals will materialize, particularly in the context of a global response that works under a disastrous funding context with a deficit for all targets and where prevention is not focused in antiretrovirals in HIV-positive-appropriate individuals. We are also aware that these goals can turn from audacious to absurd in the blink of an eye if funding, political will and community leaders continue to lack.

(Translator's note and Seropositive Editor Web: Impossible not to make an aside and mention that the executive in Brazil has met even "evil-and-evil," their proposals and except for logistical incidents [very serious because in a matter of HIV / AIDS logistics failure is the determinant condition of life and death] there is the reckless "evangelical bench", which should rather be taking care of his flock (donors), than to be giving pitaco in anti-homophobic education as on the contrary, are keen to encourage homophobia and stigmatizing people with HIV as unworthy creatures, "offenders" {as if they prevaricassem like pigs in the sty} - and I would not end to say how many things we are unworthy by these dogs, I nominate the main, Malafaia, marina cintra, feliciano, Bolsonaro, and all Quatrilho (...) all without capital letter because my intent is to make them unworthy of your countertops, since they are site session unworthy I created for them and baptized of evil in its essence, which hinder important adolescent AIDS prevention policies, based on the ridiculous principle that education, sex education, including gender issues, would lead to sodomy, in the sense of creating a society like Sodom, if Sodom existed ; returning, sex education would lead to the premature exercise of sexuality in a country where there are ghettos where twelve-year-old girls are married and live in a marital (sic) relationship with men of 50 years, just so that the family that literally sold the girl can have an income_ - This is the devil with all the letters -. It is necessary, and urgently, that the state be secular, and I think it fair that the pastor, or the man connected and made a marionette of the Church, in any way, should not stand for elective or commissioned position in the name of maintenance of the laity of the state, because we have beautiful examples of what is tin is not secular (see the self-titled iSTAMMIC eSTADO, which every day shows, in satellite chain the return to barbarism ... THE STATE HAS TO BE LAY NOT there are some misrepresentations about what is in the public interest and what is of religious interest.I do not discuss religion here.I have frequented many of them, from the most dramatic manners, to know the interior of them well and know that it is nothing more than a wolf pack I SAW !!!!!! WITH MY EYES)

In this submit myself and understand that work for him for almost 15 years, after a life of daydreams and delinquency in affective ...
In this submit myself and understand that work for him for almost 15 years, after a life of daydreams and delinquency in affective ...

The HVAC works in coalitions in many of the countries hit by the epidemic. Goals that are developed Geneva, Washington DC and other power corridors may have little Urban Povertysimilarities with the realities of countries where AIDS is endemic in their communities. Where there is no reality, there is no relevance. It is essential that countries have the technical and financial resources to the relevant global goals to the national context, analyzing, including pockets of poverty, systematically ignored in their ghettos. Otherwise, the higher goals will be void by belittling and political commitment with the planet and civilization. AIDS is a threat to the continuity of the human species solution on the planet, and when little threat all the achievements of the past and present century.

As we have argued in this report, the goals have played a key role in changing the course of the epidemic. Similarly, a poorly designed target may have no impact. At this time, it is essential that the goals and tactics are compatible with the ambitious but achievable which is to put an end to AIDS. That is why we have dedicated the first part of the report to a rapid clamped on why the important goals, goals that are missing, and as advocates for a comprehensive response must work together to ensure smart, strategic goals across the spectrum of options HIV prevention and AIDS around the planet.

Also focus on issues that support (and sometimes undermine) the ability to meet these goals. We have identified three specific areas for action:

  • align the high impact strategies to human rights and the advancement of biomedical reality of the past eight years making scientifically plausible talk about the end of the epidemic. However, "plausible" does not mean "possible". Today some scientists and public health professionals are focused on what can be achieved by biomedical intervention, without sufficient attention to the structural and social contexts in which the prevention and treatment are delivered. At the same time, some rights of partners focused on talking about HIV as just walked the pills, which suggests that there is no dynamism or action on the fronts based on rights. It need not be a permanent combat medical truth, can not be. If science is not synchronized with human rights, there is little hope to bring the epidemic to a conclusive end.
  • Invest in a paradigm shift PrEP orally oriented. The world is not producing the most effective interventions with a clever strategy and large-scale. PrEP daily orally for prevention of HIV is only one example. Global targets for PrEP may be launched in the coming months, but there are no plans to meet them. Demonstration projects are small and unconnected, funding is limited and political "decision makers are not meeting the growing demand for men and women, including young women in Africa. Now is the time to spend and act to fill those gaps.
  • Short-term demand results on the path to long-term goals. "Spending will be years until you have a truly effective vaccine against AIDS, healing strategies, injectable antiretrovirals or multipurpose prevention technologies that reduce the risk of HIV and provide long-acting contraception systems. But there are many activities in clinical trials and basic science to establish means to achieve these long-term goals. These activities need to be aligned with the short-term goals that can be used to measure progress and manage expectations.

As the HVAC report goes to press this week and as we prepare for CROI next week, the United States are grappling with profound questions about the ways in which the lives of men and black women are valued under the law (...) .

namibia and the law that condemns homosexuals to death
namibia and the law that condemns homosexuals to death

The world is trying to understand how the Ebola epidemic in East Africa was out of control and how to do it over. And it's not continuing concern and monitor the anti-homosexuality laws in Nigeria and Gambia, and in environments of hatred and legislation which endanger the LGBT individuals and many other marginalized groups around the world.

These events are not separate from the work we do to combat AIDS. They incorporate issues of racism, inequality, poverty and security that drive the epidemic that must be addressed to end it. In addition to specific HIV work set out in these pages, it is essential to work in the fundamental sense, lasting and positive change in each of these areas. This will be making history, no doubt.

Originally published in AVAC Report on Thursday, 19 for February, 2015.

Translated, adapted and edited by Claudio S. Souza with technological support Google Translator in 02 / 03 / 2015 with publication scheduled for 03 / 03 / 2015

Video: Is A World Without AIDS Possible? BBC Brazil

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