(Press-News.org) A study looking at 15 years of HIV transmission and suppression in Uganda reveals how closing gender gaps in treatment could slash infection rates.
Providing more heterosexual men with easy access to HIV treatment and care could help to suppress the virus and rapidly cut transmission to their female partners, shows a new study published in Nature Microbiology.
The research, led by scientists from Imperial College London and the Rakai Health Sciences Program in Uganda, analysed 15 years of data from 2003-2018, during which the US President’s Emergency Plan For AIDS Relief (PEPFAR) has delivered an extensive programme of HIV/AIDS testing, prevention, and treatment.
This included distributing Antiretroviral Therapy (ART) drugs, which supress the virus so a person is no longer infectious. The analysis shows that the PEPFAR program and other services have greatly reduced new infections among young women and heterosexual men, but that reductions were less substantial in women aged 25 and above.
This is thought to be because women are more likely to reach viral suppression through uptake and effective use of HIV treatment, preventing them from passing HIV to their male partners, but that the same is not true the other way around.
The analysis showed that the number of women reaching and maintaining undetectable (non-transmissible) levels of HIV infection were 1.5 to 2 times higher than men across all ages by the year 2018. The analysis shows that had men reached the same levels of virus suppression as women, around half the new infections that occurred between 2016 and 2018 could have been avoided.
The team also reconstructed transmission networks based on the genetic code of the virus from thousands of participants, which confirmed that overall, the proportion of transmissions from men is increasing and is now at 63% of all transmissions in the area – even though a greater number of women are living with HIV than men.
The team say the disparity could be because men need to travel for work, that clinics are closed when they are back home, or for other reasons, including social stigma.
Dr Oliver Ratmann, senior author of the study from the Department of Mathematics at Imperial, said: “In this evolving battle against HIV, it is critical we adapt our strategies, bridge gaps in care, and ensure that individuals, regardless of their gender, have access to the lifesaving benefits of ART.
“It is important to design services in a way that everybody who would like to use them is able and feels empowered to do so. By routinely monitoring the changing dynamics of the epidemic and striving for equity in HIV care, we can move closer to the ultimate goal of controlling and, one day, eliminating HIV transmission.”
Dr Kate Grabowski, a co-author of the study from the Johns Hopkins School of Medicine, added: “The continued success of the President's Emergency Plan for AIDS Relief (PEPFAR) in reducing infections and saving lives is crucial for ending HIV transmission. With United States Congress currently evaluating PEPFAR funding, our evidence strongly supports the program's efficacy and provides a clear roadmap to ending the pandemic through enhanced HIV treatment coverage, particularly among men.”
Closing the gap in transmission
The team used data from the Rakai Community Cohort Study (RCCS) in southern Uganda, a region where more than 9% of adults are living with HIV – approximately 20 times higher than in the US. Since 2003, a period predating the widespread availability of ART in Africa, RCCS has enrolled nearly 37,000 individuals, tracking changes in HIV infection as new interventions came on board.
The analysis tracked evolving heterosexual HIV epidemic dynamics in 36 communities over a 15-year span of RCCS surveillance data, including records of new infections, deep sequence HIV genomic data, HIV treatment uptake, viral suppression, and behavioural information.
Analyses in earlier years showed that the highest number of new HIV cases in southern Uganda was among adolescent girls and young women aged 15-24 years. In more recent years tracked in the new study, women 25-34 years old have become a new focal group, experiencing a slower decline in new infections than other age groups. This is alongside a significant difference in the declines in new infections between men and women, with those among boys and men declining much faster.
To estimate the likely impact of getting men to the same level of viral suppression, the team applied statistical models based on the data about transmission dynamics. The resulting projections indicate that closing the viral suppression gap in men could have effectively halved rates of new infections among women and eliminated gender disparities in acquiring HIV.
Dr Joseph Kagaayi, previous director of the Rakai Health Sciences program and senior co-author of the study, said: “Our study findings emphasise the importance of addressing disparities in ART uptake and viral suppression between men and women. By doing so, we can not only reduce HIV infections among women but also work towards closing the gender gap in HIV transmission. Achieving these goals will require concerted efforts, informed policies, and strengthened healthcare services.”
Engaging heterosexual men more effectively could slash HIV infections in Uganda
ELSE PRESS RELEASES FROM THIS DATE:
A fork in the rhod: Janelia researchers unveil comprehensive collection of rhodamine-based fluorescent dyes
When Senior Scientist Jonathan Grimm came to Janelia 13 years ago, he didn’t know much about fluorescence or fluorescent dyes. But as an organic chemist who had been working in drug discovery at Merck, he certainly knew a thing or two about medicinal chemistry. On a whim, Grimm and Janelia Senior Group Leader Luke Lavis decided to try using a mainstay medicinal chemistry reaction Grimm had picked up in the pharmaceutical industry to improve centuries-old dye chemistry. They thought this approach could allow access to completely new, previously inaccessible rhodamines – molecules Lavis had been working to make brighter and longer-lasting so they could be ...
The Gerontological Society of America congratulates new 2023 awardees
The Gerontological Society of America (GSA) — the country’s largest interdisciplinary organization devoted to the field of aging — is proud to acknowledge the work of 34 outstanding individuals through its prestigious awards program. GSA salutes outstanding research, recognizes distinguished leadership in teaching and service, and fosters new ideas through a host of awards. Nominated by their peers, the recipients’ achievements serve as milestones in the history and development of ...
Texas A&M Institute part of national effort to harness nuclear laser fusion for limitless energy
Nuclear fusion, the process that powers the sun, is the ultimate source of energy for all life on Earth. On the sun, deuterium and tritium nuclei combine to produce an alpha particle (the nucleus of a helium atom) and a neutron. The dream is to do the same down here, on Earth, in a controlled manner. It’s for good reason that harnessing fusion energy is one of the greatest scientific and technological challenges of the 21st century. Fusion requires the fuel to be heated to more than 100 million degrees (10 times hotter than the core of the sun). Practical fusion energy also requires that the burning fuel is kept at these hot temperatures long enough so that energy ...
How health system hesitancies contributed to COVID risks
More than 1.2 million people have died in the United States during the COVID-19 pandemic to date, more documented deaths than any other nation on Earth. While many have attributed the high death toll on widespread personal hesitancy to wear masks, avoid crowded places or receive vaccines once they were developed, there were several “system hesitancies” that contributed to the tragic outcomes that need addressing, according to an analysis published Dec. 6, 2023, in Health Affairs Forefront. The analysis ...
Stand Up to Cancer names Julian Adams, Ph.D., President and CEO
LOS ANGELES – December 8, 2023 – Stand Up To Cancer® (SU2C) today announced the appointment of Julian Adams, Ph.D., as president and chief executive officer, which will be effective on January 1, 2024. Adams had previously served on SU2C’s Scientific Advisory Committee since 2008, and officially joined SU2C in July 2023 in the newly created position of chief science officer. He succeeds Russell Chew, who joins SU2C’s Board of Directors. Adams is a longtime oncology researcher and pharmaceutical industry senior executive specializing in drug discovery and development in cancer. With this appointment, Adams assumes management responsibility for SU2C’s overall ...
Immersive VR goggles for mice unlock new potential for brain science
Northwestern University researchers have developed new virtual reality (VR) goggles for mice. Besides just being cute, these miniature goggles provide more immersive experiences for mice living in laboratory settings. By more faithfully simulating natural environments, the researchers can more accurately and precisely study the neural circuitry that underlies behavior. Compared to current state-of-the-art systems, which simply surround mice with computer or projection screens, the new goggles provide a leap in advancement. In current systems, mice can still see the lab environment peeking out from behind the screens, and the screens’ ...
Racial and ethnic differences in hospice use among Medicaid-only and dual-eligible decedents
About The Study: In this study, in both Medicaid only and dual-eligible populations, Hispanic and non-Hispanic Black individuals had the lowest odds of receiving hospice, and Hispanic individuals had the highest odds of a short hospice stay. Knowledge about, access to, and acceptance of hospice may be lacking for these low-income individuals. Further research is needed to understand barriers to and facilitators of hospice use for people with nursing facility stays. Authors: Julie ...
County–level variation in preterm birth rates
About The Study: In this analysis of U.S. county-level preterm and early preterm birth rates, substantial geographic disparities were observed, which were associated with place-based social disadvantage. Stability in aggregated rates of preterm birth at the national level masked increases in nearly 1 in 6 counties between 2007 and 2019. Authors: Sadiya S. Khan, M.D.,M.S., of the Northwestern University Feinberg School of Medicine in Chicago, is the corresponding author. To access the embargoed study: Visit our For The Media website at ...
T cells tackle new 'Pirola' SARS-CoV-2 variant
LA JOLLA, CA—In August, researchers detected a new SARS-CoV-2 "variant of concern" in patients in Israel and Denmark. Since then, this variant, dubbed BA.2.86 or "Pirola," has made its way around the globe. The Pirola variant has raised alarms because it is highly mutated. In fact, Pirola is as mutated as the Omicron variant was, compared with the early SARS-CoV-2 variant included in the original vaccinations. As Pirola spreads, researchers at La Jolla Institute for Immunology (LJI) are investigating whether COVID-19 vaccines (or previous ...
MIT engineers design a robotic replica of the heart’s right chamber
MIT engineers have developed a robotic replica of the heart’s right ventricle, which mimics the beating and blood-pumping action of live hearts. The robo-ventricle combines real heart tissue with synthetic, balloon-like artificial muscles that enable scientists to control the ventricle’s contractions while observing how its natural valves and other intricate structures function. The artificial ventricle can be tuned to mimic healthy and diseased states. The team manipulated the model to simulate conditions of right ventricular dysfunction, ...