Doctors want Pap tests for gay men…
Posted by pozlife on May 20, 2007
Nationwide, there has not been widespread use by physicians of anal Pap screening, partly because there is debate about its effectiveness. But in the Bay Area, physicians are leading a drive for anal Pap exams in order to cut the rate of anal cancers. Anal cancer rates are low in the general population but are considerably higher among gay men, people with HIV, and other immune-compromised persons.
Anal cancer rates have increased 37 percent in the United States over the last decade. Like cervical cancers, anal cancers are caused by human papillomavirus. Anal Pap smears, say the Bay Area physicians, would help doctors spot the disease before it grew malignant. Outside the Bay Area, though, many doctors wait for a malignancy to develop, and then treat the anal cancer with chemotherapy and radiation.
The waiting time for appointments to remove pre-cancerous anal lesions is four months at the UC-San Francisco Anal Neoplasia clinic specializing in the outpatient procedure, with a recovery period that can take about two weeks.
The UC-SF clinic director plans to publish a paper later this summer, encouraging physicians to utilize Pap exams for gay men to prevent anal cancer. Until more definitive results are available, however, doctors will decide whether they want to perform a visual exam or Pap test.
New drug recommended for approval…
Pfizer’s new HIV drug Maraviroc has been recommended for approval by a 12-member FDA advisory panel of medical experts.
The drug is the first of a new class of drugs that interfere with those HIV strains that enter human immune cells through the CCR5 receptor. FDA granted Maraviroc priority review status, which applies to drugs that are seen as an advance over existing therapies.
Pfizer, which would market Maraviroc as Celsentri, proposes that it be used for people with advanced HIV infection or whose treatment regimens have failed. An estimated 40,000 Americans meet that description. Both FDA and Pfizer cite studies showing that adding Celsentri to a traditional HIV treatment regimen is effective in dropping the virus below detectable levels.
FDA said it remains concerned, however, about potential side effects from the CCR5 inhibitor, including potential liver damage, heart problems, lymphomas, and the types of infection that stopped GlaxoSmithKline’s similar drug last year. Most worrisome is that the drugs could accelerate a shift from one variety of HIV to another, a problem most often seen in long-time infections or failed treatments.
If approved, people would need to be screened to determine whether their particular HIV strain uses the CCR5 pathway. They would then need continual monitoring to determine whether the drug is causing any shifts in their particular strain of HIV.
Backlash to abstinence-only teaching…
Students who took part in sexual abstinence programs were just as likely to have sex as those who did not, according to a study ordered by Congress. Also, those who attended the abstinence classes that were studied report having similar numbers of sexual partners as those who did not attend the classes. And the students first had sex at about the same age — 14.9 years.
The federal government now spends about $176 million annually on abstinence-until-marriage education. Critics have repeatedly said they don’t believe the programs are working, and the study gives them reinforcement. Some lawmakers and advocacy groups believe the government should use that money for “comprehensive sex education,” which would include abstinence as a piece of the larger curriculum.
Members of Congress need to listen to what the evidence tells us,” said the vice president for public policy at the Sexuality Information and Education Council, which promotes comprehensive sex education. “This report should give a clear signal to members of Congress that the program should be changed to support programs that work, or it should end when it expires at the end of June.”
Eight states have so far declined to take part in the grant program, giving up the federal money due to increasingly restrictive federal mandates about how it can be spent. The most recent is Massachusetts, whose Governor Patrick last month turned down a $700,000 federal abstinence grant that it has received since 1998.
“We don’t believe that the science of public health is pointing in the direction of very specific and narrowly defined behavioral approaches like the one that is mandated by this funding,” said the state commissioner of public health.
In addition, last month the American Civil Liberties Union called on the U.S. Department of Health & Human Services to enforce a federal mandate that sex education programs teach “medically accurate information.” The ACLU says an HHS Web site and pamphlet and three federally funded abstinence programs “all violate a federal law requiring certain educational materials to contain medically accurate information about condom effectiveness.”
The ACLU says it “intends to bring legal action” if HHS does not address the violations by the end of May. They say HHS has been notified “numerous times” about inaccuracies, particularly those regarding condoms and HIV/AIDS.
AIDS vanity plates for New York…
A member of New York’s State Assembly has introduced a bill to create an HIV/AIDS awareness auto license plate for the state. The tag would cost $25 per year, plus the initial vanity plate fee of $43. Proceeds from the plate would go to the state Department of Health’s AIDS Institute and would be earmarked to help transport people with HIV/AIDS to their medical appointments. The bill is expected to pass.
A lot of people with AIDS, said the bill’s author, “don’t get the care they need because of transportation issues.”
Canadian nurses demand safer needles…
The Ontario Nurses Association wants the province’s government to pass proposed legislation to require the use of safety-engineered needles in an effort to dramatically reduce their risk of contracting hepatitis C and HIV at work. About 70,000 Canadian health care professionals are injured by needles each year and must wait for tests to determine if they have contracted diseases as a result.
About 33,000 needle injuries are reported annually in Ontario alone. Injuries dropped by 51 percent in the United States within the first year of passing similar legislation – even before full compliance with the new rules was achieved. Once facilities had completely changed over to safer needles, injuries went down 80 percent.
But the nurses’ association fears the government will not follow through on the bill. Ontario’s Labor Minister said the government has spent nearly $11 million on safer needles, but is awaiting a committee report before deciding what to do with the proposed legislation, and believes hospitals’ costs to implement the legislation would be prohibitive.
The Ontario Public Service Employees Union explained, however, that any financial impact would be minimal. The province spends nearly $19 million in testing and treatment for needle accidents within acute-care facilities, while it would cost about the same to buy the safety-engineered needles.
Officials will supplement AIDS cuts…
San Francisco officials have promised that no one with HIV or AIDS will lose subsidized housing due to cuts in federal HIV funds to the city. Municipalities are now required to allocate 75 percent of Ryan White CARE Act funds to medical services; housing falls outside this category.
City officials say they will cover shortfalls in housing support. The city currently spends nearly $4 million in Ryan White funds for housing. This year, the city’s budget proposal for AIDS housing is $3.8 million, and an additional $2 million is being proposed to make up for the Ryan White cuts.
“We are going to make our best effort to make sure there are not these catastrophic cuts to these programs,” said Mayor Gavin Newsom.
Benefit plant sale, May 20…
Mark your calendar for Robert Hamm’s upcoming spring plant sale, with a portion of proceeds going to local AIDS charities and agencies. The next event is scheduled from 10 am to 3 pm, rain or shine, in the covered parking area behind the Gifted Gardener at 18th and J St., in Sacramento on Sunday May 20.