Abstract
Teen Boys Not Getting Enough HIV and STD Counseling
Boys who are sexually active are not receiving an adequate level of counseling for HIV infection and STDs. Researchers at Johns Hopkins Children's Center have found that doctors still provide too little counseling despite national guidelines aimed at improving sexual health services for teenagers.
The study analyzed data from the 1995 National Survey of Adolescent Males and the 2002 National Survey of Family Growth. Researchers found that only 26% of teens who reported high-risk sex said that they received HIV/STD counseling at the doctor's office in the year preceding the survey. High-risk sex was defined as having sex with a prostitute or an HIV-infected person or having sex while high or drunk. Twenty-one percent of all sexually active boys, regardless of risk, said they discussed HIV and other STIs with their doctors.
In addition, the study also found no improvement in how well teenage boys were screened for STIs and HIV between 1995 and 2002. Before this, in the early 1990s, the American Medical Association and the American Academy of Pediatrics both issued guidelines urging physicians to make sexual health counseling and related services part of the regular examination for teenagers.
Researchers also found that in 1995, less than one fourth of male teens said they had discussed STIs and HIV with a doctor or a nurse. This compares with less than 22% in 2002. Fewer than 18% of male teens reported ever discussing birth control with their doctors in 2002.
More details on this study can be found in the March 15 articles online first of the Journal of Adolescent Health.
New Data Support Telaprevir as Therapy for HCV
The PI telaprevir, combined with standard hepatitis C treatment, cures a significantly higher number of difficult-to-treat patients than standard treatment alone. Such are the findings from a new study conducted by researchers around the world. More than 50% of patients who did not have HCV eliminated with other treatments were successfully treated with telaprevir. Forty percent of patients who were considered nonresponders had their hepatitis C eliminated with the additional treatment.
The researchers specifically looked at retreatment for patients who were initial nonresponders with genotype one HCV. Telaprevir was given in combination with the standard treatment of peginterferon and ribavirin. In total, 453 patients were enrolled and divided into four treatment groups. Three groups were given varying combinations and durations of telaprevir, along with peginterferon and ribavirin. The control group was given the standard retreatment therapy of peginterferon and ribavirin.
Patients retreated with telaprevir fared better than patients not given telaprevir. Those given both telaprevir and peginterferon and ribavirin showed a cure rate ranging from 24 to 53%. The control group of peginterferon and ribavirin had a cure rate of only 14%.
According to the researchers, telaprevir is effective in combination with the current medications used in the retreatment of hepatitis C. In addition, treatment for 12 weeks appears to be sufficient. Patients who received only telaprevir and peginterferon had a lower response in the study. This suggests that ribavirin remains important in this combination therapy. FDA approval is expected sometime in 2011.
The study was published in the April 8 issue of the New England Journal of Medicine, 2010;362(14):1292–1303.
Community-based Organizations Successful at Teen Risk Reduction
An approach designed to reduce HIV/STDs previously used exclusively by academic researchers has now been successfully implemented by community-based organizations (CBOs). The CBOs were able to implement successfully an evidence-based HIV/STD risk-reduction intervention with adolescents. Although the intervention did not reduce the frequency of sexual intercourse, participants did report a greater proportion of condom-protected intercourse. The new study was conducted by researchers at the University of Pennsylvania.
The study also looked at the impact of extended training and found that CBO facilitators who received more training were no more effective than were those who received a basic intervention packet alone. Results suggest that the training of CBO facilitators does not need to be “extraordinarily extensive or expensive” to achieve desired results.
A total of 86 community-based organizations conducted the interventions with a total of 1,707 adolescent participants divided into a control group and an HIV/STD risk-reduction group. The intervention was designed to give adolescents the knowledge, motivation, and skills necessary to reduce their risk of STDs, including HIV. The teens reported in 3, 6, and 12 months after the intervention. Throughout the study, the HIV/STD-intervention participants were more likely to report consistent condom use than was the control group.
Two Novel Approaches Effective in Killing TB
Researchers at Albert Einstein College of Medicine of Yeshiva University have discovered two ways of killing TB bacteria. Because the novel approaches are different from anti-TB drug mechanisms, they have the potential to be effective at eliminating drug-resistant strains.
The research focused on an enzyme called GlgE. Earlier research has suggested that GlgE may be essential for the growth of TB bacteria. No enzymes similar to it are found in humans or in the bacteria of the human gut. Research has revealed a previously unknown enzymatic pathway by which TB bacteria convert the sugar trehalose into longer sugar molecules, known as alpha glucans. These compounds are essential for maintaining bacterial structure and for making new microbes through cell division. GlgE was the third of four enzymes involved in this pathway leading to alpha-glucan molecules.
When the researchers inhibited GlgE, the bacteria underwent “suicidal self-poisoning.” A sugar called maltose 1-phosphate accumulated to toxic levels that damaged bacterial DNA. This caused the death of TB bacteria grown in the laboratory as well as in infected mice.
A second approach to killing TB was discovered after researchers observed a crucial connection between their novel alpha-glucan pathway and a second pathway that also synthesizes alpha glucans. When one of the other enzymes in the novel pathway was knocked out, the pathway's shutdown did not kill the bacteria. Inactivating an enzyme called Rv3032 in the second alpha-glucan pathway failed to kill the microbes. Inactivating both of those enzymes caused what the researchers term synthetic lethality: two inactivations that separately were nonlethal but together cause bacterial death.
TB bacteria must synthesize alpha glucans to survive and replicate. Knocking out both of these alpha-glucan pathways would be a potent method that could be incorporated into drug therapy against GlgE and Rv3032. TB bacteria need both pathways. Combination therapy would not likely leave behind any bacteria that could develop later into resistant strains. In addition to TB, the two novel approaches could also be used against other mycobacterial diseases, such as leprosy.
The study was published in the March 21 advance online publication of Nature Chemical Biology.
Substance-Abuse Treatment Facilities Not Performing Infectious Disease Screening
Fewer than half of all substance-abuse treatment facilities surveyed nationwide report conducting on-site infectious disease screening. The finding comes from a new study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). According to SAMHSA researchers, infectious disease screenings should be a routine aspect of services delivered at substance-abuse treatment centers.
This study was based on data from the 2007 National Survey of Substance Abuse Treatment Services (N-SSATS), an annual census of all known facilities in the United States, both public and private, that provide substance-abuse treatment. The survey solicits information regarding the provision of on-site screening for the following infectious diseases: hepatitis B, hepatitis C, HIV, STDs, and tuberculosis.
One of the findings from the study was that facilities most likely to provide infectious disease screening were operated by the federal government, followed by a state government. More than half of the approximately 1,100 opioid-treatment programs provided on-site screening for hepatitis B (62.1%), hepatitis C (64.1%), HIV (69.8%), other sexually transmitted diseases (67.8%), or tuberculosis (93.3%).
Facilities that provided hospital inpatient treatment were more likely than were facilities providing outpatient or nonhospital residential treatment to offer screening for hepatitis B, hepatitis C, HIV, other sexually transmitted diseases, or tuberculosis. Where available, the most common types of on-site screening were for tuberculosis, (34.3%) and HIV (29.7%).
The full report is available online at
Websites Offer STD Tests and Education
Two related websites are available for individuals to learn more about STDs and then to be tested for several of the most common infections. Education and awareness is offered at
Both sites provide interactive, personalized STD test recommendations developed by experts. These recommendations include screening guidelines from leading authorizers, including the CDC. An assessment delivers a personalized test recommendation for the most common and prevalent STDs, including Chlamydia, gonorrhea, herpes, syphilis, HIV, and hepatitis B and C. Test recommendations are based on a person's individual risk, lifestyle, and national statistics.
Most Women Do Not Know Their HIV Status
A recent poll of 1,000 women in the United States found that 73% of them do not know their current HIV status. This is just one of the surprising findings from the poll sponsored by the MAC AIDS Fund, the AIDS charity of MAC Cosmetics.
The poll also found that 78% of women said that they have had unprotected sex. More than half admitted to never having an HIV test. Nearly six in 10 of the women believed they were in a monogamous relationship and, therefore, are not motivated to get tested.
As a way to increase the awareness of HIV, the MAC AIDS Fund is benefitting from a relationship with singer Lady Gaga. The singer serves as a spokesperson for the Fund. During her talks, she emphasizes the importance of overall sexual health, including using protection, encouraging partners to go together to get tested, and validating the ability to say no.
More information can be found at