New Aids challenge: how to fight the lure of the 'blessers'

24 July 2016 - 02:00 By KATHARINE CHILD

The Aids conference in Durban made the headlines because Sir Elton John, Prince Harry, Bill Gates and Charlize Theron were there.

But while the VIPs cruised around Durban , thousands of delegates at the 21st International Aids Conference were engaged in the finer nuances of the fight against the disease.Out of more than 6,600 scientific papers submitted, 2,500 were accepted for presentation in 500 sessions over five days.story_article_left1The pre-conference gathering noted that research for a cure is getting minimal funding and is probably years from success.On the upside, scientists know how to keep HIV-positive people alive.Out of 37million HIV-positive people, 20million were not on treatment, Gates said, adding that another 16million didn't even know their status.He agreed with Michel Sidibé, executive director of the Joint UN Programme on HIV/Aids, that self-testing was the way forward - but it was not happening in South Africa.No Aids event in South Africa is complete without mentioning the "blessers" - younger versions of "sugar daddies".A study by Professor Salim Abdool Karim, head of the Centre for the Aids Programme of Research in South Africa, detailed an analysis of the genetic code of HIV taken from 1,589 HIV-positive people.The study looked at who is responsible for infections and showed women and young teenagers get it most often from men eight years their senior.Chris Beyrer, head of the International Aids Society, said the transmission dynamics between young adolescent women and teens showed that men in their 20s were highly infectious, unaware of their status and not on treatment.To get South Africa's epidemic under control, "you have to be getting men in care", he said.But KwaZulu-Natal MEC for health Sibongiseni Dhlomo admitted nurses chased teenagers who wanted birth control or condoms away from clinics, and referred them to their priests.mini_story_image_vright1Much of the conference dealt with how to protect women.Nine trials of various vaginal gels to prevent HIV infection have failed.Hope has come from a new analysis of a trial of a vaginal ring that secretes an antiretroviral gel. The rings are changed monthly and in some women the new data showed a 75% reduced risk of infection.A vaccine would be the ultimate weapon against HIV and researchers are beginning to be "cautiously optimistic" about a vaccine in the future.The conference heard that the Medicines Control Council would license a vaccine being tested on 5,700 South Africans if it offered 50% protection against HIV. Modelling showed this to be enough to reduce infections even though it wouldn't work 100% of the time, said Medical Research Council president Glenda Gray, head of the trial.The vaccine is a modified version of one tested in Thailand that reduced the risk of infection by 31% over three years.Gray said: "The first prize is to roll it out in a school-based programme ... The most bang for your buck is to target young girls before they sexually debut and create a five-year blanket protection for them as they ... navigate the blessers."A vaccine is the ultimate female empowerment technology. You put it in a girl's arm and you get protection in their vagina."In the meantime, it needs to be easier for teenage girls who are at very high risk of HIV infection to get into clinics.On the treatment front, ARV drug Dolutegravir from international pharmaceutical ViiV got a lot of attention. It is not yet in the South African public sector but talks are ongoing between pharmaceuticals about bringing a generic to the market. It is an ARV with fewer side effects and is less likely to cause drug resistance.Lobby group Section27 interrupted the conference to demand condoms be distributed at schools, making it easier for teens to protect themselves.childk@timesmedia.co.za..

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