April 28, 2017
This week, a study finds that as people living with HIV continue to age, the prevalence of non-AIDS-defining cancers will go up. Another study predicts that even a moderately effective HIV vaccine could prevent millions of new infections. And finally, people who were incarcerated during adolescence are more likely to engage in riskier sexual behaviors than the general population, according to a study. To beat HIV, you have to follow the science!
The number of non-AIDS-defining cancers among people living with HIV (PLWH) is expected to slightly increase by 2030, according to a study reported at the annual meeting of the American Association for Cancer Research.
Conversely, the frequency of certain AIDS-defining cancers (Kaposi's sarcoma, non-Hodgkin lymphoma and cervical cancer) is expected to decline sharply by then. The most common types of cancers among PLWH will likely shift from Kaposi's sarcoma and non-Hodgkin lymphoma in 2010 to prostate, lung, liver and anal cancer in 2030. That change is probably driven by modern antiretroviral therapy, researcher Jessica Y. Islam, M.P.H., explained in a related press release.
At the same time, the proportion of PLWH who are at least 65 years old is expected to increase from less than a twentieth in 2006 to more than a fifth in 2030. The higher burden of non-AIDS-defining cancers among older people will be reflected among PLWH, accounting for the projection of non-AIDS-defining cancers becoming more common. Study authors therefore called for targeted cancer prevention, detection and control among PLWH.
The rate of diagnoses among people living with HIV in the U.S. is approaching UNAIDS targets for 2030, but only about half of those diagnosed are receiving treatment, a press release about a mathematical model of the HIV pandemic's future noted.
The study evaluated the impact that a moderately effective HIV vaccine could have in 127 countries during the next 20 years, and was published in Proceedings of the National Academy of Sciences. If a 50% effective HIV vaccine were to be rolled out globally in 2020, 6.3 million seroconversions could be averted by 2030, researchers predicted. This number comes on top of the 25 million people that would not live with HIV if the UNAIDS targets were met. Achievement of these goals varies widely across the globe.
"It seems really frustrating that a place like Rwanda can do well [in achieving the UNAIDS targets] and the U.S. can lag so far behind, despite the huge disparity in wealth," commented lead study author Jan Medlock in an associated video. A vaccine would be "a great addition" to currently available tools for HIV prevention and treatment, he added.
People who were in jail or prison during adolescence are more likely to engage in sexual behaviors that put them at risk of acquiring HIV than is the general population, a longitudinal study reported in Pediatrics found.
Study participants were randomly recruited between 1995 and 1998 from detention facilities in Chicago and were periodically interviewed for a period of 14 years after their release. Ten percent of the 1,829 participants reported recent unprotected vaginal sex with a partner at high risk of living with HIV.
Over time, fewer participants had multiple sexual partners during the three months preceding the interview. Even so, almost 10% of women and more than 25% of men reported having multiple partners at the 14-year mark, compared to 14% of women and 18% of men in the general population, a related press release noted. This held true to an even higher degree for people of color, the study noted
"The challenge for pediatric health is to address how disproportionate confinement of racial/ethnic minority youth in the United States leads to health disparities in the HIV/AIDS epidemic," study authors concluded.
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