Condoms West

False Positive's Halt Oral HIV Test in NYC

THURSDAY, June 19 (HealthDay News) -- Due to problems with false-positive results, the use of an oral rapid HIV test was recently halted by the New York City Department of Health and Mental Hygiene, which operates 10 sexually transmitted disease walk-in clinics.

In January 2004, the clinics introduced on-site, rapid HIV testing of finger-stick, whole-blood specimens using the OraQuick test. Then, in March 2005, the clinics replaced the finger-stick test with an oral fluid test, the OraQuick Advance Rapid HIV-1/2 Antibody Test.

However, beginning in late 2005, the clinics noted an unexpected increase in false-positive oral test results. This increase subsided after several months, notes a report released online June 18 in Morbidity and Mortality Weekly Report, published by the U.S. Centers for Disease Control and Prevention.

The use of oral fluid tests was suspended for three weeks in December 2005 and replaced with the finger-stick test while city health officials investigated the increase in false-positive test results. The finger-stick tests didn't produce any false-positive results.

The oral fluid test was re-introduced in late December 2005. However, any positive result from an oral fluid test had to be followed up with a finger-stick test.

In late 2007, there was another larger increase in the incidence of false-positive oral fluid tests. The cause has not been determined and the city health department has stopped the use of the oral fluid test. Only the finger-stick test is being used.

"These findings underscore the importance of confirming all reactive HIV tests, both from oral fluid and whole-blood specimens," the report authors wrote.

"In addition, the results suggest that the NYC DOHMH strategy of following up reactive oral fluid test results with an immediate finger-stick whole-blood test reduced the number of apparent false-positive oral fluid test results and might be a useful strategy in other settings and locations," they added.

Many May Trust Their Partner is a Low STD Risk

 NEW YORK (Reuters Health) - Too many people may consider themselves at low risk of sexually transmitted diseases simply because they trust their partner, a new study suggests.

The study of patients at an STD clinic found that many people relied on subjective measures in judging their partner's "safety" -- such as how long they had known the partner or how intelligent or well-educated he or she was.

The findings suggest that when people feel they "just know" their partner, they may consider their STD risk to be low even in the absence of any STD/HIV testing, the researchers report in the journal Sexually Transmitted Diseases.

For the study, Cindy Masaro and colleagues at the University of British Columbia gave questionnaires to 317 men and women attending an STD clinic. All were visiting the clinic for the first time for an assessment and not yet been diagnosed with any STD.

The questionnaire asked patients whether they would be "pretty sure" that a sex partner was "safe" in various situations -- such as when they knew the person well, knew his or her friends, or simply felt they could trust the person.

The researchers found that people often took such subjective qualities as a sign that their partner would put them at low STD risk. For example, more than 70 percent of patients said they would probably consider a partner "safe" if he or she were generally trustworthy.

However, people's perceptions of their partners do not necessarily match reality.

Past studies, Masaro and her colleagues point out, have found that while many people are "confident in their assessments of their partner's character," their knowledge of the partner's STD risk factors is often off the mark.

"Developing interventions that target assumptions of safety and dispel incorrect beliefs about the selection of safe partners is needed to promote safer sexual behavior," the researchers conclude.

Pharmacists Unhappy About New Morning-After-Pill Availability.

The emergency contraceptive drug known as Plan B will likely be coming out from behind the pharmacy counter, a move the Canadian Association of Pharmacists is not happy about.

The National Association of Pharmacy Regulatory Authorities accepted a recommendation this week to change the way the drug is sold, allowing it to be freely available on drugstore shelves instead of behind the pharmacy counter.

Currently, women who want to buy the drug have to ask pharmacy staff, a condition critics have contended may discourage some women from using it to prevent unwanted pregnancies.

The proposed change would see the contraceptive, sold under the brand name Plan B, stocked on shelves near the dispensary, so purchasers could easily ask for advice on its use if they need it.

The national body advises provincial and territorial pharmacy regulatory authorities, each of which will have final say over the matter in their own jurisdiction.

The Canadian Association of Pharmacists (CPhA) does not support the proposed changes.

“Health Canada’s decision in 2005 to take emergency contraception off prescription status [but keep it behind the counter] was based on the need to have a trained health professional provide advice on the appropriate use of ECP,” said Janet Cooper, CPhA’s Senior Director of Professional Affairs, in a news release Friday.

"What will be lost is the opportunity for a pharmacist to use consultation on emergency contraception as a bridge to a referral to other health care providers, when needed, as well as providing important education regarding contraception and reproductive health.”

She says many women don't actually need to take the pill, which can be used within three days of unprotected sex to prevent pregnancy. And once the pill is easily accessible on pharmacy shelves, they'll be losing out on key information about the product, its correct usage and contraception information that pharmacists currently provide.

She says previous studies have shown that many women have misconceptions about Plan B, which is made up of a synthetic hormone called levonorgestrel that is used in varying doses in other contraceptives, and are confused about birth control generally.

In taking the decision, Canada, where the drug is sold by Montreal-based Paladin Labs Inc. Research, becomes the fifth country to agree to allow Plan B to be sold as an over-the-counter product. Other countries where the drug is sold this way are Norway, the Netherlands, Sweden and India.

"CPhA is also disappointed by the lack of an open and transparent consultation with health professionals on this issue," said Cooper. "We believe that such decisions should be both evidence-based and socially responsible."

It could be some time before the result of the decision is seen on drugstore shelves, even if provinces and territories accept the recommended change. Where some can almost automatically accept a decision of the national body and incorporate it into their own provincial drug schedules, others may have to go through more regulatory steps to make the change.

Russia Must Grab Chance to Beat AIDS Epidemic

MOSCOW (Reuters) - Russia will undo good progress in combating HIV/AIDS and miss the chance to stem the epidemic if it does not offer more help to people who inject themselves with drugs, U.N. AIDS chief Peter Piot said on Saturday.

Piot also warned Russia and Ukraine of a rise in the proportion of women infected with the HIV virus who neither inject drugs nor work as prostitutes -- a segment of the population previously considered less vulnerable.

After Sub-Saharan Africa and South Asia the former Soviet Union has the highest number of people who carry the HIV virus which transmutes into the deadly AIDS infection, although the infection rate in the region has slowed over the last few years.

"They are on the right path, the right trajectory but some difficult decisions have to be made," Piot told Reuters in Moscow during a conference on AIDS in the former Soviet Union.

"The region is at a critical point."

Russia and the Central Asian states lie on the main heroin trafficking route from Afghanistan to Europe and drug users injecting themselves with infected needles account for up to 80 percent of people with the HIV virus.

The former Soviet states have ploughed millions of dollars into combating HIV over the last few years and boosted partnerships between civil society and the government with positive results.

Despite a 150 percent increase in people infected with HIV since 2001 to around 1.6 million, the rate of annual new infections slowed to about 150,000 in 2007 from 210,000 in 2001.

In Sub-Saharan Africa around 22.5 million people are infected with HIV and in South Asia about 4 million people live with the virus.

"Here the big difference is that injecting drug use is so widespread compared to other countries in the world, millions of people are doing it," Piot said.

ECONOMIC COLLAPSE

Drug usage is high partly because of an economic collapse after the 1991 fall of the Soviet Union which cost millions of people their jobs and livelihoods across the region and the relative cheapness of heroin as it is smuggled to Europe.

New figures showed a third of drug users in Uzbekistan are infected with HIV.

But Russia has declined to invest in clinics where heroin users can take the opiate substitute methadone in a clean, controlled environment -- a technique which has reduced HIV infections in Europe and North America.

"If you don't supply clean needles, if you don't supply methadone you can't control the epidemic," Piot said.

A stigma against people infected with HIV remains strong in Russia and both the public and the government are unwilling to invest in methadone and needle exchange clinics for drug users.

Some experts also argue that introducing methadone will increases the number of drug addicts.

And a new characteristic of HIV infection in the ex-Soviet states is the rise in the percentage of women among newly infected people -- doubling to around 40 percent in Russia and Ukraine in 2007 from 2000.

"The question for me is: Is this the beginning of the generalization of HIV, is HIV getting out of the classic high risk groups?" Piot said.

These women typically contract HIV through sex and often only discover they carry the virus when checking for infections during a pregnancy, Piot said.

"Women here have the illusion that they are not at risk, that HIV is just for gays and drug users," he said.

Researchers Tackle HIV from a New Angle

TUESDAY, April 29 (HealthDay News) -- Most drugs aimed at suppressing HIV target proteins lying on the virus itself, but new research suggests that focusing on the human host's immune cells might work even better.

That's because human cells mutate at much slower rates than does HIV, so the virus would have much less chance of mutating around the drug, scientists explained.

The research is still in its early stages, but it "provides a very nice model that you can inhibit a cellular protein and affect HIV replication," explained co-senior author Dr. Pamela Schwartzberg, a senior investigator at the U.S. National Human Genome Research Institute.

Her team published the findings in this week's edition of the Proceedings of the National Academy of Sciences.

Almost all antiretroviral drugs work by targeting a viral protein. But HIV replicates continually, raising the odds for drug-resistant mutations. For this reason, HIV-positive patients must often take two or three different medications, so that if one drug fails, the others will still fend off the virus.

But there's another player in HIV infection: the human immune system T-cell, the virus' preferred host. T-cells carry their own surface proteins, but because humans replicate much less often than HIV, the odds of developing drug-resistant genetic mutations are much lower.

"If you are looking to affect a human protein, it's going to be much less susceptible to the process of developing resistance," explained Rowena Johnston, vice president of research at The Foundation for AIDS Research (amfAR) in New York City.

In their research, Schwartzberg and co-senior author Andrew Henderson, of Boston University, decided to focus on a T-cell protein called interleukin-2-inducible T-cell kinase (ITK). ITK is a "signaling" protein that works in a variety of ways to activate T-cells.

An activated T-cell is the ideal host for HIV, Schwartzberg pointed out, and ITK appears to be crucial to HIV's invasion and spread.

"We found that there were several cellular processes in T-cells that HIV needs to use and that ITK was important to," she said. "In fact, it seems to affect three stages in the HIV life cycle. That was a real surprise to us."

But would inhibiting ITK inhibit HIV? The researchers got help in answering that question from the pharmaceutical industry, which has been developing ITK inhibitor drugs as possible anti-asthma medications.

In laboratory experiments, Schwartzberg and Henderson used these experimental ITK inhibitors -- as well as another technique, called RNA interference -- to reduce ITK activity in HIV-infected T-cells.

"We could see rather dramatic effects on HIV replication in T-cells," Schwartzberg said.

Without active ITK in host T-cells, HIV found it much harder to enter the cell and to transcribe its genetic material into new viral particles, the team found. "The effect was quite strong over the course of a week, which was the length of time that we looked at," Schwartzberg said.

Of course, ITK is important to the proper function of immune T-cells, so questions remain as to whether its suppression might have unwanted side effects, such as a weakening of immune function. But experiments in mice suggest these effects might be minimal.

ITK-suppressed mice did have impaired immune function, but it was mostly confined to a specific type of response -- the defense the body mounts against allergies and asthma, Schwartzberg said. In other respects, ITK-suppressed cells appeared to "function in many circumstances, and they can fight off many infections," she noted.

Still, it's a long way from research in the test tube and in mice to human clinical trials. But the promise of a human cell-based HIV medication that attacks the virus at three different spots in its life cycle is hugely attractive, Johnston said.

"The virus would have to mutate in three different ways at once to overcome this ITK effect," she said. "It's not impossible, the virus can do it, but it would take a very long time."

Dampening down T-cell activity might not be such a bad idea, either, Johnston added, since HIV thrives on fully activated T-cells.

Schwartzberg said her team will continue to investigate the biological mechanisms underpinning the ITK-HIV relationship. In the meantime, she is optimistic that the drug industry will take up the gauntlet, in terms of clinical research.

"We hope that one of these companies that have developed ITK inhibitors will try and pursue this -- that would be wonderful," Schwartzberg said.

 

Health Canada warns against use of product touted to treat erectile dysfunction

Canadian Press: THE CANADIAN PRESS

OTTAWA - Health Canada is warning consumers not to use an unauthorized product promoted for the treatment of erectile dysfunction.

In a release issued Friday, officials said the product, Vigoureux, may pose serious health risks, as it was found to contain the prescription drug sildenafil which is not indicated on the product label and should only be used under the supervision of a health-care professional.

Patients with pre-existing medical conditions, including those with heart problems, taking heart medications or at risk for strokes, may be at an increased risk of serious health effects associated with the use of Vigoureux.

Use of sildenafil by patients with heart disease can result in serious cardiovascular side-effects such as sudden cardiac death, heart attack, stroke, low blood pressure, chest pain and abnormal heartbeat.

Additionally, the drug may be associated with other side-effects including vision loss, seizure, sudden loss of hearing, dizziness, prolonged erection, headache, flushing, nasal congestion, indigestion and abdominal pain.

Sildenafil should not be used by individuals taking any type of nitrate drug - such as nitroglycerin - due to the risk of developing potentially life-threatening low blood pressure. Vigoureux is labelled as being distributed by International in Montreal and labelled in French only, but officials said the product may be available at retail outlets across Canada.

Retailers are advised to remove Vigoureux from their shelves, and customers should return the product to the place of purchase. Those who have used it and are concerned for their health should consult with a health-care professional.

Health Canada advises consumers not to use any unauthorized products promoted for the treatment of erectile dysfunction that are advertised as all-natural, as they may contain undeclared pharmaceutical ingredients that may pose serious risks to health.

Consumers requiring more information can contact Health Canada's public inquiries line at 613-957-2991, or toll-free at 1-866-225-0709.

Expert Clinical Guidelines for HIV Treatment Needed

NEW YORK (Reuters Health) - A review of antiretroviral treatment (ART) regimens initiated in HIV-infected women revealed that nearly half of the regimens were either not specifically recommended for initial ART or were in fact against US HIV treatment guidelines.

University of California at San Francisco investigators, led by Dr. Jennifer Cocohoba, evaluated initial ART regimens given to 217 ART treatment-na -ve women in the Women's Interagency HIV Study.

Their findings were unexpected, Cocohoba and colleagues note in the Journal of Acquired Immune Deficiency Syndromes.

Only 53 percent of the women reported use of ART consistent with the US HIV treatment guidelines, they report.

Treatment that was counter to the guidelines was prescribed for 17 percent and another 30 percent of the women were on a treatment regimen that was not listed in the guidelines.

"As the epidemic affects increasingly diverse and geographically dispersed patient groups and therapeutic choices continue to increase, the generation of HIV expert practice guidelines and promotion of their use are important means of ensuring quality of care and minimizing acquired drug resistance," Cocohoba and colleagues conclude.

SOURCE: Journal of Acquired Immune Deficiency Syndromes, March 1, 2008.

Sexual Abstinance Programs Don't Work

WASHINGTON (Reuters) - Programs teaching U.S. schoolchildren to abstain from sex have not cut teen pregnancies or sexually transmitted diseases or delayed the age at which sex begins, health groups told Congress on Wednesday.

The Bush administration, however, voiced continuing support for such programs during a hearing before a House of Representatives panel even as many Democrats called for cutting off federal money for so-called abstinence-only instruction.

"Vast sums of federal monies continue to be directed toward these programs. And, in fact, there is evidence to suggest that some of these programs are even harmful and have negative consequences by not providing adequate information for those teens who do become sexually active," Dr. Margaret Blythe of the American Academy of Pediatrics told the committee.

These programs, backed by many social conservatives who oppose the teaching of contraception methods to teenagers in schools, have received about $1.3 billion in federal funds since the late 1990s. Currently, 17 of the 50 U.S. states refuse to accept federal funds for such programs.

Experts from the American Public Health Association and U.S. Institute of Medicine testified that scientific studies have not found that abstinence-only teaching works to cut pregnancies, sexually transmitted diseases or the age when sexual activity begins.

The American Psychological Association and American College of Obstetricians and Gynecologists also issued statements to the House Committee on Oversight and Government Reform criticizing the abstinence-only programs.

Comprehensive sex education programs should emphasize abstinence as the best way for a teenager to avoid pregnancy or a sexually transmitted disease (STD), Blythe said.

"Those adolescents who choose to abstain from sexual intercourse should obviously be encouraged and supported in their decisions by their families, peers and communities. But abstinence should not be the only strategy that is discussed," Blythe said.

HIGH STD RATES

Lawmakers cited government statistics showing that one in four U.S. teenage girls has a sexually transmitted disease and 30 percent of U.S. girls become pregnant before the age of 20.

Republicans said even if some abstinence-only programs do not work, others do, and it would be wrong to end the funding.

Rep. John Duncan, a Tennessee Republican, said that it seems "rather elitist" that people with academic degrees in health think they know better than parents what type of sex education is appropriate. "I don't think it's something we should abandon," he said of abstinence-only funding.

Sperm Under Siege

Though a man makes 100 million sperm every day, a variety of chemicals and workplace conditions put reproduction at risk

We hear occasional reports of declining sperm counts in certain parts of the world, warnings that fish downstream of major pollution sites have reproductive abnormalities and, most recently, that the chemical bisphenol A may be linked to fertility problems in animal studies.

So if a guy has in mind that he wants to start a family some day, should he be concerned? Or, as the saying goes, might he be wondering if his "boys can swim?"

While many things are beyond any individual man's control, experts do have some advice about what to avoid and what may be helpful as men attempt to put to use what is an astonishing natural resource.

"Men produce about 100 million sperm a day, every day, basically 1,000 sperm for every heartbeat. From puberty until death," says Bernard Robaire, a professor in the departments of pharmacology and therapeutics, and obstetrics and gynecology, at McGill University in Montreal.

Cigarette smoking, Saturday Night Fever fashions, saunas and hot baths are all hard on sperm production, urology expert Dr. Keith Jarvi says. (Frank Gunn/The Canadian Press)

Dr. Robaire has been interested in the effects of chemicals - mainly anti-cancer drugs - on male reproduction for 30 years.

"If you look at any drug that affects cell division, so all of the anti-cancer drugs, for example, all of those will affect spermatogenesis, the making of new sperm, and will affect both the quantity and the quality of the sperm you make."

Certain environmental exposures - including heavy metals, organic solvents and some pesticides such as DDT - have been a focus of attention as well.

"We know that auto mechanics, painters, have a higher incidence of abnormal progeny, have a higher rate of infertility, have a longer time to pregnancy," Dr. Robaire says.

"We haven't necessarily narrowed down what is the one chemical - there probably isn't one chemical. It probably is a mix of solvents and greases and whatever else they're exposed to that's affecting them."

But by far, it's exposure to the toxins in cigarette smoke that fertility experts are unequivocal about - men who are trying to get someone pregnant should avoid smoking.

"Cigarette smoking does have an effect on the quality of sperm, motility of sperm and the DNA of the sperm," says Keith Jarvi, director of the Murray Koffler Urologic Wellness Centre at Mount Sinai Hospital in Toronto.

"So you can damage the DNA by smoking. If you stop smoking, it seems to improve."

Whether a man's mother smoked could be a factor as well.

Dr. Robaire and Dr. Jarvi both note that studies found lower sperm counts in men in Denmark over a 40-year period starting in the 1940s, while the numbers remained stable in nearby Finland.

The researchers saw that men who had lower sperm counts in Denmark had mothers who were smokers, but in the past 20 years the sperm counts there have been rising again, Dr. Robaire says.

And for men who toke rather than smoke, Dr. Jarvi warns that marijuana is also bad for sperm quality.

Alcohol can be a problem as well.

"If you are having trouble conceiving, then alcohol consumption is also something that you'd want to watch," says Warren Foster, director of the reproductive biology division and a professor in the department of obstetrics and gynecology at McMaster University in Hamilton.

There's some evidence that a glass of red wine may act as an antioxidant, which in theory might improve sperm quality, Dr. Jarvi notes. "However, if you use more alcohol or excessive alcohol or enough to damage the liver, then you're going to cause an effect on sperm production."

Dr. Robaire says a lot of alcohol can inhibit the making of testosterone, produced along with sperm in the testes.

"The sperm have grown to depend on having very high levels of testosterone in order to be made," he explains. "If you decrease testosterone production in the [sperm] factory ... then the consequence is that you will be making less sperm. So most alcoholics have low sperm production."

Many people have heard the warnings about tight underwear and pants, but it's still something Dr. Jarvi discusses with patients.

"The Saturday Night Fever look is definitely not good for the sperm count," he says with a laugh, recounting some of the "slightly bizarre" research to back that up.

"There's one study that came out where they put fairly snug underwear on men and all the men became azospermic, which means they have no sperm at ejaculation, after a couple months."

It's a heat issue, Dr. Jarvi says, adding that saunas or hot baths aren't a good idea either.

"We have a few people who are in flight suits, and they had quite a bit of heat in the groin region, and so we think that's related to [difficulty conceiving]. Workplace exposures - people on the line, chefs who are on the line, they have heat exposure because their testicles are around the same height as the preparation area."

But sperm often improves once the men spend time away from the heat, he says.

There was a theoretical study looking at the temperature of laptop computers - again, a possible heat issue - but Dr. Jarvi says he doesn't know if they could be implicated in infertility.

And Dr. Robaire is fairly dismissive of preliminary research in the journal Fertility and Sterility from the Cleveland Clinic that found an association between duration of patients' cellphone use and their sperm quality.

"It was not impressive," he says of the data, adding more research is needed.

Still, Dr. Jarvi says he would position his cellphone, which he wears on his belt, away from his testicles. "I actually, about two years ago, changed to wearing it on my hip, so it was about 20 centimetres, 25 centimetres away."

In terms of food intake, Dr. Jarvi points to a "really good study" recently that found men who had more folic acid in their diets had a reduced chance of sperm DNA abnormalities. Folic acid is found in leafy green vegetables, citrus fruit and enriched breads and pasta.

"Right now, we have enough evidence for the infertile men to say that folic acid might be beneficial and [it's] very unlikely to hurt you by taking a supplement."

Diane Allen, executive director of the Infertility Network based in Toronto, says a diagnosis of infertility is really difficult for men because they typically don't have the support networks or talk about their feelings as women do.

"A lot more needs to be done about male infertility," she says. "Certainly people who are struggling with infertility need to get treatment. But also, at the same time, we need to get our focus on looking at prevention."

Dr. Foster says those worried about chemicals in the environment may want to reduce fat intake because any of these compounds primarily would be stored in the fat component of meat and fast foods. "Anything deep fried you want to avoid."

Aim for a well-balanced diet, he says.

As for bisphenol A, which can leach from polycarbonate bottles, especially when heated, Dr. Robaire says, some animal studies suggest it can mimic estrogen and act on hormone receptors. "It can cause growth of the prostate and it can cause a decrease in spermatogenesis."

There are differing findings on whether enough is absorbed from the plastic to have an effect, he says.

"The same men who are going to be worrying about the polycarbonate are going to be riding a bicycle, and are going to have more damage on the testes from the saddle of the bicycle than anything they could take from the bottle they would be using. ...

"Or they're going to be wearing tight underwear. So it's a question of understanding what the level of risk is. And the risk is very low because the doses are very low."

Vatican Cardinal who Led Campaign Against Condoms Dies at 72

VATICAN CITY - Cardinal Alfonso Lopez Trujillo, a Colombian prelate who helped lead the Vatican's campaign against abortion and insisted condoms do not prevent HIV transmission, has died, one of his assistants said Sunday. He was 72.

Lopez Trujillo died Saturday night at the Pius XI private clinic in Rome, where he had been admitted for tests on March 17, Monsignor Jorge Raigosa said.

He died after suffering cardiac arrest following medical complications over several weeks that had put the cardinal in intensive care at times, said Raigosa, who declined to elaborate.

Vatican Radio said the cardinal had been hospitalized for "grave health problems."

In March 2007, Lopez Trujillo traveled to Mexico to launch the Roman Catholic Church's aggressive campaign against plans in the predominantly Catholic country to legalize abortion. Catholic teaching forbids abortion as a grave sin.

The cardinal inaugurated an international anti-abortion conference in Mexico City by celebrating Mass in the Basilica of the Virgin of Guadalupe, the most important Catholic shrine in the Americas.

The next month, the Mexico City assembly passed a measure legalizing abortion in the capital during the first 12 weeks of pregnancy. Opponents appealed the law, and Mexico's Supreme Court is reviewing it.

Lopez Trujillo also made headlines in 2003 for saying that condoms do not prevent HIV transmission. He contended that condoms may even help spread the virus by creating a false sense of security.

The World Health Organization, among others, called the cardinal's message "totally wrong" and said condoms are 90 percent effective when used correctly.

Priests for Life, an organization that seeks to end abortion and euthanasia, hailed Lopez Trujillo as "one of the Church's strongest advocates for the dignity of the human person and the family."

Born in 1935 in Villahermosa, Colombia, Lopez Trujillo moved with his family when he was a young boy to the capital, Bogota. While a university student, he decided to attend a seminary, and later received a philosophy degree from Rome's prestigious Angelicum university.

Lopez Trujillo was ordained a priest in 1960 and made a bishop in 1971 by Pope Paul VI. He later headed the Latin American bishops' conference, CELAM.

He was archbishop of Medellin in 1979 when Pope John Paul II attended a CELAM conference, and in 1983 was elevated to cardinal's rank by the pontiff.

He headed the Vatican's Pontifical Council for the Family since 1990.

With Lopez Trujillo's death, the number of cardinals eligible to elect a pontiff drops to 118, Vatican Radio said.

Raigosa said Pope Benedict XVI was expected to celebrate a funeral Mass for the cardinal at the Vatican on Wednesday.

FDA says Pfizer's Online Viagra Ad did not Warn for Risks

WASHINGTON - Federal regulators have warned Pfizer Inc. for not mentioning the risks of Viagra in an advertisement featuring country musicians singing the praises of its popular impotency pill.

The Food and Drug Administration called on Pfizer to discontinue the online video advertisement in a warning letter issued last week and posted online Monday.

The 30-second video, which appeared on CNN.com, showed a group of Nashville musicians singing the refrain "Viva Viagra" in a song about the benefits of the drug.

Pfizer said in a statement that a technical issue with CNN's Web site prevented the risk information from displaying on a banner accompanying the video and that it has since pulled the ad.

"Pfizer discovered the error, notified the Web site of the error, and our understanding was that the Web site corrected its error immediately," the New York-based company said in a statement.

Drug makers are required to mention a drug's negative side effects in any advertisement that highlights benefits. Viagra's label warns of potential risks to patients with existing heart conditions as well as reported headaches and abnormal vision.

In its warning letter, the FDA said the ad "raises public health and safety concerns through its complete omission of risk information for Viagra."

Shares of Pfizer Inc. fell 33 cents Tuesday to $20.14 in afternoon trading.

Effective One-Day Treatment for Genital Herpes

NEW YORK (Reuters Health) - Recurrent outbreaks of herpes simplex virus 2 (HSV2), or "genital herpes," can be effectively treated with a one-day course of valacyclovir (sold under the trade name Valtrex), according to results of a pilot study published in the journal Sexually Transmitted Diseases.

Dr. Stephen K. Tyring of the University of Texas Health Science Center in Houston and colleagues enrolled 115 patients with recurrent HSV2 infection. The patients were given a one-day supply of valacyclovir - 2,000 milligrams, twice daily, for a total of 4,000 milligrams a day), to be taken at the first signs of a recurrence. Patients kept diaries of their symptom duration and collected genital swabs for viral cultures to be performed 14 days following initiation of treatment.

Tyring's team reports that 90 patients (78 percent) had a recurrence or the signs of initial symptoms, and 4 patients (5 percent) developed a second recurrence during the 14 days after valacyclovir treatment. The average duration of genital sores and pain was 5 day and 3 days, respectively.

Viral shedding was detected in 60 patients and lasted an average of 2 to 3 days. Viral shedding is when virus is detectable in the genital area -- a time when the infection is easily transmitted. Of the 60 subjects with viral shedding, 14 (23 percent) had an additional shedding episode after the initial sore healed, and this second recurrence lasted about 2 days.

"The one-day course appears to be as effective as the three- to five-day course," Tyring commented in an interview with Reuters Health. "The question of viral shedding between these different schedules, however, is yet to be studied."

He and his colleagues conclude that the one-day valacyclovir regimen "may be a convenient treatment for recurrent genital herpes and comparative trials are warranted."

Comments from Condoms West:

Despite the effective treatments for genital herpes, the most effective treatment is still prevention. Please consider condom use every time you have sex.

Egypt Sentences Five Men Because of Homosexuality

Egyptian police have denied making any arrests CAIRO, Egypt - An Egyptian court convicted five men Wednesday on charges of homosexual behavior and sentenced them to three years in prison, officials said.

Defense lawyer, Adel Ramadan, said the judge found the men guilty of the "habitual practice of debauchery" — a term used in the Egyptian legal system to denote consensual homosexual acts.

The convictions were confirmed by a judicial official, who spoke on condition of anonymity because he was not authorized to talk to journalists.

Homosexuality is not explicitly referred to in Egypt's legal code, but a wide range of laws covering obscenity, prostitution and debauchery are applied to homosexuals in this conservative country.

The five men were arrested in what human rights groups describe as a crackdown on people with the AIDS virus, using the debauchery charges as a means to prosecute them.

Four of the five men tested HIV-positive after all were forced to undergo blood tests in custody, Human Rights Watch says. The New York-based rights group issued a statement Tuesday signed by more than 100 other organizations around the world condemning the prosecutions.

Ramadan, a lawyer with the Egyptian Initiative for Personal Rights, said the five men were abused and tortured over the past several months to "extract confessions" from them.

In addition to their prison time, the men were sentenced to an additional three years of police supervision, meaning they will have to spend every night at a police station, from 6 p.m. to 6 a.m., the lawyer said.

Ramadan said the four HIV-positive defendants were shocked by their convictions.
"Two of them cried, screamed and shrieked," he said. "The other two, they remained silent, but I saw anger in their eyes for the injustice they have been exposed to."

Ramadan said he appealed the verdict to Egypt's Court of Cassation, the country's highest appellate court.

Dozens of human rights groups have criticized this trial and other similar ones as being driven by ignorance and fear of AIDS. They have warned that the convictions could undermine AIDS prevention in Egypt.

The five convicted Wednesday were among 12 people arrested in a sweep that began in October, when police arrested a man during an altercation with another man on a Cairo street, Human Rights Watch said.

After one of the men said he was HIV-positive, authorities opened investigations into other men whose names or contact information were uncovered in interrogations of the first group of men, Human Rights Watch said.

In mid-January, four other HIV-positive men from the group of 12 were sentenced to one-year prison terms on similar charges of debauchery. Three others from the 12 were not prosecuted, Human Rights Watch said.

Pull Your Horns in Boys - Stolen Rhino Horn Preparation Could be Deadly

CAPE TOWN (Reuters) - Two 19th century rhino horns stolen from a South African museum could be deadly if sold as a popular aphrodisiac because they are drenched in poison, a museum official said on Monday.

The "priceless" horns were snatched from a display at the historic mammal gallery in Cape Town on Saturday evening, said Jatti Bredekamp, chief executive of Iziko Museums.

"Unknowingly, the thieves have exposed themselves to more than the danger of arrest and prosecution," Bredekamp said in a statement.

"Before the mid-twentieth century, taxidermy mounts were prepared by being soaked in arsenic and preserved from insect infestation through regular applications of DDT, both highly toxic poisons that retain their toxicity over time," he said.

Bredekamp said the horns were deliberately targeted in a carefully planned robbery, and might be destined for Asia, where ground rhino horns are a prized aphrodisiac.

"This could have unforeseen consequences," he said.

Rhino populations have fallen dramatically over the last few decades as poaching decimated the animals across Africa.

Bredekamp said museums worldwide were being targeted by organized crime to help supply lucrative markets with a wide range of artifacts. After a previous robbery attempt, South African museum officials removed several other specimens of rhino horn from public display, he said.

A new study links alcohol consumption with an increased risk of the most common form of breast cancer in postmenopausal women.

The study analyzed health data from more than 180,000 postmenopausal women. After an average follow-up of seven years, physicians diagnosed 5,461 cases of invasive breast cancer. The research showed that women who had one to two small drinks per day had a 32 per cent greater chance of developing an estrogen-sensitive tumour. Three or more drinks per day boosted the risk by 51 per cent.

About 70 per cent of women who are diagnosed with breast cancer have what are known as estrogen-positive tumours. The growth of these tumours is believed to be fuelled by the presence of both estrogen and progesterone.

For the study's purposes, one glass of alcohol was considered to be three ounces, which means that one drink in some bars and restaurants could actually equal two according to the study's criteria.

The research was conducted by the National Cancer Institute (NCI) and presented Sunday at a meeting of the American Association for Cancer Research (AACR). Jasmine Lew, of the NCI, said that researchers aren't yet sure how alcohol influences a woman's risk for breast cancer, but it may be that it acts on estrogen levels.

"What we think the alcohol is doing is increasing the amount of estrogen that a woman is exposed to, hence increasing her risk of getting this more common type of breast cancer," said Lew.
Dr. Michael Leitzman, also of the NCI, said that the risk was deemed the same no matter what type of alcohol a woman drank: wine, beer or spirits.

"That points to alcohol itself being the culprit that is associated with increased risk," said Leitzman.
Leitzman added that it's too early to make public health recommendations, but women should take note of the findings.

"One important message to take away from this is that our study found regular alcohol consumption was associated with an increased risk of breast cancer; that included even small amounts of alcohol," Leitzman said.

In England, authorities are planning an advertising campaign to advise women not to drink more than 14 units (or glasses) of alcohol per week.

"If you choose to drink at all, limit your intake to less than one drink a day or don't drink at all," said the Canadian Cancer Society's Heather Logan. Lew also cautioned that while this research supports earlier studies that link alcohol to breast cancer, more research needs to be done on how alcohol might affect the different types of breast cancer.

 

Young Girls in Saskatchewan Vaccinated Against HPV

Young girls in Saskatchewan will soon be vaccinated against a virus that can cause cancer. The provincial government is spending close to $3 million on a provincewide human papillomavirus (HPV) vaccination program that will see, beginning this fall, all girls in Grade 6 and 7 in Saskatchewan schools receive the vaccine.

Certain types of the virus are sexually transmitted and can cause genital warts and cervical cancer. The vaccine is considered most effective before girls become sexually active.

"The problem with waiting until later for this particular vaccine is that it's not nearly as effective once girls or women become sexually active," said Dr. Ross Findlater, Saskatchewan's chief medical health officer.

Regina's Planned Parenthood applauds the move but its executive director, Barb McWatters, said she had hoped the program would include more people. She worries that at $400 a treatment, the cost of the vaccine may be prohibitive for people who don't get it for free.

The Saskatchewan Cancer Society is also concerned the price will deter people.
However, Findlater said, the province simply can't afford to include any more people in the publicly funded program.

"Unfortunately the older children will have to depend on their families trying to pay for it," he said. "The girls we are not immunizing right away will, of course, get older each year and some of them will have been infected already."

Women up to the age of 26 can still buy the vaccine through their doctors, he said. The vaccine protects against strains of HPV that cause 70 per cent of cervical cancer cases.
About 45 new cases are reported in Saskatchewan each year.

Sex therapists: A few minutes is best

NEW YORK - Maybe men had it right all along: It doesn't take long to satisfy a woman in bed. A survey of sex therapists concluded the optimal amount of time for sexual intercourse was 3 to 13 minutes. The findings, to be published in the May issue of the Journal of Sexual Medicine, strike at the notion that endurance is the key to a great sex life.

If that sounds like good news to you, don't cheer too loudly. The time does not count foreplay, and the therapists did rate sexual intercourse that lasts from 1 to 2 minutes as "too short."

Researcher Eric Corty said he hoped to ease the minds of those who believe that "more of something good is better, and if you really want to satisfy your partner, you should last forever."

The questions were not gender-specific, said Corty (who, it must be noted, is male). But he said prior research has shown that both men and women want foreplay and sexual intercourse to last longer.

Dr. Irwin Goldstein, editor of the Journal of Sexual Medicine, cited a four-week study of 1,500 couples in 2005 that found the median time for sexual intercourse was 7.3 minutes. (Women were armed with stopwatches.)

It's difficult for both older men and young men to make sexual intercourse last much longer, said Marianne Brandon, a clinical psychologist and director of Wellminds Wellbodies in Annapolis, Md.

"There are so many myths in our culture of what other people are doing sexually," Brandon said. "Most people's sex lives are not as exciting as other people think they are."

Fifty members of the Society for Sex Therapy and Research in the U.S. and Canada were surveyed by Corty, an associate professor of psychology at Penn State Erie, The Behrend College, and student Jenay Guardiani. Thirty-four members, or 68 percent, responded, although some said the optimal time depended on the couple.

Corty said he hoped to give an idea of what therapists find to be normal and satisfactory among the couples they see.

"People who read this will say, 'I last five minutes or my partner lasts 8 minutes,' and say, 'That's OK,'" he said. "They will relax a little bit."

Circumcision - the Snip That Could Save His Life

Circumcision has become a booming business in Africa as more men learn of its protective effect in the fight against HIV and AIDS

March 27, 2008

MBABANE, SWAZILAND — Zandi Dlamini ran a practised eye over the anxious young men in the waiting area before summoning the first one into her small counselling room. Shongwe Bonginkosi, 34, told her he was interested in having a cleaner penis, more hygienic generally. Ms. Dlamini nodded. She'd heard it hundreds of times before.

"Nobody ever says 'HIV,' " she said later." They talk about hygiene, and better sexual performance. Never HIV." Even here, where nearly one in two men has the virus that causes AIDS, no one wants to admit to being afraid of it.

With Mr. Bonginkosi before her, Ms. Dlamini quickly explained how, in a few minutes, a doctor would make an incision at the top and middle of his penis, cut all the way around it, and slide off the "sleeve" of his foreskin. He would have local anesthetic, she said. He would have to come back a week later to have his stitches checked. He would have to abstain from sex for six weeks. The young man, a government clerk who had taken the day off, nodded, shifting in his seat, clasping and unclasping his fingers. She took him through a door to the back of the clinic, handed him a maroon surgical gown, told him to take off his pants and underwear and wait.

With the operation minutes away, Mr. Bonginkosi admitted HIV was also one of his motivations. "You can still get it if you are faithful," he said. He doesn't know about his girlfriend's previous sex life. He can't know, really, whether she is having sex only with him. He had heard that circumcision could help to protect him, and that's what brought him to the tiny clinic of the Family Life Association of Swaziland.

Once primarily a family-planning organization, the agency these days does a booming business in circumcision and has a waiting list of hundreds for its lone doctor, who does about 10 of the operations a day.

Swaziland, which has the highest rate of HIV infection in the world, 42 per cent of young adults, is eager to see as many men circumcised as possible. The government would like to offer the procedure to an estimated 200,000 sexually active men over the next five years. The problem here is a shortage of doctors, fewer than 100 for a country of one million.

The Family Life Association has been offering "Circumcision Saturdays," assembly-line procedures in various clinics around the country, but one day last fall the crowd of would-be patients was so large at a rural clinic that it turned into a small riot.

In the past few months, a piece of information long muted in the medical world has suddenly seeped into public consciousness in this tiny southern African country, and many of the other nations worst hit by AIDS: Circumcision helps to protect men from contracting HIV from infected female sexual partners. It's cheap, about $82 an operation at this clinic, although the U.S. AIDS program is helping the Swazi government to offer it free. It's relatively easy. (A wincing Mr. Bonginkosi, when his anesthetic had worn off, was quick to point out that it is, however, initially very painful.)

It isn't just Swaziland: In most countries in east and southern Africa, private urologists are reporting an upsurge in demand from educated men who have heard about the research and can afford to have it done privately. And several countries are moving ahead with national plans to increase rates of circumcision.

In the perennially bleak work of the fight against AIDS, the hope offered by male circumcision is a rare piece of good news. Research has shown that a circumcised man is 65 per cent less likely to contract HIV from a woman who has the virus than is a man whose penis still has a foreskin.

Circumcision appears to offer protection from heterosexual transmission of HIV in a number of different ways.

First, the fragile inside of the foreskin is rich in a kind of white blood cell, called the Langerhans cell, which are favoured targets of HIV, which hooks itself on to them to gain entry to a new body. Remove the foreskin, and remove a key entry point.

Also, a circumcised penis develops a toughened layer of skin that is much harder for the virus to penetrate. And finally, circumcised men are less likely to contract herpes, syphilis, genital ulcers and other infections, all of which increase the likelihood of contracting the virus.

Research has not shown that a woman having sex with an HIV-infected circumcised male would be less likely to get the virus than one whose HIV-positive partner was not circumcised, but women do benefit from a larger "herd immunity" effect, in that if more men are circumcised, women are less likely to encounter an HIV-positive partner.

IDS researchers often note that although hundreds of millions of dollars have been spent on research into vaccines and microbicides trying to figure out how to stop the virus, the condom remains the only successful piece of technology for blocking its spread. Meanwhile, behaviour-change campaigns pushing abstinence, fidelity or condom use have limited impact. In Africa, home to 70 per cent of the world's HIV-AIDS cases, where nearly half of men are not circumcised, the procedure could prevent millions of infections.

Kenya has decided to offer circumcision to men of all ages, and public health officials are working on how to do that safely, cost-effectively and with cultural sensitivity.
"It certainly is an appropriate strategy from a scientific and public-health perspective, but must be reconciled with the deep culturally embedded issues that define the procedure as a rite of passage, for circumcising communities, and more so as a mark of identity for the non-circumcising communities," said Peter Cherutich, who heads the team making the plan.

In January, Rwanda kicked off a campaign to get more men circumcised, targeting soldiers, police officers and university students first. While the government said the campaign would be voluntarily, Rwandan media said soldiers were seeing it more as an order. Very few men in the predominantly Christian country are circumcised. The Ministry of HIV-AIDS is also working to make the procedure more commonplace for newborns.

Back in July of 2005, French and South African scientists working together on a study outside Johannesburg called it off early when midpoint results revealed that men who were being circumcised through the research were contracting HIV 65 per cent less often than the young men in the control group who were not circumcised. Ethically, they were obliged to offer the control group circumcisions as well

But two more large trials were under way, both funded by the United States National Institutes of Health, and when their results were announced in December of 2006, they were nearly identical. Adjusted for factors such as the fact that some of the non-circumcised men did not have sex during the course of the study, the protective effect looked to be as high as 70 per cent.

he trial results show a protective effective over the course of 18 months. Over a lifetime, depending on their behaviour, circumcised men could end up with rates of HIV infection as high as non-circumcised men. But the herd immunity effect would serve to slow the spread of the virus in the population as a whole.

In March of 2007, the World Health Organization and UNAIDS endorsed the procedure as a good way of preventing HIV infection, and the major donors began talking to African governments about how to make the procedure widely and safely available.

Yet many advocates of the procedure are angry that it has taken this long for circumcision to begin to be adopted. It was the early 1980s when the U.S. anthropologist Priscilla Reining noticed the correlation between circumcision and low HIV infection rates among people she was working with in Tanzania; she started discussing it back then. Many others working in HIV, both Africans and outsiders, also noticed the link through the 1980s and early 1990s.

In Kenya the general HIV prevalence is about 6 per cent of the population, but among the Luo, the only tribe that does not routinely circumcise, 20 per cent are infected. Across the continent, the lowest rates of infection are in West Africa, where circumcision is widely practised, and highest in the regions of southern Africa where it is not. By the end of the 1990s, 30 different pieces of research suggested a correlation.

Yet it was after 2000 that scientists started the randomized, controlled trials that are considered the necessary level of proof before the practice becomes public-health policy.
Why the delay? In part, no doubt, because the procedure is not, in the words of researcher Robert Bailey of the University of Illinois, "just a shot in the arm," but rather surgery to chop something off, of a body part about which most people are emotional.

Daniel Halperin, a Harvard University public health researcher, a former HIV prevention adviser to the United States development agency and a leading proponent of scaling up circumcision, sees other factors at work. "The tendency is to look for biomedical, technological solutions, and while circumcision is biomedical, in Africa it's always been a traditional, 'savage' practice so it has not been on the radar," he said.

Cultural factors, and ignorance thereof, have played a role, Dr. Halperin said. The AIDS "elite" in the developed world assumed, inaccurately, that the practice would be culturally rejected in non-circumcising areas. "They don't realize that circumcision is part of the African landscape and has been so for many hundreds of years."

The challenge, Dr. Halperin said, is to find the medical personnel and equipment safely to do hundreds of thousands, possibly millions, of the operations in the next couple of years. "But then it's done. It's like a mass vaccination campaign. ...We're not still looking for it, we have it and we know it works."

A Blood Marker that Denotes the Progression of the AIDS Virus

FRIDAY, March 28 (HealthDay News) -- Researchers at Temple University think they may have found a blood marker that denotes the progression of the virus that causes AIDS. The researchers found an increase in the CD163+/CD16+ monocyte subset may coincide with the advancement of human immunodeficiency virus (HIV), according to a study published in the March issue of AIDS Research and Human Retroviruses.

"It looks like, based on these correlations, that this particular cell type may be involved in immune impairment and the progression of HIV," Jay Rappaport, a professor of neuroscience and neurovirology who oversaw the study, said in a prepared statement. "Is it a good prognostic indicator? If you have a lot of these monocytes, does it mean you are going to progress into AIDS faster? Right now, all we know is what the correlations are."

A monocyte is a specific white blood cell, a part of the human body's immune system that protects against blood-borne pathogens and moves quickly to sites of infection within the body's tissues. As monocytes enter tissue, they undergo a series of changes.

The researchers investigated these alterations by examining 18 patients with HIV and seven individuals without HIV.

"We did, indeed, find that patients with detectable virus had an increase of this monocyte subset that correlated with the amount of virus they had in their blood," study author Tracy Fischer-Smith, an associate scientist in Temple's Neuroscience Department, said in a prepared statement. "We were surprised to find that in patients with CD4+ T-cell counts of less than 450 cells per microliter [200 or less per microliter is defined as AIDS], the increase of this monocyte subset correlates inversely with the number of T-cells."

Fischer-Smith said this finding suggests that as the monocyte cells are increasing, these patients are losing CD4+ T-cells, which are critical for maintaining one's immune system.

"This may actually provide an earlier window into what is happening with HIV-infected patients where we might be able to see that immune impairment is taking place before we see a dramatic loss of CD4+ T-cells," she said.

The researchers plan to expand this study by following a cohort of patients over time to see if their findings can provide doctors with an early warning system and help them design better therapeutic strategies, Fischer-Smith said.

 

AIDS Infection Rate to Jump in Asia by 2020

UNITED NATIONS (Reuters) - The number of people in Asia infected with HIV could jump by more than 150 percent, or 8 million, by 2020 unless more is done to combat the spread of the virus that causes AIDS, a report presented to the U.N. secretary-general said on Wednesday.

That increase could be kept to 3 million if a response program is adopted immediately, according to the report from The Commission on AIDS in Asia, which called for more involvement from political leaders, greater resources and stronger prevention programs to quell the epidemic.

Nearly 5 million people are infected with HIV in Asia now, with 440,000 dying annually, the report said. The annual death toll will rise to almost 500,000 by 2020 without a scaled-up response, according to the report, entitled "Redefining AIDS in Asia - Crafting an Effective Response."

"By implementing the recommendations of the commission, Asian countries can avert massive increases in infections and death, prevent economic losses and save millions of people from poverty," U.N. Secretary General Ban Ki-moon said in a statement.

The HIV epidemic in Asia is characterized by risky behavior among three groups, the commission found: commercial sex workers and their customers, injectable drug users and men who have sex with men.

These groups should be the focus of prevention efforts to control HIV, Commission Chairman Chakravarthi Rangarajan told reporters at a briefing.

MOST LIKELY CAUSE OF DEATH

AIDS is the most likely cause of death and work days lost among 15-to-44-year-olds in Asia, according to the commission, which worked on the report for 18 months. Asia ranks second regionally in HIV cases behind Sub-Saharan Africa, which has an estimated 22.5 million people living with HIV.

Although prevalence rates are low in Asian countries, the large populations drive up the overall numbers, said Rangarajan, who is also chief economic adviser to India's prime minister.

The commission recommended a minimum annual investment of 30 cents to 50 cents per capita on focused prevention programs. By spending $1 per person, the countries can implement a broader approach including treatment.

Government heads of state should directly become involved in HIV control efforts to show leadership, Rangarajan said, which has generally not occurred.

Prevention programs should take steps to ensure more extensive use of condoms, Rangarajan said.

The commission said efforts to develop policies to combat HIV also must directly include the communities most affected by the disease.

Governments also need to repeal or change laws that foment HIV-related discrimination, the report said.

"It shows clearly that the response to the epidemic has to be tailored to Asian realities," Peter Piot, Director of the Joint U.N. Program on HIV/AIDS, said at the briefing. "There is not one Asian reality, there are many. The time is gone that with a blueprint for the whole world we can stop this epidemic."

 

Retrospective on the Use of Viagra - Friend or Foe?

WASHINGTON (AFP) - Ten years ago this month the lives of millions of men and women were changed almost overnight by the advent of a little blue pill -- the first oral treatment for impotence. Viagra, developed by accident by scientists at Pfizer Laboratories, was first approved for use by the US Food and Drug Administration on March 27, 1998.

"Originally, we were testing sildenafil, the active drug in Viagra, as a cardiovascular drug and for its ability to lower blood pressure," said Dr Brian Klee, senior medical director at Pfizer.

"But one thing that was found during those trials is that people didn't want to give the medication back because of the side effect of having erections that were harder, firmer and lasted longer."

Since Viagra went on the market it has been used by 35 million men around the globe, and it took impotence off the taboo list, making it infinitely easier to treat.

Urologists' waiting rooms became busier as news got round that the condition, which was rechristened with a new, scientific name -- erectile dysfunction, or ED -- could be treated with a triangular blue pill.

Previous treatments had involved surgically inserting a prosthesis into the penis, injecting a substance into the male sex organ or using urethral suppositories.

"Viagra brought a lot more people into the office because of the ease of treatment," Dr Irwin Shuman, a urologist of 40 years' experience in Washington, told AFP.

"In the old days, when we didn't have much in the way of treatment, we would do a lot more evaluation, looking for answers as to why somebody had the problem," he said.

In one test, men would be observed while sleeping to see if erections occurred.

Men who failed to get the usual five to six erections per night were deemed to have a physical problem, and those who did get nocturnal erections were said to have a psychological problem and were sent to see a sex counsellor.

So Viagra helped move impotence out of the psychological realm and into the world of physical illnesses. "What we have come to understand in the past 10 years is that ED is a vascular disease," said Klee.

"What happens is veins and arteries that deliver and remove blood from the penis are not working the way they should, and Viagra allows those vessels to dilate and increase blood flow to the penis," he said.

Dr Abraham Morgentaler, director of Men's Health Boston, and associate clinical professor of urology at Harvard Medical School, hailed Viagra as a "benefit to medicine."

But, he added, the drug has not delighted all those who took it.

"There are two truths to Viagra: for those who refill (get a new prescription), it's wonderful and they're happy," Morgentaler told AFP.

"But a lot of people look to Viagra for personal happiness, thinking a hard penis can resolve relationship issues," and they end up disappointed, added the doctor and author of the book "The Viagra Myth."

Some patients say taking Viagra "does not correspond to the way they want to have sex," Morgentaler said.

Viagra works best on an empty stomach or after eating a low-fat meal, the medication's official website says. It kicks in about 30 minutes after being taken, works for four hours, and only with sexual arousal, the website says.

But it's not the answer for everyone. Morgentaler said he had a 78-year-old patient in his office who "didn't like the idea of programming sex. Guys, and often women, too, don't necessarily want to compromise the ideal of sex as something magical, spontaneous, romantic."

Morgentaler also spoke of the darker side of Viagra, which has evolved since it and two other ED treatments became easily available over the Internet.

"It's the use of Viagra by healthy young men who don't need it," he said.

"These young men take a pill whenever they go out ... Maybe because they are inexperienced or shy and Viagra makes them more confident, or maybe because they have inflated ideas about what sex is supposed to be like from seeing Internet porn, which they also have easy access to, and they want to heighten their feelings of masculinity," he said.

"I am concerned -- not that these young men will get addicted physically, but that they will become psychologically dependent on Viagra," said Morgentaler.

"Sex is an entree into a relationship, and most often what we want from a relationship is to be loved for what we are.

"But some of these young men feel they have to take a pill to be acceptable, and I fear they are potentially missing the opportunity to have true emotional connections with a partner, based on reality, not mythology."

Comments from Condoms West:

Viagra and other erectile enhancing pharmaceuticals have brought relief to many people who otherwise had little hope of reversing erectile dysfunction (ED). It is a sad day when healthy, young men turn to a pill to produce immediate "results" first time, every time. The sexual act takes compassion, understanding and presence to be complete. Instant erections, like fast food may do the job but have negative long-term health consequences.

 

Sex Education May Help Reduce Teen Pregnancies

MONDAY, March 24 (HealthDay News) -- Comprehensive sex education may help reduce teen pregnancies without increasing levels of sexual intercourse or sexually transmitted diseases.

So find U.S. researchers who reviewed data from a 2002 national survey of more than 1,700 heterosexual teens, ages 15 to 19.

There is ongoing debate about whether abstinence-only education or comprehensive sex education (including instruction in birth control) is best for students.

Study lead author Pamela Kohler, a program manager at the University of Washington in Seattle, and colleagues found that about 25 percent of teens received abstinence-only education and about two-thirds received comprehensive sex education. About 9 percent -- particularly teens from poor families and those in rural areas -- received no sex education at all.

The researchers found that teens who received comprehensive sex education were 60 percent less likely to get pregnant or to get someone pregnant than those who received no sex education.

Other results -- not statistically significant, however -- suggested that comprehensive sex education, but not abstinence-based sex education, slightly reduced the likelihood of teens having vaginal intercourse. Neither approach seemed to reduce the likelihood of reported cases of sexually transmitted diseases.

The findings, published in the April issue of the Journal of Adolescent Health, support comprehensive sex education, Kohler concluded.

"There was no evidence to suggest that abstinence-only education decreased the likelihood of ever having sex or getting pregnant," she said in a prepared statement.

This study offers "further compelling evidence" about the value of comprehensive sex education and the "ineffectiveness" of the abstinence-only approach, said Don Operario, a sex education expert and professor at Oxford University in England.

In Support of the Female Condom - India

NEW DELHI: A five-rupee female condom (FC) will now spearhead India's fight to control HIV spread among women.

Under the first phase, the National AIDS Control Organisation (Naco) is procuring 15 lakh female condoms from UK's Female Health Company (FHC), which will be doled out to sex workers and housewives in Andhra Pradesh, Maharashtra, Tamil Nadu and West Bengal over the next 8 months. A decision on a countrywide upscale will be undertaken after reviewing data from these four states.

According to Naco director-general K Sujatha Rao, a year-long pre-programme acceptability and feasibility study, involving 60,000 women in 13 sites — 11 involving high risk groups like sex workers and two family planning programmes — in eight states from November 2006, found 60% women re-purchasing the condom and over 98% of the users finding it comfortable. Naco through UNFPA had procured five lakh condoms from FHC for its acceptability study.

Rao told TOI: "The pilot project was highly successful showing consistent use of FCs. We have, therefore, decided to scale up the programme under which we will first train women on how to use these condoms."

Union health minister A Ramadoss said: "When a male partner refuses to wear a condom, women need self-initiated methods to protect themselves against unplanned pregnancies and HIV/AIDS."

According to Manoj Gopalakrishna from Hindustan Latex Limited, India till now imported FCs making them expensive. "We have now set up an FC manufacturing unit in Kochi. FHC has transferred the condom manufacturing technology to us. We will manufacture 10 million FCs annually. Though the cost of making each condom will be Rs 40, it will be available to women for Rs 5 through 200 NGO-led targeted interventions."

Esther Bayliss from the Female Health Foundation told TOI: "Female condoms — FC1 and FC2 — are the only ones approved by US FDA and WHO. These condoms are the first and only female-initiated barrier method that is safe and effective if used correctly and consistently providing dual protection against the transmission of sexually transmitted infections, including HIV/AIDS and unintended pregnancy."

Nearly 40% of the 2.5 million HIV positive victims living in India are women, most of them hapless housewives who don't look at their husbands as a threat and commercial sex workers unable to negotiate with clients refusing to use a condom.