TIME HIV/AIDS

Court: Not Disclosing HIV Before Sex Is A Misdemeanor

A man faces a misdemeanor charge instead of a felony for exposing a partner to HIV

(ALBANY, N.Y.) — An HIV-positive man who told a partner that they could safely have unprotected sex should face a misdemeanor reckless endangerment charge, not a felony, New York’s highest court ruled Thursday.

The Court of Appeals said Terrance Williams didn’t expose his partner “out of any malevolent desire” to give him the virus that causes AIDS, though he lied about having the infection and his partner did get sick. The court said the Syracuse man didn’t show “depraved indifference,” which is necessary to support the felony charge.

The judges declined to decide whether HIV infection no longer “creates a grave and unjustifiable risk of death” because of advances in medical treatment. Two lower courts had reached that conclusion while knocking down the felony indictment to the lesser charge.

The felony could have sent Williams to prison for seven years. He still faces the misdemeanor and a possible year in jail if convicted.

“Without a doubt, defendant’s conduct was reckless, selfish and reprehensible,” the court majority said in a memorandum. “Under our case law, though, this is not enough to make out a prima facie case of depraved indifference.”

Ruling in the majority were Chief Judge Jonathan Lippman and Judges Susan Read, Jenny Rivera and Sheila Abdus-Salaam.

In a dissent, Judge Eugene Pigott Jr. said he’d reinstate the felony charge, because Williams’ repeated lies showed “utter indifference” for the victim’s fate, though he had later expressed remorse.

Attorney Kristen McDermott, who argued Williams’ appeal, said New York has never passed a specific law about HIV transmission, unlike some other states. Onondaga County prosecutors are trying to make it a criminal act under the reckless endangerment statute, she said.

The partner’s risk of contracting HIV in the four or five times they had sex were low, and his prospects of that and also dying from AIDS were “extraordinarily low,” McDermott said. There are now 20 different medications that effectively put the virus to sleep in people’s bodies, she said.

“It’s still a potentially deadly disease,” Assistant District Attorney James Maxwell said, adding that he agreed with Pigott. “It’s not always a death sentence, but it can be.”

TIME HIV/AIDS

Scientists Find a Way to Block HIV from Infecting Healthy Cells

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Getty Images HIV viruses infecting a human immune cell

Researchers overcome a major hurdle in developing the ultimate protection against HIV

Reporting in the journal Nature, scientists describe a new way to potentially block HIV from infiltrating healthy cells. Such interference is key to protecting people from HIV infection, but most efforts so far haven’t been successful.

This time, however, may be different. Michael Farzan, professor of infectious diseases at Scripps Research Institute, and his team used a gene therapy technique to introduce a specific HIV disruptor that acted like gum on HIV’s keys. Once stuck on the virus’s surface, the peptide complex prevents HIV from slipping into the molecular locks on healthy cells. Because the gum isn’t picky about which HIV strain it sticks to—as long as it’s HIV—the strategy works against all of the strains Farzan’s group tested in the lab, including both HIV-1 and HIV-2 versions that transmit among people, as well as simian versions that infect monkeys. In lab dishes containing the virus and human and animal cells, the disruptor managed to neutralize 100% of the virus, meaning it protected the cells from getting infected at all.

MORE: The End of AIDS

The strategy is based on what HIV experts know about how the virus infects healthy cells. HIV looks for a protein, or receptor on immune cells called CD4, which serves as the lock, and uses a specially designed portion of its own viral coat made up of three proteins as the key. Once HIV finds its target and the match is made, the virus changes its shape to better slip inside the healthy cell, where it takes over the cell’s machinery and churns out more copies of itself. Farzan’s gum, called eCD4-Ig, not only seeks out these parts of the key and renders them useless, but by glomming onto the key, also causes the virus to morph prematurely in search of its lock. Once in lock-finding mode, the virus can’t return to its previous state and therefore is no longer infectious.

The encouraging results suggest that eCD4-Ig could provide long-term protection against HIV infection, like a vaccine; in four monkeys treated with gene therapy to receive eCD4-Ig, none became infected with HIV even after several attempts to infect them with the virus. The protection also seems to be long-lasting. So far, the treated monkeys have survived more than a year despite being exposed to HIV, while untreated control monkeys have died after getting infected.

MORE: This Contraceptive Is Linked to a Higher Risk of HIV

The strategy, while promising, is still many steps away from being tested in people. Farzan used a cold virus to introduce the eCD4-Ig complex directly into the muscle of the animals, and it’s not clear whether this will be best strategy for people. Previous gene therapy methods have led to safety issues, and concerns have been raised about controlling where and how much of the introduced material gets deposited in the body. It may also be possible to give the peptide as an injection every few years to maintain its anti-HIV effect.

MORE: HIV Treatment Works, Says CDC

Farzan anticipates that if proven safe, the strategy could help both infected patients keep levels of HIV down, as well as protect uninfected, high-risk individuals from getting infected. But many more tests will need to be done before we might see those results. Four monkeys can provide valuable information, but can’t answer questions about safety and efficacy with any confidence. “Things change when we get to humans and when we get to larger numbers,” he says. “But the data in monkeys are as encouraging as one could hope.”

TIME Innovation

Five Best Ideas of the Day: February 9

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. A humanitarian intervention for Aleppo could provide a glimmer of hope in Syria.

By Ana Palacio in Project Syndicate

2. The U.S. needs a new Church Committee to strengthen oversight of our intelligence services.

By Michael German at the Brennan Center for Justice

3. A regional force is the wrong approach to fight Boko Haram — and might make things worse.

By Hilary Matfess in Al Jazeera America

4. The mystery of autism might be unlocked by studying the microorganisms in children’s stomachs.

By Ruth Ann Luna at the Baylor College of Medicine

5. Test for HIV and syphilis with an iPhone.

By Tasbeeh Herwees in Good

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Venezuela

A 36-Pack of Condoms In Venezuela Now Costs $755 at Official Rates

Because of a near-defaulting economy, consumer goods such as condoms are scarce and hugely marked up

In Venezuela, a 36-pack of Trojan condoms now costs $755 at the official exchange rate. That’s the price being asked on the MercadoLibre website, where Venezuelans go to buy goods in short supply.

Compare that to a box in the U.S., which goes for $21.

The huge markup is due to the collapse in oil prices, which has had disastrous consequences in Venezuela, Bloomberg reports.

The South American country relies on crude-oil exports for 95% of its foreign-currency earnings and has seen a 60% fall in those exports over the past seven months.

As a result of the government’s policy of slashing imports to make up for the deficit, consumer goods have become scarce and expensive, and people are forced to queue for hours to get basic products such as meat, sugar, medicine and now contraceptives.

For those with access to American dollars, condoms can be bought on the black market for around $25. But this is only the lucky few.

The lack of access to contraceptives could deepen the country’s social problems. Venezuela has one of South America’s highest rates of HIV infection and teenage pregnancy. Because abortion is illegal, the disappearance of condoms and other forms of birth control like the pill may force more women to clandestine abortion clinics, increasing the risk of maternal deaths.

[Bloomberg]

TIME Research

There’s a Smartphone Attachment That Will Test for HIV in 15 Minutes

Blood testing for HIV
Getty Images

The device has the potential to save millions of lives

A team of researchers from Columbia University have developed a device that can be plugged into a smartphone and used to quickly test for HIV and syphilis.

The mobile device tests for three infectious-disease markers in just 15 minutes by using a finger-prick of blood, and draws all the power it needs from the smartphone, Science Daily reports.

The accessory costs an estimated $34 to make and is capable of replicating tests done in a laboratory using equipment that costs many thousands of dollars.

Samuel K. Sia, head researcher and associate professor of biomedical engineering at Columbia, described the smartphone accessory as “full laboratory quality.”

Because it can be easily used in remote and impoverished areas, like rural Africa, it is hoped the small but effective smartphone accessory will save millions of lives from sexually transmitted diseases.

[Science Daily]

TIME Innovation

Five Best Ideas of the Day: February 3

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. “Even from a libertarian point of view, vaccination is a matter of rational self-interest.”

By Ben Boychuk in the Orange County Register

2. ‘Doubt everything:’ Ukrainian students are warning their Russian counterparts not to trust Putin.

By Arslan Saidov and Claire Bigg in the Guardian

3. To reach kids where they are, provide teens crisis counseling by text.

By Alice Gregory in the New Yorker

4. Is the secret to a cure for HIV lurking in dormant pools of the virus?

By Catharine Paddock in Medical News Today

5. 3D-printed ‘cool bricks’ can naturally air condition a room.

By Whitney Hipolite in 3DPrint.com

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Davos

Bill Gates: HIV Vaccine a Reality by 2030

Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation gestures next to his wife Melinda French Gates during the session 'Sustainable Development: A Vision for the Future' in the Swiss mountain resort of Davos
Ruben Sprich—Reuters Bill and Melinda Gates at the World Economic Forum in Davos, Switzerland on Jan. 23, 2015.

New drugs would significantly impact the global struggle against the virus which has claimed the lives on millions over the past 30 years

Philanthropist and Microsoft founder Bill Gates believes an HIV vaccine, as well as new intensive drugs to combat the disease, will be available by 2030. That would significantly impact the global struggle against the virus which has claimed the lives of millions over the past 30 years.

Speaking the World Economic Forum in Davos, the billionaire founder of the Bill & Melinda Gates Foundation said the two “miracles” were within reach. “We’re pretty optimistic in this 15-year period we will get those two new tools,” he said. The Gates Foundation, founded fifteen years ago, spends tens of millions of dollars on medical research.

A vaccine is seen as pivotal in preventing new infections, while drug treatments would do away with the need for life-long treatment, he added.

[The Guardian]

TIME Infectious Disease

Unlicensed Cambodian Medic Charged With Murder After Allegedly Spreading HIV

212 HIV cases were found in the community where he practiced

An unlicensed medic is being charged with murder after Cambodian medical authorities found 212 cases of HIV in the district where he had been treating patients, allegedly with contaminated equipment.

Yem Chrin treated poor patients and was believed to have healing powers, Reuters reports. However, he did not have a medical license and was allegedly delivering injections and blood transfusions using unclean equipment. Authorities tested 1,940 people in the northwestern province where Yem Chrin worked, and 212 tested positive for HIV. Some children as young as 6 years old tested positive for the virus, according to al-Jazeera.

Yem Chrin allegedly told police that he sometimes used the same syringe on two or three patients before disposing of it.

The World Health Organization and UNAIDS found that “the percentage of people that reported receiving an injection or intravenous infusion as part of their health treatment was significantly higher among the people who tested positive for HIV than the people who were HIV negative,” in the area in which Yem Chrin treated patients, Reuters reports.

The development is a setback in Cambodia’s largely successful efforts to eradicate the virus since it first spread through the country in the 1990s.

[Reuters]

TIME HIV/AIDS

This Contraceptive Is Linked to a Higher Risk of HIV

Depending on the contraceptive they’re using, women may be at higher risk of getting HIV

When it comes to the double duty of preventing both pregnancy and HIV, condoms are the best option, especially in the developing world where treatment for the infectious disease is harder to access. But the same isn’t true of other contraceptive methods, according to the latest study in Lancet Infectious Diseases.

Lauren Ralph, an epidemiologist at University of California San Francisco, and her colleagues conducted a review of all of the available studies on hormonal contraceptive methods—including injections of Depo Provera and Net-En that work to prevent pregnancy for about 12 weeks, as well as the pill. Among 12 studies involving nearly 40,000 women in sub-Saharan Africa, those using Depo showed a 40% higher risk of getting HIV than those using other methods or no contraception at all.

Previous studies suggested that Depo, which is made up of a hormone that mimics the reproductive hormone progesterone, was linked to higher risk of infection, but other studies showed conflicting results. Ralph found that only Depo was associated with a higher risk of HIV infection; there was no similar increase among women using the pill, which is composed of two hormones, estrogen and a form of progesterone. The correlation remained even after they considered potentially confounding factors, such as the women’s condom use.

While the study didn’t address the reason for the difference between oral contraception and Depo, some research suggests that their differing hormone combinations may have varying effects on the structure of the genital tract, a woman’s immune response or her vaginal flora, all of which could influence her vulnerability to acquiring HIV.

The results raise a difficult question about whether the increased risk of HIV infection warrants removing Depo from a woman’s contraceptive options in places like Africa. Worldwide, according to the authors, 41 million women use injectable contraception, and they have played a role in lowering death and health complications among women of child-bearing age. “Whether the risk of HIV observed in our study merits complete withdrawal of hormonal contraception, especially Depo, needs to be balanced against the known benefits of highly effective contraception in reducing maternal morbidity and mortality worldwide,” says Ralph, who conducted the research while at University of California Berkeley. More research needs to be done to quantify the risks and benefits of providing Depo, and these calculations also have to be adjusted for specific regions and even particular clinics. “One thing to consider is whether women have access to other contraceptive options, whether they will be willing to take up these contraceptive options, and ensuring that women will be comfortable with them,” she says. “I would love to see these findings applied to specific regions. I think that would help women make the most informed decisions.”

TIME HIV/AIDS

African Countries Should Spend More in AIDS Response, Study Says

A mother holds the hand of her Aids stricken son in Rakai, Ugand
Getty Images

To meet AIDS eradication goals, study says funding should be re-allocated

Twelve African countries with the highest prevalence of HIV/AIDS are currently the largest recipients of international AIDS funding. But it’s now possible for many of them to make domestic spending on the disease a priority, a new study says.

As countries in sub-Saharan Africa gain better financial footing, funds from donor countries are tightening. Researchers from Harvard School of Public Health and the Results for Development Institute decided to test a couple of scenarios to see whether funding for the AIDS response could be re-allocated so African countries would finance a greater share.

Their results, published in the journal The Lancet Global Health, show that overall, the 12 countries—Botswana, Côte d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia—could provide a greater share of the costs of AIDS programs in their countries over the next five years. However, several countries will still need support from donors, even if they were to provide their maximum funds.

MORE: The End of AIDS

By looking at factors like expected growth and total government spending, and then comparing them to the countries’ AIDS needs, the researchers found that in most scenarios, AIDS expenditures for three of the upper-middle-income countries (Botswana, Namibia and South Africa) exceed their needs. In many cases, they found, these three countries could actually fund their needs solely from domestic resources. Other low-income countries like Mozambique and Ethiopia would still need to largely rely on donors.

Currently, the dozen countries are home to more than 50% of AIDS cases worldwide, as well as 56% of financial aid for the disease. They also account for 83% of funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which makes up one of the largest shares of international donations. In 2014, the United Nations program UNAIDS estimated that a “fast-tracked” response to ending the AIDS epidemic would mean we’d need $35 billion each year by 202o, but in 2012, only $19 billion was available and almost half came from international sources. To meet such goals, the researchers suggest their new funding strategy.

Almost none of the 12 countries meet possible financing benchmarks that the study authors believe to be reasonable. If the countries spent more domestically, researchers say that self-funding could increase 2.5 times and could cover 64% of future needs. That would still leave a gap of about $7.9 billion.

“Coupled with improved resource tracking, such metrics could enhance transparency and accountability for efficient use of money and maximize the effect of available funding to prevent HIV infections and save lives,” the study authors conclude. Sharing the financial burden of AIDS more equitably may be one strategy for eradicating the disease faster.

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