Monthly Shots of HIV Drugs Are as Effective as Daily Pills, 2 Big Studies Show

SEATTLE (AP) — Monthly shots of HIV drugs worked as well as daily pills to control the virus that causes AIDS in two large international tests, researchers reported Thursday.

If approved by regulators in the United States and Europe, the shots would be a new option for people with HIV and could help some stay on treatment. Instead of having to remember to take pills, patients instead could get injections from a doctor or nurse each month.

“Some people will be thrilled” at the convenience, said Mitchell Warren, executive director of AVAC, an AIDS advocacy group.

Condoms remain the most widely available and inexpensive form of HIV prevention. Pills taken daily can keep HIV levels so low the virus is not transmittable to sex partners, but not everyone takes them as prescribed.

The shots could improve how well some people stick to treatment, perhaps helping those who have trouble remembering to take daily medicine to keep infection at bay.

There are other potential benefits. Getting shots at a clinic can lend more privacy to patients worried about the stigma of filling an HIV prescription at a pharmacy, said Dr. Susan Swindells of the University of Nebraska Medical Center in Omaha, who presented results Thursday at an HIV conference in Seattle.

Cost will be an issue “to make sure that everyone has access to this medication,” said Dr. Hyman Scott of the San Francisco Department of Public Health, who was not part of the study. It’s not clear how much the shots would cost. HIV pills can cost a patient up to thousands of dollars monthly , depending on the drug combination, insurance coverage, rebates and discounts.

And there will be concerns about patients missing a monthly shot, which could lead to drug-resistant strains of the virus. It will be “a good option for some people,” Scott said.

Whether monthly shots will also work to protect users’ sex partners hasn’t been studied yet, but there is reason to think they will, said experts at the conference.

The shots are a long-acting combo of two HIV drugs — rilpivirine, sold as Edurant by Johnson & Johnson’s Janssen, and ViiV Healthcare’s experimental drug known as cabotegravir.

ViiV Healthcare paid for the research. The drugmakers are seeking approval later this year in the United States and Europe.

One study included 616 people who were taking pills to treat their HIV infection. The other study enrolled 566 people who hadn’t yet started treatment, so they first got pills to get the virus under control.

In each of the studies, half the participants switched to the shots while the rest stayed on pills. After nearly a year, 1 to 2 percent of people in both groups had traces of virus in their blood, whether they got shots or pills. That shows the shots worked as well as the standard pill therapy. A few people withdrew from the studies because of pain after the injections.

The studies were done in Europe and North America and in nations including Argentina, Australia, Russia, South Africa, South Korea, Sweden, Japan and Mexico.

“We don’t have experience rolling out an injection in the real world,” said Warren, the AIDS advocate. He said the next challenges will be how to deliver the shots and whether patients will remember to come back monthly. “These are big questions.”

Sports – TIME

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Humans are unusual in that women go through menopause and stop reproducing long before reaching the end of their life expectancy. One theory holds that this aspect of human life history may be explained by the evolutionary benefits associated with the role of grandmothers in helping their grandchildren. Now, two studies add to evidence for this so-called ‘grandmother hypothesis.’ However, they also show that there are limits.
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5 Questions With a Clinical Psychologist Who Studies Social Factors That Affect Health

What motivates you?

What bothers us is often what motivates us. And it bothers me that scientific knowledge often does not inform the care people receive. A new area called “implementation science” is devoted to ensuring that evidence-informed interventions are implemented to benefit those in need.

Read Dr. Lewis’ latest paper published on JAMA Psych.

Specifically, I’m focused on improving mental and behavioral health care by integrating evidence-based practices such as cognitive behavioral therapy into community settings. My new paper in JAMA Psychiatry discusses how to advance the integration of measurement-based care into behavioral health treatment.

What first got you interested in implementation science?

While working on a study in graduate school, I found CBT worked for many young people. But at that time, cognitive behavioral therapy was largely unavailable outside of research trials. Implementation science promised to bring evidence-based care into practice. So, I decided to focus on this new field, even though no one at my university, including my mentor, was expert in this type of work.

Kayne Mettert, Caitlin Dorsey, Lewis, and Elena Navarro (L-R) all moved together to work at the Kaiser Permanente Health Research Institute in Seattle from Indiana University in Bloomington.

Kayne Mettert, Caitlin Dorsey, Lewis, and Elena Navarro (L-R) all moved together to work at the Kaiser Permanente Health Research Institute in Seattle from Indiana University in Bloomington.

Which projects have excited you most?

My work with Wolverine Human Services — residential treatment centers housing teens throughout Michigan — made the impossible, possible. It was the first time, to my knowledge, that frontline staff received training to deliver cognitive behavioral therapy with fidelity. Through our five years of systematic, tailored implementation with the Beck Institute for Cognitive Behavior Therapy, Wolverine was transformed. They’ve trained most of the staff in cognitive behavioral therapy and embedded onsite coaches to ensure the program is sustainable.

Now, I’m leading an implementation evaluation of a new member of the primary care team in Kaiser Permanente Washington clinics designed to connect patients with community resources. Specifically, we’re evaluating the impact of community resource specialists on patients’ experience and care teams’ ability to work at the top of their license.

I serve on the steering committee of Kaiser Permanente’s Social Needs Network for Evaluation and Translation group. We bring experts together and support them to think about how best to address social risk, build capacity and conduct pragmatic evaluations. Kaiser Permanente is at the cutting edge in terms of investing in care for the whole person and their community. Very few organizations have that vision — and the infrastructure to support this work.

What makes Kaiser Permanente a good place to do implementation science?

Kaiser Permanente is willing to invest in implementing evidence-based care. Being embedded in a delivery system affords the opportunity to contribute to the science and the practice of implementation.

Lewis, PhD, an associate investigator at the Kaiser Permanente Washington Health Research Institute, after keynoting the Global Evidence and Implementation Summit 2018 in Melbourne, Australia.

Lewis after keynoting the Global Evidence and Implementation Summit 2018 in Melbourne, Australia.

What keeps you going outside of work?

What I do most outside of work is to spend time with my 2-year-old son River. I’m an avid cyclist. I love to bike to work and bike River to school, the grocery store, you name it.

Our family is very musical, and we play music every day. I like to sing — but don’t ask me to. River and my husband Eric play all the things: We have five guitars (including River’s guitalele), a piano, drums and many other instruments. We don’t watch TV shows as a family — we watch live music videos together.

I’m proud to say River now requests Pearl Jam, a Seattle-born band that recently raised $ 12 million to address homelessness in our local communities. I have family nearby in British Columbia, where I was born and raised — and those are two reasons why Seattle is a great place for us to be.

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A First Look at Virgil Abloh’s Limited Social Studies New York T-Shirt Design

During this weekend’s eagerly-awaited Social Studies event, attendees will have the chance to meet with some of the biggest names in the youth culture, customize a variety of garments and listen to exclusive talks between creatives. They’ll also have the opportunity to grab exclusive merch, including this duo of Virgil Abloh-designed T-shirts. Emblazoned with “STUYVESANT LEADER PHYSICAL ED.” verbiage, the red/yellow and black/white shirts juxtapose the collegiate text on the front with the logos of every single event contributor on the rear, making for a crowded, yet communal, design.

All proceeds of the $ 100 USD shirt will go to Casita Maria, a Bronx-based youth charity. Guests will be able to grab their choice of tee at the event this weekend, November 16-18.

Most recently, Abloh got into hot water over his work on Serena Williams’ GQ cover.

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