HIV Prevention -- New Strategies Are Under Investigation to Limit HIV's Spread
John G. Bartlett, MD
Robert Grant, MD, of the Gladstone Institute at the University of California, San Francisco, provided a review of novel HIV prevention efforts under investigation. The data for the United States show an estimate of 40,000 new HIV infections per year for 16 consecutive years, and the data for the world show an estimate of 5 million new infections per year. This review addresses strategies that may or may not reduce HIV incidence.
Intensive Counseling. It does not work. The best study is EXPLORE, which compared an intensive intervention of 10 one-hour counseling sessions vs standard, less-intensive counseling in 4295 men who have sex with men (MSM).[1] Results showed a transmission rate of 2.1% and no statistically significant difference between groups; also, any trend in benefit was eliminated after 6 months.
Circumcision. The rationale for circumcision is based on biological (removal of HIV target cells), epidemiologic (low prevalence in circumcised men), and clinical trial data. The ANRS randomized trial[2] showed HIV incidence of 0.85/100 person-years vs 2.1/person years for a relative risk of 0.40. These results are impressive, but the challenges will be safety, cultural acceptance, and scale-up.
Herpes Simplex Virus-2 (HSV-2) Prophylaxis. The indirect supporting evidence includes the observations that:
1. HSV-2 increases the risk for HIV infection 2-fold;
2. HSV-2 infection is associated with an HIV viral load that averages 0.3 log10 copies/mL higher; and
3. HSV-2 infection increases the risk for HIV transmission by 5-fold.[3-5]
There are 2 large trials addressing the potential benefit of HSV-2 suppression to prevent HIV transmission: HPTN 0.39 with 3277 participants (fully enrolled) and Partners in Prevention with 3000 discordant couples (70% enrolled).
Mother-to-child Transmission. The data from multiple studies are summarized in Table 1:
Table 1. Mother-to-Child HIV Transmission Rate, by Strategy
Strategy HIV Transmission Rate
No therapy 20%-40%
Monotherapy 4%-8%
HAART 0%-1.5%
Preexposure Prophylaxis. Several trials are ongoing, as summarized in Table 2:
Table 2. Status of Preexposure Prophylaxis Trials to Prevent HIV Acquisition
Location N Participants Enrollment Follow-up
Ghana 400 High-risk women 2004-2005 2005-2006
US 400 MSM 2005-2007 2007-2009
Thailand 1800 IDU 2005-2007 2007-2008
Botswana 1200 Heterosexual males and females 2007-2008 2008-2009
Andean 1400 MSM 2007-2008 2008-2009
MSM = men who have sex with men; IDU = injection-drug user
All of these studies are blinded and placebo-controlled, and all use tenofovir with or without emtricitabine. Main concerns are increased high-risk behavior, HIV drug resistance, and adverse drug reactions. The first of these trials, the Ghana study, was presented at the 2006 International AIDS Conference in Toronto.[6] There were 8 seroconversions among 400 participants: 6 in placebo recipients and 2 in tenofovir recipients (P = .24). Testing of one seroconverter on tenofovir showed no tenofovir resistance. Analysis of adverse reactions showed none attributed to tenofovir. Interviews with participants showed a reduction in high-risk behavior. The cost of this treatment is determined by the laboratory monitoring and drug costs. For the United States, this ranged from $5000 to $24,000 per person per year.
Serosorting. This refers to selection of sexual/romantic partners by HIV serostatus.
Access to Harm-reduction Messages. The point was made that prevention tools need to be used in order to be effective, and many are. Data from USAID, UNAIDS, and UNICEF Policy Project from June 2004 showed estimates for 2001 and 2003 for access to prevention services
wife & girlfriend
Wife is like a TV. Girlfriend is like a handphone.
At home watch TV. Go out bring h/p.
No money watch TV. Got money change h/p.
Sometime enjoy TV but most of the time play with h/p.
TV free for life but....
h/p, if you don't pay,
services will be terminated....!
know u star...
SCORPIO:. The sex addict
Can be mean. EXTREMELY sexy. Intelligent. Energetic. Predict future. Most erotic. (Freak in bed.) (GREAT kisser.) Always get what they want. Sexy. Attractive. Easy going. Loves being in long relationships. Talkative. The sexiest ever....Romantic. Caring.
.:LIBRA:. The lame lover
Very pretty. Very romantic. Nice to everyone They meet. Their Love is one of a kind. Silly, fun and sweet. Have own unique sexiness. Most caring person you will ever meet! Amazing n Bed..!!! Did I say Amazing in Bed?Not the kind of person you wanna #### with... u might end up crying.... the most irresistible.
.:ARIES:. The Liar
Outgoing. Lovable. Spontaneous. Not one to #### with. Erotic. Funny. Take you on trips to the moon in bed. Excellent kisser EXTREMELY sexy. Loves being in long relationships.=) Addictive. Loud. best in bed.
.:AQUARIUS:. Does it in the water
Trustworthy. Sexy. Great kisser. One of a kind. Loves being in long-term relationships. Extremely energetic. Unpredictable. Will exceed your expectations. Not a Fighter, But will Knock your lights out. Amazing in bed, THE BEST LOVERS BETTER THAN EVERYONE!
.:GEMINI:. Does Twosomes
Nice. Love is one of a kind. Great listeners Very Good in bed. Lover not a fighter, but will still knock you the #### out. Trustworthy. Always happy. Loud. Talkative. Outgoing VERY FORGIVING. Loves to make out. Has a beautiful smile.. Generous. Strong. ULTRA SEXY. THE MOST IRRESISTABLE.
.:LEO:. The Lion in bed
Great talker. Sexy and passionate. Laid back. Knows how to have fun. Is really good at. Great kisser. Unpredictable. Outgoing. Down to earth. Addictive. Attractive. Loud. Loves being in long relationships. Talkative. Not one to mess with. Rare to find. Good when found.
.:CANCER:. The Cutie
MOST AMAZING KISSER. Very high ### appeal. Great in bed!!! Love is one of a kind. Very romantic. Most caring person you will ever meet! Entirely creative. Extremely random and proud of it. Freak in bed. Spontaneous. Great tellin stories. Not a Fighter, But will Knock your lights out if it comes down to it.
Someone you should hold on to.
.:PISCES:. The Piece of ass
Caring and kind. Smart. Center of attention. Very high ### appeal. Has the last word. The best to find, hardest to keep. Fun to be around. Freak in the sheets. Extremely weird but in a good way. Good Sense of Humor!!! Thoughtful. A partner for life. Always gets what he or she wants. Loves to sleep. Very popular. Silly, fun and sweet.
.:CAPRICORN:. The passionate Lover
Love to bust. Nice. Sassy. Intelligent. Sexy. Predict future. Irrestible, awesome kisser. Loves being in long relationships. Great talker. Always gets what he or she wants. BY FAR the BEST in BED. Very sexy. Coolest. Loves to own Gemini's in sports. Extremely fun. Loves to joke. Loves to be your first. So you'll never forget. Smart.
.:TAURUS:. The Tramp
Aggressive. Freak in bed. Rare to find! Loves being in long relationships.=]
Likes to give a good fight for what they want. Extremely outgoing. Sexy as ........
Loves to help people in times of need. Outstanding kisser. Very funny. Awesome personality. Stubborn. Sexual as ......... Most caring person you will ever meet! One of a kind. Not one to #### with. Are the most sexiest people on earth!
.:SAGITTARIUS:. The Sexy one
Spontaneous. Horny. Freak in Bed. High appeal. Rare to find. Great when found. Loves being in long relationships. The one. So much love to give. Not one to mess with. Very pretty. Very romantic. Nice to everyone they meet. Their Love is one of a kind. Silly, fun and sweet. Have own unique sexiness. Most caring person you will ever meet! Amazing in Bed..!!! Did I say Amazing in Bed? Not the kind of person you wanna with you might end up crying.
.:VIRGO:. The Virgin
Dominant in relationships . Sexy. someone loves them right now. Freak in bed. Always wants the last word. Caring. Smart. Intellectual. Attractive. Loud. Loyal. Easy to talk to. Hard to forget Love at first sight. Everything you ever wanted. Easy to please. The one and only. Ultimate sexiness..
女友
*把每一次见面都当作最后一次见面那么重视。
*在冬日的街头把我的手放在他的口袋，带我穿过大街小巷，即使我们彼此不说话。
*和我一起去作礼拜，我睁开眼偷看他，看到他认真的表情。
*言而有信
*从来不迟到，我迟到他不生气。
*拥抱很久，很紧，每次我起身几乎是需要慢慢推开他。
*睡的比我迟一点，醒来比我早一点。
*打完电话总是让我先挂电话然后他才挂。
*走路的时候总是走我的外面，让我走里面。
*过马路的时候牵我的手，可以让我放心的闭着眼睛就这么跟着他走。
*每次送我回家，目送我直到看不到我才转身离开。
*记得我的日期，鞋号，尺寸，最害怕的事。
*干净，胡子一定会剃。
*不舒服时，请假带我去看医生，回来路上买好吃的奖励我。
*在我面前绝对不抽烟。
*经济赤字时，坦白告诉我没钱，但绝不会让我为钱操心，自己已经想好怎么努力赚钱了。
*说：希望你是我女儿。
*吃不下的东西都可以给他吃
*我累的时候会背我，说：你可以再胖一点。
*吵架的时候不会一走了之，冷战不会超过12小时。
*错了会认错
*我的缺点他会指出，我的优点他不吝啬赞扬。
*在朋友面前很好的树立我的形象
*鞋带松了他看到会主动蹲下帮我绑好。
*我路过橱窗，无意流露对橱窗里东西的喜欢，他会记在心里，然后买来送我。
*常常说，别怕，有我呢。
*指甲整齐干净，喜欢我替他修指甲。
*轻轻拧开我拧不开的汽水瓶。
*告诉我24小时随时打电话，不会不接我电话不回我消息，即使睡着了，看到我消息不管隔了多久都 会回复。
*告诉我不要省钱。
*买情侣衫，然后和我说：我们以后一起穿。
*收集我和他所有的经历，电影票，车票，照片……
*记得每一个纪念日。我忘了还会提醒我。
*不沉迷网络游戏。
*会叫我陪他妈妈逛街。
*很早就和他的家人提过我。
*说谎会结巴脸红。
*有送过我花。
*和我下棋，允许我悔棋。
*喜欢运动，带动我一起运动。
*穿十年前的牛仔裤依然合身。
*他有很多朋友，他的朋友也喜欢我。
*我失眠时他陪我聊天，聊到我想睡，他睡觉时我打电话，他放弃睡觉陪我聊天。
*和以前的女朋友不再联系。
*比我高，取不到的东西他帮我取。
*我感冒了，他还是会吻我，并说：把病毒感染给你就会好了。
*从不对我说：我很累，我很忙，我没时间。
*每个星期起码要见我一次，并且主动提出。
*不要让我哭。
1、不要找到一個有腦子的女人，就抱怨她沒有胸部；找到個有胸部的，又抱怨她沒有腦子；那個有腦子又有胸部的女人，你又會抱怨她的壞脾氣。沒有十全十美的女人，就像沒有十全十美的男人一樣。
2、別以為女人是你肚子裡面的蛔蟲，你愛不愛她，你什麼也不說，你什麼也不做，她怎麼會知道？
3、別在女人撒嬌的時候冷落她，如果你不理會她的撒嬌，她可能會認為她在你心裡已經不重要了。
4、性關係對女人來說，遠遠沒有男人想的那麼重要，所以，不要以為她愛你，就該在你需要的時候，無條件的滿足你，那樣她只能認為你只在乎性，而不是她。
5、在她穿上新衣服的時候，適當的讚揚她一下，別總說這個太暴露、那個太透明；即使真的如此，你可以跟她說：「這件衣服你穿著真漂亮，但只能穿給我看！」，她會明白的。
6、別動不動跟她說：「你懂什麼？我的事你別管！」女人也有自尊，即使在她最愛的男人面前，她依然有自尊。
7、在她獨處的時候，給她自由，別說她今天很奇怪；她靜默的時候，給她擁抱，別問她為什麼。
8、她一定會有異性朋友，甚至會是知心朋友，別擔心，女人對愛情和友誼，往往比男人分得清楚。
9、別總是獨自去外面玩，再大度和自信的女人，都會認為你不喜歡和她一起，是因為厭倦了她。
10、吃醋是女人的專利，如果女人有天不吃你的醋了，那只能是告訴你，她不愛你了；但醋吃多了，女人會傷心的，依然會離開她愛的你。
11、女人對於愛情的需要和男人對於性的需要一樣多，所以不要指責她對愛情的追求是「奢侈」。
12、能容忍自己的男人去偷吃的女人，永遠是少數，不要期待你的女人是少數派；即便她真的是，那她可能也找到了平衡心態的方式：也去偷吃。
13、記住：這個世界的男女比例是1.04：1，女人永遠比男人少，而且，每個男人都想擁有幾個女人。結論是：女人永遠比男人有性別優勢！
BEAUTIFUL STOR Y TO SHARE WITH EVERYONE
There was once this guy who is very much in love with his girl. This romantic guy folded 1,000 pieces of paper cranes as a gift to his girl. Although, at that time he was just a small fry in his company, his future didn't seem too bright, they were very happy together. Until one day, his girl told him she was going to Paris and will never come back. She also told him that she cannot visualize any future for the both of them, so they went their own ways there and then... Heartbroken, the guy agreed. But when he regained his confidence, he worked hard day and night, slogging his body and mind just to make something out of himself. Finally with all the hard work and the help of friends, this guy had set up his own company.. You never fail until you stop trying. One rainy day, while this guy was driving, he saw an elderly couple sharing an umbrella in the rain walking to some destination. Even with the umbrella, they were still drenched. It didn't take him long to realize they were his girl's parents.With a heart in getting back at them, he drove slowly beside the couple, wanting them to spot him in his luxury sedan. He wanted them to know that he wasn't the same any more; he had his own company, car, condo, etc.He made it! What he saw next confused him, the couple was walking towards a cemetery, and so he got out of his car and followed...and he saw his girl, a photograph of her smiling sweetly as ever at him from her tombstone and he saw his paper cranes right beside her... Her parents saw him. He asked them why this had happened. They explained, she did not leave for France at all. She was ill with cancer. She had believed that he will make it someday, but she did not want to be his obstacle... therefore she had chosen to leave him.
Just because someone doesn't love you the way you wa nt them to, doesn't mean they don't love you with all they have. She had wanted her parents to put his paper cranes beside her, because, if the day comes when fate brings him to her again...he can take some of those back with him... Once you have loved, you will always love. For what's in your mind may escape but what's in your heart will remain forever. The guy just wept...The worst way to miss someone is to be sitting right beside her knowing you can't have her, see her or be with her ever .........hope you understand.
Find time to realize that there is one person who means so much to you,
for you might wake up one morning losing that person who you thought
meant nothing to you.
sexuality speaking
Parents, teachers, religious leaders and the government need to talk about sexuality openly . This is necessary as teenagers become increasingly sexually active but are almost clueless about contraceptives or sexually transmitted diseases.
There are a lot of unwanted pregnancies . you cannot ignore that. It shows that young people are not taking proper care of their bodies. It shows ignorance about sex. In a recent survey, boys as young as nine years old said they had sex before. The youngest girl who said she was sexually active at ten years old...