Thailand Aids Vaccine results

[dab69]

http://www.msnbc.msn.com/id/32997306/ns/health-aids/

First time an AIDS vaccine reduced
infection rates by 31%

[gearguy]

I like to hear good news on the HIV front, but I wonder if the results are actually that as statistically significant as the media
is portraying them.

"Results: New infections occurred in 51 of the 8,197 given vaccine and in 74 of the 8,198 who received dummy shots. That worked out to a 31 percent lower risk of infection for the vaccine group."

It will interesting to see the actual paper when it is presented and see the statistical analysis. The question is the delta of 23 new infections statistically significant or could be due to standard variation. I'm in the middle of a graduate program in statistics, so I think I'll use this paper for a project in one of my classes.

Nonetheless, indicates a promising line for future developments.

[dab69]

maybe considering the population studied, it's best to
focus on the 16,000 that didn't get infected :)

[gearguy]

According to the press release all participants were given frequent safe sex counseling, condoms, and every six month testing.
Forgetting the value of the vaccine study, a testament that aids prevention campaigns that are focused and on-going work at decreasing new infections. Sadly, through out much of world, there appears to be decreasing emphasis on such programs. Not too mention the stupidity of the abstinence programs the previous US admin pushed both in the states and abroad.

Ditto to all of the above.

The selection criteria was a little bizarre.

My partner, who lives with me monogamously, was asked at our local clinic if he wanted to take part in the study after the ancient receptionist noticed me waiting for him to have a dressing changed after a m/c accident (he said no).

My ex's wife in Pattaya, who was obviously not practicing safe sex as she had already had one son with him and at the time the study started was pregnant with another despite knowing that my ex was HIV+, was never asked about the study by the government doctor regularly checking her, even though he knew the HIV status of both of them.

[gearguy]

from what I read, all the participants needed to test HIV neg at the start of the study. So your ex and your ex's wife would not meet the selection criteria; that's why they were probably not asked about participating. Likewise, I would expect that a person HIV neg but stating they are in a monogamous relation with another HIV neg person, would not have been selected as well.

There have been studies in the past that looked for "magnetic" couples.

Sorry, GG, I can't have been clear, particularly about the ex.

Even though my partner and I were/are HIV neg, and monogamous, he was still asked.

Even though my ex's wife was HIV neg, while he was HIV pos and they obviously were having unprotected sex, she was not asked (and surely fewer people could be at higher risk?).

[giggsy]

According to the press release all participants were given frequent safe sex counseling, condoms, and every six month testing.
Forgetting the value of the vaccine study, a testament that aids prevention campaigns that are focused and on-going work at decreasing new infections. Sadly, through out much of world, there appears to be decreasing emphasis on such programs. Not too mention the stupidity of the abstinence programs the previous US admin pushed both in the states and abroad.
This is not good news. If these people were given sex councelling and free condoms and 125 still managed to get HIV then how many would have got it without counceling and condoms.The mind boggles.

[Beachlover]

According to the press release all participants were given frequent safe sex counseling, condoms, and every six month testing.
Forgetting the value of the vaccine study, a testament that aids prevention campaigns that are focused and on-going work at decreasing new infections. Sadly, through out much of world, there appears to be decreasing emphasis on such programs. Not too mention the stupidity of the abstinence programs the previous US admin pushed both in the states and abroad.
This is not good news. If these people were given sex councelling and free condoms and 125 still managed to get HIV then how many would have got it without counceling and condoms.The mind boggles.

Disturbing to say the least... that 125 still got it. I wonder how they got it... and if it was through consensual unsafe sex... what was their decision process?

[Beachlover]

I like to hear good news on the HIV front, but I wonder if the results are actually that as statistically significant as the media
is portraying them.

"Results: New infections occurred in 51 of the 8,197 given vaccine and in 74 of the 8,198 who received dummy shots. That worked out to a 31 percent lower risk of infection for the vaccine group."

It will interesting to see the actual paper when it is presented and see the statistical analysis. The question is the delta of 23 new infections statistically significant or could be due to standard variation. I'm in the middle of a graduate program in statistics, so I think I'll use this paper for a project in one of my classes.

Nonetheless, indicates a promising line for future developments.

Well apparently the search for a vaccine has been so bleak, they felt even this was big news. I think it is only a breakthrough if it leads onto bigger and better discoveries.

On BBC someone said it would need an efficacy rate of 70-80% to be considered a vaccine.

I'm worried if they got close to making a viable vaccine people would get careless in terms of safe sex.

[Surfcrest]

IтАЩm guessing that with comments like these, some of you donтАЩt have many / if any friends with HIV. Every case is different. How absurd it is to assume that this is simply a matter of decisions.

I have quite a few friends that are HIV positive. Many became infected in relationships that they thought were monogamous. They never thought they needed to use protection in a relationship where their only sexual partner started out HIV negative. How many of us here are in or think weтАЩre in monogamous relationships? How many still like to eat out from time to time, with / without your partner knowing or suspect your partner of doing the same?

Party drugs have had a huge impact on infection rates. There is an undercurrent of this sort of thing on gay social sites, in bathhouses at rave parties on Craigslist. Crystal Meth (Yaba) and sex play is known as тАЬparty and playтАЭ or PnP. Certainly none of these terms are foreign to Thailand.

How about the world of porn? One of the biggest tickets out there appears to be BB or barebacking. ThereтАЩs a fascination with BB for some reason, that when combined with any of the above leads to infections and the domino effect.

ThereтАЩs a great big mix happening out there. People from opposite sides of the city and indeed opposite sides of the world are meeting up, hooking up. All that crap that I described above is floating in that big mix of people. You may never know how close youтАЩve come to any of this crap or even becoming infected yourselfтАжor maybe you do.

I can understand testing vaccines on lab rats or mice, but asking for volunteers, especially for HIV.

It's like telling these people that they'll eventually contract the virus anyway so they may as well test the vaccine for them. THem being major drug corporations who will make huge massive profits from these vaccines, at the peril of these people who agree to this.

I hope they're being compensates well for putting their lives on the line.

[Bob]

I can understand testing vaccines on lab rats or mice, but asking for volunteers, especially for HIV.

It's like telling these people that they'll eventually contract the virus anyway so they may as well test the vaccine for them. THem being major drug corporations who will make huge massive profits from these vaccines, at the peril of these people who agree to this.

I hope they're being compensates well for putting their lives on the line.

I think there's some misunderstanding here on a couple of points.

Based on what I've read about this study, the volunteers (both the ones given the test vaccine and the ones given the placebo) were provided counseling about safe sex practices and the danger of HIV. For the volunteers who ended up testing positive for HIV, they apparently ignored the counseling advice given and obviously engaged in unprotected sex. I don't see how you can blame the study for that (those that contracted the disease didn't get it from the vaccine being tested).

And all vaccines are ultimately tested this way (to my knowledge, no vaccine has ever been administered to the public simply by studying how lab rats react to it).

[Beachlover]

My ex's wife in Pattaya, who was obviously not practicing safe sex as she had already had one son with him and at the time the study started was pregnant with another despite knowing that my ex was HIV+, was never asked about the study by the government doctor regularly checking her, even though he knew the HIV status of both of them.

Goodness... interesting situation.

So the wife had unsafe sex with him knowing he was HIV+? I hope the son didn't get it. Or was he conceived before the husband had HIV?

[Beachlover]

IтАЩm guessing that with comments like these, some of you donтАЩt have many / if any friends with HIV. Every case is different. How absurd it is to assume that this is simply a matter of decisions.

I have quite a few friends that are HIV positive. Many became infected in relationships that they thought were monogamous. They never thought they needed to use protection in a relationship where their only sexual partner started out HIV negative. How many of us here are in or think weтАЩre in monogamous relationships? How many still like to eat out from time to time, with / without your partner knowing or suspect your partner of doing the same?

Party drugs have had a huge impact on infection rates. There is an undercurrent of this sort of thing on gay social sites, in bathhouses at rave parties on Craigslist. Crystal Meth (Yaba) and sex play is known as тАЬparty and playтАЭ or PnP. Certainly none of these terms are foreign to Thailand.

How about the world of porn? One of the biggest tickets out there appears to be BB or barebacking. ThereтАЩs a fascination with BB for some reason, that when combined with any of the above leads to infections and the domino effect.

ThereтАЩs a great big mix happening out there. People from opposite sides of the city and indeed opposite sides of the world are meeting up, hooking up. All that crap that I described above is floating in that big mix of people. You may never know how close youтАЩve come to any of this crap or even becoming infected yourselfтАжor maybe you do.

You're right... I don't know anyone (that I'm aware of) with it. I'm sure I've come across it before.

That's why I'm curious as to how normally-rational (or perhaps, irrational?) people get it. I saw Nicholas Snow's story on YouTube... seems like he was depressed and lonely at the time and a younger guy convinced him he was clean so he took the risk... even though (he says) he has always had safe sex previously. What a terrible slip up.

I've never BB'd so no idea what it feels like. But the condom is so thin, I don't know if not having it on makes that much of a difference. The last time I topped the boy was so tight it felt amazing once it was in...

Yeah, I've heard a lot of people get it when they're in a long-term relationship and decide it's ok to start having unsafe sex. I heard someone say this is one way women get it too... from their bi-sexual husbands.

[Beachlover]

I can understand testing vaccines on lab rats or mice, but asking for volunteers, especially for HIV.

It's like telling these people that they'll eventually contract the virus anyway so they may as well test the vaccine for them. THem being major drug corporations who will make huge massive profits from these vaccines, at the peril of these people who agree to this.

I hope they're being compensates well for putting their lives on the line.

1. I don't think there's any other way to properly test a vaccine... would you start injecting 6 billion people with something untested on even a small sample of humans?

2. I don't think they're giving the message that these people will eventually contract it anyway... they're simply doing the study on a massive number of people knowing that a certain percentage of them will be exposed to it. Having said that... I agree it is a bit gruesome... but it needs to be done. And remember that 99%+ of the people didn't end up with HIV... as opposed to 1/3 people getting cancer and similar large percentages of people dying from heart problems.

3. The massive profits from these vaccines/drugs is justified. Part of the profits needs to go back into recouping research costs. Without these drug companies, who's going to fund (and have the incentive to work hard at) finding a cure/vaccine? These drug companies take massive risks... investing millions and billions into research, which may never earn them a cent. You need someone with deep pockets for this. Part of the profits they make go back into research for more vaccines/cures/drugs. Part of it goes to the business owners as reward for risk.

Making some of these critical drugs cheaper in developing countries is a great thought (I hear some countries threaten to just go ahead and manufacturing them without license) but the worry is... if you take away the drug company's certainty of making profits... you also take away their incentive to research and develop new medicines. The risk factor goes up if they know there's a chance part of their profits would be taken away.

Not saying drug companies are completely innocent (far from it)... but the commercial/incentive dynamics need to be taken into account.

Thailand has never been anywhere near it's previous estimates about the numbers of HIV positive people or any other number put out that they think might damage 'the reputation' of the country such as their ridiculous numbers with regard to the number of people working in the sex industry etc. etc.
Anything that the scientists come up with that might better help protect from any known virus is a great thing, but because this particular (HIV) virus is such a clever one, mutating itself into different strains over the years I think we are still a very long way away from a vacine, if indeed they ever come up with one. On a good light better drugs to combat the progression of illnesses caused by being infected can indeed come about by these continuing programs. Again, safe sex is the only sure prevention.....

:cheers:

[Beachlover]

I agree... a vaccine is likely a long way off. But it may happen eventually... they've only been going for 20 years and there's plenty of vaccines, which have taken decades to research.

For the drug companies... the incentive is that if anyone were to develop a vaccine... the demand for it would be unbelievably high. If they got just $5 from everyone who was vaccinated....

I agree... a vaccine is likely a long way off. But it may happen eventually... they've only been going for 20 years and there's plenty of vaccines, which have taken decades to research.

For the drug companies... the incentive is that if anyone were to develop a vaccine... the demand for it would be unbelievably high. If they got just $5 from everyone who was vaccinated....

Agreed the demand would be high, but in the same light consider how much the drug companies are making now on manufaturing/supplying anti viral HIV drugs, the amounts are astronomical......

:cheers:

I don't trust the study at all. For one major reason; it is from Thailand. I have lived and worked here for a while and I know their education system. This country DOES NOT PRODUCE any new thinking, research or studies that are not flawed due to the education system here. Generally, Thai people don't know HOW to think, do research or study.

ajarntrade

I don't trust the study at all. For one major reason; it is from Thailand. I have lived and worked here for a while and I know their education system. This country DOES NOT PRODUCE any new thinking, research or studies that are not flawed due to the education system here. Generally, Thai people don't know HOW to think, do research or study.

ajarntrade

Yep, the Thai education system is focused on and around the elite who send their kids abroad for education. Keeping the masses as they are i.e. a basic education so as to not think or question such matters as to why the wealth of Thailand belongs to around 12 percent of the population. Still as some would say that helps keep the go-go bars full of available guys and gals, sad but true.

One might ask why did the USA use Thailand for this particular vaccine research?

:cheers:

Because Thailand has a high risk of AIDS exposure.

Because Thailand has a high risk of AIDS exposure.

Very true Bunny....

:cheers:

[Surfcrest]

Because Thailand has a high risk of AIDS exposure.

No, HIV exposure...not AIDS exposure.

[giggsy]

Because Thailand has a high risk of AIDS exposure.

So has America

[attachment=0:1g4ydh86]800px-People_living_with_HIV_AIDS_world_map.png[/attachment:1g4ydh86]

[Beachlover]

I don't trust the study at all. For one major reason; it is from Thailand. I have lived and worked here for a while and I know their education system. This country DOES NOT PRODUCE any new thinking, research or studies that are not flawed due to the education system here. Generally, Thai people don't know HOW to think, do research or study.

ajarntrade

I thought it was done in conjunction with the US Army. And there's a good chance the Western drug company developing it would've monitored procedures closely... a 7-year, 16,000 person study isn't the sort of the thing people knowingly take a half-arsed approach to.

Goodness... interesting situation.

So the wife had unsafe sex with him knowing he was HIV+? I hope the son didn't get it. Or was he conceived before the husband had HIV?

He was HIV+ at least 3 years prior to meeting his wife.

When he told me she was pregnant for the first time I persuaded him to tell her; I also arranged for both of them to see Dr Seur (Heartt 2000), whom my partner's brother had coincidentally worked for - they never went.

When she was pregnant for the second time, two years later, she was again routinely tested for HIV and was still HIV-. Unless they had used some other method (artificial insemination?) it was a pretty obvious conclusion, even for me, that they had not been practicing safe sex. I again arranged for them to get advice, again they were "too busy".

Both children are, as far as I know, HIV-.

Apart from his initial blood test for HIV, several years ago, he has had no follow up tests on the grounds that they are not necessary until/unless he becomes ill.

"Apart from his initial blood test for HIV, several years ago, he has had no follow up tests on the grounds that they are not necessary until/unless he becomes ill."

Western reseach has for sometime now concluded that HIV treatment with anti-viral medication should commence when the CD4 count is at around 350 copies, some researchers are now suggesting at 500 copies but that is still being debated. Once the count drops below 200 illness can and does occur leading in some cases to death. A person who has access to the right drugs and starts taking them at the correct time can in most cases lead a normal life........

:cheers:

Agreed, 100%. What's more not only do you and I and "western research" know it, but so do most Thais who know they are HIV+. Unfortunately that seems to make very little difference, as I pointed out in the post I repeated at the end of last year (repeated again below, for which I make no apologies, highlighting what I believe to be the most important point). Nothing much seems to have changed, except that the mama-san/owner of the bar where my partner used to work has recently been added to the growing list of my partner's friends who have died of Aids:

I personally know a number of "working" Thais who have/had HIV and who are cases in point.

My "ex" was identified as HIV+ around 8 years ago. None of his friends know this and he has not had any follow up tests/treatment, despite my encouragement in the past to do so, on the basis that he will do so when he "needs to". When he told me four years ago that his wife was seven months pregnant I persuaded him that for her sake and that of his baby he should tell her, which he did. I arranged for them both to see a specialist, but they were "too busy". One year later she was pregnant again and had another son (also apparently healthy). Same advice, same reaction, same total lack of interest in safe sex/responsibility, etc, by both of them. In his case the only thing that surprises me is that having been a glue sniffer for most of the last 20 years, and an alcoholic for all of it, that he is still alive at all.

Last year my partner's brother's ex-girlfriend, who had become a close friend of my partner (who is 100% gay) left Pattaya to go home after she became "ill". One month later she died, leaving a young son (and a mother who lived in Germany, who visited her bedside for 5 minutes, and could not have cared less). Although the words HIV or Aids were never mentioned, this was simply unspoken - when I last saw her, just before she left, she was looking tired and a little drawn, nothing more. She never once tried to have any treatment. (Edit: Apparently she now may have done, as a friend reported seeing her in the HIV treatment area of Banglamung hospital; if so, it was too little and too late)

My partner's brother (who is 100% straight) had left Pattaya several months before, but was certainly subsequently aware of her death. After working in BBB he had worked for some time assisting Dr Seur (Heartt 2000) in his clinic so was well aware of the effect of both HIV and the treatment available, having helped " victims carried in at death's door" and later " seen the same people walk in looking like you or me " just as Michael Burchall describes and as he had described them to his brother (my partner); despite this he has never had an HIV test and his new wife is totally unaware of any of this.

One month ago one of my partner's oldest friends, living in Bangkok, phoned him to say that he was a "bit ill" and going home to get better. A month or so before, when he had last see him, he had lost a little weight and was slightly pale, but he was still well. He was highly intelligent, spoke very good English and made a lot of internet "contacts", many of whom sent him money without ever meeting him - he visited farangs in both Australia and Switzerland who arranged his flights, visas, expenses, etc, also before they had met in person. Yesterday my partner called his mobile, which was answered by his mother who said that he was "sleeping" and would not be able to answer the phone anymore; she suggested he call another friend who had visited him a few days before, which he did. The words HIV or Aids, again, have never been mentioned although he is clearly in a coma, in the last stages of Aids with only days or hours to go, and he had known he was HIV+ for over a year (having evidently told his mother). He had never tried to have treatment.

One week ago one of my partner's friends from his home village who had not seen him for several years telephoned him to say that he was leaving his job as a waiter at a restaurant near Si Racha to come to Pattaya to work as a waiter/host in a gay bar. He has known he is HIV+ for over a year, as do his family and close friends (including my partner). He has been receiving medical treatment, has put back the weight he lost and now looks fully healthy. He has to be careful to take his drugs exactly as prescribed and has to return regularly to his local hospital for tests and a three months supply of drugs, which are free under the Government health scheme. So far nobody else in Pattaya knows he is HIV+.

Why is it that out of these six, only one has sought treatment - and he is probably the least intelligent/educated/informed (as we would see it) of all of them?

I have no idea - I can only suggest it has something to do with his trusting his family and his friends to support him, whereas the others would, literally, prefer to "die in agony" with their family rather than risk trusting their friends and getting treatment.

The only conclusion I can draw from my own, limited, experience is that the key is not only treatment or education, but acceptance, which will be far harder to achieve.

Last weekend my partner was told that his friend, who had been in a coma at the time I wrote, had died.

Sad story G.F. I don't think anyone could or can put their finger on the reasons why some won't seek medical treatment until sadly in a lot of cases it is too late. Perhaps it is the fear and stigma that still surrounds HIV/AIDS in certain communities. Some cases often arise in Western countries where individuals will not get tested for various different reasons, one being the "I don't want to know" attitude or "if I get sick I'll get treatment" theory.
Education and more education which will also help with the acceptance and less fear is of course the best way forward, other than that everyone is different and walks their own path...................

:cheers:

[Surfcrest]

For an HIV+ man to have inseminated and HIV- woman and conceived two HIV- children is a miracle. His sperm, HIV+ of course uniting with an HIV- egg, not once but twice is worthy of close scientific study. The assumption is that, the sperm still alive at fertilization was uninfected or for that matter cured of HIV virus by the egg or possibly something else in the reproductive tract.


Western reseach has for sometime now concluded that HIV treatment with anti-viral medication should commence when the CD4 count is at around 350 copies, some researchers are now suggesting at 500 copies but that is still being debated. Once the count drops below 200 illness can and does occur leading in some cases to death. A person who has access to the right drugs and starts taking them at the correct time can in most cases lead a normal life........ :cheers:

The side effects from anti viral medications were quite severe not all that long ago. So bad they were that people were giving up on the medications opting to die from AIDS related complications instead. When it comes to research, this is where most of the real gains have been made. The side effects from the new anti viral treatments for people just starting to take treatment are much milder now. This is why there is discussion now around starting the treatments sooner. The premise is that if you delay treatment until the CD4 count is too low, the immune system could become irreparably damaged or leave the patient vulnerable to infection. Viral load counts and CD4 counts should probably be done every 3 to 6 months after infection.

Once treatment starts, the viral load count can drop to the point of being undetectable for some for 20 or more years. Since the disease has only been around since the early-eighties and with improvements to anti viral treatments, this could stretch much farther than that. LetтАЩs hope so!

[Beachlover]

That's a sobering string of stories.

I'm really shocked your ex's wife had sex to another baby with him... just astounding. You would think, with the fear they associate with HIV, she would not. I suppose the positive side of this story is that your ex has been able to have kids and start a family that would look after him. Great that the 2 kids don't have it.

Perhaps part of all this behaviour comes from the "when it's time to go it's time to go" and "not think to much" and thinking with emotions rather than logic attribute of many Thais. I'm not sure they're as concerned about death as most Westerners are. Denial probably plays a big role in it.

I'm really shocked your ex's wife had sex to another baby with him... just astounding. You would think, with the fear they associate with HIV, she would not. I suppose the positive side of this story is that your ex has been able to have kids and start a family that would look after him. Great that the 2 kids don't have it.

They did not have sex to have another baby - they had sex to have sex. The second son has been "adopted" and registered as born to parents who had no children of ther own; I have no idea of the specific circumstances or of any financial consideration involved, but this is not unusual here. Worringly, at least for any potenial adoptive parents, is that (as far as I know) HIV+ babies may not show any symptoms for up to two years even with full blood tests so it is possible that the second baby was HIV+, although I think it is very unlkely as I am sure I would have heard something about it had this been the case.


..... Perhaps it is the fear and stigma that still surrounds HIV/AIDS in certain communities. Some cases often arise in Western countries where individuals will not get tested for various different reasons, one being the "I don't want to know" attitude or "if I get sick I'll get treatment" theory.

I agree, but when I said so recently I was told that this was 2009 not 1990! In that post (http://www.sawatdee-gay-thailand.com/forum/gay-thailand/boys-tested-for-hiv-t18308-60.html?hilit=excuse#p187383) I also explained that my own reason for not being tested when logic and reason cried out that I should was simply fear - in my case not fear of death, but fear of dying hence my choosing the "I don't want to know" path.


For an HIV+ man to have inseminated an HIV- woman and conceived two HIV- children is a miracle. His sperm, HIV+ of course uniting with an HIV- egg, not once but twice is worthy of close scientific study.

It is also a miracle that after what must now be nearer to 10 years of being HIV+ and despite having an immune system weakened by a couple of decades of glue sniffing and heavy drinking/alcoholism he still shows no signs or symptoms of the virus.

[Impulse]

It is also a miracle that after what must now be nearer to 10 years of being HIV+ and despite having an immune system weakened by a couple of decades of glue sniffing and heavy drinking/alcoholism he still shows no signs or symptoms of the virus Maybe hes a long term non-progresser,they do exist but not too many of them.More than likely he will get sick fast and if he goes to a doctor his cd4 count will be well below 200.

Maybe hes a long term non-progresser,they do exist but not too many of them.More than likely he will get sick fast and if he goes to a doctor his cd4 count will be well below 200.

Yes, the percentage of non-progressers are very, very few and they, when known still confound the specialists. I personally know one European guy who was confirmed to be HIV + in 1992 and still, on his last test a few months back had a normal CD4 count of over 1000. None of his doctors can say for sure though that this high might dramatically drop or continue to stay reasonable high.

:cheers: