Pasted Graphic
Gilead AIDS drug safe for HIV prevention in study
By Kate Kelland
VIENNA (Reuters) - Gilead's HIV drug tenofovir is safe to be given to men at high risk of contracting the virus as a preventative measure, scientists said on Friday, but further trials are needed to test its efficacy.
Researchers from the Centers for Disease Control and Prevention (CDC) in the United States studied the safety of the drug in gay and bisexual men who did not have the human immunodeficiency virus (HIV) that causes AIDS and said their results showed there were no concerns.
"We didn't find any increased risk of harm in medical terms, and on the behavioral side the preliminary work we've done also suggests there is no increased risk," said Lisa Grohskopf, who led the study and presented the findings at the International AIDS Conference in Vienna.
The approach of taking a daily antiretroviral drug to try to prevent HIV infection is known as pre-exposure prophylaxis, or PrEP. Scientists around the world are currently conducting studies to see if it may be an effective way to reduce HIV infection in high-risk groups, including gay men.
A previous study in Ghana, Nigeria and Cameroon found that the Gilead drug was also safe when given to heterosexual women at high risk of contracting HIV.
South African researchers presented research at the Vienna conference on Monday which showed that a microbicide gel also containing Gilead's tenofovir can sharply reduce HIV infections in women.
More than 2.7 million people around the world become newly infected with HIV each year and 33.4 million people are currently living with the virus.
Although prevention methods such as using male or female condoms can be very effective, many people don't use them and scientists are constantly searching for other ways of trying the prevent the incurable virus from spreading.
This trial looked at whether a 300 milligram tablet of tenofovir taken daily was safe among 400 HIV-negative gay men in San Francisco, Atlanta, and Boston.
The men were divided into four groups. Two groups were started immediately on either tenofovir or a placebo, or dummy pill, while the other two received either tenofovir or a placebo nine months after the start of the study. This design allowed researchers to compare risk behaviors among those taking a daily pill and those not taking pills.
"It is conceivable that if someone was taking a pill and thought that it was effective (in preventing HIV infection) that it might lead to a greater likelihood of risky behavior," Grohskopf explained.
The researchers said they were "encouraged" that no serious safety concerns emerged in the trial. There were also no serious side effects and no significant differences in effect on kidney function between those taking tenofovir and those on a placebo.
"If PrEP proves effective it could provide an additional safety net for men who have sex with men and other individuals at high risk, when used in combination with other proven prevention strategies," they said.
(Editing by
Ben Hirschler, Greg Mahlich)
 Elderly Staying Sexually Active
Rob Stein, Washington Post Staff Writer Thursday, August 23, 2007; A01
Many people maintain rich, active sex lives well into their 80s, according to the first detailed examination of sexuality among older Americans.
The nationally representative survey of more than 3,000 U.S. adults ages 57 to 85 found that more than half to three-quarters of those questioned remain sexually active, with a significant proportion engaging in frequent and varied sexual behavior.
Sexual problems do increase with age, and the rate of sexual activity fades somewhat, the survey found. But interest in sex remains high and the frequency remains surprisingly stable among the physically able who are lucky enough to still have partners.
"There's a popular perception that older people aren't as interested in sex as younger people," said Stacy Tessler Lindau of the University of Chicago, who led the study, being published today in the New England Journal of Medicine. "Our study shows that's simply not true. Older people value sexuality as an important part of life."
"This study paints a portrait of this aspect of older Americans' lives that suggests a previously uncharacterized vitality and interest in sexuality," agreed Georgeanne E. Patmios of the National Institute on Aging, the primary funder of the study. "This has not perhaps been fully appreciated."
The survey found a close link between sex and health, with healthier people reporting the highest rates of sexual activity. In addition to supporting the well-known idea that illness can interfere with sex, that finding suggests that a healthy sex life may itself help keep people vibrant, the researchers said.
"Individuals who remain sexually active gain the benefit of the physical exercise that comes with sex," Lindau said. "It's also possible the hormones -- the endorphins released by orgasms -- give a general sense of well-being that could be beneficial. The psychological benefits of being loved and cared for may also trickle over to physical health."
Despite the intense focus on sex in popular culture, political sensitivities have severely limited funding for reliable, detailed studies of sexual activity among Americans of any age. Smaller, more limited studies have provided glimpses into the sex lives of the elderly, but no one had previously attempted an in-depth, nationally representative survey among this rapidly growing segment of the population.
"We just don't know very much about sexuality in the later years," said Robert N. Butler, president of the International Longevity Center in New York, a nonprofit think tank. "There's been a tremendous amount of resistance to such studies. That's what makes this so terrific."
For the study, researchers conducted face-to-face interviews with a randomly selected sample of 3,005 Americans from July 2005 to March 2006.
"We found people to be grateful to have an opportunity to discuss these issues," said Lindau, noting that researchers achieved an unusually high 75 percent response rate from those they approached. "The topics we were asking about resonated with people. Many said they had never had a chance to talk to anyone about these issues, not even a spouse or their physicians."
About 28 percent of men and about 14 percent of women said sex was very important, and about three-quarters of those with partners reported being sexually active, which is about equivalent to what previous research had found for people in their 40s and 50s. Being sexually active was defined as having had mutually voluntary sexual contact with another person within the past 12 months.
"Our findings indicate that when it comes to sexual activity, older people are really just younger people later in life," Lindau said "There's no reason to believe they give up the basic human desire for love and intimacy and the kind of pleasure that comes from intimate relationships."
The proportion of those having sex did decline somewhat with age. By ages 75 to 85, it was down to 39 percent of men and 17 percent of women.
Among those who remained sexually active, frequency also fell somewhat with age. But even among the oldest age group, 54 percent of those who were sexually active reported having sex at least two to three times per month and 23 percent reported having sex once a week or more.
"This just shows that the light doesn't go out. The flame doesn't go out," said Todd P. Semla, president of the American Geriatrics Society.
The most common sexual activity was vaginal intercourse. But the survey found a significant proportion reported engaging in oral sex, both giving and receiving, as well as masturbation.
Mirroring their younger counterparts, elderly men reported more sexual activity than women, but researchers said that was largely because women live longer than men, giving the surviving men more opportunities to have sex than women.
"This doesn't necessarily mean that women aren't necessarily interested in intimacy and sexuality," Lindau said. "A substantial number of women say the reason they are not having sex is they don't have a partner."
Among those who remained sexually active, nearly half reported at least one sexual problem. Forty-three percent of women reported a lack of sexual desire, 39 percent of women reported vaginal dryness, and 37 percent of men reported problems achieving an erection.
Given the availability of new medical treatments such as Viagra, those findings indicate that the elderly would benefit from more frank and open discussions about sex with their doctors.
"This should increase awareness among physicians to pay more attention to this," said John E. Morley, director of geriatrics at St. Louis University. "This is extraordinarily important, and we need to pay more attention to it."
Chemical in Bananas Identified as Potent Inhibitor of HIV Infection
5:04am EDT
100315091303
This is a 3-D structure of BanLec, a chemical isolated from bananas identified as a potent new inhibitor of HIV infection. (Credit: University of Michigan Medical School)
ScienceDaily (Mar. 16, 2010) — A potent new inhibitor of HIV, derived from bananas, may open the door to new treatments to prevent sexual transmission of HIV, according to a newly published University of Michigan Medical School study.
Scientists have an emerging interest in lectins, naturally occurring chemicals in plants, because of their ability to halt the chain of reaction that leads to a variety of infections. In laboratory tests, BanLec, the lectin found in bananas, was as potent as two current anti-HIV drugs. Based on the findings published March 19 in the
Journal of Biological Chemistry, BanLec may become a less expensive new component of applied vaginal microbicides, researchers say.
New ways of stopping the spread of the HIV are vitally needed. The rate of new infections of HIV is outpacing the rate of new individuals getting anti-retroviral drugs by 2.5 to1, and at present it appears an effective vaccine is years away.
"HIV is still rampant in the U.S. and the explosion in poorer countries continues to be a bad problem because of tremendous human suffering and the cost of treating it," says study senior author David Marvovitz, M.D., professor of internal medicine at the U-M Medical School.
Although condom use is quite effective, condoms are most successful in preventing infection if used consistently and correctly, which is often not the case. "That's particularly true in developing countries where women have little control over sexual encounters so development of a long-lasting, self-applied microbicide is very attractive," Markovitz says. Some of the most promising compounds for inhibiting vaginal and rectal HIV transmission are agents that block HIV prior to integration into its target cell.
The new research describes the complex actions of lectins and their ability to outsmart HIV. Lectins are sugar-binding proteins. They can identify foreign invaders, like a virus, and attach themselves to the pathogen.
The U-M team discovered BanLec, the lectin in bananas, can inhibit HIV infection by binding to the sugar-rich HIV-1 envelope protein, gp120, and blocking its entry to the body. Co-authors Erwin J. Goldstein, Ph.D., professor emeritus of biological chemistry at U-M and Harry C. Winter, Ph.D., research assistant professor in biological chemistry at U-M, developed the biopurification method to isolate BanLec from bananas. Following their work, the U-M team discovered BanLec is an effective anti-HIV lectin and is similar in potency to T-20 and maraviroc, two anti-HIV drugs currently in clinical use. Yet therapies using BanLec could be cheaper to create than current anti-retroviral medications which use synthetically produced components, plus BanLec may provide a wider range of protection, researchers say.
"The problem with some HIV drugs is that the virus can mutate and become resistant, but that's much harder to do in the presence of lectins," says lead author Michael D. Swanson, a doctoral student in the graduate program in immunology at the University of Michigan Medical School. "Lectins can bind to the sugars found on different spots of the HIV-1 envelope, and presumably it will take multiple mutations for the virus to get around them," he says. Swanson is developing a process to molecularly alter BanLec to enhance its potential clinical utility. Clinical use is considered years away but researchers believe it could be used alone or with other anti-HIV drugs as a vaginal microbicide that prevents HIV infection. Authors say even modest success could save millions of lives. Other investigators have estimated that 20 percent coverage with a microbicide that is only 60 percent effective against HIV may prevent up to 2.5 million HIV infections in three years.
Swanson et al. A Lectin Isolated from Bananas Is a Potent Inhibitor of HIV Replication. Journal of Biological Chemistry, 2010; 285 (12): 8646 DOI: 10.1074/jbc.M109.034926
Why Do Sexually Experienced Girls Resume Sexual Activity After Abstinence?
ScienceDaily (Mar. 15, 2010) — An Indiana University School of Medicine study provides a better understanding of why sexually experienced girls resume sexual activity after periods of abstinence, information key to dealing with sexually transmitted diseases (STDs) and pregnancy in high school girls and beyond.

While there has been a significant amount of research on teenagers' initial sexual experiences, the IU study is among the first to examine changes over time in decision-making about sexual abstinence among sexually active teenage girls. This information may help tailor effective counseling to prevent adolescent pregnancy and STDs.
The new findings are reported in the March 2010 issue of
Perspectives on Sexual and Reproductive Health.
Characteristics associated with the risk of a teen girl having sex after a period of abstinence differed according to how long she had been abstinent. In the short term, a young woman was more likely to have sex when her relationship with her partner was good, when the girl felt good and when she was interested in having sex. Long term, sexual interest and relationship quality were the two most important predictors of resumption of sex after a period of abstinence.
"Sexuality is an important developmental task for teens. They need to go from childhood to sexually mature adulthood while remaining sexually disease free and without getting pregnant. We conducted this study to better understand the factors that influenced teenage girls who became sexually active again after a period of abstinence. With this new understanding we can better help young women remain healthy and avoid unwanted pregnancy," said study first author Mary A. Ott, M.D., assistant professor of pediatrics at the Indiana University School of Medicine.
Diagnosis of a STD was associated with a reduced risk of subsequent sex for a short time. However having an STD increased risk for sexual activity in the intermediate time period and was unrelated to the decision to have sex in the long run. The study authors hypothesize that the switch may reflect either relationship turmoil after diagnosis of an STD, followed by "make up" sex, or may reflect adherence to Center for Disease Control and Prevention recommendations for a period of abstinence following STD treatment, followed by resumption of previous sexual activity.
"Either way, the findings suggest that counseling only about abstinence after a sexually transmitted infection is insufficient. Clinicians should anticipate resumption of sexual behavior and tailor counseling appropriately," said Dr. Ott.
The researchers also found that, in the short term, girls who characterized themselves as irritable, angry or unhappy were unlikely to return to sexual activity after a period of abstinence. That finding contradicts anecdotal information that depressed individuals are likely to engage in sexual activity.
The researchers evaluated 354 sexually active urban teen girls for up to four and a half years between 1999 and 2006. Study participants were 14 to 17 years old and not pregnant when they enrolled. Sexual experience was not an inclusion criterion, but 81 percent of participants were sexually experienced at enrollment; most of the others had their first sexual experience during the study period.
Participants reported a total of 9,236 abstinence periods, which averaged 31 days.
"Having data from the same group of young women over such a long period of time, as they go through periods of having sex and times when they are not having sex and as they change partners, enables us to understand a complex process of motivation in a way that previous studies have not. What we have established in this study are the major factors associated with the decision to resume sex," said study senior author J. Dennis Fortenberry, M.D., professor of pediatrics.
In addition to Dr. Ott and Dr. Fortenberry, co-authors of "Characteristics Associated with Sex After Periods of Abstinence Among Sexually Experienced Young Women" are Susan Ofner, M.S.; Wanzhu Tu, Ph.D., associate professor of medicine; and Barry P. Katz, Ph.D., professor of medicine. Dr. Tu is a Regenstrief Institute investigator. Dr. Katz is a Regenstrief affiliated scientist.
The study was funded by the National Institutes of Health.

More Women Having Wilder Sex, Watching Porn
Thursday, February 18, 2010
By Lyla Katz

LONDON — A new survey reveals more women are having wilder sex and watching porn.
The survey, done by the English Netmums website, found three-quarters of women having less sex because of longer work hours, but when they do have sex, they’re much more adventurous when compared to last year’s survey,
TheSun.co.uk reported.
The study shows 76 percent of women use porn, that’s a 10 percent rise from last year’s survey of women who admitted watching porn with their partners.
The most popular format is online porn, which is watched by 61 percent of couples.
Just one couple in 20 looks at magazines, while 18 percent watch porn DVD’s.
The survey of 4,200 women also revealed four in five women like to dress up and indulge in role play.
A French maid uniform is used by 42 percent of women, followed by nurses uniform, while 16 percent of couples like the policewoman uniform.
More than half of the women said they use sex toys in the bedroom to add excitement.
"Our survey shows they are taking control in the bedroom," Netmums founder Siobhan Freegard said. "They know what to do to get their sex lives back on track and are not afraid to experiment and introduce new methods to spice things up."
"During this age of multi-tasking, when we all wish there were 25 hours in a day, at least women are going after quality sex when they are having it," Katy Zvolerin, Adam & Eve's public relations director told XBIZ. "That women are willing to experiment more and become more adventurous says a lot. We are finding that themed lingerie, costumes and toys are much more popular than in years past, and a great way to add fun in the bedroom."
Last year’s survey showed more than half weren’t happy with their sex life, but this year more than 60 percent claimed to enjoy a fulfilling sex life.

http://www.sciencedaily.com/releases/2010/02/100204144815.htm
 


First Discovery of the Female Sex Hormone Progesterone in a Plant
Leaves of the walnut tree contain progesterone, the female sex hormone, discovered for the first time in a plant. (Credit: iStockphoto)
ScienceDaily (Feb. 7, 2010) — In a finding that overturns conventional wisdom, scientists are reporting the first discovery of the female sex hormone progesterone in a plant. Until now, scientists thought that only animals could make progesterone. A steroid hormone secreted by the ovaries, progesterone prepares the uterus for pregnancy and maintains pregnancy. A synthetic version, progestin, is used in birth control pills and other medications.The discovery is reported in the American Chemical Society's Journal of Natural Products.
"The significance of the unequivocal identification of progesterone cannot be overstated," the article by Guido F. Pauli and colleagues, states. "While the biological role of progesterone has been extensively studied in mammals, the reason for its presence in plants is less apparent." They speculate that the hormone, like other steroid hormones, might be an ancient bioregulator that evolved billions of years ago, before the appearance of modern plants and animals. The new discovery may change scientific understanding of the evolution and function of progesterone in living things. Scientists previously identified progesterone-like substances in plants and speculated that the hormone itself could exist in plants. But researchers had not found the actual hormone in plants until now. Pauli and colleagues used two powerful laboratory techniques, nuclear magnetic resonance and mass spectroscopy, to detect progesterone in leaves of the Common Walnut, or English Walnut, tree. They also identified five new progesterone-related steroids in a plant belonging to the buttercup family.
100204144815
Genital Herpes Virus Reactivates Widely Throughout Genital Tract
ScienceDaily (Jan. 30, 2010) — Genital herpes caused by a reactivation of herpes simplex virus type 2 (HSV-2) is generally treated as a lesion in one specific area of the genital region. A new study, however, finds that the virus can frequently reactivate throughout the genital tract, an important new concept that could help guide both HSV-2 treatment and prevention. Now available online, the study appears in the Feb. 15 issue of The Journal of Infectious Diseases.
In the study, Christine Johnston, MD, MPH, and colleagues at the University of Washington and the Fred Hutchinson Cancer Research Center in Seattle collected daily samples during a 30-day period from seven separate genital sites in four women infected with HSV-2. HSV-2 was detected from more than one anatomic site on 56 percent of days when there was viral shedding -- and on genital surfaces on both sides of the participants' bodies on most days when virus was detected at more than one site.
Using a detailed sampling method and a sensitive assay, the authors showed that both symptomatic and asymptomatic HSV-2 reactivations often occurred at widely spaced regions throughout the genital tract. These reactivations were often on both sides of the body, even though clinical lesions typically emanate from one anatomic spot. The study's findings illustrate an important new concept in HSV-2 pathogenesis, the authors wrote, and may help in developing comprehensive treatment that both suppresses and limits the transmission of HSV-2 infection.
The authors also noted limitations of their study, including a small sample size and the unique features of the study's subjects. For example, all participants had a history of symptomatic genital herpes, and three of the four had acquired HSV-2 infection within the past year, increasing the chances of high viral reactivation and lesion rates. Additionally, although there were a high proportion of days with lesions during the study period, two of the participants who had recently acquired genital herpes contributed the majority of lesion days.
In an accompanying editorial, Edward W. Hook III, MD, of the University of Alabama at Birmingham, called the study's findings "of great potential importance, as they further challenge widely held beliefs regarding genital herpes and, by extension, its management." Many clinicians treat patients with newly diagnosed herpes episodically, managing the signs and symptoms of periodic symptomatic recurrences, Dr. Hook wrote. "From a personal and public health perspective, the biology of the infection suggests that a national campaign for serological testing of those at risk would provide the foundation for more effective efforts to control HSV transmission to others, and that for most sexually active persons with HSV-2 whose sex partners are not known to also be infected, suppressive therapy should be the preferred approach."
Adapted from materials provided by Infectious Diseases Society of America.

TV Drama Can Be More Persuasive Than News Program, Study Finds
ScienceDaily (Feb. 11, 2010) — A fictional television drama may be more effective in persuading young women to use birth control than a news-format program on the same issue, according to a new study.
Researchers found that college-age women who viewed a televised drama about a teen pregnancy felt more vulnerable two weeks after watching the show, and this led to more support for using birth control.
However, those who watched a news program detailing the difficulties caused by teen pregnancies were unmoved, and had no change in their intentions to use birth control.
The results show the power that narratives like TV shows can have in influencing people, said Emily Moyer-Gusé, co-author of the study and assistant professor of communication at Ohio State University.
"A message that is hidden inside of a story may overcome some of the resistance people have to being told how to behave," Moyer-Gusé said.
"The impact that dramatized stories have on people's beliefs and intentions depends a lot on the individual viewers, and not just the message -- but our results suggest the effect can be there."
Moyer-Gusé conducted the study with Robin Nabi of the University of California, Santa Barbara. Their research appears in the current issue of the journal
Human Communication Research.
The study involved 353 undergraduate students between the ages of 18 and 25. All of them watched one of two programs that focused on the difficulties associated with unplanned teen pregnancies.
Half of the participants watched a program developed by the National Campaign to Prevent Teen Pregnancy to be broadcast on Channel One -- a news program that airs in many U.S. high schools. This program used a news format, and profiled male and female teen parents. The overall message was that teen pregnancy makes life as a young adult more difficult.
The remaining participants watched an episode of the U.S. teen drama,
The OC. In this episode, high-school students Ryan and Theresa faced the difficult consequences of an unintended pregnancy.
The programs were pre-tested with other students, who agreed that they both had the same main message concerning the difficulties of teen pregnancy.
Before watching the programs, participants completed questionnaires concerning how often they used some form of birth control if they were sexually active, and their intentions to use birth control over the next year.
Immediately after viewing the programs, participants filled out questionnaires concerning how much they were emotionally involved in the program, how much they identified with the characters, and other issues concerning their response to the programs they viewed.
Two weeks later, they were contacted again and asked about their intentions to use birth control.
The researchers found that male and females had different responses to the programs.
Watching the news-format program had no effect on men's safe-sex intentions two weeks later.
But two weeks after watching
The OC, men said they were actually less likely to follow birth control practices than they did before they viewed the program. That was probably because men reported they didn't like the program as much as women did, and didn't identify with the characters, Moyer-Gusé said.
Women had a different reaction to the programs. The news-format program had no effect on their intentions to use birth control. But those who watched
The OC episode were more likely to report in two weeks that they planned on taking steps to prevent pregnancy.
The findings revealed some of the underlying mechanisms that made the TV drama persuasive to many women viewers.
Findings showed that viewers who said they identified with the two main characters in
The OC episode also felt, when contacted two weeks later, that they were more vulnerable to an unplanned pregnancy. That, in turn, led to greater intentions to use birth control.
"Many of the women participants were able to put themselves in the place of the characters and sense they could end up in a similar situation if they weren't careful," Moyer-Gusé said.
Feeling vulnerable was the key to accepting birth control practices for the women in the study.
"One of the reasons why some people avoid safer sex behaviors is because they feel invulnerable -- they have this optimistic bias that nothing bad will ever happen to them," she said.
"But if you vicariously experience a bad result happening to you by watching a narrative program, that may change behavior in a way that is difficult to achieve through a direct message."
Participants, particularly women, were more likely to be persuaded to use birth control if they felt the program they watched didn't have an overt safe-sex message.
Most people didn't think
The OC episode was preaching the use of birth control, but those who did were much less likely to increase their intentions to use birth control, the findings showed.
In addition, those who reported that they reacted to the characters in
The OC as if they were friends were also less likely to see an overt message in the show, and were more likely to accept birth control practices.
Moyer-Gusé emphasized that the results don't mean that men aren't persuaded by narratives such as TV dramas.
"The show we chose happened to connect less with the men. But if we picked another topic or another show, I believe a narrative program could also be persuasive to male viewers."
While these results suggest persuasive messages might be better received by people if they are wrapped up in a story, Moyer-Gusé cautions that it isn't always that simple. As the different reactions of men and women
in this study showed, a lot depends on the individual viewers and not just the message.
"The problem with using stories to persuade people is that people can interpret them in different ways. You don't always get the results you expect," she said.


 http://www.sciencedaily.com/releases/2010/02/
 100209144153.htm
Science News
Web address:
Science Daily (July 15, 2009) — Condom use is associated with a reduced risk of contracting herpes simplex virus 2, according to a report based on pooled analysis of data from previous studies.
Herpes simplex virus 2 (HSV-2) typically causes genital herpes, a chronic, life-long, viral infection. Although studies indicate that consistent condom use reduces the spread of HIV and other sexually transmitted diseases such as chlamydia and gonorrhea, the effectiveness of preventing the transmission of HSV-2 through condom use is less certain, according to background information in the article.
Emily T. Martin, M.P.H., Ph.D., of Children's Hospital Research Institute and the University of Washington, Seattle, and colleagues analyzed data from six HSV-2 studies to assess the effectiveness of condom use in preventing the virus. The studies included three candidate HSV-2 vaccine studies, an HSV-2 drug study, an observational sexually transmitted infection (STI) incidence study and a behavioral STI intervention study. These yielded results from 5,384 HSV-2-negative individuals (average age 29) at baseline for a combined total of 2,040,894 follow-up days.
More than 66 percent of those who took part in the six studies were male, 60.4 percent were white, 94.1 percent were heterosexual and most reported no prior STIs.
A total of 415 of the individuals acquired HSV-2 during follow-up. "Consistent condom users [used 100 percent of the time] had a 30 percent lower risk of HSV-2 acquisition compared with those who never used condoms," the authors write. "Risk of HSV-2 acquisition decreased by 7 percent for every additional 25 percent of the time that condoms were used during anal or vaginal sex." The risk of acquiring the virus increased significantly with increasing frequency of unprotected sex acts. There were no significant differences found in condom effectiveness between men and women.
"Based on findings of this large analysis using all available prospective data, condom use should continue to be recommended to both men and women for reducing the risk of HSV-2 acquisition," the authors conclude. "Although the magnitude of the protective effect was not as large as has been observed with other STIs, a 30 percent reduction in HSV-2 incidence can have a substantial benefit for individuals as well as a public health impact at the population level."
Funding for this project was provided by grants from the National Institutes of Health, National Institute of Allergy and Infectious Diseases. 

Journal reference:
  • Emily T. Martin, MPH; Elizabeth Krantz, MS; Sami L. Gottlieb, MD, MSPH; Amalia S. Magaret, PhD; Andria Langenberg, MD; Lawrence Stanberry, MD, PhD; Mary Kamb, MD, MPH; Anna Wald, MD, MPH. A Pooled Analysis of the Effect of Condoms in Preventing HSV-2 Acquisition. Arch Intern Med, 2009;169(13):1233-1240 [link]
Adapted from materials provided by JAMA and Archives Journals.

Revision to the bible of psychiatry, DSM, could introduce new mental disorders
By Rob Stein Washington Post Staff Writer Wednesday, February 10, 2010; A01
Children who throw too many tantrums could be diagnosed with "temper dysregulation with dysphoria." Teenagers who are particularly eccentric might be candidates for treatment for "psychosis risk syndrome." Men who are just way too interested in sex face being labeled as suffering from "hypersexual disorder."
These are among dozens of proposals being unveiled Wednesday by the
American Psychiatric Association in the first complete revision since 1994 of the Diagnostic and Statistical Manual of Mental Disorders, or "DSM" -- the massive tome that has served as the bible for modern psychiatry for more than half a century.
The product of more than a decade of work by hundreds of experts, the proposed revisions are designed to bring the best scientific evidence to bear on psychiatric diagnoses and could have far-reaching implications, including determining who gets diagnosed as mentally ill, who should get powerful psychotropic drugs, and whether and how much insurance companies will pay for care.
"It not only determines how mental disorders are diagnosed, it can impact how people see themselves and how we see each other," said Alan Schatzberg, the association's president. "It influences how research is conducted as well as what is researched. . . . It affects legal matters, industry and government programs."
The proposals will be debated in an intense process over the next two years, with potentially billions of dollars at stake for pharmaceutical companies, insurance companies, government health plans, doctors, researchers and patient advocacy groups.
But perhaps more important, the outcome will help shape which emotions, behaviors, thoughts and personality traits society considers part of the natural spectrum of the human persona and which are considered pathological, requiring treatment and possibly even criminal punishment.
Even before being made public, the proposed changes have been the subject of sometimes bitter debate over whether the process was based on solid scientific evidence and was adequately shielded from influence by the pharmaceutical industry, and whether some critics were driven by financial interests in maintaining the old diagnostic criteria.
Supporters argue that the revisions would make diagnoses more accurate, creating more useful and precise definitions and sometimes reducing the number of psychiatric labels. For example, "autistic disorder" and "Asperger's disorder" would be replaced with a new, single category called "autism spectrum disorders." Critics, however, fear the new diagnoses could unnecessarily stigmatize many people and lead to the unnecessary use of psychiatric medications that can sometimes produce serious side effects.
"By massively pathologizing people under these categories, you tend to put them on an automatic path to medication, even if they are experiencing normal distress," said Jerome C. Wakefield, a professor of social work and psychiatry at New York University.
After being posted on the Internet, which of the proposed changes become final will be determined by a public comment period that will last until April 20, studies to validate some of the changes, further review, and votes by the association's Board of Trustees and Assembly. A final version is expected to be released by May 2013.
"We're mindful of the concern that we don't want to overdiagnose," Schatzberg told reporters during a telephone briefing Tuesday. "We want to, in fact, get an accurate assessment of what the degree of psychopathology might be in the culture."
Among the concerns are proposals to create "risk syndromes" in the hopes that early diagnosis and treatment will stave off the full-blown conditions. For example, the proposals would create a "psychosis risk syndrome" for people who have mild symptoms found in psychotic disorders, such as "excessive suspicion, delusions and disorganized speech or behavior."
"There will be adolescents who are a little odd and have funny ideas, and this will label them as pre-psychotic," said Robert Spitzer, a professor of psychiatry at Columbia University, who has been one of the most vocal critics of the DSM revision process.
Similarly, a proposal to create a new condition for people at risk for dementia could cause unnecessary anxiety, treatment and other harms, critics said.
"These people will never get long-term-care insurance if they have that on their chart," said Michael B. First, a professor of psychiatry at Columbia University.
William Carpenter of the University of Maryland, who chaired the working group that made the risk syndrome recommendation, acknowledged those concerns but said that experts decided that the potential benefits of early intervention warranted the move.
Others expressed concern about the proposals to create new conditions such as "temper dysregulation with dysphoria," or TDD. Supporters say it is intended to counter a huge increase in the number children being treated for bipolar disorder by creating a more specific diagnosis, though critics argued that it would only compound the problem of overtreatment.
"They are close to treating the children like guinea pigs. I think that's appalling and outrageous," said
Christopher Lane, author of "Shyness: How Normal Behavior Became a Sickness." "The APA should be moving to prevent such controversial practices, not encouraging them, as it is doing here."
In addition to classifying the symptoms of grief that many people experience after the death of a loved one as "depression," the proposals include adding "binge eating" and "gambling addiction" as bona fide psychiatric conditions; they also raise the possibility of making "Internet addiction" a future diagnosis. Some critics questioned the proposal to create a "hypersexual disorder."
"How many people with just healthy sex drives will be given that label?" First said.