Use a Condom - You'll Live Longer

At the 2008 National STD Prevention Conference held in Chicago in early March, Dr. Sara Forhan released an alarming set of data referring to a study of Sexually Transmitted Diseases in female teenagers.

Forhan studied 838 participants in the 2003-2004 National Health and Nutrition Examination survey, all of whom were female teenagers between the ages of 14 and 19. The study showed that approximately one in four teens had one of the four most common STDs found in women-HPV (Human papillomavirus,) Chlamydia, HSV-2 (Herpes simplex virus type 2), or Trichomoniasis.

That is 3.2 million members of America?s female population that have STDs that can cause lifelong damages such as genital cancers, genital herpes, and infertility, among other symptoms. Out of those 3.2 million, 15 percent have more than one of the four major STDs.

While there is no comparable data for male teenagers or young adults between the ages of 20 and 24, it is no secret that STDs in teen and young adults are on the rise. Quite often, it is more difficult to detect STDs that are generally symptom-free, such as HPV and Chlamydia in men, who typically do not undergo regular STD screening tests such as those for women. While the diseases are more prevalent in certain genders and backgrounds, it?s time for every one of us to take to step back to see what we?re up against and how we can fix this ever-growing problem.

Of the four STDs targeted in this study, the most prevalent STD found in teen girls was HPV, which affected 18 percent of the study's participants. According to the Center for Disease Control, over 25 percent of women aged 20 to 24 also have the disease at any given time. The majority of the American population will come in contact with one of the many strains of HPV before their 50th birthday. This is especially unfortunate because there is a strong link between HPV and cervical, penile, and anal cancers, as well as the occasional case of genital warts.

Next comes Chlamydia, a disease with little to no detectable symptoms. The rate of Chlamydia has gone up 36% in men and 16% in women from 2002 to 2006, the CDC says. Still, the disease is more than three times more common in women than men. Unfortunately for these women, Chlamydia is an extremely destructive force if left untreated and can lead to damage of the reproductive organs and infertility.

One out of five adolescents has genital herpes, the catalyst of which is primarily HSV-2, according to the CDC. Apart from genital herpes outbreaks, which do not occur right away and may be mistaken for another condition such as skin irritation in the early stages, there is no way to track HSV-2.

"Genital HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of eight),? the CDC website states. "This may be due to male-to-female transmission being more likely than female-to-male transmission."

Forhan's study also found a disparity in the race of infected teenagers in her study. While 20 percent of non-Hispanic whites and Mexican females were infected with one of the main four STDs, a shocking 48 percent of African-American females were affected.

"Factors contributing to the severe STD impact among African Americans include limited access to quality health care, as well as poverty. Additionally, a higher prevalence of STDs in this population may translate into a greater risk of being exposed. Finally, misperceptions of personal or partner risk may also be factors in increased risk for STDs among African American women," says Nikki Kay of the Center of Disease Control.

However, Dr. John Douglas, Director of the STD Prevention Division at the CDC, assures that the minority trend is not exclusive to African-Americans. ?When compared to whites, the Chlamydia rate among Hispanics is three times higher and the gonorrhea rate is twice as high. Hispanics also have the second highest rate of syphilis in the nation, followed closely by Native American/Alaska Natives, who also have the second highest rate of gonorrhea and Chlamydia in the U.S."

Overall, young females have more STDs than young males. Young African-Americans have more STDs than other races. Now we must consider that statement and ask ourselves why this is happening.

"We are seriously overdue to re-invent 'sex education' - to ensure that adolescents gain understanding about the underlying gender norms that actually shape much of their sexual health and well-being. Specifically, policies and programs need to emphasize young people?s critical thinking skills and their awareness of gender issues," Nicole Haberland and Debbie Rogow say in an editorial reacting to Forhan's study. The two authors wrote the article on behalf of the Population Council, a program which seeks to improve programs and policies for HIV/AIDS; poverty, gender, and youth; and reproductive health.

Haberland and Rogow suggest that the rise in STDs is directly linked to America?s perception of the traditional gender roles men and women play out in a sexual relationship.

"Girls who are submissive to male partners, or who agree that males should 'have more power in the relationship' are less able and less likely to negotiate condom use or to refuse unwanted sex. Boys who are socialized to equate masculinity with physical strength, emotional toughness, and aggressive behavior; with proving their heterosexuality; and with having multiple sexual partners are also at greater risk."

According to the authors, the only way to fix the problem is to develop a stronger focus on gender dynamics among teens. This focus is absent in most sexual education programs, whether they are abstinence or prevention-based.

"Unfortunately, sex educators in the US are busy battling right wing opposition and have had little time or space to heed this call,? Haberland and Rogow explain. "Indeed, most sex education programs ignore gender issues, or touch on them at best superficially."

The call for education on gender relations and stereotypes also offer a solution to the controversial call for "sex education" to be taught at a younger age since many students drop out of school before high school, when sexual education is usually taught. The authors discuss this in a November 2005 article entitled Sexuality and Relationships Education: toward a Social Studies Approach:

"Unfortunately, in some cases, implementing this shift boils focusing only on negative aspects of sexuality (protection against abuse) or on lessons about intercourse and contraception for children who are not prepared for such information. In contrast, a culturally appropriate focus on social norms related to gender might also be considerably more appropriate for under-12 children than focusing predominantly on sexuality per se."

Even when taught to teens, Haberland and Rogow have found that the few gender-based sexual education programs that exist have had their success. In Latin America, the Project H program for young males targets gender awareness issues. An evaluation of the program showed more condom use and less STD symptoms among its participants.

In the US, where there is also a great concern about the growing levels of STDs in youth, the authors have also found a program that?s got the attention of teens. "Another example, closer to home, is the Brooklyn-based nonprofit Scenarios USA. Scenarios sponsors a critical thinking and creative writing program through public school districts in New York City, Cleveland, South Texas, and Miami, as well as through Planned Parenthood and through Black Entertainment Television."

Scenarios USA presents a new theme based around issues of love, sex, and gender every year. This year?s theme is "What?s the real deal about masculinity?" The theme was discussed through a story, play, and scriptwriting contest, which will be translated into publications, performances, and films that will be displayed throughout high schools and via television.

The data released by Dr. Sara Forhan at the National STD Prevention Conference only supports a pattern that America has been trying to deter for years though health and education programs. STDs have a significant prevalence in teens between age 14 and 19, as well as young adults between age 20 and 24. This is especially true for women and minorities, who are as much affected by society?s social constructs as they are sexually transmitted diseases.

It is only through gaining a greater understanding of our own strengths and, perhaps more importantly, vulnerabilities that teens can conquer the norms of sex as we know it. We need to recognize the faults of traditional gender roles and utilize that knowledge to protect ourselves from undesirable sexual situations and consequences.

Those who see themselves as being in a favorable sexual situation must still be aware of both contraceptive and STD screening services available to them, both of which are crucial to STD prevention and treatment. According to a study by Sherry Farr and her colleagues at the CDC, it shows that only 39% of women are actually taking advantage of both services, thus putting themselves at unnecessary risk.

The old cliché "knowledge is power" has never been more relevant than in a case such as the struggles of teens and young adults against sexually transmitted diseases, so get educated and get involved!

SOURCE: Kait Silva, acedmagazine.com

1 in 4 teenage girls found to have sex-related disease

More than one in four teenage girls is infected with common sexually transmitted diseases, federal researchers reported Tuesday in a new study that for the first time quantifies a persistent problem.

Young women and girls ages 14 to 19 in "alarming" numbers are contracting human papilloma virus, chlamydia, genital herpes and trichomoniasis, said Dr. Sara Forhan, a researcher at the U.S. Centers for Disease Control and Prevention who led the study team. Almost half of black teens were infected.

An estimated 3.2 million have one or more of those four sexually transmitted diseases, or STDs, all of which can cause permanent damage. Cancer-causing HPV was the most common STD by far, followed by chlamydia.

Teen girls get such diseases when they don't protect themselves by avoiding sex, using contraception and remaining monogamous. The problem of disease transmission is compounded because many do not get tested or treated, CDC officials said.

"They don't really think they can catch it. They just don't believe they would be the ones to get it," said Lourdes Salgado, 17, a Plantation High School senior who gives talks to students about how to avoid STDs.

STD rates were higher among black female teens, with 48 percent infected compared with 20 percent of white and Mexican teens, the study showed. CDC officials blamed the disparity partially on a lack of access to health care and education, but said the main reason is that STDs are more prevalent in the black community, making each sexual encounter more risky.

"This does not mean African-Americans are taking higher individual risks than other groups. In fact, research suggests the opposite," said Dr. John M. Douglas Jr., director of sexually transmitted disease prevention at the CDC. Still, he said, the nation must face "this extraordinary racial disparity."

The high infection rates were not a surprise, said health officials in South Florida and elsewhere, but the study puts harder numbers to the problem. Researchers based the new estimate on a 2004 nationwide health assessment program that examined, among others, 838 teen girls in what was called a representative sample of the U.S. population.

No state breakdowns were done, but Florida has reported rising numbers of teen girls with STDs. Almost 14,000 girls ages 10 to 19 contracted chlamydia in 2005, including 1,100 in Broward and 615 in Palm Beach County. Overall, chlamydia cases rose 75 percent in the prior decade.

The four STDs are not considered as serious as HIV/AIDS, gonorrhea and syphilis, which were not tracked in the study. But all can damage the body if left untreated. HPV can cause cervical cancer, the bacterial infection chlamydia can lead to abnormal pregnancies, and genital herpes viruses and the parasite trichomoniasis can make it easier to catch HIV/AIDS.

The study showed that about half of teens reported being sexually active, and about 40 percent of those were infected.

A second CDC study showed that the nation's health care system misses many opportunities to test teen girls when they come into clinics for contraception, Douglas said. Only 38 percent who came in after unprotected sex were tested, counseled or treated.

"We need to do a better job on lots of different fronts," Douglas said.

An HPV vaccine for girls and women ages 11 to 26 has been available since 2006 but is controversial. Critics have argued that giving it to young girls may encourage promiscuity and expose them to side effects. But many advocates say it's a strategy for preventing an infection that kills 3,700 women annually.

A few states made the vaccine mandatory for school admission, while Florida and others have not.

Plantation High School's Salgado said South Florida teens often ignore advice to get tested because it's not easy to find or reach a testing site.

"It's far away and some can't get there," she said. "Some don't know about it. Some are scared to go because of their parents."

Salgado is leading a group organizing an HIV/AIDS testing day March 25 across from her school. A small-scale attempt at another school last month brought 46 teens to a mobile testing van, said Norman Powell, president and CEO of Comserv Inc., a community group.

SOURCE: Bob LaMendola, www.sun-sentinel.com

Contraceptives: What about your health?

Your method of birth control can actually do more than just protect against pregnancy. It may also affect things such as your appearance and your risk of certain kinds of cancer.

Health benefits
Some methods of birth control have benefits for your health.

Clearer skin: Studies have shown a connection between the use of the birth control pill and decreased amounts of acne. This is because the pill can moderate levels of hormones called androgens, regulating the production of oil in the skin.

Protection from certain diseases: The birth control pill is associated with protection from some diseases affecting women. These include benign ovarian cysts, endometrial (uterine) cancer, ovarian cancer, iron deficiency (anemia), and pelvic inflammatory disease.

Reduced pain and menstrual flow: Birth control methods that contain hormones are linked to a reduction in the volume of menstrual flow and the painful cramps that often accompany your period.

Protection against STIs: Condoms provide protection against sexually transmitted infections (STIs). Depending on the nature of your sexual relationship, this protection can be vital, even if you use another form of birth control, because the other forms of birth control do not provide protection from diseases such as AIDS/HIV, chlamydia, gonorrhea, genital herpes, human papillomavirus (associated with genital warts and cancer of the cervix), and syphilis.

Things to watch out for
Your state of health is an important consideration when deciding on or during the use of any birth control method. Certain birth control methods may affect some medical conditions, and medication for some conditions may change the effectiveness of some birth control methods.

Antibiotics: The antibiotic rifampin reduces the effectiveness of birth control pills. As for other antibiotics, there is less conclusive evidence that they decrease the effect of oral contraceptives. This effect may only occur in a small number of women. But it's best to err on the side of caution, as more research is needed to determine the effect of antibiotics on the modern low-dose birth control pills used today. Adding a barrier method (e.g., male or female condom) is a good idea if you're taking antibiotics.

Medical conditions: Women with epilepsy need to determine the proper form of birth control with their doctor and neurologist. Many anti-seizure medications may reduce the effectiveness of hormone-based birth control methods by speeding up the breakdown of these hormones in the liver. Including a barrier method will reduce the chance of pregnancy.

Women who have any of the following conditions should talk to their doctor before deciding on a birth control method:

• high blood pressure
• liver disease
• history of blood clots in a vein (deep vein thrombosis) or lung (pulmonary embolism)
• migraine headaches
• family history of stroke

Latex allergy: Most male condoms are made of latex. People who are allergic to latex can consider such options as condoms made from polyurethane and female condoms. Lambskin condoms are also available, but they offer less protection against STIs. If protection from STIs is not an important issue, there are many options, ranging from sponges to IUDs to pills.

SOURCE: MediResource, canada.com

Sex Ed For Your Kids: One Talk Won't Do

(WebMD) Ideally, that "facts of life" talk you have with your children should be a series of sex ed discussions that cover a range of topics, rather than one long talk, according to a new study.

"Because of discomfort with the topic, there is that hope that it can be taken care of with a single talk," says Steven C. Martino, PhD, study researcher and a behavioral scientist at Rand Corp. in Pittsburgh.

But his new study, published in the March issue of the journal Pediatrics, suggests that a continuous, repetitive, wide-ranging conversation with your kids about sex is the better approach.


Study: Beyond the "Big Talk"

"We know [already] that the more parents talk to their kids [about sex], the better off the kid is in terms of healthy beliefs," Martino says, citing previous research. Children whose parents talk often about sex education are more likely to delay sex until an older age and to take precautions when they do become sexually active, he says.

In the new study, Martino and his colleagues wanted to assess the independent influence of repeating topics and covering many topics on the teen's perceptions of their relationships and communication with their parents.

"What we were interested in is whether the extent to which having repeated discussions about sexual topics and also covering a wide variety of topics matter" in terms of how teens feel about their relationship with their parents and how easy it was or wasn't to talk to them about sex.

The researchers polled 312 teens in grades 6 through 10, and their parents. They responded to four surveys during the yearlong study, telling whether they had discussed each of 22 sex-related topics and how often they had. Teens rated their overall relationship with their parents, too, including their ability to communicate about sex and other topics.

Among the topics: the making of decisions about whether to have sex, consequences of getting pregnant or getting someone pregnant, selection of a birth control method , what it feels like to have sex, and protection offered by condoms.


Study Results: Repetition Key in Sex Ed

Repetition was good, the researchers found. "We found that kids whose sexual communication with their parents involved more repetition felt closer to their parents, better able to communicate with them in general and about sex in particular, and they perceived their discussions about sex happened more easily and with more openness in comparison to kids whose communication involved less repetition," Martino tells WebMD.

The greater the number of topics that were discussed, the more openness teens said they felt during these talks.

At the start of the study, the average number of topics that teens had discussed was seven of the 22.

"On average we found that parents and teens had 10 repeat discussions over the course of the year," Martino says. That is, they revisited a topic previously discussed that often. Regarding breadth of topics, the average number of new topics discussed during the study was reported as three, on
average.


Sex Ed: The Role of Repetition and "Breadth"

"We think that having these repeated discussions is so important because it helps kids to better understand the information," Martino says. "It helps them to get a clear sense of what their parents' values are, and it boosts parent and child feelings of comfort in talking about sex ."

Revisiting a topic allows children to ask clarifying questions, he says, and allows parents to talk about topics in a more age-appropriate way as a child matures. Some abstract topics become less so as the child gets older, he adds.


Second Opinion

The study reinforces what is seen anecdotally, says Vanessa Cullins, MD, MPH, MBA, vice president for medical affairs for Planned Parenthood of America, New York, who reiewed the study results for WebMD.

What is new about the study, she says, is the importance of the repetition and variety of topics.

The study, she says, "reinforces what Planned Parenthood has always believed in, and that is that parents should be the primary educators in a child's life, and that the best way to keep teens healthy and safe is to have open, honest communication [about sexual matters]."

As parents, she says, "you just can't deal with the subject of sex infrequently or every blue moon." It should be a frequent part of household conversation, she says.


Sex Ed Advice for Parents

Lack of preparation is one cause of discomfort for parents when asked questions about sex by their kids, Martino says. Prepare yourself for the expected questions ahead of time, he suggests. Anticipate you'll be asked questions sooner than you think -- maybe even when your children are still toddlers.

"It's OK to admit you feel uncomfortable," he says. It's also OK, he says, to gather more information on a topic and get back to your kids.

One way to ease into talks about sex, Martino says, is to look for what he calls "teachable moments." If something is in the news that is sexually related, or something happened at school that lends itself to discussion, take advantage, he says.

Take advantage, too, of prepared materials that may help you, Cullins says. Many Planned Parenthood affiliates in the U.S. offer special programs that help parents talk to their kids about sex, she says.

SOURCE: Kathleen Doheny, Web MD, article featured on CBSNews.com

5 things you didn't know about HPV

1 Cancer connection: There are more than 100 types of Human papillomaviruses or HPV, the most common sexually transmitted infection in the United States. Most are harmless, but about 30 types put you at risk for cancer. Almost all women will have HPV infections at some point, but very few will develop cervical cancer; their immune systems will usually suppress or eliminate HPVs, says the Centers for Disease Control and Prevention. Only HPV infections that do not go away over many years lead to cervical cancer.

2 How you get it: Through skin-to-skin sexual contact with an infected partner. Transmission by genital contact without intercourse is not common, but it has been reported. Oral-genital and hand-genital transmission of some HPV types is possible, says the American Cancer Society.

3 Common: Infection is very common soon after a woman becomes sexually active. In one recent study, more than 50 percent of college-age women were found to have acquired an HPV infection within four years of first having sex, says the American Cancer Society.

4 Prevention: Abstinence or a long-term, mutually monogamous relationship with an uninfected partner, although it's difficult to tell if a partner who has been sexually active in the past is infected. Correctly using latex condoms greatly reduces the risk, but it doesn't completely protect because areas not covered by a condom. A new vaccine called Gardasil is recommended for 11- and 12-year-old girls before their first sexual contact. Another promising vaccine, Cervarix, is being tested, but hasn't been approved yet. Studies suggest the vaccines can protect against some HPV for at least four years; the need for a booster vaccine is being researched. A controversial Florida bill that would have required all sixth-grade girls to be vaccinated died in the Florida Legislature last year.

5 Guys: HPV also can cause genital warts, penile and anal cancer. It now causes as many cancers of the upper throat as tobacco and alcohol, probably due both to an increase in oral sex and the decline in smoking, researchers say. A vaccine for boys may soon become available, which also would help prevent men from spreading the virus to women.

SOURCE: JODI MAILANDER-FARRELL, MIAMIHERALD.COM

Safety is sexy, chlamydia is not

Back in the day it was called VD for venereal disease. And then we had STD for sexually transmitted disease. At present, the medically appropriate term is STI, for sexually transmitted infection.

The terminology changes, as does the awareness about them and the number of people afflicted. With an increase in education and awareness about condoms and STI testing, one might think that the numbers are going down. But the horizon ain't totally rosy. Let's check in on some stats of those with bacterial ants in the pants.

There is some good news, particularly on the increasingly less grim front of HIV/AIDS. New diagnoses of those with the virus have been relatively stable in Oregon since 1997, and they've been taking a slight decline in the last couple of years, hovering around 300 new cases a year in the state, but dipping to 270 in 2006.

Syphilis, too, has been a virtually nonexistent issue with a rate of 1.3 per 100,000 new Oregonians diagnosed with it in 2006. (As my doctor of a mother said, "Jesse, you really don't need to worry about that unless you're doing it with sailors or something.") And Oregon's rate of those newly diagnosed with any infection-for which data is available-is lower than the national average.

In some cases, however, our genital health is a little less jolly. Chlamydia rates, for example, have been on an aggregate rise in our state since a historic low in 1997. The rate then was 184.9 per 100,000 people. In 2006 it was 259.5. The scariest part about this is the fact that while chlamydia is often easily cured with antibiotics, the infection usually occurs with no symptoms, and as a result, often goes undiagnosed. The health consequences can be harsh, especially on women. In a report on recent STI trends, the Centers for Disease Control (CDC) tells us "Up to 40 percent of females with untreated chlamydia infections develop PID, and 20 percent of those may become infertile." The report goes on to say that while chlamydia complications among men are "relatively uncommon," it can, in rare cases, cause sterility.

Gonorrhea rates, while having remained relatively stable in Oregon for the last few years (and even showing signs of going down), have a separate and frightening can of worms to deal with. Long dealt with as an infection cured by antibiotics, a fast-growing number of cases are turning out to be resistant to the leading class of antibiotics used to treat it. Of the cases tested through a CDC surveillance project in 2006, 13.8 percent were found to be resistant. Alternative antibiotics are now being used to treat it, but other drug-resistant strains exist, and alternative antibiotics can often come with higher prices and more side effects.

Not to mention diseases like HPV, which the CDC estimates half of sexually active people will get at some point in their lifetime and which men cannot be tested for. Or genital herpes, which, it's estimated, one out of five adolescents and adults in the United States has. Scary stuff.

Finally, the fact that some rates of new diagnoses are stable is, quite bluntly, not good enough. A total 270 new diagnoses of HIV/AIDS a year in this state is 270 too many.

So what's the deal in our age of supposed enlightenment? Most people are smart enough to not fuck total strangers without protection. Most of us are smart enough to know how to put on a condom, and most of us know that using the withdrawal method is about as safe as taking the MAX out to Gresham.

But having unprotected sex with anybody, no matter how well you know them, is still unprotected and unsafe. Urban myths, like the idea that putting on two condoms means double the protection (uh, not true, by the way) or that you can't contract infections through oral sex, still persist. And condoms are effective, but like everything, they are not 100 percent.

So it bears repeating: If you are sexually active, use protection effectively and get screened for infections regularly. There are enough resources out there to get it done confidentially, cheap and without judgment. If your antsy untested partner is loath to the idea of protection, don't forget that it's not a matter of "Don't you trust me?" It's a matter of protecting yourself as well as your partner, every time, all the time.

SOURCE: Jesse Thiessen, dailyvanguard.com

Study Finds Anti-AIDS Drugs May Prevent HIV Infection

A new study involving monkeys suggests that antiretroviral drugs used to treat HIV could also protect people from getting infected with the virus. The development is being hailed by AIDS researchers. VOA's Jessica Berman reports.

More than 33 million people worldwide are living with HIV. There were 2.5 million new infections last year alone.

Despite years of intensive effort, researchers have been unable to develop a vaccine. But antiretroviral drugs have turned HIV into manageable disease by keeping it from progressing to AIDS.

Now, researchers are finding that these drugs may be a potent weapon against the spread of HIV.

In a study involving monkeys, researchers at the US Centers for Disease Control and Prevention in Atlanta, Georgia used two antiretroviral drugs to prevent transmission of a primate version of HIV.

The scientists injected macaques with single daily doses of the antiretroviral drug FTC and then exposed them once a week for 14 weeks to a primate version of the AIDS virus. In that experiment, the drug reduced the risk of infection 3.8-fold compared to untreated primates.

The researchers then gave oral doses of FTC and another antiretroviral drug, tenofovir, to the monkeys, reducing the risk of infection 7.8-fold compared to untreated animals.

In a third experiment, the macaques were given daily shots of FTC and higher doses of tenofovir before being exposed to the primate HIV virus. Lead researcher Walid Heneine says that provided 100 percent protection, as did another regimen in which the macaques received the FTC-tenofovir combination two to three hours before exposure to the virus and 24 hours after each weekly exposure.

Heneine says the research provides a model for human use.

"The findings from this intermittent study suggests that ultimately it is possible to provide a promising new avenue for future research, where it opens up the floor for a lot of more research for intermittent dosing," said Walid Heneine.

The results of the study were published in the online journal Public Library of Science Medicine.

The Centers for Disease Control is currently conducting HIV prevention trials using antiretroviral drugs in Thailand with injection drug users, Botswana involving heterosexuals and in the United States in the homosexual community.

Lynn Paxton is coordinator of the clinical trials at CDC. Paxton says the notion of antiretroviral drug use to prevent HIV transmission is not new. She points to the use of drugs to prevent the spread of the AIDS virus from pregnant women to their unborn babies.

Paxton says the use of these drugs may soon take its place alongside other HIV prevention methods, such as condoms.

"So, we look upon pre-exposure prophylaxis as potentially a powerful new weapon that we may be able to add to this armamentarium," said Lynn Paxton.

Myron Cohen is with the University of North Carolina's Department of Medicine.

"This is not, like, business as usual," said Myron Cohen. "There are 30 to 40 million people infected. There is an urgent thing for us to have better and better tools."

Cohen commented on antiretroviral prevention therapy in the journal PLoS Medicine.

SOURCE: Jessica Berman, voanews.com