The suggestion to pay for individuals to engage in pro-health behaviors and the question if this idea is an effective, sustainable, as well as cost-efficient tool to promote individual and public health is a controversial issue. This week's PLoS Medicine reports on the view of an international team of researchers from the Philosophy Department and Center for Ethics and Policy at the Carnegie Mellon University in Pittsburgh, USA, who write: "When incentives are used to encourage utilization of, or compliance with, established means of producing individual or public health benefits and when it is likely that recipients are already favorably disposed to these goals, then traditional concerns about the provision of incentives in research may be misplaced, and even misguided." Leading author Alex John London and his team examine the ethical issues that are raised when researchers aim to establish whether incentives, either in form of cash payments, gift cards, vouchers, prizes, or other material benefits, encourages people to start or adhere to health interventions, care plans, or activities that change their behavior.
Spanish and Danish researchers have developed a method for the in vivo study of the unknown metabolism of selenium, an essential element for living beings. The technique can help clarify whether or not it possesses the anti-tumour properties that have been attributed to it and yet have not been verified through clinical trials. "It is vox populi that doctors around the world recommend selenium supplements to complement traditional therapy against cancer and the AIDS virus but the truth is that the basics of these properties are not clear, " explains to SINC Justo Giner, a chemist from the University of Oviedo (Spain). "Even the general metabolism of selenium has not been completely cleared up, " adds Giner who, along with other researchers at the same university and the University of Pharmaceutical Sciences of Copenhagen (Denmark), has developed a new methodology for discovering how this element moves around living organisms.
In people with a primary HIV infection, the need to restart treatment during chronic HIV infection can be delayed if they receive a 24-week long temporary therapy with antiretroviral drugs (cART). The study findings published in this week's PLoS Medicine are significant, given that treatment for HIV-infected individuals is currently often deferred until their CD4 count drops below a certain level (350) or is based on clinical symptoms. Leading researcher, Marlous Grijsen, from the Academic Medical Center at the University of Amsterdam in the Netherlands, recruited 168 patients with primary HIV infection who were randomized to either receive 24 or 60 weeks of cart or no treatment. They discovered that the average viral setpoint, i.e. the stable point that is reached in the amount of virus in the blood after the immune system begins to produce HIV antibodies, was lower in the cART group who received early therapy compared with those who received no treatment.
Physical violence, sexual abuse and other forms of childhood and adult trauma are major factors fueling the epidemic of HIV/AIDS among American women. Scientists have known for years that traumatized women are at greater risk of becoming infected. Now, two new studies from the University of California, San Francisco (UCSF) and Harvard Medical School demonstrate that a high rate of trauma among women already infected with HIV also plays a role in the epidemic. Described in back-to-back papers in the journal AIDS and Behavior, the new work demonstrates that women with HIV are exposed to trauma and suffer from post-traumatic stress disorder (PTSD) at rates far higher than those occurring in women in general. The work may help to reframe many types of discussions about HIV/AIDS so that more clinicians take trauma into account when working with their patients.
A study from Rhode Island Hospital examined the two-year period when the current ban on federal funding for syringe exchange programs (SEPs) was lifted in order to learn whether SEPs received or anticipated pursuing federal funding during that time. Only three of the 187 SEPs that responded had received funding at the time of the survey, and early experiences cited many barriers to accessing the federal funds. With the ban reinstated, the researchers state that the effect of federal SEP funding can therefore not realize its full public health potential. The findings are published in the American Journal of Public Health. SEPs, which have been controversial since their inception, have been found to be effective and cost-effective interventions that prevent the spread of HIV and hepatitis infections among drug users.