Dear ARHP Members, Friends, and Colleagues, We are delighted to share new changes at ARHP that reflect over a year of thoughtful and hard work on behalf of our board members, staff, and advisors. With an historic election just days away, now is a critical and urgent time for sexual and reproductive health (SRH) professionals and advocates to share, communicate, and collaborate. Since the passage of the Patient Care and Affordable Care Act in 2010, there has been a shift in health care to emphasize primary care services and patient clinical homes. Yet despite a greater number of insured people and expanded coverage for preventive health services, millions still do not receive comprehensive sexual and reproductive health care. We strongly believe that health care is a social justice issue and should be accessible to everyone, everywhere. In response, ARHP is launching a new long-term strategy to improve access to high quality, science-driven sexual and reproductive health (SRH) care for all people regardless of age, ethnicity, gender identity and expression, ability, race, sexual orientation, religion, national origin, socioeconomic status, HIV status, and immigration status. Our approach is based on a strong commitment to support team-based care so all members can contribute to their fullest potential, including but not limited to: clinicians, researchers, educators, counselors, clinical staff, and advocates. We proudly share with you our new mission statement and new organizational values that were informed by emerging issues in our field and will provide a roadmap for our future work. As part of our commitment to members, we have created a new membership structure that will save you money without compromising the quality of our resources. Finally, we will give you a glimpse of plans to improve our communications and outreach to our members and the public at large.
1. A New Mission Statement ARHP transforms and improves sexual and reproductive health care through professional training and advocacy 2. New Organizational Values We are inherently: Driven by science Person-centered We believe: Health care is a right Diversity and inclusion strengthens We are committed to: Disseminating evidence-based, open-access information Inspiring, connecting, and collaborating Promoting team-based health care Applying imagination and innovation to our work 3. A new membership model with a flat structure and lower fees You spoke and we listened. Based on your feedback, we are launching a new and equitable membership platform that respects the contributions of all SRH professionals. Fees have been reduced to a reasonable $95 per year for everyone – regardless of professional background or discipline. Students and retirees professionals will pay even less. 4. An unfaltering commitment to open-access resources and improved delivery of these resources We believe the best health care happens when trusted information is freely available, easy to access, and evidence-based. We recognize the importance of leveraging technology to make sure our resources are available to as many people as possible, regardless of where they work or live. To do so, we plan to update and seamlessly integrate all our communication systems, including our website and social media platforms. This work will be challenging, but is necessary to promote far-reaching and meaningful knowledge and skills-transfer and dissemination.
As your professional home, ARHP serves as a nexus for you to access continuing education, stay abreast of relevant legislation and policy, and network with others who share your commitment and passion to improving sexual and reproductive health. This just the start—there is so much more work to be done and challenges ahead for us and for everyone in the field of sexual and reproductive health. Thank you for being part of a vital and evolving movement to ensure that every individual receives the best possible sexual and reproductive health care. Please give us your impressions of ARHP’s new mission, values, and focus. And if you’re not already involved, please let us know how you could help. Contact arhp@arhp.org, or call 202-466-3825 any time with your comments, suggestions, and follow-up information about volunteering for ARHP. Warmly,
Justine Wu ARHP Board Chair	Wayne C. Shields ARHP President and CEO
P.S., Click here for a visual of our new mission and values.

On November 10, 2016, APAOG hosted a webinar with Dr. Neil Silverman who gave an update on the Zika Virus situation that is facing many of our states and country.

A recording of the webinar is available on the webinar library page and handouts are available for download as well.

APAOG is currently looking into 2017 Webinar topics, please consider submitting an idea to our office today!

Timothy Jost - Health Affairs Blog

On November 8, 2016, in a stunning upset, Donald Trump was elected president of the United States. The Republican Party, under whose banner he ran, retained control over both the House and Senate. President Trump will be able to appoint at least one Supreme Court justice almost immediately and possibly more during his term in office. He will also appoint dozens of district and appellate court judges. Finally, he will presumably replace the cabinet secretaries and most of the political appointees in the Departments of Health and Human Services, Labor, and Treasury — that administer the Affordable Care Act. The Republicans own the national government, and many state governments.

So what does his victory mean for the Affordable Care Act? This post is a tentative first pass at this question. More will follow. It only addresses the coverage expansion of the ACA and does not discuss Medicare or prescription drugs, two other areas likely deeply affected by a Trump presidency.

Donald Trump states at his website, “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.” If by Obamacare Trump means the Affordable Care Act in its entirety, this will not happen. First, any repeal proposal would be subject to a filibuster in the Senate and the Democrats retain more than enough votes to stop a repeal bill. Second, the Affordable Care Act contains hundreds of provisions affecting Medicare, program integrity, the health care workforce, biosimilars, prevention, and other issues unrelated to what most Americans think of as “Obamacare.” Immediate repeal of the ACA and presumably restoring the law that preceded it would likely bring the Medicare program, for example, to a halt until new rules could be written. The ACA is inextricably interwoven into our health care system and is not going away immediately.

The Uses And Limits Of The Budget Reconciliation Process

Congress and the President, can, however, repeal many of the provisions that are identified by the public as “Obamacare” using the budget reconciliation process. A budget reconciliation bill can be passed by a simple majority and cannot be stopped by a filibuster. The final ACA in 2010 contained provisions passed through the budget reconciliation process after the Democrats lost their filibuster-proof majority.

Budget reconciliation legislation is subject to strict procedural and substantive limits. Reconciliation in the Senate can only contain provisions that affect the revenues and outlays of the United States and cannot contain “extraneous provisions” that only incidentally affect revenue and expenditures. Budget reconciliation is a two-step process—first Congress adopts a budget resolution with instructions to committees to meet reconciliation targets and then it adopts the reconciliation itself. This cannot happen on “day one.”

Congress took a dry run at repeal budget reconciliation legislation in 2015. Both houses of Congress passed reconciliation legislation that would have repealed the premium tax credits; the small business tax credit; the individual mandate, the employer mandate; the expansion of Medicaid coverage for adults up to 138 percent of the federal poverty level, presumptive eligibility, maintenance of effort, and benchmark plans for Medicaid; and the ACA’s taxes—the medical device tax, insurer fee, “Cadillac” high cost plan tax, and tax increases imposed on the wealthy—most of the provisions that the public identifies as “Obamacare.” The legislation was vetoed by President Obama. The legislation would also have defunded Planned Parenthood. Presumably this legislation, already vetted for compliance with reconciliation requirements, could serve as a model for ACA repeal.

Importantly, reconciliation legislation could probably not change the insurance reform provisions of the ACA—the ban on preexisting condition exclusions and health status underwriting, caps on annual and lifetime dollar limits, actuarial value requirements, age underwriting restrictions, as they do not affect revenues and outlays. The continued imposition of these requirements without the financing provided by the ACA could cause serious distortions and damage in insurance markets. It is possible that changes to other sections of the ACA could be made part of other “must pass” legislation, although it is hard to see what that might be.

The ‘Replace’ Part Of Repeal And Replace

Repeal would, moreover, raise the question of what would replace the ACA. The Congressional Budget Office estimated that enacting the 2015 reconciliation legislation would increase the number of uninsured Americans by 22 million. The legislation would have delayed the end of the premium tax credits until 2018 to allow time for replacement legislation, which was not part of the bill.

Donald Trump has advocated tax deductions and tax subsidies for health savings accounts (HSAs) to make health insurance more affordable for those who lack it. These provisions may help some wealthier individuals, but would do little or nothing for the millions of people now receiving tax credits for coverage through the ACA, who often pay little in taxes and receive little benefit from deductions and have little to save in HSAs. Other Republican plans offer fixed dollar tax credits to purchase insurance, which would be of more value to low-income Americans, but would likely fall far short of the cost of coverage now covered by the ACA.

A Republican replacement plan could not be implemented overnight, however. Regulations would have to be written and published for comment and mechanisms set up to handle the deductions or credits, particularly if they were provided in advance, as they would have to be. Even a two year delay might not be enough to get a program in place, much less to educate the public as to how it operated.

What President Trump Could Do On His Own To Undermine The ACA

Although Donald Trump cannot unilaterally repeal and replace the ACA, he can do a great deal to interfere with its implementation. As has been exhaustively chronicled on this blog, the ACA has been implemented by hundreds of pages of regulations and thousands of pages of guidance. Regulations cannot legally be changed without an opportunity for notice and comment and some explanation as to why a change is necessary. Guidance is easier to change.

Indeed, a Trump administration could do a great deal of damage to the ACA without even changing regulations or guidance. If a Trump administration simply stopped implementing or enforcing certain regulatory requirements, there might be little that could be done about it. Just a change in leadership in the agencies implementing the ACA will cause months of disruption, and appointment of leadership committed to destroying rather than implementing the ACA will likely cause a mass exodus of lower level employees, causing an implementation vacuum.

The Obama administration is currently engaged in an aggressive campaign to enroll individuals for the 2017 open enrollment period. A Trump administration could abandon this effort, as well as efforts to work with insurers to ensure continued ACA participation or with consumers to resolve enrollment issues. The 2015 reconciliation legislation would have required marketplace enrollees who underestimated their income to pay back all excess tax credits, regardless of the financial hardship this would cause. This might create a significant deterrence to enrollment. The repeal of the individual mandate would also discourage participation.

A number of insurers have lost money in the marketplaces. Some have withdrawn and others have stuck with the program in hopes it would turn around. Without an administration committed to the program, more will almost certainly withdraw, potentially leaving parts of the country where no marketplace plans are available. Others might raise their rates in the face of the uncertainty caused by the transition, making coverage even less affordable to individuals without premium tax credits.

A Trump administration is likely to work with conservative states to loosen remaining ACA requirements. Under section 1332 states can be granted “innovation” waivers from many ACA requirements if they can provide similar coverage under their own proposals. The Obama administration has interpreted the requirements of this provision quite conservatively, but Trump could give out the waivers much more loosely to allow states to opt out of the ACA. Trump has also proposed block-granting Medicaid, a proposal that would shift much of the burden of Medicaid financing to the states. Republicans believe that the flexibility afforded by block grants could allow states to innovate and run Medicaid more cost-effectively, but millions of Americans could lose Medicaid coverage if the block grants do not keep pace with costs.

The CHIP program also comes up for reauthorization in 2017, and Trump opposition could end CHIP as well, potentially leaving millions of children without coverage.

The Obama administration is currently involved in a number of lawsuits involving the ACA. A Trump administration might simply cease defending these lawsuits, effectively allowing the plaintiffs to triumph. If the government withdrew its appeal in House v. Burwell, for example, reimbursement to insurers for cost-sharing reduction payments could cease. Indeed, the administration could simply stop paying cost-sharing reduction payments, although this would probably take a rule change. Ending cost-sharing reduction payments would dramatically increase the cost of marketplace participation by insurers and likely lead to many insurers exiting the program. It is possible that beneficiaries or insurers could sue to reinstate the payments, but that would take time, and would likely not happen quickly enough to save the program.

The administration will also likely cease defending the contraceptive cases, indeed may likely revoke the contraceptive coverage requirement. And it will likely take a more aggressive position opposing the insurer risk corridor cases in the court of claims.

It is possible that consumer and insurer groups will file lawsuits against the administration seeking to force implementation of provisions of the ACA that remain in place. This litigation could take the place of the anti-ACA litigation the administration has fought for years. Litigants may follow the path of ACA opponents and find sympathetic district court judges in isolated districts in liberal circuits looking for easy victories. A Trump appointed Supreme Court will make progressive litigation victories harder to stick.

Now It’s The GOP’s Turn

The Democrats controlled the presidency and both houses of Congress in 2010. They adopted legislation that they hoped would dramatically increase access to health care for lower-income Americans. In many respects they succeeded, covering 20 million Americans and reducing the uninsured rate to the lowest levels in history. But many Americans believe, rightly or wrongly, that they have been disadvantaged by the ACA, and dissatisfaction with it has remained high, particularly as premiums increased and insurer participation decreased in the marketplaces this year.

It is now the Republicans’ turn.  They will have to decide what they want to do with our health care system and figure out how to do it.  They now own the problems of health care, and they will be judged in future elections for how they address them.

NOVEMBER 9, 2016

BY INES MARTINS, PHD IN NEWS.

Researchers are working to develop a new breast-friendly, radiation-free method that may replace the unpleasant mammogram currently used to detect breast cancer.

The new method, described in the study “Towards Dynamic Contrast Specific Ultrasound Tomography,” and published in Scientific Reports, uses ultrasounds to provide 3-D images of the breast, and is meant to reduce not only a woman’s discomfort during the procedure, but also the number of false-positive results seen frequently with current mammogram methods.

Currently, women are screened for breast cancer through a mammogram, where the breast is squeezed tight between two plates to generate 2D X-ray images. The method is not only physically unpleasant and one of the reasons women choose to skip screening, it also comes with the risk that the radiation used in the mammograms can contribute to the development of cancer.

In addition, mammograms generate large numbers of false-positive results. In more than two-thirds of cases where doctors find an abnormal tissue that is recommended for biopsy, it turns out that the abnormal regions are not cancer. In the meantime, women are subjected to high levels of unnecessary worrisome stress.

Researchers have been trying to develop alternatives to this method that provide more accurate results and that reduce women’s discomfort. Recently, a team at Eindhoven University of Technology has been working on a possible alternative for mammograms.

According to a press release, the new technology requires patients to lie on a table with their breast hanging freely in a bowl. Using ultrasounds, a 3-D image of the breast is generated and scanned for tumors. The researchers believe this method will generate far fewer false negative results.

The technology builds up on a patient-friendly prostate cancer detection method also developed at the Eindhoven University of Technology. The approach takes advantage of the distinct vessel architecture found in tumors and healthy tissues. Tiny micro-bubbles that can be precisely monitored with an echoscanner are injected in the prostate blood vessels, allowing doctors to precisely identify the presence and location of the tumor.

Although this method is now being tested for prostate cancer in hospitals worldwide, breast motion and size have largely limited its application in breast cancer screening.

But researchers may have developed a new variant of the echography method that is suitable to be used in breast cancer. Libertario Demi, Ruud van Sloun and Massimo Mischi developed the Dynamic Contrast Specific Ultrasound Tomography, which uses the same micro-bubbles, but under a different principle. They use the fact that bubbles vibrate in the blood at the same frequency as the sound produced by the echoscanner, and at twice that frequency — the second harmonic.

When the scanner captures that vibration, it knows where the bubbles are located. Similar to the micro-bubbles, the body tissue also generated harmonics, which limited the researchers’ observations. But the researchers found that, contrary to the body tissues, the gas bubbles delayed the second harmonic. And the more bubbles the sound-waves encountered, the bigger the delay.

This, however, can be detected only if the sound is captured on the other side, which makes the technology ideal for the breast tissue.

The researchers are now starting a collaborative effort to conduct preclinical studies with the new tool, and hope it will be included in clinical practice within 10 years, possibly in combination with other methods that will generate high-quality images that allow for highly accurate diagnoses.

Global Health

By DONALD G. McNEIL Jr. 
NOV. 7, 2016

Women should see a doctor, nurse or trained midwife at least eight times during each pregnancy, with five of those visits in the last trimester, the World Health Organization said Monday as it issued 49 recommendations to prevent deaths in childbirth.

Previously, the agency had advised women to visit clinics four times per pregnancy. It also acknowledges the important role of local midwives in poor countries where mothers must travel long distances to see doctors or nurses.

But each visit should be with someone with at least two years’ medical training, “not a traditional birth attendant or a community health worker trained for a few weeks,” said Dr. Metin Gülmezoglu, W.H.O’s coordinator of maternal and perinatal health.

About 300,000 women die in pregnancy or childbirth each year, the agency said, and more than six million babies die in the womb, during birth or within their first month. Many of those deaths can by prevented through simple interventions.

Another recommendation is that every pregnant woman have one ultrasound scan before the 24-week mark to detect fetal defects and twin or triplet pregnancies and determine accurate gestational ages. Many clinics lack ultrasound machines and even electricity, Dr. Gülmezoglu said.

The agency also recommended that all women get:

■ Daily iron and folic acid pills to prevent anemia, sepsis and premature birth.

■ A tetanus shot to prevent neonatal tetanus.

■ Blood-sugar testing to detect diabetes.

■ Antibiotics when bacteria are detected in the urine.

■ Counseling about what affordable local foods contain vitamins and minerals, about the dangers of alcohol and tobacco, and about the need for exercise.

Other recommendations directed to women at higher risk for problems included calcium to prevent pre-eclampsia; vitamin A to prevent night blindness; deworming drugs; and prophylactic doses of drugs to prevent malaria or H.I.V.

The W.H.O. also recommended a spate of home remedies, like bran for constipation, compression stockings for leg swelling, antacids for heartburn and exercise or acupuncture for back pain.

by MAGGIE FOX

Researchers reported two steps toward fighting the Zika virus Monday — one from a team that has found a potential way to protect unborn babies from the virus, and a second from a team that announced the start of human trials of a new vaccine.

Neither offers immediate relief against the epidemic of Zika that has swept across the Americas and the Caribbean and parts of Asia, but they both provide hope of eventually being able to protect pregnant women and their babies from the infection.

A researcher holds a tray of Zika virus growing in cells at Washington University School of Medicine in St. Louis. No treatments exist to block Zika virus in a pregnant woman from infecting her fetus and potentially causing severe birth defects. But now, researchers report that they have identified a human antibody that prevents -- in pregnant mice -- the fetus from becoming infected and damage to the placenta. The antibody also protects adult mice from Zika disease. 

The treatment is based on the body's own defenses — an immune system particle called a monoclonal antibody that homes in specifically on the virus. In mice, it helped decrease the damage that the virus causes to developing fetuses and it also helped protect adult mice against infection in the first place.

"This is the first antiviral that has been shown to work in pregnancy to protect developing fetuses from Zika virus," said Dr. Michael Diamond at Washington University School of Medicine in St. Louis, who helped lead the research.

"This is proof of principle that Zika virus during pregnancy is treatable, and we already have a human antibody that treats it, at least in mice," Diamond added.

Zika virus doesn't cause serious disease in most people, but it causes profound birth defects in babies infected in the womb. The virus, transmitted by mosquitoes and through sex, can also cause rare neurological syndromes in a few adults.

"THIS IS PROOF OF PRINCIPLE THAT ZIKA VIRUS DURING PREGNANCY IS TREATABLE, AND WE ALREADY HAVE A HUMAN ANTIBODY THAT TREATS IT, AT LEAST IN MICE."

Mice don't naturally catch Zika, so the study is not completely able to predict what would happen in people. But lab mice bred to be susceptible to Zika show some of the same effects that humans do, with the virus going into the brains of developing fetuses and causing extensive damage.

The team scanned blood samples from people who had been infected with Zika, looking for antibodies that appeared especially effective against Zika. They found one that looked especially effective and named it ZIKV-117.

"Even a single ZIKV-117 dose given five days after infection protected mice against lethal infection," they wrote in a report published in the journal Nature.

When they gave the antibody to pregnant female mice either just before or just after infection, it reduced how quickly the virus invaded tissue.

"These naturally occurring antibodies isolated from humans represent the first medical intervention that prevents Zika infection and damage to fetuses," said Dr. James Crowe of Vanderbilt University School of Medicine in Tennessee, who also worked on the study.

The antibodies did not appear to be dangerous to the developing mouse pups, said Indira Mysorekar at Washington University. "The anti-Zika antibodies are able to keep the fetus safe from harm by blocking the virus from crossing the placenta."

It's still a long way from testing in people. Pregnant women would be the No. 1 target for any Zika therapy, and doctors will need to be very sure that a treatment is both safe and effective before trying it in pregnant women.

But the researchers say their findings also increase hope that a vaccine might be effective.

A second team started human trials of a Zika vaccine Monday. It's an unusual trial — they will first vaccinate two-thirds of the volunteers against other, related viruses to see if that makes a difference.

That's because Zika belongs to an unusual family of viruses that includes dengue virus and the yellow fever virus. Doctors have long known that dengue virus has unusual effects on the human immune system.

People who are infected with dengue once don't usually get very sick. But if they get infected with a second strain of dengue, their risk of dangerous dengue hemorrhagic fever goes up.

There are some indications that Zika may be affected by previous dengue infections.

So Dr. Kayvon Modjarrad, who helps lead the Zika program at the Walter Reed Army Institute of Research, says volunteers will have to be free of any previous infection with or vaccination against yellow fever, dengue or Japanese encephalitis.

Those getting Zika vaccines will be divided into three groups. One will just get a Zika vaccine.

"One of the groups is going to be given the Japanese encephalitis virus first and then wait a period of time and then get the Zika vaccine," Modjarrad said. "Another group will get a yellow fever vaccine, wait a few months and then get a Zika vaccine."

Military personnel often get yellow fever and Japanese encephalitis vaccines, so the researchers want to make sure a previous vaccination doesn't interfere with the new Zika vaccine.

Later, teams will test people who've had natural dengue, yellow fever or other viral infections to see if their immune response to those infections affects how the Zika vaccine works.

The vaccine has shown good effects in monkeys. It's made using Zika viruses inactivated by chemicals, and is based on an existing vaccine that protects against Japanese encephalitis.

The volunteers will be tested to see if their bodies produce a healthy response that would be expected to protect them against infection.

Florida reports more than 200 home-grown cases of Zika, caused by locally-infected mosquitoes.

Overall, more than 1,000 cases of Zika have been reported in the state, most in people who traveled from other Zika-affected regions. The state says 133 cases involve pregnant women.

The U.S. Centers for Disease Control and Prevention reports more than 30,000 cases in U.S. territories such as Puerto Rico, and more than 4,000 in the U.S., but says there are almost certainly many times more cases that have not been reported.

"We urgently need a safe and effective vaccine to protect people from Zika virus infection as the virus continues to spread and cause serious public health consequences, particularly for pregnant women and their babies," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said. 

Original article: http://www.nbcnews.com/storyline/zika-virus-outbreak/antibody-might-protect-fetus-zika-study-finds-n679161

(HealthDay)—Three injections of a therapeutic vaccine may control genital herpes as effectively as daily pills for at least a year, a new study suggests.

Researchers tested the experimental vaccine in 310 people with herpes from 17 centers around the United States. The three shots, administered three weeks apart, appeared to reduce patients' genital lesions and the process of "viral shedding" in which they can spread the disease through sexual contact.

Infectious disease experts hailed the vaccine as a promising development in the treatment of genital herpes. The incurable disease affects about one in every six people ages 14 to 49 in the United States, according to the U.S. Centers for Disease Control and Prevention.

"In general terms, people receiving [the vaccine] have greater than 50 percent fewer days in which virus is present in their genital tracts, which in theory may reduce transmission," said study author Jessica Baker Flechtner. She's chief scientific officer at Genocea Biosciences, the Cambridge, Mass., manufacturer of the vaccine.

"However, this would need to be proven in a well-powered clinical trial," she added. "Our trials have included both men and women, and to date, we have not seen a difference in the vaccine impact between genders."

Currently named GEN-003, the vaccine is believed to work by prompting a type of white blood cell known as a T-cell to recognize and kill cells in which the virus lives, Flechtner explained.

Patients were randomly split into seven dosing groups, including a placebo group.

Testing was repeated periodically for 12 months after dosing and included analyzing genital swab samples for the presence of the herpes virus. The days when genital lesions were present were also recorded.

Current herpes treatment involves taking antiviral pills that can control the length and severity of symptoms and reduce patients' outbreaks. But many patients struggle with taking their treatments regularly, infectious disease experts said.

"The antiviral drugs available for use orally are pretty good and very safe, but they don't work on everybody, and some find it very hard to take on a daily basis," said Dr. Lawrence Stanberry. He is chair of pediatrics at Columbia University Medical Center/New York-Presbyterian Morgan Stanley Children's Hospital in New York City.

"Some patients aren't very good about taking medication every day, and some don't like to for herpes because they say it's intrusive and reminds them they have genital herpes," added Stanberry, who was involved in herpes research for many years. "Regrettably, there's still a stigma... but some say a vaccine wouldn't remind them on a constant basis about their illness."

Stanberry agreed with Dr. Matthew Hoffman, of Christiana Care Health System in Wilmington, Del., that it would take at least several years until the experimental vaccine might become widely available. The U.S. Food and Drug Administration has yet to approve the vaccine, a process that requires additional successful clinical trials.

The most common side effects patients experienced after vaccination included muscle aches, fatigue and pain or tenderness at the injection site. No patients experienced life-threatening reactions, Flechtner said.

Hoffman called the vaccine "an exciting, novel approach" to genital herpes treatment, noting that it enables patients' own immune systems to "come to the rescue and create chronic suppression."

It could also positively influence patients' intimate relationships, he said, which can be dramatically affected by herpes flare-ups.

"Herpes is an uncomfortable, embarrassing disease," Hoffman said. "This [vaccine] offers the opportunity to protect people going into new relationships.

"As you can imagine, if one partner has six to 10 episodes of herpes per year and the other partner is unaffected, it can really change the nature of the relationship," he added. "But if that number goes down to one to two episodes per year based on immunization, it can help protect the other partner."

Stanberry predicted that future research would look at combining the vaccine with antiviral pills to gauge the impact on reducing sexual transmission. On its own, the vaccine "is likely to reduce the risk, but the likelihood of eliminating the risk is exceedingly small," he said.

The study was presented at the Infectious Disease Society of America's annual meeting in New Orleans that ended Oct. 30. Research presented at conferences typically hasn't been peer-reviewed or published, and results are considered preliminary.

 Copyright © 2016 HealthDay. All rights reserved. 

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by Lindsey Wahowiak on Nov 2, 2016 • 2:47 pm

This “Anatomy of a Papaya” is used to teach providers a variety of reproductive health skills, including contraceptive insertion.

Long-acting reversible contraceptives — intrauterine devices and birth control implants — are the most effective methods to prevent pregnancy. But too many people who want to choose LARC as their form of birth control are unable to get it in a timely manner because community health clinic staff is untrained or unprepared to perform an insertion.

But that doesn’t have to be the case. At a Wednesday morning session on “Expanding LARC Access and Training the Community Health Workforce,” reproductive health experts shared their tools for success in preparing community health clinic staff to stock, educate about and insert IUDs and implants. The best part: Most of the tools for training are low-cost or free and available online.

Stefanie Boltz, of the Bixby Center for Global Reproductive Health, shared many of the tools that can be used in trainings or classroom settings. Online resources like Papaya Workshop (a very interesting way to practice a variety of reproductive health services — on fruit!), the Global Library of Women’s Health, Jhpiego (an affiliate of Johns Hopkins University) and Innovating Education in Reproductive Health all offer free videos to use as teaching tools for people learning to insert the devices. In particular, Innovating Education in Reproductive Health, a project of the Bixby Center, is open source, meaning anyone can use the website and download its tools without a login, Boltz told attendees. Some of the trainings include information on health disparities, she noted, while an important resource has been the site’s contraceptive counseling training, which teaches clinic staff to improve care through listening to patients’ needs.

Of course, training is only part of the solution. Aisha Mays, a family physician and clinical researcher at Advancing New Standards in Reproductive Health, part of University of California-San Francisco, said supervising people as they practice inserting LARC helps clinic staff gain confidence in their skills, which then allows them to offer the full spectrum of reproductive health options more regularly. Where Planned Parenthood clinics are able to offer same-day insertion to 95 percent of patients seeking LARC, community health clinics were only able to offer same-day insertion to about a third of those asking for it. However, after going through six training sessions and supervised practice, those numbers increased dramatically.

Mays is also a trainer with Upstream USA, an organization that goes into community health clinic settings to train staff on LARC stocking, billing, education and insertion. It’s a pretty cool organization.

Ready to join #TeamIUD (or Team Implant)? Check out some of these training tools to see how they might help your clinic offer patients the care they need!

Original Article: Public Health Newswire

By Julie Steenhuysen | CHICAGO

A study of mice infected with Zika showed the virus caused lasting damage to key cells in the male reproductive system, resulting in shrunken testicles, lower levels of sex hormones and reduced fertility, U.S. researchers said on Monday.

So far, the findings are only in mice, but the result is worrisome enough to warrant further study because of possible implications for people, said Dr. Michael Diamond of Washington University in St. Louis, whose research was published in the journal Nature.

"It has to be corroborated," Diamond, a professor of pathology, immunology and molecular microbiology, said in a telephone interview.

Much of the global effort to fight Zika has focused on protecting pregnant women from infection because of the grave implications for their unborn children.

Zika infections in pregnant women have been shown to cause microcephaly, a severe birth defect in which the head and brain are undersized, as well as other brain abnormalities.

Previous studies have shown that Zika can remain in semen for as long as six months. But little is known about whether prolonged exposure to the virus in the testes can cause harm.

To study this, Diamond and colleagues injected male mice with Zika. After a week, the researchers recovered infectious virus from the testes and sperm, and they found evidence of viral genes in certain cells of the testes. But overall, the testes appeared normal compared with other lab mice.

After three weeks, however, the differences were stark. The testes in the Zika-infected mice had shrunk to a tenth of their normal size, and the internal structure was destroyed.

"We saw significant evidence of destruction of the seminiferous tubules, which are important for generating new sperm," Diamond said.

The researchers also found that Zika infects and kills Sertoli cells, which maintain the barrier between the bloodstream and the testes and foster sperm growth. Sertoli cells do not regenerate.

That raises the specter of long-lasting damage.

"The virus is infecting a site which doesn't really renew if it gets damaged. That is the problem," Diamond said.

Tests of testicular function showed sperm counts, sex hormones and fertility had dropped. Infected mice were four times less likely to impregnate a healthy female mouse than healthy males.

"This is the only virus I know of that causes such severe symptoms of infertility," added Dr. Kelle Moley, a fertility specialist at Washington University and a study co-author.

There is no vaccine or treatment for Zika.

(Reporting by Julie Steenhuysen; Editing by Will Dunham)

Original article click here