Bodycheck limits for minor hockey could reduce injuries

Rule changes change the culture of hockey by defining acceptable behaviour, doctors say. (Bruce Bisping/Star Tribune/Associated Press)

Restrictions on bodychecking in minor hockey can help reduce injuries, a new Canadian review suggests.

A change in rules to limit bodychecking could reduce harm to young players, neurosurgeon Dr. Michael Cusimano of St. Michael's Hospital in Toronto and his co-authors concluded in Monday's issue of the Canadian Medical Association Journal.

The researchers reviewed 18 articles on reducing aggressive behaviour in the sport. Of those, 13 involved players under 18 in Canada and the U.S.

"Clearly the bodychecking is contributing to the injury rate," Cusimano said. "If you can institute a rule that can lessen that then you're bound to reduce injuries."

Brain injuries account for an estimated 15 per cent of injuries among players aged nine to 16, previous studies suggest.

The study's authors aimed to synthesize what's known about reducing hockey injuries to suggest a path forward.

"We need to have that open discourse and to start to talk about what we need to do to make it fun again for kids to play hockey and [be] safe," Cusimano said.

He noted that the number of children registered to play hockey is down and it tends to drop off as aggression comes into the game, but none of the studies addressed attrition.

Fewer aggressive penalties

Cusimano said that in his practice he sees both the short-term and long-term effects of brain injuries. In the long-term, players may look fine, but lights and noise can bother them, or they may have trouble following along in class or concentrating.

The review also looked at the effectiveness of educational programs in hockey, such as the Think First videos to inform players, coaches and parents about recognizing concussion symptoms and removing players from games when necessary.

The educational programs were associated with declines in aggressive types of penalties, such as cross-checking or pushing a player into the boards from behind. But those studies didn't include enough players to determine if injuries declined.

Critics have argued that teaching children to bodycheck at an earlier age helps them learn to protect themselves, but that assumption isn't borne out by the data, Cusimano said.

He stressed the need to change the culture of hockey, adding that introducing and enforcing rule changes are one way to do that quickly.

The experience of the New Zealand Rugby Union suggests that a combination of rule changes and mandatory educational programs nationwide helps reduce brain injuries, the researchers said.

Cusimano also suggested changing the governance in minor hockey, such as limiting how long people can serve on boards, involving more women and allowing children to have their say.

The review also included studies on cognitive behavioural interventions, such as training on managing aggression, which focused on individual players.

Athletes participating in the studies weren't randomized and the reductions in injuries were associations. Other factors could be contributing, and no cause-and-effect relationships could be drawn.

The studies reviewed also did not consider the feasibility of the changes.

The research was funded by the Canadian Institutes of Health Research Strategic Team Grant in Applied Injury Research in partnership with the Ontario Neurotrauma Foundation.

With files from CBC's David MacIntosh

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Athletes' brains reflect stages of degenerative disorder

The brains of some deceased athletes, including NHL players, show four stages of a degenerative disorder that offer a glimpse into the potential long-term impact of brain injuries, U.S. researchers say.

The degenerative brain disease chronic traumatic encephalopathy (CTE) is associated with repeated brain trauma. It can lead to memory problems, emotional problems, behavioural problems such as loss of impulse control and eventually dementia.

Now researchers at Boston University have used post-mortem tests on the brains of 85 men aged 17 to 98 and interviews with family members to describe four stages of CTE, compared with neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.

Of the 85 men with histories of repetitive mild traumatic brain injury, researchers found evidence of CTE in 68, including 64 athletes, 21 military veterans and one person who showed head-banging behaviour.

Dr. Ann McKee of Boston University School of Medicine has examined the brains of deceased athletes to document stages of a degenerative brain disease. (Chris O'Meara/Associated Press)

"This study clearly shows that for some athletes and war fighters, there may be severe and devastating long-term consequences of repetitive brain trauma that has traditionally been considered only mild," Dr. Ann McKee, of the Center for the Study of Traumatic Encephalopathy at Boston University, and her co-authors concluded in the journal Brain.

The subjects included 33 men who played in the NFL, one in the CFL, four in the NHL and seven who had been professional boxers. The researchers also examined the brains of 18 cognitively normal people the same ages with no known history of mild traumatic brain injury.

The NHL stars found to have CTE were Reggie Fleming, Derek Boogaard, Bob Probert and Rick Martin.

Interviews with relatives and loved ones of brain donors pointed to these symptoms:

• Stage 1 – Headache and loss of attention and concentration.
• Stage 2 – Depression, explosive behaviour and short-term memory loss.
• Stage 3 – Executive dysfunction, such as impaired ability to organize thoughts and make decisions, and cognitive impairment.
• Stage 4 – Dementia, difficulty finding words and aggression.

Worsening of brain degeneration was associated with decreases in brain weight and more severe cognitive problems on the staging scale, the study's authors said.

"There's no evidence that a few isolated, well-managed concussions give rise to this disease," McKee said. "It's actually a very long-standing exposure to repetitive brain trauma, and that can be subconcussive injury."

Unlike Alzheimer's disease, the clinical course of CTE is slow with about 11 to 14 years between stages, the researchers noted.

Type of head trauma questions

They cautioned the findings can't be generalized to CTE in living athletes and veterans. That's because families of people who showed behavioural or cognitive symptoms would be more likely to participate in a brain donation program than families of normally functioning individuals.

To overcome this problem, the researchers called for future studies to include those who experienced mild traumatic brain injury and did not develop behavioural or cognitive problems.

Former defensive lineman Tim Fleiszer played in the Canadian Football League for 10 years.

Fleiszer estimates he had 60 to 100 concussive episodes during his career, including three major ones. He doesn't have any symptoms and plans to donate his brain.

"I think unfortunately you still see people that are associated with games like hockey and football and rugby who are resistant to acknowledging the fact that this is an issue," Fleiszer said.

Fleiszer said he's concerned that if the problem continues unchecked then parents will not let their children play sports and enjoy the personal development that comes with athletics.

Fleizser now does work with the Sports Legacy Institute, which tries to advance the study, treatment and prevention of brain trauma.

McKee's team is planning to study more retired NFL athletes at death as well as more veterans from Iraq and Afghanistan with histories of blast injuries.

Questions that remain include how much head trauma causes the condition, what type, how often and at what age people are most susceptible.

The study was funded by the U.S. Department of Veterans Affairs, Translational Research Center for Traumatic Brain Injury and Stress Disorders, U.S. National Institute of Aging, Sports Legacy Institute, National Operating Committee on Standards for Athletic Equipment, Edith Nourse Rogers Memorial Veterans hospital and the National Football League.

With files from CBC's Kelly Crowe and Marijka Hurko

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It's never too late to eat your way to heart health, study says

The role of healthy eating in preventing heart disease is well established, but a new international study spearheaded by researchers in Hamilton suggests that chowing down on wholesome foods improves health outcomes even for people who already suffer from cardiovascular disease.

"The main findings of the study was that a diet rich in fruit, vegetables and fish significantly reduces the chance of a second heart attack," said Dr. Mahshid Dehghan, a research associate with Hamilton's Population Health Research Institute, which coordinated the effort.

Eating healthfully, she added, provides additional benefits for people who are taking medication — blood thinners, for example — to treat their ailments.

PHRI collaborated with researchers to track the eating habits of more than 30,000 subjects over the age of 55 who suffer from cardiovascular disease or diabetes. Participants from 40 countries filled out questionnaires about their lifestyles at the beginning of the study.

Five years later, researchers checked up on the health outcomes of their subjects, many of whom were being treated with medication.

Researchers found that participants who had diets that were high in fibre and low in saturated fats carried about a 30 per cent lower risk of suffering a heart attack or stroke.

"We found similar associations in all regions of the world, in different countries with different levels of income," Dehghan said.

These findings don't come as surprise to Cory Ma, a registered dietitian at the North Hamilton Community Health Centre, who facilitates programs for seniors who suffer from — or are at a high risk of developing — diabetes or heart disease.

"If my clients don't eat enough fruit and vegetables, when they start, it really helps to relax their blood vessels," he said.

Ma teaches a diet program called D.A.S.H., which stands for Dietary Approach to Stop Hypertension.

The focus of the regime, Ma said, "is to have high-fibre whole grains instead of white flour products, lots of plant-based foods, more vegetable proteins, like beans, nuts seed and chickpeas, less red meat, less alcohol and less refined sugars."

"There's not going to be much salt in those foods. And because there's less red meat, there's less saturated fat."

The diet isn't just useful for high-risk seniors, Ma noted.

"A lot of times, we only see people when they already have [heart disease]. The diet can be followed by anybody and may actually help to prevent it."

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TB still a concern, Sask. health minister says

A case of tuberculosis at the University of Saskatchewan has raised public awareness about a disease that has yet to be eradicated in the province, Health Minister Dustin Duncan says.

Duncan says Saskatchewan has a higher rate of the infectious lung disease than the rest of the country.

There are about 80 cases a year of TB in Saskatchewan, mostly in the north.

"Tuberculosis is still an issue that we need to be concerned about," Duncan said Monday.

"I think for a lot of people, tuberculosis is something that was eradicated decades ago. That's not the case in Saskatchewan. It's not the case in Canada."

The government will be launching a five-year strategy to deal with tuberculosis in the new year, Duncan said.

Meanwhile, dozens of students at the U of S were gathering at a makeshift clinic in the Education Building the same day to be tested for tuberculosis.

A student who was in one of their classes has been diagnosed with TB and is being treated in hospital.

Arts student Cheyenne Jones, who was one of the people who showed up at the clinic Monday, said she's just taking precautions.

"I got an email and I showed up because the person had been in my classroom, so I wanted to keep myself safe and make sure I wasn't infected," she said.

The Saskatoon Health Region sent emails to about 600 students and will be doing the tests until Thursday.

Health officials say there's a very small chance any of these individuals will develop TB. Students who test negative will be re-tested as a precaution in about two months.

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New respiratory virus caused infections in Jordan

The World Health Organization has reported two additional cases of infection with the new coronavirus, the earliest on record.

The agency says retrospective testing of stored samples show two people who died in Jordan in April were infected with the virus, which is from the same virus family as SARS.

It isn't known if the cases in Jordan were spread person-to-person but if so, it wasn't sustained, says WHO spokesperson Gregory Hartl. (Denis Balibouse/Reuters)

Prior to this the first known case had been a man from Jeddah, Saudi Arabia, who fell ill and died in June.

The new report from the WHO brings to nine the number of confirmed infections with the new virus, of which five cases have been fatal.

When it came to light that a new coronavirus was causing severe human illnesses in the Middle East, questions were raised about an outbreak of severe pneumonia cases that had occurred in Jordan in April.

At the time health officials were not able to diagnose what was causing the illnesses, but stored samples from two of the patients tested positive recently for the new coronavirus.

In a statement issued Friday, the WHO says Jordan's ministry of health has asked the global health agency for assistance in investigating the infections.

Health-care workers infected

A team from WHO's Eastern Mediterranean Regional Office and from WHO headquarters arrived in the Jordanian capital, Amman on Wednesday to help with studies aimed at trying to trace the source of infection and strengthen capacity to spot new cases.

A potentially worrisome aspect of the Jordanian outbreak is that it involved health-care workers. Health-care workers can be unwitting sentinels in disease outbreaks, picking up infections from patients that they treat. If health-care workers become infected, that can often — though not always — be a sign a pathogen can spread from person to person.

To date there has been no sign of sustained person-to-person spread of the virus, though there was a recent cluster of three and possibly four family members who got sick in Riyadh, Saudi Arabia. Two of them died.

The Jordanian cases may signal spread from patients to health-care workers happened there. But it's too soon to conclude that, said WHO spokesperson Gregory Hartl, who noted the health-care workers and the patients could have been infected for a common — and as yet unidentified — source.

"Even if the cases in Jordan were human-to-human spread — and we don't know that — it wasn't sustained," Hartl said in an interview from Geneva. He noted that there has been no sign of spread to health-care workers in Saudia Arabia or Qatar, the two other countries that have had cases, nor in London or Germany, where two of the cases have been treated.

Hartl said with cases popping up over large distances in three different countries, and over months, much work remains to be done to figure out what is going on. "There are a lot of holes still to be filled in," he said.

The WHO has asked countries to be on the lookout for possible cases in people with unexplained severe infections who have recently returned from or lived in countries in the Arabian Peninsula, or surrounding countries.

To date the case count is as follows: Jordan, two, both fatal; Saudi Arabia, five, three fatal and Qatar, two.

A report on the outbreak — noted in a weekly disease report from the European Centre for Disease Control in May — said seven nurses and a doctor were among 11 cases identified in the outbreak at a hospital in Zarqa, Jordan.

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Aboriginal HIV infections a growing problem in Canada

Aboriginal AIDS activists in Canada say they are trying to lower the high rate of HIV infections among First Nations, Métis and Inuit people.

The Canadian Aboriginal AIDS Network is launching a national awareness campaign in Winnipeg on Saturday — to coincide with World AIDS Day — with the goal of reducing the number of new HIV infections and AIDS-related deaths.

"We need to say to our own community, 'Listen to the messages about HIV and AIDS. Protect yourself. Go get a test if you put yourself at risk,'" said Art Zoccole, president of the network's board.

"These are our future generations, and there is a responsibility of us in the aboriginal community to take care of each other and [get] everybody involved."

While First Nations, Métis and Inuit people represent 3.8 per cent of Canada's population, they account for 7.5 per cent of Canadians living with HIV, according to 2006 census figures.

As well, aboriginal people accounted for 12.5 per cent of all new HIV infections in Canada in 2008, according to the Public Health Agency of Canada.

That all means the HIV infection rate for aboriginal Canadians was 3.6 times higher than the rate for other Canadians in 2008.

The federal health agency says injection drug use is the main way aboriginal people get exposed to HIV, and the number of cases continues to rise, especially among women.

Risky lifestyles

Research is underway to find out why the infection rate is so high, but there is concern that an alarming number of aboriginal Canadians are engaging in risky lifestyles.

The agency has found that aboriginal HIV cases attributed to injected drug use has gone up to more than 50 per cent in the period spanning 2001 to 2008 from 18 per cent before 1995.

Brenda Pelletier says her family has withdrawn from her since she was diagnosed with HIV about 12 years ago. She is now speaking to aboriginal communities about HIV and AIDS. (Karen Pauls/CBC)

Brenda Pelletier, 60, of Winnipeg said she contracted HIV 12 years ago after she shared drug paraphernalia with a friend who she knew was HIV-positive.

"I didn't think anything of it — like, you know, sharing — because when they said, 'Use clean needles,' I just thought, 'Hmm, OK, clean needle, I got one,'" she recalled. "Four days after that, my friend died."

Pelletier said since she was diagnosed with HIV, she has been in and out of the hospital with pneumonia, tuberculosis and other ailments.

Zoccole said more education is needed on how the virus is contracted, how people can protect themselves, and how people should get tested.

The theme of the network's Aboriginal AIDS Awareness Week campaign this year is "Getting to Zero," which means zero new HIV infections, zero AIDS-related deaths and zero cases of discrimination against people with HIV and AIDS.

Workshops on aboriginal HIV and AIDS issues will be held in Halifax, Regina, Toronto, Iqaluit and Victoria in the coming days as part of the campaign.

Ottawa investing in programs

Zoccole, who has had HIV for eight years and currently heads up the Toronto-based group Two-Spirited People of the First Nations, said there are very few agencies that provide services for HIV-positive aboriginal people in large cites.

There are even fewer resources for those in small and remote First Nations, Métis and Inuit communities, he added.

"It's concerning," said federal Health Minister Leona Aglukkaq.

Aglukkaq said the federal government is investing in research, education and treatment programs, including a Health Canada project to develop aboriginal-language terminology concerning HIV and AIDS.

"We have translated a number of terms to the appropriate language of the aboriginal population," she said.

Aglukkaq said while the availability of HIV- and AIDS-related services in remote communities is an issue, there are hospitals in a number of areas that can provide treatment.

"Education is fundamental in getting to the bottom of this, and we have to work in partnership with the community to educate young people," she said. "But it has to be done in partnership with the community."

Stigma remains in some communities

But Zoccole said sometimes those very communities are part of the problem.

"There's still stigma and discrimination. So when that happens, sometimes, the result is that the person living with HIV and AIDS needs to move and relocate to a place that's safe for them," he said.

Art Zoccole of the Canadian Aboriginal AIDS Network says some people don't know what a female condom is, or how it could help women protect themselves from HIV infection. (Karen Pauls/CBC)

"They almost get ostracized from their communities, and it's very unfortunate … Aboriginal people need to take a greater stand against, you know, this kind of discrimination that we're doing to our own family and in our own community. It's not right."

Pelletier said her own family has withdrawn from her, with some members even changing their phone numbers.

"They dumped me. They didn't want nothing to do with me," she said. "You feel like you're not good enough to be with people, unless they are HIV [positive] too."

But Pelletier said she is trying to be part of the solution by taking part in a speaking tour organized by a non-profit aboriginal service agency in Winnipeg.

"I go into communities and I talk and I'll tell them how I got it, if they ask," she said. "I hope that they have listened."

Pelletier and others say the best way to stem the rise in HIV and AIDS cases among aboriginal people is by teaching young people — in a culturally appropriate way — how to protect themselves.

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Listeria scare prompts Costco veggie burger recall

The Veggie Patch brand Ultimate Meatless Burger is being pulled off store shelves because of possible Listeria contamination.

The affected product was imported from the United States and sold in one kilogram packages with two best before dates —Jan. 12 and 17, 2013 (UPC 6 10129 08477 7).

It was distributed in New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario and Quebec.

The importer, Costco Wholesale Canada Ltd., has recalled the burgers and the Canadian Food Inspection Agency is monitoring the recall.

There have been no reports of any illnesses being linked to the product.

Listeriosis can cause high fever, severe headache, neck stiffness and nausea. Pregnant women, the elderly and people with weakened immune systems are particularly at risk.

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Asperger's to be dropped from psychiatric manual

Kelli and Keith Gibson of Battle Creek, Mich., pose for a 2010 photo with their sons, from left, Kolten, 6, Keifer, 9, Caiden, 7 and Connor, 11, who all have different forms of autism. Kelli Gibson said it doesn't make sense to give them different labels, including Asperger's. (Scott Erskine/Associated Press)

The now familiar term "Asperger's disorder" is being dropped but "dyslexia" and other learning disorders remain in the first major rewrite in nearly 20 years of psychiatry's diagnostic guide.

In another revision, abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

• Other changes include: A new diagnosis for severe recurrent temper tantrums —disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.
• Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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New respiratory virus caused infections in Jordan

The World Health Organization has reported two additional cases of infection with the new coronavirus, the earliest on record.

The agency says retrospective testing of stored samples show two people who died in Jordan in April were infected with the virus, which is from the same virus family as SARS.

It isn't known if the cases in Jordan were spread person-to-person but if so, it wasn't sustained, says WHO spokesperson Gregory Hartl. (Denis Balibouse/Reuters)

Prior to this the first known case had been a man from Jeddah, Saudi Arabia, who fell ill and died in June.

The new report from the WHO brings to nine the number of confirmed infections with the new virus, of which five cases have been fatal.

When it came to light that a new coronavirus was causing severe human illnesses in the Middle East, questions were raised about an outbreak of severe pneumonia cases that had occurred in Jordan in April.

At the time health officials were not able to diagnose what was causing the illnesses, but stored samples from two of the patients tested positive recently for the new coronavirus.

In a statement issued Friday, the WHO says Jordan's ministry of health has asked the global health agency for assistance in investigating the infections.

Health-care workers infected

A team from WHO's Eastern Mediterranean Regional Office and from WHO headquarters arrived in the Jordanian capital, Amman on Wednesday to help with studies aimed at trying to trace the source of infection and strengthen capacity to spot new cases.

A potentially worrisome aspect of the Jordanian outbreak is that it involved health-care workers. Health-care workers can be unwitting sentinels in disease outbreaks, picking up infections from patients that they treat. If health-care workers become infected, that can often — though not always — be a sign a pathogen can spread from person to person.

To date there has been no sign of sustained person-to-person spread of the virus, though there was a recent cluster of three and possibly four family members who got sick in Riyadh, Saudi Arabia. Two of them died.

The Jordanian cases may signal spread from patients to health-care workers happened there. But it's too soon to conclude that, said WHO spokesperson Gregory Hartl, who noted the health-care workers and the patients could have been infected for a common — and as yet unidentified — source.

"Even if the cases in Jordan were human-to-human spread — and we don't know that — it wasn't sustained," Hartl said in an interview from Geneva. He noted that there has been no sign of spread to health-care workers in Saudia Arabia or Qatar, the two other countries that have had cases, nor in London or Germany, where two of the cases have been treated.

Hartl said with cases popping up over large distances in three different countries, and over months, much work remains to be done to figure out what is going on. "There are a lot of holes still to be filled in," he said.

The WHO has asked countries to be on the lookout for possible cases in people with unexplained severe infections who have recently returned from or lived in countries in the Arabian Peninsula, or surrounding countries.

To date the case count is as follows: Jordan, two, both fatal; Saudi Arabia, five, three fatal and Qatar, two.

A report on the outbreak — noted in a weekly disease report from the European Centre for Disease Control in May — said seven nurses and a doctor were among 11 cases identified in the outbreak at a hospital in Zarqa, Jordan.

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Controversial HIV study begins in Montreal

Montreal researchers are rounding up possible recruits for a controversial study on HIV that has already made headlines overseas.

A team of researchers is seeking the help of up to 400 HIV-negative gay men to determine whether an anti-retroviral drug could prevent the disease's spread by being ingested up to two hours before or up to a day after having sexual intercourse.

Dr. Cécile Tremblay, an infectious disease specialist at the Université de Montréal, said the medical world is not doing enough to fight the disease.

"I am not satisfied with the status quo, I am not satisfied with what exists right now because we are not moving forward with this goal of eradicating HIV transmission," she said.

Thirteen per cent of gay men in Montreal are HIV-positive, said Tremblay

Methodology

Researchers will study about 400 men who are at high risk of contracting the disease. This means men with multiple partners, who work in the sex industry or whose partners are HIV-positive.

A three-year study conducted in South America and Thailand, which evaluated the effectiveness of a drug taken once every day, showed a 43.8 per cent reduction in the spread of HIV.

In the first study of its kind in North America, Tremblay will be testing the drug Truvada. Instead of taking a pill every day for the rest of their lives, people in the study will take it only when needed.

The research methods are controversial because half of the study's participants will be taking a placebo and there is fear they could be lulled into a false sense of security and stop using condoms.

Dr. Tremblay said other trials have shown people tend to keep themselves protected.

"That's always a worry," she said. "But what we've seen so far in other trials is that it hasn't been the case."

Tremblay said people will be given counselling to support them and encourage them to wear protection.

Researchers emphasize this drug is not meant to be a replacement for condoms but should be considered as an added tool of prevention.

The research will be conducted in two stages.

First, 100 participants will be enrolled in Montreal, another 200 in Paris.

Researchers will then consider adding more people in both cities.

IPERGAY hopes to study an additional 1,600 candidates in France, Canada and other countries.

Trial overseas

The Montreal trial is part of an on-going study in Paris – a city considered to be a hotspot in the fight against AIDS – and is funded by the French National Agency for AIDS Research.

Tom Craig, who is taking part in the French study in Paris, said men should take it upon themselves to participate in the research.

"We have to take an active part in what's going to happen in the future, not just politicians or governments. It's up to us. This is why I am in the study," he said.

IPERGAY Trial (PDF)
IPERGAY Trial (Text)

For more information about the IPERGAY study and to participate call: 514-890-8000 ext: 15195

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