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JOHANNESBURG (Reuters) - Trying to prevent HIV infection through vaginal gels or daily tablets has proven ineffective in the southern African region ravaged by the disease because people did not use the medicines properly, a study released on Monday said.
A ground-breaking study issued in 2010 indicated a vaginal gel containing an HIV drug can sharply reduce infections in women who use it before and after sex.
However, a test of the gel and two types of anti-HIV pills among more than 5,000 women in South Africa, Zimbabwe and Uganda showed that, based on blood tests, more than 70 percent did not use the medication as instructed.
"We are obviously disappointed in the results. We were very hopeful that these products, which we know have been effective in other studies and clearly have a lot of promise, would work," Jeanne Marrazzo, a researcher on the project for the University of Washington, told reporters in a teleconference.
"Women did not use consistently any of the products. Adherence was very low," said Marrazzo, part of the project known as the Vaginal and Oral Interventions to Control the Epidemic (VOICE).
HIV/AIDS experts said the results showed how important a factor human behavior is when devising ways to prevent HIV.
"HIV prevention is never just biomedical - behavior is key. What we've learned from VOICE and other trials is that adherence to the prescribed dose - the behavioral component - is the variable that determines effectiveness," said Mitchell Warren, director of the HIV prevention advocacy group AVAC.
East and southern Africa are the areas most heavily affected by the HIV epidemic. Out of the total number of people worldwide in 2009 living with HIV, 34 percent were in 10 countries of southern Africa, according to the U.N. Programme on HIV/AIDS.
Experts have been searching for years for inexpensive, safe and simple medications to decrease the risk of transmission among a population that is largely destitute and with little access to quality health care.
The study also found the group most likely to contract HIV - unmarried women under 25 - was also the most likely not to use any of the medicines. The results were presented at a Conference on Retroviruses and Opportunistic Infections in Atlanta.
The three-year study that started in September 2009 tested a daily tablet called Truvada, which was approved for HIV prevention in July 2012 by the U.S. Food and Drug Administration after it was shown to significantly reduce the risk of HIV infection when used as a preventative measure.
The gel with a drug called tenofovir, which a previous study showed reduced HIV infections in women by 39 percent over two and a half years, and an oral tenofovir tablet were also tested.
Researchers have been trying for years to formulate a microbicide - a gel, cream, ring or tablet inserted into the vagina or rectum before sex to prevent transmission of the human immunodeficiency virus (HIV) that causes AIDS.
"We need to rethink the design of these intervention trials ... in healthy people because it is difficult for anybody to take a pill or anything every day, particularly when you are healthy and do not feel that you need a drug," said Marrazzo.
Truvada is made by Gilead Sciences, which also developed tenofovir. In 2006, Gilead assigned a royalty-free license for tenofovir gel to CONRAD.
Jonathan Mermin, an HIV/AIDS prevention expert at the U.S. Centers for Disease Control and Prevention (CDC) said these trial results underscored the complexities of getting healthy people to use preventative measures against HIV.
"Clinicians and public health professionals will have to further assess and better understand how to promote and support the high levels of adherence necessary," he said.
(Additional reporting by Kate Kelland in London; Editing by Louise Ireland and Michael Roddy)
David Bowie is back with another epic new mini-movie, directed by video genius Floria Sigismondi (Marilyn Manson, Sigur Ros, Ellie Goulding, Leonard Cohen, two landmark '90s Bowie vids). In a bit of inspired casting, the Thin White Duke’s new video co-stars thin white duchess Tilda Swinton as his dutiful wife—but really, she looks more like his long-lost twin.
For years, the uncanny resemblance between Bowie and the Oscar-winning actress has been noted by observers—so much so that there's an entire Tumblr site, TildaStardust.com, devoted to their separated-at-birth similarity. In 2003, fashion photographer Craig McDean actually orchestrated a shoot with Tilda during which she dressed up as Bowie, and last year, Hint Fashion Magazine even published a rather convincing compare-and-contrast blogpost titled "Visual Proof That David Bowie And Tilda Swinton Are The Same Person."
David Bowie in "The Stars (Are Out Tonight)"Well, the fact that Bowie and Swindon appear onscreen on the same time in "The Stars (Are Out Tonight)" obviously refutes Hint's theory—unless director Sigismondi used some creative CGI, of course. But perhaps what more important is how amazing Bowie looks in this video, in general.
You see, when Bowie unexpectedly emerged from a decade-long seclusion last month on his 66th birthday—releasing a new music video, “Where Are We Now,” and announcing plans to issue The Next Day, his first album since 2003’s Reality—it was cause for celebration, but there was just one minor problem: His famously aquiline likeness could barely be discerned in the “Where Are We Now” video. He merely appeared as some sort of conjoined twin, his digitally obscured face peeking out from a black shroud. Considering that Bowie had practically gone into hiding since his heart attack of '03, and that rumors about his supposed ill health had run rampant in the years since, it was worrying that he had opted to not show his full self in his comeback clip.
Model Iselin Steiro as a young BowieBut in his new video tour de force, the man looks virtually untouched by time: still handsome, glamorous, regal, and, for lack of a better adjective, positively Bowie-esque. Tilda, along with Norwegian model Iselin Steiro (who plays the younger, flame-haired Bowie in the video's band scenes) deliver stunning performances, for sure, but there’s little doubt that fans’ eyes will be riveted only to the real Bowie whenever he’s onscreen.
And as for any fans whose ears were mildly underwhelmed by the mellow moodiness of “Where Are We Now,” they'll be happy to know that Bowie’s new tune is a much more propulsively rocking affair, proving that the man hasn’t lost his edge at age 66.

David Bowie’s Tony Visconti-produced new album, The Next Day, comes out in the U.S. on March 12.
It goes without saying that Trent Reznor’s managed to notch a lot of different accolades on his resume—from his early days with Nine Inch Nails to his Grammy-winning film score work. However, here’s one you may not know about: He’s actually married to a musician, and she happens to be his partner on his latest musical endeavor.
Here's the scoop on Reznor's talented wife, who's his main collaborator in the project How To Destroy Angels, which is releasing its first full-length album on Tuesday.
Mariqueen Maandig,(who goes by the nickname “Q” with friends), a striking Filipino beauty who grew up in Orange County, Calif. and dabbled in musical theater during her school years, claimed she never wanted to be a professional musician—she actually wanted to be a fashion stylist instead.
Accordingly, she entered the Fashion Institute of Design & Merchandise following graduation. However, finding the curriculum uninspiring, she jumped at the chance to enter back into the music world when a friend offered to hook her up with an emerging band.
Maandig ended up joining Los Angeles buzz band West Indian Girl and fronted the group from 2004 through 2009, meeting Reznor during her tenure there. She released two albums with the dance/psychedelic-rock outfit and managed to keep her budding relationship with Reznor under wraps until the announcement of their engagement in 2009.
To this day, the couple has managed to maintain an air of mystery about their relationship. “I tell people [Trent and I] met at a Mensa meeting, because we met under such unusual circumstances,” she noted to WWD in 2011—without elaborating on what those circumstances were.
Maandig announced retirement from her band after accepting Reznor’s proposal; while Reznor himself played his final show with NIN in September of 2009. The two married a month later, with no apparent hard feelings from their former colleagues.
“She couldn’t be marrying a cooler guy,” noted a post on West Indian Girl’s official site. “Talk about analog and digital love --their kids might all have moogs for arms.”
The following year, the couple announced their collaborative project How To Destroy Angels—which also included c0mposer Atticus Ross and art director Rob Sheridan, both of whom had worked extensively with Reznor over the years. Shortly after the news leaked out that Reznor’s latest musical partner was, well, his literal partner, the newlyweds and their bandmates released a six-song EP under their new name.
How To Destroy Angels went on to notch a track on the 2011 Girl With The Dragon Tattoo soundtrack (which Reznor produced, scoring a Golden Globe nomination), and followed that up with yet another EP in November of 2012--with the promise to eager fans that a full-length would be on the way shortly.
Reznor and Maandig, despite juggling two young children by this time, kept their promise and announced in January that the long-awaited album, Welcome Oblivion, would be released in early March. To seal the deal, How To Destroy Angels released an ominous, dystopian video for single "How Long" later in the month.
How To Destroy Angels will be playing famed California music mega-fest Coachella in April.
KATMANDU, Nepal (AP) — It's the world's highest glass ceiling. Of the 3,755 climbers who have scaled Mount Everest, more than half are Nepalese but only 21 of those locals are women.
Aiming to change the all-male image of mountaineering in their country, a group of Nepalese women have embarked on a mission to shatter that barrier by climbing the tallest mountain on each of the seven continents.
The women, aged between 21 and 32, have already climbed Everest in Asia, Kosciuszko in Australia and Elbrus in Europe. They are preparing to climb Mount Kilimanjaro in Africa to mark International Women's Day this week.
"The main goal of our mission is to encourage women in education, empowerment and environment," Shailee Basnet, the 29-year-old team leader, said before leaving for Africa.
Women in this Himalayan nation rarely got the chance to climb because they were confined to their homes while their husbands led expeditions or carried equipment for Western climbers, Basnet said.
It was only in 1993 that a Nepalese woman — Pasang Lhamu — first reached the 8,850-meter (29,035-foot) summit of Everest. She died on the descent.
According to Ang Tshering of the Nepal Mountaineering Association, Nepalese women had traditionally expressed little attraction to mountaineering.
"It is only recently that women have shown interest," Tshering said.
Since they climbed Everest in 2008, the women have spoken in more than 100 schools across Nepal to tell students about their mission.
"We are hoping to attract more women to mountaineering, both as a profession and as a hobby," said Pema Dikki, 25, another member of the team.
Basnet said the response to the Everest climb encouraged them to push ahead.
"After Everest, we felt that we needed to go beyond the borders, so we decided to travel to all seven continents to climb the highest mountains there," Basnet said.
Basnet said the team members have spent their savings, taken out loans and sought sponsorships to finance their expensive gear, climbing permits and plane tickets.
The team plans to speak to students while in Africa to spread their theme, "You can climb your own Everest," to encourage girls to stay in school.
The team will be joined by two women from Tanzania and one from South Africa during the Kilimanjaro climb.
Nepal has eight of the 14 mountains that are more than 8,000 meters (26,240 feet) in height.

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