Answer Questions 1-20 with reference to the text which follows.

There is one and only one correct answer for each question.
1. The title of the text and the introduction suggest that: a. HIV vaccines may prove ineffective if insufficient numbers of people are willing to be inoculated b. an HIV vaccination campaign could be undermined by lack of availability of sufficient quantities of the vaccine c. there is a risk that the proposed HIV vaccine will not be absorbed into the bodies of many individuals d. the general public have failed to respond to threats and promises regarding HIV 2. According to Paragraph 2, Peter Newman believes that: a. researchers searching for an HIV vaccine have been banging their heads against a brick wall for years and are unlikely to come up with a viable vaccine in the near future b. the proposed HIV vaccine amounts to little more than sympathetic magic c. an HIV vaccine can easily be extracted from sand d. health services need to educate the public regarding the HIV vaccine before launching a vaccination campaign 3. The terms annually and currently in the first sentence of Paragraph 3 could be replaced by: a. seasonably and electrically b. each year and fashionably c. all year and at present d. per year and now 4. Crucell, mentioned in the second sentence of Paragraph 3, is: a. a piece of equipment used in the biotech industry b. a researcher c. a Dutch town d. a company 5. The term vaccine candidates, also in the second sentence of Paragraph 3, refers to: a. animals on which the vaccine could be tested b. subjects that researchers believe may respond well to the vaccine c. people who have applied for a job working on the development of HIV vaccines d. vaccines that researchers believe may be effective 6. The term meta-analysis in Paragraph 4 refers to: a. an analysis of the organic chemicals used in previous experiments b. a study of the terminology and language used to present previous studies

c. a study of the goals of previous analyses of statistical data d. a study that conducts a statistical analysis of the results of a number of previous studies without presenting any first-hand empirical evidence of its own 7. July in Paragraph 4 refers to: a. July each year b. July 2010 c. the annual deadline for the submission of reports d. an academic journal 8. The term such a yet-to-be-developed vaccine in Paragraph 4 suggests that: a. a vaccine of this kind has still not been developed b. the development of an HIV vaccine remains a distant fantasy c. some types of HIV vaccine have already been developed d. there is something wrong with the punctuation in this sentence 9. Which of the following statements CANNOT be deduced without reasonable doubt from Paragraph 5? a. Seffanie Strathdee is a senior staff member at the San Diego School of Medicine b. Steffanie Strathdee is a female employee of the University of California c. Steffanie Strathdee was not involved in Newman and Logies research d. Steffanie Strathdee believes that HIV prevention strategies should not be restricted to promoting awareness of a vaccination program 10. Which of the following drawings best illustrates the word needle in the last sentence of Paragraph 5?

A.

B.

C.

D. 11. Needle exchange programs are a. attempts to cut health-care costs by re-using needle-sticks b. schemes providing clean needles for users of illicit intravenous drugs c. pointless attempts by doctors to share experiences d. government-funded international trips to investigate various types of drug-delivery system 12. Which of the following fractions represents fewer than half? (Paragraph 6) a. 3/4 b. 1/3 c. 3/2 d. 1/2 13. Paragraph 6 states that Seth Berkley thinks that: a. the questionnaire respondents used to give their opinion of the new vaccine was not impartial b. the current response to the vaccine initiative looks good but will probably prove ineffective c. it is a relatively positive sign that some people would be willing to take a vaccine that is not 100% effective d. his election as CEO was the first significant step towards the creation of a vaccine that more than 50% of people will be prepared to take 14. Berkley goes on to argue in Paragraph 7 that: a. people tend to stop taking medication as soon as they begin to see its effects b. it is not unusual for the public to be somewhat reluctant to take pharmaceutical products when they are first introduced c. it will be easy to sell almost all stockpiles of the vaccine within the first few days after it is made available in drug stores d. people respond less positively to a theoretical drug than to one that is already available on the market 15. N. Engl. J. Med. probably stands for: a. the UK medical establishment b. discouraging the public from being too optimistic about future vaccines

c. the New England Journal of Medicine d. Norman England and John Meddoes 16. Paragraph 8 suggests that: a. the fact that the study was based almost exclusively on data from the United States and Canada may cast doubt on the validity of its findings in other parts of the world b. Katherine Kripke believes that the study gives a fair guide to the situation outside North America c. More studies are needed in parts of the United States where there is greater incidence of HIV d. All but three of the studies should be disregarded because they are unrepresentative and biased 17. Of the studies covered by the meta-analysis a. the best was conducted in Uganda b. 94% were subsequently also applied in Uganda c. 94% were conducted in Uganda d. the best 94% were carried out in North America 18. According to Paragraph 9, why did the STEP trial come to an end: a. because there was evidence that the vaccine may be harmful b. because people in Africa were demanding a better vaccine c. because it was only the first stage in a program scheduled to end in 2007 d. because communities were tired of experiments and wanted a real vaccine 19. the term hardest hit in Paragraph 10 could be replaced by: a. bearing the heaviest financial burden b. most severely afflicted c. least able to cope d. more troubled 20. The article as a whole a. denies that HIV causes AIDS b. violently opposes any attempt to introduce an AIDS vaccine c. is keen to promote the AIDS vaccine on behalf of pharmaceutical companies d. adopts a generally positive attitude towards the possibility of the introduction of an AIDS vaccine, despite its potential shortcomings

Lack of uptake threatens promise of HIV vaccines

1. The news out of Thailand last year that an experimental vaccine reduced the risk of contracting HIV by as much as a third reinvigorated hopes that a vaccine against the elusive virus was possible. But new research showing that large swaths of the public wouldnt bother getting immunized against HIV, were such a vaccine available, calls into question the effectiveness of the approach in controlling the AIDS epidemic. 2. Even if youve got a vaccine, it doesnt magically get into the people who need it, says Peter Newman, a social science researcher at the University of Toronto. If we put our heads in the sand, then when an HIV vaccine comes out, were going to hit a lot of walls unless there have been good public awareness campaigns. 3. Around $1 billion is spent annually on HIV vaccine research, and there are currently around 30 vaccines in early- to mid-stage clinical trials. The latest trial was announced last month by the Dutch biotech Crucell, which plans to test a two-shot combination of vaccine candidates in healthy adults in the US and Africa. But according to Newman, who studies the acceptability of HIV biomedical prevention tools, the rewards of this effort could be limited in the absence of a more ardent public health education strategy. 4. Newman and his graduate student Carmen Logie conducted a meta-analysis of 20 studies involving more than 7,500 people evaluating their stated willingness to receive a hypothetical HIV vaccine. Reporting in July, the researchers found that, on average, around 65% of study participants said they would get an HIV vaccine, but only around 40% were prepared to get immunized if such a yet-to-be-developed vaccine was only moderately effective against preventing infection (AIDS 24, 17491756, 2010). 5. The study uncovers the challenges were going to have once were ready to roll out an HIV vaccine into the community, says Steffanie Strathdee, associate dean of global health sciences at the University of California San Diego School of Medicine, who was not involved in the research. We need to make sure communities understand that a vaccine is one component of a comprehensive prevention strategy, which should also include microbicides, needle exchange programs and antiretroviral therapy, among other interventions. 6. Even though fewer than half of the respondents said theyd take a partially effective vaccine, Seth Berkley, president and chief executive officer of the International AIDS Vaccine Initiative, actually thinks thats a pretty good starting point. 7. You never go from zero to 100% coverage with any vaccine; you always have a slow uptake, notes Berkley, who coauthored a paper in July calling the last year a renaissance in HIV vaccine development (N. Engl. J. Med. 363, e7, 2010). After public health officials prove that a non-theoretical vaccine is safe and effective, then youd start to see acceptance and thats what weve seen with every other vaccine, he says. 8. Given that all but three of the 20 studies included in the analysis were conducted in North America, some researchers question how widely applicable the findings are in regions of the world where HIV is more prevalent. Theres a need for more studies in high-incidence populations, says Katherine Kripke, assistant director of the vaccine research program in the US National Institute for Allergies and Infectious Diseases

division of AIDS in Bethesda, Maryland. I think the issues might be different in places like South Africa than they are here [in the US]. (The study with the highest rate of acceptability in Newmans analysis, 94%, was carried out in Uganda.) 9. Indeed, after Mercks STEP trial was halted in 2007 because the vaccine seemed to increase the risk of HIV infection, many people in Africa were still clamoring to sign up for the next vaccine trial, according to Alan Bernstein, executive director of the New Yorkbased Global HIV Vaccine Enterprise. The people in the communities have said, please, we need a vaccine. 10. For his part, Newman says he is now applying for funding to repeat the studys questionnaires in African countries that are hardest hit by the epidemic. Elie Dolgin Nature Medicine volume 16 | number 9 | September 2010

Centro de Pesquisas AGGEU MAGALHES MESTRADO ACADMICO EM SADE PBLICA 2011 Prova de Ingls Quarta feira dia 03 de novembro de 2010 09h00 12h00
Nome de candidato: RG de candidato: CPF de candidato: ________________________________ _____________ _____________

Question 1 2 3 4 5 6 7 8 9 10 A A A A A A A A A A

Answer B B B B B B B B B B C C C C C C C C C C D D D D D D D D D D

Question 11 12 13 14 15 16 17 18 19 20 A A A A A A A A A A

Answer B B B B B B B B B B C C C C C C C C C C D D D D D D D D D D