January 14, 2009
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LIVING WITH HIV

Mark King Mark King: The Drug Addict Takes a Holiday
This week, Mark King returns to "the scene of the crime": the neighborhood where his drug addiction once flourished. In his latest video blog, Mark revisits his old haunt in Ft. Lauderdale, Fla., from which he fled three years ago to enter drug rehabilitation. Now back and visiting his ex-boyfriend, Mark finds himself lost in thought. "Ironically, some of the personal traits that have seemingly served me well in dealing with HIV/AIDS have not helped my recovery," he says. "Through the deaths of the 1980s and my own HIV diagnosis, I have maintained a blinders-on, healthy state of denial, in order to keep working for the community or through my own grief. ... Alas, that 'emotional insulation' betrays me when it comes to using drugs, because crystal meth is, itself, a way to choke my feelings." (Blog from TheBody.com)

IN THE NEWS

Barack Obama Advice for Obama: As a New President Steps in, U.S. HIV Advocates Sound Off
TheBody.com asked some of the top HIV advocates in the United States: What three things would you advise U.S. President-elect Barack Obama to do that would make a difference in HIV prevention and treatment in the United States? In our latest edition of Word on the Street, you can read or listen as leaders in the HIV community tell the incoming president what they feel he can do to bring sorely needed change to the fight against HIV within the U.S. (Podcasts from TheBody.com)


 U.S. HIV Advocates Livid Over "Right of Refusal" Rule for Health Workers
HIV advocates and doctors' groups are outraged at a new rule that protects U.S. health care workers who refuse to provide people with information, referrals and care on the basis of their own ethical or religious beliefs. "This 11th-hour Bush-Cheney Administration rule endangers reproductive health, exacerbates the HIV/AIDS epidemic and jeopardizes basic health care for ... groups that could evoke moral objection," says Marjorie Hill of Gay Men's Health Crisis. The rule takes effect just days before U.S. President-elect Barack Obama takes office -- and it's a final rule, passing despite vigorous opposition. (Press release from Gay Men's Health Crisis)

In the text of the 127-page rule, its authors address -- and evade -- comments from those who oppose the rule on many grounds, including the claim that its protections run counter to the medical workers' oath to "do no harm" and provide care without judgment. Click here to read the full text of the rule.


 Europe to U.S: Stop Requiring Foreign Visitors to Report Their HIV Status
HIV-positive foreigners attempting to visit the United States are still required to disclose their status to U.S. authorities, even though it's been months since the U.S. lifted its ban on HIVers entering the country, the European Commission says. The commission has called on the U.S. health department to follow through on its promises and remove HIV from an official list of diseases barring entry into the U.S. (Article from kaisernetwork.org)

Also Worth Noting: Share Your Thoughts: Dozens Have Commented on AIDS Denialist's Death
Readers like you have made our brief summary of AIDS denialist Christine Maggiore's death the most commented-on article in the history of TheBody.com! Click here to take part in the thought-provoking discussion.
HIV TREATMENT & HEALTH ISSUES

 Step Aside, Atripla? New 4-in-1 Pill to Enter Development
Atripla (efavirenz/tenofovir/FTC) changed the face of HIV treatment when it became the first once-daily, multi-class combination HIV med in the U.S. Now the same company that sells Atripla is looking to develop an alternative: the Quad pill. The idea is to create a second all-in-one option for people who can't take Sustiva (efavirenz, one of the drugs in Atripla) for any of a number of reasons, including side effects, resistance or perhaps even pregnancy. The Quad pill would combine Truvada (tenofovir/FTC) with elvitegravir (an integrase inhibitor) and a "booster" drug currently in development. The first clinical trials of the pill are expected to begin later this year. (Article from Bloomberg)


 Will You Become a Long-Term HIV Nonprogressor? Prediction Is Possible, Researchers Suggest
Can doctors predict whether someone who's newly diagnosed with HIV will become a long-term nonprogressor? French researchers believe so. Long-term nonprogressors are people who are able to keep their CD4 count above 500 for at least eight years without taking HIV meds. The researchers found that if two lab values -- HIV viral load and HIV DNA levels -- are undetectable at the time a person is diagnosed with HIV, they have about a 60 percent chance of becoming a long-term nonprogressor. (Study summary from aidsmap.com)

Long-term nonprogressors are not the same as another rare group of HIVers known as "elite controllers." While nonprogressors keep their CD4 count high for many years without needing meds, elite controllers keep their viral load undetectable for many years without meds. Click here to learn more about elite controllers, or read the thoughts of TheBody.com blogger Loreen Willenberg, an elite controller living in California.


 Starting Treatment at CD4 Above 350 May Bring Extra Immune Benefits, Study Says
As experts continue the "when to start treatment" debate, a new study provides support to those who feel people should start HIV meds when their CD4 count is still above 350. The three-year U.S. study found that starting HIV meds had a better impact on people's immune systems if their CD4 count was higher (above 350) than if it was lower. Although research has shown that people who start HIV treatment with very low CD4 counts can still recover very well, this study supports the views of many experts that the earlier an HIV-positive person gets diagnosed and begins treatment, the better off he or she will be in the long term. (Study summary from aidsmap.com)


Also Worth Noting: Connect With Others
How Could My First CD4 Count Be So Low?
(A recent post from the "I Just Tested Positive" board)

I got my first numbers today, and they weren't quite what I expected. I was hoping I could go a few years without medication, but that doesn't seem to be the case: viral load 1,000, CD4 count 209. My viral load is relatively low, but my CD4 is just hovering above diagnosable AIDS. The doctor was a bit shocked, both at the difference in the numbers and because I'm relatively healthy. ...

We decided to retest again in a month. I'm sort of suspecting he gave me that option just to get me used to the idea of being on meds, not because he expects them to miraculously jolt above 350. Am I wrong in thinking that? ... Is there anything I can do to encourage the CD4 to go up a little bit, if only just so they don't drop below 200?

-- personpitch

Click here to join this discussion thread, or to start your own!

HIV TRANSMISSION & TESTING

 HIV-Positive Surgeons Extremely Unlikely to Transmit HIV During Surgery, Report Suggests
The risk of an HIV-positive surgeon transmitting the virus to a patient is very low, according to an Israeli report. The report covers an experienced Israeli surgeon who was diagnosed with HIV in 2007. When the surgeon (whose gender was not revealed) tested positive, hospitals offered HIV tests to everybody he or she had operated on since 1997. Of the 545 people who got tested, none tested positive. Israel's health ministry has given the surgeon a green light to return to work -- without any restrictions, and without any need to inform patients of his or her HIV status. (Article from kaisernetwork.org)


 U.S. Harm Reduction Programs: The Cloud in the Silver Lining
There's a dark side to needle exchanges and other harm reduction programs: They sometimes claim the lives of the very people who run them, the Wall Street Journal reports. We know that harm reduction programs work: Studies show that by teaching people to be more responsible about their drug use, the programs prevent fatal overdoses and reduce the spread of HIV. But in this in-depth article, the Journal takes a closer look at the lives of the heroic people who make needle exchanges and other harm-reduction programs possible in the U.S., but whose own drug problems may go untreated, with tragic results. (Article from the Wall Street Journal)

Also Worth Noting: Make a Difference: Support New U.S. Legislation Backing Needle Exchange
U.S. lawmakers are attempting to ring in the new year with change that the HIV community can believe in: new funding for needle-exhange programs across the country, which can reduce rates of HIV and other bloodborne disease in injection drug users.

Click here to find out more about the Community AIDS and Hepatitis Prevention (CAHP) Act of 2009, which has just been introduced in the U.S. House of Representatives. You can also sign and send a pre-written message to your representative urging him or her to support the act!
HIV THROUGHOUT THE WORLD

 Gay HIV Advocates Jailed in Senegal; Activists Are Fuming
International gay-rights advocates are "deeply disturbed" by a recent ruling handed down by a Senegalese court. Nine gay men were sentenced to eight years in jail -- the most extreme sentence of its kind ever handed down in this West African nation -- on charges of "indecent conduct and unnatural acts." In Senegal, as in many African countries, sex between men is a punishable offense. However, the judge increased the men's five-year maximum sentence because of their membership in a "criminal organization" -- that is, an HIV advocacy group. (Article summary from kaisernetwork.org)

The arrests of these nine men happened just 10 days after Senegal played host to a major conference on HIV and other sexually transmitted diseases in Africa. At that conference, the director of the International AIDS Society proclaimed that "the fight against HIV is a fight for the human rights of all human beings"; health, community and political leaders from across the continent also made commitments to address HIV among sexual minorities in their countries. Click here to read a statement by international public health leaders condemning the recent events in Senegal.