A Few Good Women

A few good women who participated in study ACTG 175, made a profound and significant impact on the lives of all women living with HIV/AIDS. Getting involved in drug studies is an important decision for HIV+ women. If you've ever thought to yourself, "I don't want to be a guinea pig", I have news for you. If you're taking medication for HIV, you already are one.

There is a growing awareness and concern among HIV positive women that medications prescribed for them have been developed and approved as a result of clinical trials conducted primarily, and sometimes exclusively in men. New therapies for HIV infection and opportunistic infections that come with having AIDS have not been well studied in women prior to drug approval and widespread use. Since most of these drugs have not been in the bodies of very many women, researchers really don't have a clear understanding of how the drugs may work differently in us.

In her presentation at Vancouver, B.C., Dr. Judith Currier of U.S.C. cited a large phase III trial (ACTG 175) as the only study in 12 years with enough women enrolled (18%) to draw any conclusions about how women differed from men. Below are the results of that substudy.

At baseline, (before drugs were given) women were more likely than men to:

• Have a history of IV drug use
• Weigh less (averaging 22 lbs. less than men)
• Be of Color
• Have slightly higher CD4 counts
• Report having headaches
• Have had less prior drug therapy
• Have a lower white blood count
• Have a lower incidence of elevated liver enzymes

The drugs in the study were AZT, ddI and ddC administered in various combinations to study participants. After drugs were started, women were more likely than men to:

• Change their dose earlier in the study (please see note)
• Report severe or worse symptoms (headaches, nausea and pain)

• During the study, men were more likely to:
• Develop lab abnormalities
• Develop a 50% decrease in CD4

Dr. Currier states that the differences between men and women in this study are important and that "further analyses are warranted to understand the gender differences in tolerance of specific therapies."

The only way to understand these differences is for more women to enroll in clinical studies.

If you'd like to talk about clinical trials or would like a copy of the entire text of Dr. Currier's presentation, please call Nina at:1.800.554.4876 or email her at: askNina@aol.com

See AIDS Clinical Research Projects for a list of trials in the Los Angeles area.

Note: Increasing, lowering, OR skipping your doses of Protease Inhibitors: (Crixivan, Retonivir, and or Saquinivir) can be DANGEROUS, can cause much HARM, and undo the benefits of the drug. If you miss a dose, it doesn't mean you have to stop therapy. Just take the next dose at the scheduled time.

A study was conducted to assess the personal dynamics of women who were knowingly infected with HIV by their stable partners. Although this study took place in Brazil, the traits or "patterns of coping"that influenced women's decision to risk unprotected sex may be universal. At the very least, they're worth being aware of when we take stock of our own thoughts and behaviors concerning safer sex and harm reduction. The traits identified were classified as follows:

• Destructive: Anger surfaced in aggression towards herself and/or others.
• Symbiotic: Had a relationship of total dependence with partners.
• Submissive: Gave-in to partners wishes for fear of his reaction.
• Romantic: Had unrealistic and naive expectations of love, where dying for love had an altruistic meaning. (think Romeo and Juliett)
• Mystic: Wished to give birth to a child thinking that the baby would have some power to restore its parents health.
• Fatalistic: Believed in predes-tiny of life and a divine being who could change the end.
• Penitent: Thought the infection was a divine punishment.
• Gambler: Behavior was related to the pleasure of risk taking.
• Denial: Denied the seriousness of the situation or their role in determining the outcome.
• Apathetic: Prolonged depression interfered with taking constructive action.
• Victim: Complained but still did not take constructive action.

If any of the above ring even a distant bell for you, try to stop and listen. Recognizing the thought process that leads to possible risky (or addictive) behavior is a constructive act in itself.