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International Aids Conference Personal Highlights

Fall 1996

There were several presentations for and about women at this Eleventh International AIDS Conference, undoubtedly more than ever before. And of course, there were numerous presentations of interest for anyone with HIV. Among all the studies, theories and medical trials, certain information stood out and seemed "concrete", and therefore would impact any HIV positive persons' decisions about their care, treatment and life-style.

Female Controlled Prevention

First of all, a very important subject - safer sex. "Reality" Female Condom had a booth, and was handing out handfuls of free condoms following their very informative and amusing presentation. The female condom is stronger than the typical latex condom. It is impermeable to HIV, CMV and HPV. Bottom line - this is a very effective barrier to disease transmission. Remember all you HIV positive ladies, not only do we not want to spread this disease, we don't want to get any other sexually transmitted germs or diseases.

Although non-oxynol-9 kills HIV on contact, we still don't know if the existing chemical spermicide products which lubricate male condoms fully protect against HIV. In fact, they can be very irritating to the vagina and may actually increase the risk of infection.

Treatment Guidelines

By now, most everyone has heard of, and hopefully has had, a viral load test. This is now seen as the most important test used to monitor HIV. Basically the viral load test, which measures the amount of HIV particles in the blood, has two primary functions; -1- It tells how active the HIV is. High is bad, low is good, non-detectable is the goal, and it can easily be achieved with protease inhibitors. -2- The doctors can now use this test to know when to change treatments, as the viral load test is a better barometer of how medications are working.

So what about T-cells? Do they still matter? Why do we continue to monitor them? T-cells are an indicator of how much damage has been done to your immune system. The T-cells are still the marker used by doctors to determine if and when to initiate prophylactic therapies (i.e. Bactrim, Diflucan, Zovirax, etc.). If your T-cells are low and you are doing preventative therapies, you must continue to take them, even if your viral load is undetectable. This is because your immune system is damaged. As yet, there doesn't seem to be much on rebuilding the immune system with western medicine. For myself, I believe that alternative therapies such as acupuncture and stress-reducing massages help to strengthen the immune system.

Triple Drug Therapies

The goal of the triple drug combination, (two anti-retrovirals and a protease inhibitor), currently being used with such success, is complete suppression of HIV. Many doctors think this is entirely possible. Of course, this is the best news in years. This exciting news gave this International Conference a very optimistic "vibe". This means, at some point, it is possible that therapy could be stopped.

The bottom line on the current therapies is this:

  1. Best is the triple combination. Besides being a potent combination against HIV, taken together they suppress drug resistance and side effects.
  2. Second best is a protease inhibitor alone.
  3. AZT + 3TC combo is third.

Never take just one antiretroviral. If your doctor is prescribing this, either get a new doctor, or insist that he/she prescribes what you want. And, when switching to new drugs, switch at least two of them. Remember, the more your doctor knows about HIV, the longer you will live. It's a good idea to actively seek-out a specialist, if possible.

Decisions To Make

What this means is that those of us who have resisted taking antiretro-virals because we fear the drugs more than the disease, must now seriously reassess our thinking. Whereas before, we might be inclined to wait until our T-cells had dropped as low as we felt we could stand - before initiating any kind of drug therapy, if indeed we opted to take anything at all. Now, the goal is to keep the virus at bay, and prevent any further damage to our immune systems. The idea that therapy might perhaps be able to be stopped entirely is amazingly good news. Several esteemed physicians believe this is entirely possible.

Keep Hope Alive

Of course, there are people who want to be cautious, and don't want to "get our hopes up." But, why shouldn't we have high hopes? After all, what once seemed impossible now seems achievable. Research is likely to start focusing on rebuilding the immune system. Personally, I'll take Dr. James Curan's advice "Keep Hope Alive".

Throughout the conference, one point which was made clear was that those of us in countries like the United States are very fortunate to have access to these treatments. Most AIDS patients in the world haven't even seen these drugs, let alone have access to them. They are lucky if they even have a doctor, clean water and food.

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This article was provided by Women Alive. It is a part of the publication Women Alive Newsletter.