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What's So Special About Research? Dr. Carl Dieffenbach Answers

By Candace Y.A. Montague

May 18, 2011

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The first sentence in Dr. Fauci's statement in the 2010 National HIV testing day reads "Routine testing is central to ending the HIV pandemic." Yet the term routine does not appear once in the Obama administration National HIV/AIDS strategy and the term. Is there a disconnect between the administration at NIAID and the White House?

What Dr. Fauci means by routine is that taking an HIV test needs to be the equivalent of getting your blood pressure taken. It should be the fifth vital sign. It's cheap. It's accurate. And that is the way to reduce stigma. We have 20% of the American population that has HIV and doesn't know their status. We need to get to the bottom of this. That's what he means by routine. It's a part of the CDC guidelines. The National HIV Strategy talks about full implementation of the guidelines. That's what we're talking about.


Any new findings that we should be looking out for as the clinical trial networks are winding down?

The next major activity at the completion of some of these studies will be really defining what the best first line will be. There have been some surprises. The next question to explore will be is there some clinical benefits to an individual starting treatment significantly earlier than the guidelines of the past. That will matter a lot because if you think about it, people who don't start HIV therapy in the beginning may not want to start because they feel ok. They don't feel sick. But there's an emerging body of evidence that shows they are actually causing harm to their bodies because HIV continues to grow and replicate. It's not just damaging to their immune system but it's damaging to their heart, their kidneys, their liver, and their bones. So we will be getting the data that shows that starting earlier actually protects you in the long run. One of the factoids tucked into the information about women and the antimicrobicidal gel is that it also protects them from herpes. That's another fact we'll be able to confirm. Having the protection for both is ideal. Start with a woman who goes through sexual debut. Use protection, don't get pregnant, and by the way if you can't get your boyfriend to use a condom, use this gel.

Side note: This interview was conducted prior to last week's announcement regarding early antiretroviral treatment.

The International AIDS Conference is coming next year. What can we expect from NIAID in regards to participation?

I'm excited. I am looking forward to showing off DC and all that it has. I'm looking forward to working with the White House and the mayor. Additionally, we hope that by the time we get to 2012, the culmination of the work that has gone on in the Department of Health and the work that NIH is doing with DOH will showcase the improvements we've made in HIV/AIDS in the city.

Are we any closer to a cure?

I think we are closer. I think we understand a little bit about what we need to do. There has been at least one patient cured, however; that poor person started with a very aggressive form of Leukemia and ended up with a bone marrow transplant. I do believe he's cured. The reason I say that is because of time. Have you ever seen a thermometer with mercury in it break and watch the mercury roll around? It always finds a way through. HIV is like mercury in that it always finds a way through. If he still had it, it would have found a way through by now.

Special thanks to Ms. Anita Greene, Outreach Program Director, National Center for Complementary and Alternative Medicine at NIH for assisting me in arranging this interview.

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D.C. HIV/AIDS Examiner

Candace Y.A. Montague

Candace Y.A. Montague

Candace Y.A. Montague has been learning about HIV since 1988 (and she has the certificates from the American Red Cross to prove it). Health is a high priority to Candace because she believes that nothing can come of your life if you're not healthy enough to enjoy it. One of her two master's degrees is in Community Health Promotion and Education. Candace was inspired to act against HIV after seeing a documentary in 2008 about African-American women and HIV. She knew that writing was the best way for her to make a difference and help inform others. Candace is a native Washingtonian and covers HIV news all around D.C. She has covered fundraisers, motorcycle rides, town hall meetings, house balls, Capitol Hill press conferences, election campaigns and protests for The DC and emPower News Magazine.

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