Why Are Women The Last To Know?

I've always been disturbed by the fact that women living with HIV/AIDS are the last to know. The last to know about the latest concoctions for treating HIV, the last to know about new research trials that could provide access to potentially life-saving therapies (although in most cases HIV and AIDS clinical trials test more of the same old things), the last to know about how to work the system to prolong their lives. It's long been a theory of mine that women's lack of access to information kills just as quickly as lack of access to healthcare.

Certainly not all the stuff we read in AIDS journals or in the press about the latest therapies can be taken to heart, in fact most of the stuff turns out to be just plain junk. I hesitate to talk about the hot new topics, given the fact that the history of this epidemic has, in part, been a series of dashed hopes. When I hear about something that makes sense, that has a relatively low risk of side effects (relative to other drugs for HIV), is inexpensive and available, and is being looked at and taken by the boys in New York and California, I tend to sit up and take notice. At the very least, we all ought to know about it too.

Two articles appeared last year in the journal Science looking at the possibility of using hydroxyurea (brand name Hydrea) to treat HIV. While the research is only in vitro (in the laboratory, not in actual people yet), The New York Times, AIDS Treatment News, and GMHC's treatment newsletters have all covered the subject. And, rumor has it, that the boys have been using hydroxyurea since the information was first presented at the International Conference in Berlin in the summer of 1993.

Hydroxyurea has been around since 1968, and is used for treating certain types of cancer. (Don't let this scare you off, AZT was a cancer drug until Burroughs Wellcome figured out they could make money selling it for HIV and AIDS.) In theory, the drug slows DNA synthesis by inhibiting the formation of a basic DNA building block called dNTP.

HIV enters cells (lymphocytes) and uses a substance called reverse transcriptase to convert viral RNA into DNA in human cells. The rate at which HIV can replicate (copy itself) depends on the "activity" status of human cells. Active cells have large amounts of dNTP, while resting cells have low dNTP levels. If hydroxyurea could deplete dNTP in active cells, would it then block the replication of HIV?

"rumor has it, that the boys have been using hydroxyurea since the information was first presented."

In one of two Science articles, researchers at the Nat.Cancer Institute showed that treating active cells with hydroxyurea (in the laboratory), decreased dNTP levels & DNA synthesis to levels comparable to resting cells. In a second article, it showed that hydroxyurea inhibited HIV replication in human cells; a function of depleting dNTP.

They showed that adding hydroxyurea to ddI, ddC, and AZT made the actions of those drugs greater. Since ddI, ddC & AZT inhibit the HIV reverse transcriptase, and hydroxyurea acts at a different site, two steps of HIV replication are inhibited, so this seems logical. (Don't forget this is all still theoretical since these are laboratory studies.)

So what's left to know?

Well, does it really work in real live people with HIV and AIDS? Big question with a long and short answer. The short answer may be at AIDS Treatment News in San Francisco. In a November article, an "800" number was published for people to call who had information on the use of hydroxyurea in HIV disease. Call them and find out what they know so far. Ask them what doses people report taking, what happened to their CD4 counts, and what the side effects of taking it are. 800-873-2812.

The long answers are in the elaborate research trials being developed to test the drug in people. But asking the "boys" gives us the answers long before that. What the hell, they won't let women in the trials anyway.