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June 30, 2004

In This Update:
  • HIV Treatment
  • HIV/HAART-Related Health Problems
  • HIV Transmission
  • U.S. HIV/AIDS Policy & Activism
  • XV International AIDS Conference
  • HIV/AIDS Outside the U.S.

    Before You Talk Treatment With Your Doctor...
    Not sure if you're ready to start HIV treatment? This article from Project Inform may be able to help you organize your thoughts and discuss your options with your doctor. It includes an overview of the goals of treatment, the different types of drugs available and the current guidelines regarding when treatment is recommended.

    Why Are There So Many "Recommended" HIV Meds?
    Many HIV medications are listed as "strongly recommended" in the U.S. treatment guidelines, so how do you choose between them? Is there a best drug among equals? HIV clinical trials advocate Anne Monroe explains why, with so many effective HIV meds out there, choosing a first treatment regimen isn't always a black-and-white issue.

    Taking Part in a Therapeutic Vaccine Study
    Thinking of joining a clinical trial to test out a therapeutic HIV vaccine, an experimental form of therapy that researchers hope will one day make HIV treatment far easier and less toxic? As with studies of any unproven treatment, there can be benefits to signing up, but there are plenty of risks as well. Wise Words describes some of the issues you should consider before enrolling.

    NNRTI Not Working? It May Be Safe to Stop It, One Study Suggests
    If a person has become resistant to the NNRTI in a HAART combination, cutting the NNRTI out of the regimen appears not to do any harm, according to the results of a small study. The study found that removing the NNRTI after the development of resistance won't increase a person's viral load or decrease their CD4 count. This suggests that, once NNRTI resistance sets in, the drug has no activity whatsoever -- and that there is thus no real reason to continue taking it. (Web highlight from aidsmap.com)

    Study Supports Early Start to NNRTI-Based HAART
    Although the jury is still out on whether there's any benefit to starting treatment during acute HIV infection, a new, small study in London seems to support the strategy. The study analyzed the viral loads of long-term nonprogressors, and compared them to two groups of HIV-positive people starting NNRTI-based HAART: those who were infected within the past year and those who were infected two or more years ago. The results? Recently infected patients who received treatment were
    more likely to see their viral loads drop to levels similar to the long-term nonprogressors. Read this journal abstract to see some of the data on this study. (Web highlight from the Journal of AIDS)



    Can Your Diet Improve Lipodystrophy?
    Is the currently chic, carb-free Atkins diet beneficial for lipodystrophy, or is moderation the key? Read this article for a closer look at the impact various diets can have on the metabolic complications associated with HIV and some HIV meds.

    Vulvar Abnormalities More Likely in HIV-Positive Women; Screening Important
    Human pappilomavirus (HPV) is the most common sexually transmitted disease in the United States, and is the primary cause of cervical cancer and genital warts in women. According to a recent study, HIV-positive women also appear to be at greater risk than HIV-negative women for developing genital warts and vulvar abnormalities that can lead to cancer, although HAART seemed to help reduce the occurrence of these abnormalities. The Canadian AIDS Treatment Information Exchange explains these findings, and why they underscore the importance of frequent gynecological checkups for women with HIV.

    HIV-Positive Teenage Girls Have Higher Cervical Cancer Risk
    More HIV-positive teenage girls than HIV-negative girls in the United States are infected with some of the most dangerous strains of human papillomavirus (HPV), according to the results of a moderately sized, nationwide study. The study also found that HIV-positive girls are less likely to clear the virus from their immune systems, placing them at much greater risk than HIV-negative girls for developing cervical cancer as adults. For these reasons, the researchers say, frequent cancer screening is an extremely important part of the medical care of HIV-positive teenage girls. (Web highlight from aidsmap.com)

    Transplants and HIV: No Longer an Impossible Pair
    As recent research has made increasingly clear, organ transplants can often be safe and highly successful in otherwise healthy people with HIV. As this down-to-earth overview explains, however, transplants are still a solution of last resort, and there's a lot that HIV-positive people need to keep in mind before deciding whether to enroll in a study to receive one.

    New Discovery on Kaposi's Sarcoma May Yield Better Testing, Treatment
    British scientists believe they've solved a century-old mystery by discovering the location within the human immune system where Kaposi's sarcoma first develops. The finding could help researchers develop new ways to test for and treat Kaposi's sarcoma, and even help them prevent it from occurring in people who are found to be at risk. (Web highlight from Agence de Presse Medicale)

    Lipid-Lowering Drug Helps Triglyceride Levels in HIVers With Lipodystrophy
    Fenofibrate (Tricor), a drug used to treat people with high triglycerides and a type of cholesterol, may also be able to help HIV-positive people with metabolic problems, researchers have found. In a small study in Texas, a daily dose of fenofibrate was discovered to lower abnormally high triglyceride levels in HIV-positive people with lipodystrophy, without causing any severe side effects. This study abstract offers more details. (Web highlight from the American Journal of Medical Science)

    How Vaccines Work Their Magic
    How do vaccines, like those you might take to prevent you from getting the flu, actually work? This guide from Project Inform offers a quick walk through the basics.



    Rapid HIV Test Will Become Available at U.S. Doctors' Offices, Clinics
    The U.S. Food and Drug Administration (FDA) announced on June 25 that the OraQuick Rapid HIV-1/2 Antibody Test can now be used in doctors' offices and HIV counseling centers in addition to certified laboratories, a decision which should expand its use to an estimated 180,000 locations throughout the United States.

    Top Partner in Anal Sex May Be at Greater Risk for HIV Than First Thought
    A new study has found that the amount of HIV present in rectal secretions far exceeds the amount of HIV in blood or semen -- even if a person is taking HAART. The results raise a warning flag that, during anal sex in which the receptive partner is HIV positive, the insertive partner may be at a higher-than-expected risk for becoming infected. (Web highlight from Advocate.com)

    Disinfecting Needles: For Injection Drug Users, a Plan B for HIV Prevention
    There's an alternate option for injection drug users who don't have access to new syringes or a needle-exchange program: disinfection. It's not a foolproof technique, but it's an awful lot safer than reusing dirty needles, and it can greatly reduce the risk of becoming infected with hepatitis or HIV by sharing needles with someone else. This FAQ from the U.S. Centers for Disease Control and Prevention explains the what, why and how of disinfecting needles.

    Updated Numbers on the U.S. HIV/AIDS Epidemic
    Through the end of 2002, an estimated 886,575 people in the United States had been diagnosed with AIDS since the start of the epidemic, with nearly as many African Americans diagnosed as whites. AIDS-related illnesses have already claimed the lives of an estimated 501,669 Americans. This review from the U.S. Centers for Disease Control and Prevention (CDC) breaks down the numbers.

    A PDF of the full U.S. HIV/AIDS Surveillance Report is also available; it provides much more detailed statistics through the end of 2002, including breakdowns by age, ethnicity and region.

    Washington Man Charged for Exposing 17 Women to HIV
    A 32-year-old Lacey, Wash. man has been charged with 17 counts of first-degree assault and several other offenses for willfully exposing 17 women to HIV, despite having received an order from health officials to stop having unprotected sex. (Web highlight from the Associated Press)



    Americans Take Stock of Bush's New Announcements on the AIDS Fight
    On June 23, U.S. President George W. Bush made a series of announcements on the HIV/AIDS battle in a speech he gave in Philadelphia. They included $20 million in emergency funding for cash-strapped AIDS Drug Assistance Programs in the United States; $500 million in immediate funds for his global AIDS initiative; the addition of Vietnam to the list of countries who benefit from that initiative; and a rare expression of support for the use of condoms to prevent HIV transmission. What did the rest of America think of these new developments? Read this article for a collection of thoughts from the country's newspapers and editorial writers.

    The HIV Medicine Association (HIVMA), a large group of HIV physicians, is one of many organizations that have praised U.S. President George W. Bush's pledge to funnel $20 million in emergency funding to shore up struggling ADAPs. HIVMA cautions, however, that the cash infusion is only the first step of many needed to improve the chilly HIV treatment and prevention climate in the United States.

    The AIDS Quilt Returns to Washington
    On June 25, 8,000 panels of the AIDS Memorial Quilt were put on display at the Ellipse south of the White House. It is the first large portion of the quilt to be unveiled in Washington since 1996, when 40,000 panels covered the Mall.



    I Have to Pay How Much to Get In?
    How much does it cost to register for the International AIDS conference? The early registration fee for the conference was $800, not a paltry sum to begin with. However, after May 1 the fee rose to $1,000 -- that's $1,250 after taxes. Many AIDS advocates are furious over the high cost of registration; they warn that the fees will mean "thousands of key voices" will go unheard at the world's most important AIDS Conference, which this year is themed "Access for All."

    Ashley Judd, Dionne Warwick, Oprah Winfrey: The Red Carpet Heads to Bangkok
    Some well-known singers, actresses and politicians will join the thousands of people heading to Bangkok for the XV International AIDS Conference, which begins in two weeks. Actors Richard Gere and Ashley Judd are scheduled to officially launch the 2004 AIDS Film Festival in Siam Square, along with the Asian premiere of the global AIDS documentary A Closer Walk. Singer Dionne Warwick is scheduled to perform the last song at the closing ceremony of the conference on July 16 and appear at an elite, 600-person dinner concert on July 14 -- a concert that is expecting such guests as Oprah Winfrey and former South African President Nelson Mandela. Also scheduled to appear at the conference are the Dalai Lama and the ubiquitous Irish rock star Bono.

    Looking for the best place on the Web to read through highlights and summaries of the XV International AIDS Conference, which begins on July 11? Look no further: The Body's next-day coverage will keep you informed on important new research, and our news feed from kaisernetwork.org will give you complete access to Webcasts, video interviews and breaking news.



    Vatican's Stubbornness on Condoms Costs Millions of African Lives, Official Says
    The refusal of the Catholic Church
    to accept that condoms can effectively prevent the spread of HIV is "bringing into great danger the lives of millions" in Africa, according to Poul Nielson, the European Commissioner for Development and Humanitarian Aid. Even many Catholic groups have criticized the Vatican's reticent stance: Austen Ivereigh, an editor for the international Catholic newspaper the Tablet, says the home of the Holy See is "misguided" when it says the "only realistic and long-lasting response to AIDS is a change in moral behavior."

    "The Sex Workers": A Video Report from India
    In this 21-minute video, Raney Aronson of Frontline reports on the sex industry in Kamathipura, one of the poorest districts in India. Her investigation sheds light on the brutal living conditions of the district's sex workers, as well as efforts by AIDS prevention workers to make safe sex a mantra among a group of people who may be one of the primary conduits through which HIV spreads into the general Indian population. (Web highlight from Frontline)

    Image from the November 2003 Visual AIDS Web Gallery
    "Antiviraled Architecture," 2001;
    Larry JaBell
    Visit Visual AIDS at The Body to view this month's Web Gallery, or to browse through Web Galleries from the past five years!

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