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July 28, 2004

In This Update:
  • From the Editor
  • HIV Treatment
  • Life With HIV
  • HIV/HAART-Related Health Problems
  • JournalView
  • HIV Prevention
  • U.S. HIV/AIDS Policy & Activism
  • HIV/AIDS Outside the U.S.

    "I Was a Viread Guinea Pig"
    Carlos Perez was not the biggest fan of clinical trials. "Who wants to take a new chemical formulation that has only been tried on rats and monkeys?" he asks. Yet he did: Lured by the promise of free medical care, he enrolled in a study of tenofovir (Viread).
    In this Positively Aware article, Carlos admits that it wasn't nearly as bad as he had expected.

    Rare Study Compares Drugs From Three Major Drug Classes
    A study presented at the XV International AIDS Conference (AIDS 2004) pitted one representative from each of the three major classes of drugs against one another in a first-line HAART regimen. Which came out on top: the protease inhibitor, the nucleoside reverse transcriptase inhibitor (NRTI) or the non-nucleoside reverse transcriptase inhibitor (NNRTI)? There was no clear-cut answer, reports David Wohl, M.D.; each type of drug had its strengths and weaknesses, though the triple-NRTI regimen underperformed, as expected, and fewer people switched off the regimen containing the NNRTI.

    Could Ritonavir's High Price Damage the Drug Pipeline?
    What kind of impact will last year’s 500% price increase of ritonavir (Norvir) have on the development of new meds -- especially other protease inhibitors designed to be taken with ritonavir? Treatment advocate Bob Huff argues that these so-called “boosted” protease inhibitors, which are increasingly used in HIV treatment, could be doomed if the price hike is allowed to stand.

    Boosted Fosamprenavir Works Well as First-Line Therapy
    A HAART regimen containing fosamprenavir (908, Lexiva, Telzir) and ritonavir (Norvir) is highly effective and well-tolerated when used as first-line therapy in people with advanced HIV, according to newly published data. Although these findings have been reported previously in our conference coverage, this is the final publication of results from this important study. Click on the link above to read the abstract. (Web highlight from AIDS)



    Crystal Meth Addiction: "A Mirage in the Dry Desert"
    Anyone experimenting with crystal meth, or considering it, may want to read this personal perspective from Daniel Berger, M.D. As a prominent HIV physician who mostly treats gay men, he's seen first-hand the devastating impact meth has had on his patients, and explains how its use has rapidly become one of the most catastrophic problems he's seen in his practice.

    Strategies for Counseling Crystal Meth Users
    What’s the best way to counsel people who are using crystal meth and putting themselves at a greater risk for HIV infection? The growing popularity of meth -- and its association with new HIV infections among gay men -- has left many HIV educators and prevention counselors asking that very question. Susan Kingston, a prevention strategy specialist, offers her take.

    Personal Story: For Older People, HIV Can Be a Missed Diagnosis
    “How many people over 50 have fallen through the cracks because of an inaccurate diagnosis and have then had to face advanced disease, opportunistic infections and death?” wonders Joan Warner. A former drug user, Joan was 51 when she was diagnosed with HIV -- 14 years ago and counting. She might never have even been tested if it weren’t for her daughter's suggestion; none of her doctors thought HIV was a possibility for someone her age.



    Some News, But Nothing Huge, on Metabolic Complications at AIDS 2004
    Although most of the research at the XV International AIDS Conference (AIDS 2004) regarding metabolic complications added little to the body of knowledge on the subject, several thought-provoking studies were showcased, reports David Wohl, M.D. He summarizes them in this overview of key presentations on body-shape and lipid abnormalities in people with HIV.

    Looking for more coverage of the XV International AIDS Conference? Visit The Body's AIDS 2004 home page to browse through highlights, watch Webcasts, listen to major speeches and flip through our one-of-a-kind Photo Journal.



    The July 2004 JournalView: A Detailed Look at the Latest Studies
    One of our most popular articles every month has been JournalView, a new monthly review of published research authored by one of The Body's experienced HIV physicians. Offered on The Body Pro, The Body's sister site for healthcare professionals, JournalView examines some of the most intriguing and noteworthy studies to appear in major medical journals over the past several weeks. For those who enjoy diving into abstracts and reading the nitty-gritty details of the latest clinical trials, JournalView is an excellent reference.

    In the July 2004 JournalView, Keith Henry, M.D., looks at a dozen different studies offering various angles on the epidemic, including the risks of sexual transmission during acute infection; the prospects of successful treatment after failing a protease inhibitor-based HAART regimen; and a possible explanation for why an enigmatic virus known as GBV-C appears to help prevent HIV from replicating inside the body.



    Why Condoms Aren't Enough to Protect Women From HIV
    When used properly and consistently, condoms are almost guaranteed to prevent sexual transmission of HIV for women. But evidence clearly shows that, throughout the world, the use of condoms by both men and women is inconsistent, even when condoms are readily available and prevention education is provided, according to this British Medical Journal editorial. For women to truly protect themselves from HIV, more options must be available. (Web highlight from the British Medical Journal)



    The Makings of a Crisis: HIV Treatment in the U.S.
    Virtually across the board, HIV treatment programs in the United States are in a state of crisis; Medicare, Medicaid, Ryan White, AIDS Drug Assistance Programs, the Veterans Administration and even private insurers are cutting back on HIV care. How did the situation get so ugly, and what hope does the future hold for improvement? Christine Lubinski, executive director of the HIV Medicine Association, takes a closer look.

    Lack of Treatment Access Must Be Fixed Now, Advocates Say
    Half a million people in the United States have HIV but aren’t receiving medical care, according to government estimates. This not only puts their health at risk, but also makes them more likely to transmit HIV to others and strain the country’s healthcare system when they become sick. It’s a growing emergency in this country that must be dealt with immediately, says the advocacy group AIDS Action.

    Bush's Speech on AIDS: What Doesn't Add Up
    What was wrong with U.S. President George W. Bush’s major speech on HIV in late June, during which he announced his support of, and emergency funding for, several domestic and international AIDS programs? Longtime HIV treatment advocate John James explains.



    Nelson Mandela Calls on World to "Rise to Challenge" of AIDS Threat
    When Nelson Mandela speaks, the world stops to listen. The supposedly retired 86-year-old former president of South Africa left his home this month to talk at the closing ceremony of AIDS 2004 in Thailand. “I cannot rest until I'm certain that the global response is sufficient to turn the tide of the epidemic,” he said. “Allow me to enjoy my retirement by showing that you can rise to the challenge.” Click on the link above to read the transcript or watch a video of Mandela’s rousing speech.

    Most UK Male Heterosexual HIV Infections Occur When Traveling Abroad
    Seven of every 10 United Kingdom-born men who were infected with HIV through heterosexual sex between 2000 and 2002 contracted the virus while traveling abroad, a new study claims. Of these men, almost a quarter were probably infected in Thailand, the study added. About a quarter of heterosexually infected UK women were also infected while outside the country.

    "AIDS Could Be a Good Thing for India"
    Can a disease as devastating as AIDS possibly have a positive impact on a country? Indeed it can, according to San Francisco Chronicle columnist Marshall Kilduff. "The threat [of AIDS in India] should yank social thinking and institutions forward. ... If a country like India can find a response, it will be a huge victory over AIDS and the injustices that allowed it to spread." (Web highlight from the San Francisco Chronicle)

    Condom Maker Expects Olympians to Go for Gold ... In the Bedroom
    While TV networks scramble to cover the Summer Olympics in Athens next month, condom maker Durex will provide coverage of a different kind: It's providing
    130,000 free condoms to the games' 17,000 athletes and officials. Durex will also donate 30,000 packets of lubricant "to smooth the performance of the world's elite sports people in the arena and under the covers," the company said in a statement. (Web highlight from Reuters)

    Richard Gere: From "American Gigolo" to Global AIDS Activist
    Actor Richard Gere has become almost as ubiquitous as Bono on the HIV/AIDS scene. In this interview with ABC News correspondent Jackie Judd, he talks about his take on the pandemic and some of his efforts to fight the spread of HIV in India.

    Eastern European, Asian Leaders Urged to Curb HIV Before Epidemic Explodes
    It's long past time for leaders in Eastern Europe and Central Asia to realize that the region's accelerating HIV epidemic needs to be acted on quickly, wrote Shigeo Katsu, the World Bank's Regional Vice President for Europe and Central Asia, in anticipation of the International AIDS Conference in Thailand. (Web highlight from The Messenger, a daily English-language newspaper in Georgia)

    The Hands Project
    Image from the AIDS 2004 Photo Journal
    In most of the world it is too dangerous to disclose that you're HIV positive. The Hands Project in Thailand asks simply for a handprint and signature from HIV-positive people to help provide a visual sense of the scope of the pandemic. This photo is part of The Body's AIDS 2004 Photo Journal.
    Image from the July 2004 Visual AIDS Web Gallery
    "Apparitions: Museum," 2004;
    Kermit Berg
    Visit the July 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.