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August 11, 2004

In This Update:
  • HIV Treatment
  • Life With HIV
  • HIV/HAART-Related Health Problems
  • AIDS 2004: Selected Abstracts
  • HIV Transmission
  • HIV/AIDS Activism & Drug Pricing
  • HIV/AIDS Outside the U.S.
  •   HIV TREATMENT

    AIDS Far More Likely to Kill Blacks Than Whites in U.S.; Treatment Gap Cited
    Nearly twice as many blacks than whites in the United States died from AIDS-related causes in 2002, "a gap that has been increasing since 1998," according to a report by The New York Times. Researchers have attributed the worse outlook for blacks to later diagnosis of HIV, inferior medical care to that received by whites and an increased prevalence of coinfections and other health problems. HIV-positive African Americans are also less likely than HIV-positive whites to receive life-sustaining HIV medications because they are more likely than whites to be uninsured or underinsured.


    Making Current Meds Better: Tweaks to T-20
    Drug companies continue to work on ways to improve existing HIV medications: Plans are in the works, for instance, to develop a needle-free injection system for T-20 (enfuvirtide, Fuzeon), as well as a once-daily dosing option. This update from GMHC Treatment Issues has more.


    Beyond T-20, Another Type of Entry Inhibitor
    There's a lot more to entry inhibitors than just T-20 (enfuvirtide, Fuzeon). In fact, there’s a whole subset of entry inhibitors known as "attachment inhibitors," which are close cousins to T-20 but attempt to fight HIV in a slightly different way. Several attachment inhibitors are currently in development; this overview from Project Inform explains what they are and how they work.


    HIV Treatment = HIV Prevention?
    New study findings from Taiwan support the idea that HIV treatment is HIV prevention: Since the country started providing free HIV meds to its HIV-positive citizens, its HIV infection rate has been cut in half, while rates of syphilis and gonorrhea have remained the same. Experts point to the findings as yet another reason why HIV treatment access is so pivotal in the developing world. (Web highlight from BBC News)


    Cytokine Therapy Investigated as Immune Booster
    The immune system uses a group of naturally produced chemicals called "cytokines" to help it fight off infections. For many years, scientists have tried to harness the power of cytokines to develop treatments for HIV and related infections, with mixed success. In this review, Project Inform provides a review of cytokine therapy research to date.


    New Drug-Addiction Treatment Could Revolutionize HIV Primary Care for Drug Users
    A new drug called buprenorphine (byoo-preh-NOR-feen) is being developed as a safer alternative to methadone as a treatment for addiction to heroin and related drugs. It has the potential to revolutionize treatment for HIV-positive drug users by giving HIV doctors the ability to treat drug abuse and HIV at the same time. That, in turn, could allow HIV-positive drug users to more easily stay healthy, stop sharing needles and reduce the odds that they'll infect someone else with HIV. (Web highlight from The Hopkins HIV Report)

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      LIFE WITH HIV

    Life as an HIV-Positive Grandmother
    Sharon is a 59-year-old widow and a grandmother of four. When she was diagnosed in 1994, two weeks after her husband, she had a CD4 count of only 70. Though her husband didn't make it, Sharon did -- and while the adjustment to being alone and HIV positive has been difficult, she says, it's also been successful. "As I look back on where I've been and where I'm going, there's hope," she says. "I am doing well on the meds, enjoying my family and friends, my retirement, and my time to myself."


    Mother and Son, Bonded By HIV
    "From the time we were diagnosed with HIV as a family in 1987, my focus has been to fight for our lives. I believed it was my job to instill the same fight in my son, resisting the urge to curl up and wait to die. I was determined to find a way to beat this disease." Eva Powell describes her long and difficult struggle to save herself and her son.

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      HIV/HAART-RELATED HEALTH PROBLEMS

    The Basics on Tuberculosis
    Tuberculosis may not be a major problem in most parts of the United States, but it kills more people with HIV worldwide than any other disease. If tuberculosis infection is diagnosed early, though, it’s completely curable for those with access to treatment. Learn more about tuberculosis in this fact sheet from the U.S. Centers for Disease Control and Prevention.


    Preventing the Spread of Disease in Prisons
    The U.S. prison system is a breeding ground for all sorts of contagious diseases, from skin infections to HIV. Crowded conditions, frequent movement of new prisoners in and out of custody, restricted access to soap, water and other tools for hygiene, and limited availability of condoms and clean needles all increase the risk of infections -- infections that could, in turn, be passed along to the outside community when prisoners are released. Dr. Joseph Bick reviews some of the key steps that correctional facilities can take to reduce the spread of infectious diseases.


    Managing Medical Conditions Associated With Cardiac Risk in HIV-Positive People
    In this newly updated chapter of a widely acclaimed online HIV textbook, Dr. Daniel Wlodarczyk provides a detailed overview of the health problems associated with heart risk in people with HIV, namely hypertension, diabetes and hyperlipidemia (high levels of cholesterol, triglycerides, etc.). Also included is a review of the role that key risk factors, such as smoking, play in the development of cardiac problems. (Web highlight from the HIV InSite Knowledge Base)

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      AIDS 2004: SELECTED ABSTRACTS

    With more than 8,000 posters and oral presentations at the XV International AIDS Conference in Bangkok, Thailand, it's impossible for us to cover everything. The conference was jam-packed with unique projects and fascinating studies from around the world. Starting this week, in each e-mail update we will highlight two interesting studies that were presented at the conference.

    It Takes a Village: "Barefoot Doctors" in New York City
    A New York City program called "Health Bridge" goes door-to-door in order to provide care to HIV-positive people who would otherwise avoid, or can't access, more traditional health care. It's a cost-effective way to bring essential services right into the homes of needy people with HIV -- and to give HIV care a much more personal touch, this abstract asserts.


    "Condomovil": A Novel Way to Encourage Condom and Lube Use in Mexico
    A traveling Mexican program called Condomovil (i.e., "Condom Mobile") has publicly promoted the use of condoms and water-based lubricants through a wide range of activities, including theatre, instructional workshops and explicit educational materials, according to this abstract. The goal: to "counter conservative media and physical attacks" on the use of condoms in the country.

    For The Body's comprehensive coverage of this conference, which includes research highlights, transcripts and video of major speeches, Webcasts of important sessions and our one-of-a-kind Photo Journal, be sure to visit The Body's AIDS 2004 home page.

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      HIV TRANSMISSION

    Prisons Play a Pivotal Role in Spread of HIV Among Blacks
    The link between high incarceration rates and HIV infection among African Americans is a "complex domestic issue" that has proved to be a "continuing struggle" in the effort to curb the virus in the United States, The New York Times reports. Of the almost 2.1 million people currently incarcerated nationwide, 40% are African American. More than half of all new HIV infections in the United States occur among African Americans, and African-American women comprise 72% of new HIV cases among all women.


    Most HIVers Don't Have Risky Sex With HIV-Negative People, Study Says
    Most people with HIV in the United States are not engaging in sexual activity that would put HIV-negative people at risk, according to the results of a large study. A survey of 3,723 HIVers in Los Angeles, Milwaukee, New York and San Francisco did find plenty of recent sexual activity, and much of it was unprotected, particularly among gay men. But most of the time, that unprotected sex was with other HIV-positive people, not HIV-negative people or people with unknown HIV status. The researchers estimated, however, that among the 3,723 people surveyed, unprotected sex could have led to more than 30 new infections. (Web highlight from aidsmap.com)


    British Survey Suggests HIV Infection Through Oral Sex Is Small, But Real, Risk
    Although it's widely known that the risk of becoming infected with HIV during oral sex is extremely low, there's still some debate over just how low that risk is. New results from a large survey of HIV-positive gay men in the United Kingdom show that about 3% say that oral sex was the only possible risk factor for HIV. The fact that the survey relies completely on the honesty and memory recall of its participants, however, leave the reliability of the results in question. (Web highlight from aidsmap.com)

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      HIV/AIDS ACTIVISM & DRUG PRICING

    Doctors Urged to Join the Fight Against Rising Drug Prices
    HAART has single-handedly saved countless lives, but its ability to continue doing so is at risk in the United States, as drug prices increase and available funding for treatment drops. It's time HIV doctors stopped waiting for the situation to improve and made their voices heard, says Dr. Ben Young of the University of Colorado Health Sciences Center. "We talk about public policy, we talk about involvement, we talk about ethical principles, but ultimately it all boils right down to the fact that we are talking about peoples' lives ... and their families and the communities that are affected by what we do or fail to do."


    The Ritonavir Price Increase: A Bitter Pill for HIVers
    The Los Angeles times offers its two cents on the ritonavir (Norvir) price hike: "You'd think an industry accused of gouging the sick and dying while raking in billions in profit would start developing a better public relations strategy. Alas, pharmaceutical companies remain adept at ruining their own good names." (Web highlight from the Los Angeles Times; free registration required)

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      HIV/AIDS OUTSIDE THE U.S.

    U.S.'s "Benevolence" in Developing World Is Anything But, Advocate Says
    Why is the U.S. National Institutes of Health about to dump tremendous amounts of money into HIV treatment research in the developing world? Is it to help prevent the pandemic from spreading even further? Is it the humanitarian desire to help people who are most in need? No such luck, writes AIDS advocate Gregg Gonsalves: It's nothing more than a new kind of colonialism.


    China Still Treats AIDS Activists Like Criminals
    Leading Chinese AIDS activist Li Dan and a colleague were briefly detained by government officials recently as they prepared to visit Shuangmiao village to plan a protest with AIDS advocates and patients. Four other activists, whom Li had been on his way to visit when he was detained, were detained for one month and recently released. The arrests, activists said, show that despite Chinese leaders' new openness about the AIDS epidemic, harsh tactics are still being used to silence AIDS protesters.

    Although Li was released a day after his detention, he was assaulted as he left custody. Meanwhile, Chinese authorities have detained yet another person over an HIV-related issue: Zhu Longhua, a popular village doctor who was arrested for allegedly dispensing too much medication to HIV-positive people.


    The Perils for Youth and Women in Developing Nations
    "Many young women are engaging with older men. They find HIV wrapped inside a valentine's gift when they are in love," says Gracia Violeta Ross, a 27-year-old Bolivian woman with HIV. Among the many desperately needed steps the world must take to prevent the spread of HIV in the developing world, "We must end all forms of violence against women and girls and provide education and legal services for them," she said in her speech at the closing ceremony of the XV International AIDS Conference.

    Powerful speeches and thought-provoking interviews took place throughout last month's International AIDS Conference; to read transcripts or view Webcasts of many of them, visit The Body's AIDS 2004 "Speeches and Interviews" page.


    Slum-Dweller Sets Example for India by Adopting HIV-Positive Orphan
    In a country where heartbreaking accounts of discrimination against HIV-positive children are the rule rather than the exception, the story of Surya, an impoverished 30-year-old woman, and Subha, the one-year-old HIV-positive orphan she adopted, offers hope that India’s deeply entrenched HIV stigma can be reversed. (Web highlight from Agence France Presse)


    AIDS Numbers Rising in Saudi Arabia
    In 2003, the number of new AIDS cases in Saudi Arabia increased by 17%, according to a recent government announcement. Saudi Arabia counts 84 children among its 1,238 people living with AIDS, according to to Dr. Tarek Madani, a government health adviser. Nearly half of all Saudi Arabians with AIDS are women, Madani said.

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    AIDS 2004 PHOTO JOURNAL:
    Condom Art Pins
    Image from the AIDS 2004 Photo Journal
    These are "Condom Art Pins" from The Condom Project, a group of AIDS educators and activists committed to providing current, accurate information about condoms and their role in reducing HIV risk. The image above is one of many that comprise The Body's AIDS 2004 Photo Journal.
    ART FROM HIV-POSITIVE ARTISTS
    Image from the August 2004 Visual AIDS Web Gallery
    "Medium Shot," 1998;
    Stephen Andrews
    Visit the August 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.