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August 25, 2004

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

    Once-a-Day Drugs: Are There Risks to Greater Convenience?
    The United States' approval of two new combination drugs for HIV -- Epzicom (abacavir/3TC) and Truvada (tenofovir/FTC) -- raises an interesting question: Are we embracing once-a-day HIV medications a little too quickly? HIV treatment advocate John James warns that we still have a lot to learn about once-a-day drugs before deciding whether they're invariably better than their twice- or three-times-a-day counterparts.

    Stay in the Loop on HIV Drug Interactions
    Many HIV medications can pose a health risk when mixed with other drugs, including other HIV meds. "ARV Alert," a service provided by HIV InSite, offers periodic updates on newly discovered interactions involving HIV medications. Each update features a brief synopsis of the interaction, as well as a chart outlining key information. (Web highlight from HIV InSite)

    The Body's drug interaction library also provides information on potentially hazardous med combinations, as well as a list of resources that can help you determine whether the drugs you're currently taking -- or are planning to take -- pose any risk when taken together.



    Mixed-Status Relationship Expert Offers Advice
    HAART may have revolutionized HIV treatment in the 1990s, but the issues that face people in mixed-status relationships -- where one person has HIV and the other doesn't -- haven't changed much from the epidemic's early days. HIV researcher Dr. Robert Remien briefly discusses these issues, and offers some advice on how to deal with them, in this interview with Body Positive.

    Are you in a mixed-status relationship and looking for some advice? Dr. Remien has been answering questions from serodiscordant couples at The Body's "Ask the Experts" forums for more than five years. Talk to him about whatever's on your mind, or browse his forum archive to read through some of the questions he's already answered!

    Thankful to Be Alive at 63, HIV and All
    "Living with HIV/AIDS for sixteen years has changed my life dramatically," writes J. Edward Shaw, 63, in this first-person essay. "I'm indebted to my faith, the healthcare professionals, and all of the many wonderful people who have made my life full of growth. Asking questions and attending conferences and educational forums over the years have been the key to all that I've accomplished."

    Don't Mess With These Girls: Transgendered HIVers Fight Back
    Many transgendered people face the double whammy of HIV and a hostile healthcare system. Rebecca Minnich describes some of the mistreatment that transgendered people face when trying to get medical care -- and how they're finally fighting back. (Web highlight from POZ)

    Depression and HIV: It Must Not Go Ignored
    Danny Meyers, an HIV-positive inmate in the Colorado prison system, knows firsthand the kind of impact that depression can have on prisoners with HIV. As he points out in this essay, the issues that depressed HIV-positive prisoners have to deal with are essentially the same as for any depressed person with HIV -- as are the risks of not seeking help.



    HAART May Need Help to Treat Severe Kaposi's Sarcoma, Study Suggests
    Contradicting earlier studies that appeared to show that HAART by itself is enough to treat Kaposi's sarcoma (KS), a new study has found that this is not the case for people with moderate to severe KS. For these people, the study indicates, chemotherapy plus HAART works better than HAART alone. (Web highlight from

    Genetics Influence Response to HAART and Incidence of Pancreatitis, Studies Show
    Genetic testing could one day help doctors predict how well HAART is likely to work in HIV-positive people, according to one study by Australian researchers. In a related study, Swiss researchers found that genetic testing might also be able to determine an HIV-positive person's risk of developing an inflamed pancreas, a potential side effect of some HIV and hepatitis C meds. (Web highlight from



    With more than 8,000 posters and oral presentations at the XV International AIDS Conference in Bangkok, Thailand, it was impossible for us to cover everything. This week, we highlight another two interesting studies that were presented at the conference.

    Why Are So Many HIV-Positive Americans Not Seeking Treatment?
    The United States has a well-established network of programs that provide low-income people with free access to HIV treatment. However, many HIV-positive Americans never attempt to take advantage of those services, and others wait to enter care until they've already developed opportunistic infections or have extremely low CD4 counts. This is true both in areas with limited resources, such as parts of the southeastern United States, as well as places like San Francisco, which has a rich assortment of HIV-assistance programs and organizations.

    Researchers are making efforts to understand why so many HIV-positive people still don't seek out the help they need. There were a few studies presented at AIDS 2004 that documented this phenomenon; here are two of them:

    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.



    San Francisco Official Says Viagra Should Be a Controlled Substance
    A San Francisco public health official has asked the U.S. Food and Drug Administration to make Viagra a controlled substance, which would make it harder for doctors to prescribe the drug. The official, Dr. Jeffrey Klausner, citied several studies that have shown a link between the use of Viagra and higher rates of HIV and other sexually transmitted diseases (STDs). Dr. Klausner also requested that labels for Viagra and similar drugs include a warning that the drug is linked to an increased risk of STDs.

    Experimental Donated-Blood Test Is Ready for Prime Time, Study Suggests
    Although the risk of getting HIV and hepatitis from blood transfusions or donated tissue is already extremely low in the United States, a new type of test could make the risk even lower, according to two new studies. Nucleic acid testing, which has already been in use for several years to screen a portion of the U.S. blood supply, could help reduce the number of HIV transmissions through tainted blood by five per year, and the number of hepatitis C transmissions by 56 per year, one of the studies found.

    ACLU Rails Against New U.S. Prevention Guidelines
    The American Civil Liberties Union (ACLU) has denounced proposed changes to the U.S. Centers for Disease Control's HIV prevention guidelines, which include a requirement that all groups providing educational materials must have those materials approved by state and local officials before they can be posted on the Web. "At a time when HIV prevention efforts are more important than ever, there's a real fear that partisan politics will begin dictating prevention messages," writes James Esseks, litigation director of the ACLU AIDS Project. "To be effective, these messages must connect with their intended audiences. Let's face it, abstinence until marriage isn't going to go over well with gay teens who can't marry."



    Where Do Bush and Kerry Stand on HIV/AIDS Issues?
    The advocacy group has prepared online profiles detailing President George W. Bush's and Senator John Kerry's public records on HIV/AIDS issues. From global AIDS to the epidemic at home and from prevention efforts to treatment research, the profiles describe where the candidates stand -- and whether their actions to date have matched their words. (Web highlight from

    Examining HIV Treatment Access From the Insurers' Perspective
    Private health insurers in the United States are "caught between a rock and a hard place" in terms of trying to juggle the need to serve patients with the need to avoid running out of money, according to Michael Allerton, HIV Operations Policy Coordinator for Kaiser Permanente. In this talk at a conference earlier this year, Allerton discussed the effects of drug pricing on private practice. He also took a moment to express his skepticism about recent efforts to investigate drugs that could be taken before exposure to HIV to help prevent infection.

    Debate Over Renewal of Ryan White CARE Act Approaches
    Next year around this time, U.S. lawmakers will debate reauthorizing the Ryan White CARE Act, a pivotal law that has provided millions of dollars each year to treatment programs for people living with HIV and their families. How has the HIV treatment situation changed since the last reauthorization in 2000, and how are those changes likely to impact us next year? Advocacy group AIDS Action takes a closer look.



    In Latin America, Battling for the Rights of HIVers
    The Agua Buena Human Rights Association is one of precious few organizations fighting against HIV-related discrimination and for HIV treatment access throughout Latin America. The group, founded in 1997, has its work cut out for it: Although countries like Costa Rica have made great strides against the virus, in most of the region HIV is spreading largely unchecked while thousands of HIV-positive people go without access to medications.

    The Evolution of the International AIDS Conference: Science vs. Policy
    The biannual International AIDS Conference is "no longer the cutting-edge scientific meeting that it once was" and instead has become "a forum to focus public attention on the many aspects of the epidemic," writes Dr. Robert Steinbrook, a national correspondent for the New England Journal of Medicine. He says it's time the organizers of the conference come to a decision on whether the conference is about the science or the politics.

    Saudi Arabian Researchers Give Islamic Perspective on HIV Prevention (PDF)
    Although HIV infection rates are still relatively low in Saudi Arabia, they have been increasing. The solution? According to an analysis by Saudi Arabian medical researchers, the best way to decrease rates is to strengthen Islamic laws and values. Efforts to prohibit sex before marriage, homosexuality, adultery and the use of injection drugs must be strengthened, the researchers say -- and Saudi Arabia's rulers are "obliged" to "eliminate" the factors that promote those activities by imposing "Islamic penalties" on sex workers and drug smugglers. The researchers specifically criticized two commonly used prevention techniques in the West, safe-sex education and needle-exchange programs, as methods that are completely inconsistent with Islamic values. (Web highlight from BMC Infectious Diseases)

    Randall Tobias,
    U.S. Global AIDS Coordinator
    Image from the AIDS 2004 Photo Journal
    The image above is one of many that comprise The Body's AIDS 2004 Photo Journal. For a full range of XV International AIDS Conference coverage, visit The Body's AIDS 2004 home page.
    Image from the October 2002 Visual AIDS Web Gallery
    "Non-Compliance Plays Russian Roulette," 2001; Max Greenberg
    Visit the Visual AIDS Web Gallery to view hundreds of thought-provoking artworks created by HIV-positive artists. A new Web Gallery is posted every month, and an archive of previous galleries stretches back to 1999!