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September 1, 2004

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

    The Next Generation of Entry Inhibitors
    It's been more than a year since the approval of T-20 (enfuvirtide, Fuzeon), the first of a new family of HIV meds known as entry inhibitors. Why is T-20 still the only drug of its kind? Another promising entry inhibitor, T-1249, was yanked from the development pipeline, but several others are in the works. Project Inform takes a closer look.

    Nelfinavir Levels a Third Lower in Pregnant Women
    Pregnancy appears to considerably reduce the effectiveness of nelfinavir (Viracept), although that reduction doesn't increase the baby's risk of contracting HIV, according to a small study conducted by Dutch researchers. In almost all cases, the pregnant women still had undetectable viral loads despite the lower nelfinavir levels, although the researchers suggested doubling the drug's dose if it falls below therapeutic levels. (Web highlight from

    Lab Test Basics: The Big Four
    Four of the most common blood tests HIV-positive people receive are the viral load test, CD4 count, complete blood count and chem-screen. What do each of these tests determine, and why are they so important? AIDS Survival News explains.

    Want to learn more about the various lab tests HIVers often get? Browse through our collection of articles, or talk to Dr. Mark Holodniy in our "Ask the Experts" forum devoted specifically to the topic!



    David and Eric: A Mixed-Status Couple Loving Life, and Living Love
    "David and I are polar opposites in almost every way," says Eric Rodriguez, Executive Director of Body Positive, about his relationship. "He's obsessed with the arts, I play ice hockey; I love action flicks, he prefers incomprehensible foreign films with subtitles; he's Jewish, I'm Christian … I'm HIV-positive and he's HIV-negative. The list seems to go on forever. And yet it still seems to work for the two of us." In this essay, Eric writes about the mysteries of love, for HIVer and non-HIVer alike.

    Avoiding or Treating Depression Linked to Survival for HIVers
    Fighting depression can not only make you feel better, a new study says -- it might even save your life. HIV-positive women in the United States who are chronically depressed are almost twice as likely to die from AIDS-related causes than HIV-positive women who are not clinically depressed, the study found. Depressed women who received mental-health services, though, were half as likely to die than depressed women who didn't seek out any help. The study analyzed data from the large, multicity Women's Interagency HIV Study.

    Despite So Many Advances Against HIV, the Stigma Remains
    Scientists might know more about HIV/AIDS today than ever before, but myths and misinformation continue to threaten the health and well-being of both HIV-positive and HIV-negative people in the United States, says Vincent J. Lynch, Ph.D. In this article, Dr. Lynch writes about how far U.S. society has come in accepting HIV as a fact of life -- and how far we have yet to go.



    Stroke Risk, Odds of Bypass Surgery Increase for Every Year on HAART
    New results from the landmark D:A:D study show that HAART use may not only increase a person's risk of heart attack by 26% per year (as was reported last year), but that it similarly increases the risk of stroke and the likelihood that a person will need invasive heart surgery. Before you scramble to stop your meds, though, keep in mind that some studies -- like the massive HIV Outpatient Study -- don't show similar results, and not all HIV meds are created equal when it comes to cardiovascular risk. (Web highlight from

    New Hepatitis C Combo Regimen May Cause Serious Eye Problems
    Treatment with peginterferon alfa-2b (PEG-Intron) and ribavirin can cause potentially serious eye problems in people who are coinfected with HIV and hepatitis C, according to U.S. researchers. The researchers don't suggest avoiding the combination therapy, since they are still unsure what actually caused the eye problems to occur. However, they did recommend regular ophthalmologic eye exams for anyone taking the two drugs. (Web highlight from

    How the Hepatitis Viruses Damage the Liver
    Why do the hepatitis A, B and C viruses harm the liver, and how do they actually cause liver disease? The AIDS Community Research Initiative of America provides a brief overview of the impact these viruses have on liver health.



    With more than 8,000 posters and oral presentations at the XV International AIDS Conference (AIDS 2004) in Bangkok, Thailand, it was impossible for us to cover everything. This week, we highlight another three interesting studies that were presented at the conference.

    A Novel HIV Testing Strategy Could Revolutionize HIV Prevention Efforts
    Last year, news of an outbreak among black college students in North Carolina made national headlines, and brought researchers' attention to the unique HIV testing system that made the discovery possible. Called STAT (short for Screening & Tracing Active Transmission), the system has two primary purposes: (1) to spot HIV outbreaks as they're occurring, rather than months or years afterward, so that they can potentially be stopped before they spread further; and (2) to piece together a complete picture of who's infecting who in a specific geographic area, and what key factors put people at risk for HIV in that area.

    If researchers can prove STAT is successful at achieving these goals, it could potentially revolutionize our approach to HIV prevention, by offering prevention experts more information than ever before about who's currently getting HIV, how, and where. That could mean we'd effectively be able to stop HIV outbreaks before they get wildly out of hand, rather than trying to contain them after the fact -- and we'd be able to get newly infected people into care right away, which could help them stay physically and emotionally healthy.

    AIDS 2004 featured some new results from several studies involving the STAT program:

    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.



    An HIV Testing Nightmare: The Eight-Year False Diagnosis
    In 1996, California resident Jim Malone got an Elisa test that said he was HIV positive. To confirm that first test, he then got the Western Blot -- only, for some reason, he never saw the results. They were negative. For these long eight years Malone attended biweekly counseling sessions for HIV-positive men, while Project Open Hand delivered free meals and a home-health nurse visited him every two weeks. The mistake was finally discovered this month by a software program designed to periodically review HIV cases.

    The Deadly Mix of Crystal Meth and Casual Sex
    Four years ago, 34-year-old Bobby Darnell started casually experimenting with crystal meth and checking out New York City's gay club scene. When he lost his job in 2001, the bottom fell out from under him, and he slipped into a dangerous cycle of meth use and casual sex -- a cycle that it seems is being repeated by a growing number of gay men in New York and elsewhere. (Web highlight from The New York Times; free registration required)



    Where Does Your Candidate Stand on Health Coverage for HIVers?
    With insurance coverage shrinking and drug prices rising, healthcare reform is becoming a major issue in the 2004 U.S. elections, particularly for people with HIV. Social worker Mary Lynn Hemphill explains some of the most pressing issues, and offers a list of questions you can ask of your state and federal candidates to determine whether they have your best interests in mind.

    In This Election Year, Your Vote Is More Important Than Ever
    We're two months away from what may well be one of the most important election of our lives -- and that's doubly true for people with HIV and those who help them, since most major decisions on funding for HIV/AIDS assistance programs (like Medicare, Ryan White and ADAP) are made by the people we vote into office. AIDS Survival News' Jeff Graham explains why, in his home state of Georgia, every ballot this fall is a pivotal one for people with HIV.

    Medicaid "Spend Down" Requirements Make HIVers Sicker, Study Says
    Thirty-five U.S. states have what are called "spend down" requirements for Medicaid, which force people to pay a certain amount of their yearly healthcare expenses out-of-pocket before they can qualify for Medicaid assistance. In the case of at least one of these states -- North Carolina -- those "spend down" requirements actually cause more illnesses among HIV-positive people, and end up costing the state more money, than if the out-of-pocket requirement was eliminated and those people were allowed to receive Medicaid assistance immediately, Duke University researchers say.

    Pharmacist Group Sues Drug Makers Over High Prices
    A group of 14 independent pharmacists in California have filed a lawsuit against some of the world's largest pharmaceutical companies (including Bristol-Myers Squibb and Pfizer, Inc., which manufacture and distribute HIV meds), accusing them of conspiring to inflate drug prices in the United States as part of an illegal price-fixing scheme. (Web highlight from the San Francisco Chronicle)



    Global AIDS Funding Increases, But Not Nearly Fast Enough
    The cost of providing HIV meds, care for AIDS orphans and HIV prevention services in developing countries is expected to reach US$12 billion by 2005 and could hit US$20 billion by 2007, according to a new UNAIDS report. Despite increased funding for the efforts, the report anticipates a US$6 billion shortfall in 2005, and predicts that the gap between the level of assistance needed and actual assistance will only grow over the next few years.

    South Africa's Revealer of Secrets
    Dr. Ashraf Grimwood stands in the examining room doorway, a genial, gentle physician of the sort you might hope to have at your side when you find out whether you have HIV. He's been at the forefront of the campaign to test and treat the estimated 5 million South Africans infected with HIV -- and the news he must break to those who test positive often tears their families apart. (Web highlight from the Los Angeles Times; free registration required)

    New, Online Program Offers Price Comparisons on HIV Meds
    The Global Fund to Fight AIDS, Tuberculosis and Malaria has launched the "Price Reporting Mechanism," a boring name for an exciting online tool aimed at helping developing countries secure the lowest possible prices on HIV medications and other drugs and equipment. The tool gathers and offers information about countries receiving discounted products and the suppliers that provide them, including price, product quality and the overall performance of the supplier. (Web highlight from The Global Fund to Fight AIDS, Tuberculosis and Malaria)

    The Flying Condom
    Image from the AIDS 2004 Photo Journal
    The flying condom above is one of many images 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 September 2004 Visual AIDS Web Gallery
    "The Stolen Jesus," 1997;
    Rebecca Guberman
    Visit the September 2004 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists.