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January 19, 2005

In This Update:
  • HIV Treatment News
  • Life With HIV
  • HIV/STD Transmission
  • U.S. ADAPs & AIDS Services
  • HIV/AIDS Outside the U.S.
  •   HIV TREATMENT NEWS

    Near-Perfect Adherence Is Best Way to Avoid Resistance, Study Finds
    What's the best way to avoid drug resistance? Take all your HIV meds, on time, at least 95% of the time, according to a large new study. The study found that people who nearly always took their meds properly showed no signs of developing resistance. Who was most likely to develop resistance? People who missed their doses 20% of the time -- they were 4 times as likely as people with near-perfect adherence to have drug-resistant HIV mutations.



    Taking the Weekends Off: An Experimental HIV Treatment Strategy
    HAART-free weekends? That's the strategy being investigated by HIV researcher Dr. Cal Cohen. As The Body reported in its conference coverage last summer, Dr. Cohen is running a trial to determine whether people who have well-suppressed viral loads on HAART can safely switch to a 5-day-on, 2-day-off schedule. In this interview, he talks about how the study is progressing.

    Want a more detailed review of the interim results of Dr. Cohen's study? Click here to read an analysis by Dr. Gerald Pierone, who covered a presentation of the study at the XV International AIDS Conference last July.


    New Drugs on the Horizon in 2005
    A number of new HIV meds could receive U.S. approval this year. The most widely known of them is tipranavir, a protease inhibitor that may be able to help people who have developed resistance to many existing meds. Treatment Action Group provides this review of research on tipranavir, as well as two other prominent meds in the pipeline: TMC-114 and TMC-125 (etravirine).


    "Replication Capacity": Measuring the Fitness of Your Virus
    One type of monitoring test that's little-known among HIVers, but is becoming used more widely by doctors, is the "replication capacity" test (or, as docs call it, the "RC" test). The test basically measures the "fitness" of the HIV in a person's body. It turns out that some strains of HIV are in better shape than others; the less fit the virus is, the slower it reproduces, and the less likely disease progression becomes. The RC test is particularly useful in figuring out how necessary it is for someone to switch HAART regimens when their current one is no longer working optimally. Want to learn more? Check out this overview from Project Inform.


    Epzicom and Truvada: The Pros and Cons
    New to HIV treatment and still unsure about the advantages and disadvantages of the United States' newest fixed-dose combination drugs? Read this interview with HIV researcher Dr. Cal Cohen about the pros and cons of Epzicom (abacavir/3TC, Kivexa) and Truvada (tenofovir/FTC).

    Looking for more information on these 2 combination drugs? Browse through The Body's collection of overviews, advice and research articles on Epzicom and Truvada.

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      LIFE WITH HIV

    "Hard Drug" Use Increases HIV-Positive Women's Risk for Opportunistic Infections
    HIV positive and using "hard drugs" like cocaine, heroin or injection drugs? In a large study of HIV-positive women, hard-drug usage was not associated with any change in CD4 count or viral load, but women who used hard drugs did have an increased risk of developing non-fatal opportunistic infections -- especially herpes, pulmonary tuberculosis and recurrent pneumonia.


    An HIVer in London Writes About What It's Like to Live With the Virus
    London resident Michael Carter knows how lucky he is to have HIV in a country where, and at a time when, treatment is readily available. "But I also need to acknowledge that life with HIV medication brings its own set of problems," he admits. "Like HIV itself, they've become part of my life, and, with varying degrees of success, I've had to find ways of coping with them." In his book, Living With HIV, Michael offers his first-hand take on what it's like to live with HIV: his highs, his lows, his fear of disclosure and his own advice on how to deal with the physical and emotional hurdles HIV-positive people sometimes have to face. (Web highlight from BBC News)


    Be Aware of End-of-Life Policies at Religiously Affiliated Hospitals
    Did you know that some religiously affiliated hospitals refuse to honor do-not-resuscitate orders, or any other measures that would withhold available care -- no matter how bleak a person's prognosis might be? Many people are unaware of these restrictions, but several dozen advocacy groups are fighting to change that. The organization Compassion in Dying outlines the demands advocates are making to ensure that all people are made fully aware of a hospital's end-of-life policies.

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      HIV/STD TRANSMISSION

    Elective Cesarean Reduces HIV Transmission Risk for Babies, Even in HAART Era
    Elective cesarean delivery can reduce the odds that an HIV-positive woman will transmit the virus to her baby -- even if that woman is already on HAART and has an undetectable viral load, according to new research. A large, long-term European study found that the risk of HIV transmission to newborns dropped by two thirds for women who chose cesarean delivery instead of vaginal delivery. The study also found that the main risk factor for HIV transmission was the mother's viral load: Women with viral loads above 1,000 were 12 times as likely to transmit HIV to their babies as women with lower viral loads. Overall, however, the risk of HIV transmission from a woman on HAART to her baby was low: just 0.25% for women who started HAART before becoming pregnant, and 1% for women who started HAART while they were pregnant. (Web highlight from aidsmap.com)


    As More New York MSM Inject Crystal Meth, Officials Express Concern
    Some New York City needle-exchange programs have recently reported seeing more men who have sex with men (MSM) injecting crystal meth. Experts are concerned not just because of the general health risks of crystal meth use, but also because of a practice called "booty-bumping," in which people use a needleless syringe to force a meth solution up their butt. This can damage the colon and, if followed by unsafe sex, facilitate HIV transmission.


    You're Never Too Old to Have HIV -- And Americans Are Finally Admitting It
    In the age of AIDS and Viagra, sex among seniors may finally be coming into the open, but not without some ambivalence and plenty of discomfort. The number of AIDS cases among people older than 50 has quintupled since 1990, now representing an estimated 14% of all people -- and 18% of all women -- diagnosed with AIDS. (Web highlight from the Chicago Tribune)

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     U.S. ADAPs & AIDS SERVICES

    Alabama ADAP Warns It May Need to Drastically Cut Enrollment
    Without millions in new funding, Alabama's AIDS Drug Assistance Program (ADAP) will have to stop providing treatment to 514 people in April, a state health official warns. There are already 443 people on Alabama's ADAP waiting list; 1,189 people are currently enrolled in the program.


    In New Hampshire's ADAP, It's T-20 for Two
    HIV treatment funding in New Hampshire is reportedly so tight that only 2 people in the state's AIDS Drug Assistance Program (ADAP) can receive T-20 (enfuvirtide, Fuzeon) at any given time. (Web highlight from The Advocate)

    Although New Hampshire's 2-person-only rule for T-20 might be somewhat unique, many ADAPs aren't able to provide T-20 to anybody at all. This online resource from the Kaiser Family Foundation provides a state-by-state breakdown of the number of HIV meds in each drug class that are offered by each state's ADAP. However, the information is only current as of the end of 2003, so call the ADAP in your state for more up-to-date details.


    AIDS Organizations Increasingly Serve Non-HIVers
    Many U.S. AIDS organizations are struggling to adapt to a landscape that has changed massively since HAART came into use. HIVers are now living longer, healthier lives, and fewer American children than ever are being born with HIV. In order to stay alive, these groups have begun expanding their services to people with other illnesses, as well as to HIV-positive people in developing countries.


    In New York, a Sign of Tough Times: Housing Programs for People With AIDS Are Stretched Thin
    In the age of HAART, and with the U.S. economy supposedly improving, you may believe that life is getting better for poor people with AIDS. Unfortunately, you'd be wrong: In New York City, the number of people with AIDS who need housing assistance is growing -- and the number of people with AIDS who are dying despite getting such assistance is growing as well. Ronald C. Russo reviews the worsening housing situation for people living with AIDS in New York City.

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      HIV/AIDS OUTSIDE THE UNITED STATES

    Mandela Family Publicly Discloses Another Member Died From AIDS
    Former South African President Nelson Mandela shattered one of South Africa's biggest taboos this month when he publicly announced that his only remaining son had died from AIDS. Now his grandson, Mandla Mandela, has followed suit: At his father's funeral, Mandla disclosed that his mother had also died of AIDS-related causes.


    Spain's Catholic Church Backs Condom Use to Prevent HIV
    In an apparent break with the Roman Catholic Church's strict stance against condom use, Spain's Catholic Church has acknowledged that contraceptives have a place in the global fight against the spread of HIV. Official Roman Catholic doctrine holds that condoms, because they are a form of contraception, should never be used. (Web highlight from Reuters)

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    Connect With Others at
    The Body's Bulletin Boards

    A recent post from the "Living With HIV" board:

    "I seroconverted in April 2004 and received my results in July 2004. I am 99.9% sure I got HIV from my girlfriend who is an IV drug user. ... I asked my girlfriend once to get tested but she refused. ... We practice safe sex now, but I worry she is going to get ill. I know she won't take the test as she is that type of person -- if it's bad news or a chance of it, she'd rather ignore the whole thing. She doesn't realize that I am thinking of leaving her. Anybody in a similar situation?"
    -- Anonymous

    Click here to join this discussion thread, or to start your own!
    Art From HIV-Positive Artists
    Image from the January 2005 Visual AIDS Web Gallery
    "We Are One," 1999;
    David Krueger
    Visit the January 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists!
    HIV Positive and Looking
    For Advice or Support?
    Need to get U.S. government help for housing? Want to join a support group? Can't figure out how to get help paying for medications? You are not alone!

    There are AIDS organizations throughout the world that offer varying degrees of help. If you live in the United States, search The Body's ASO Finder to find an AIDS group near you.

    The Body's browsable listing of AIDS organizations and hotlines can also be useful for people in the United States or anywhere in the world.

    Your Unused HIV Meds
    Can Save Lives!

    AID for AIDS

    AID for AIDS is a New York-based nonprofit organization that collects unused, HIV-related medications and redistributes them to people living with AIDS in Africa, the Caribbean and Latin America.

    Have HIV-related medications (including antiretrovirals and meds used to prevent or treat opportunistic infections) you'd like to donate? Click here to find out how.