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March 23, 2005

In This Update:
  • HIV-Related Health Problems
  • HIV Treatment & Side Effects
  • HIV Prevention & Education
  • HIV/AIDS Policy in the U.S.
  • HIV/AIDS Outside the U.S.
  •   HIV-RELATED HEALTH PROBLEMS

    Is It Age, Or Is It HIV?
    Over 50, HIV positive and experiencing health problems? Some of them may be caused not by HIV, but by aging itself. It's a growing concern for many HIVers as they hit the big 5-0, and the solutions aren't always easy to come by. This chart from nutritionist Edwin Krales may be able to help you discern between the health risks of HIV, the health risks of plain old aging, and the risks of a lifetime of bad habits that have come back to bite you as you grow older.


    HIV and Depression: Antidepressant Use Improves HAART Adherence
    Clinically depressed HIVers who receive antidepressants are more likely to adhere to their HAART regimens -- and the better they adhere to their antidepressant meds, the better they adhere to their HAART meds as well, according to a large study by Colorado researchers. Given that depression is a pretty common problem in HIV-positive people, these findings signal how important it is for healthcare workers to spot the warning signs of depression among HIVers. (Web highlight from aidsmap.com)


    Fosamax May Help Reverse Bone Problems in HIVers
    The osteoporosis drug alendronate (Fosamax) can help reverse bone thinning in HIV-positive people, according to a new U.S. study. The study also found that taking daily calcium and vitamin D supplements helped improve bone health, though not as well as alendronate. The study did not examine whether alendronate or supplements can help prevent bone problems from occurring in the first place. Bone disorders, such as osteopenia and osteoporosis, happen more frequently in HIVers than HIV-negative people; researchers aren't certain whether these problems are caused by HIV itself, HIV meds or a combination of the two. (Web highlight from aidsmap.com)


    An HIV-Positive Woman Copes With Lipodystrophy
    Sylvia's been living with HIV for more than nine years, and has been struggling with lipodystrophy for almost as long. She tried taking human growth hormone (somatropin, Serostim) to treat it, but had to stop because of side effects. She tried taking a break from her HIV meds, but the fat gain remained. Eventually, she decided she couldn't let her lipodystrophy continue to weigh on her spirit.
    "Life is too short to think about my body," she says.

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      HIV TREATMENT & SIDE EFFECTS

    To Switch or Not to Switch: The Latest Research
    As the number of HIV meds continues to grow, and as researchers learn more about the long-term health risks of certain meds, the dilemma over whether -- and how -- to switch HAART regimens has become more complicated. Are you trying to get a handle on this difficult topic? Check out this comprehensive overview from Drs. Edwin DeJesus and David Wohl. As part of our coverage of the 12th Conference on Retroviruses and Opportunistic Infections (CROI 2005), they've authored a research update and case studies to examine why people switch their HIV medications, and whether switching can help stop (or even reverse) health problems like wasting, high cholesterol and anemia.
    Stop in at The Body Pro, The Body's sister site for healthcare professionals, to read this in-depth discussion! (Note to U.S. physicians and nurses: Free CME and CE credit is available for these articles.)


    Abacavir Hypersensitivity Reaction More Common Than Previously Thought
    Two new studies -- one from the U.S. Food and Drug Administration (FDA), the other from GlaxoSmithKline -- find that abacavir (Ziagen) hypersensitivity reaction (HSR) occurs at higher rates than the previously accepted 5% of HIVers. The FDA found that HSR occurs among 8% of patients, which led the agency to change abacavir's package insert. Glaxo found that HSR occurs among 5.4% of patients. Ben Young, M.D., reports from CROI 2005.

    Looking for more highlights from CROI 2005? Stop in at The Body's CROI 2005 home page to read expert recaps and analyses of the latest breaking HIV research.


    Getting to Know Your HIV Meds: Interactions and Pharmacokinetics
    Why are some HIV meds dangerous to take with one another? The answer lies in a branch of medicine called "pharmacokinetics," which is medicalese for "how drugs work." In this special issue of Positively Aware, a team of pharmacists explains the basics of pharmacokinetics, and reviews some important facts about drug interactions between various HIV medications.

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      HIV PREVENTION & EDUCATION

    Why I Signed Up for an HIV Vaccine Trial
    "I'm impatient. I want results. Enough is enough already. This scourge of AIDS must be stopped. Here's my arm; take as much blood as you need." Gloria Abitol is an HIV-negative AIDS advocate who has joined a clinical trial for an experimental HIV vaccine. In this essay, she explains why she decided to volunteer for a type of study that many aren't willing to join.


    HIV Negative and Interested in Becoming an HIV Vaccine Volunteer?
    Thinking of volunteering for an HIV vaccine trial? It's an admirable thing to do, but before you sign those enrollment forms, be sure you're doing it for the right reasons. Joining a trial may involve not just committing your time and your body for months or even years, but could force you to be more open about your sexual behavior than you may be comfortable with. In this article, Dr. J. Buzz von Ornsteiner shares some helpful words of advice for anyone who's HIV negative and considering an HIV vaccine study.


    Knowing Is Beautiful -- Or Is It?
    A huge new AIDS awareness campaign has hit U.S. streets -- and subways, and TV stations, and radio airwaves -- urging people to get tested for HIV because, as the campaign puts it, "Knowing Is Beautiful." The ads, part of a global HIV education effort by Viacom and the Henry J. Kaiser Family Foundation, are big, bold, flashy and attractive -- and that, some AIDS advocates say, is exactly what's wrong with it. "When you get your first diagnosis, you don't think it's beautiful," says Tonia Hines, an HIV outreach worker. (Web highlight from The Boston Globe)

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      HIV/AIDS POLICY IN THE UNITED STATES

    Kentucky Court Says Doc Can Disclose Patient's HIV Status in Certain Situations
    The Kentucky Supreme Court has narrowly ruled that workers' compensation laws allow a doctor to disclose his or her patient's HIV status to an employer for workers' compensation claims. The court ruled that state workers' compensation laws require disclosure of health matters, including HIV status, to employers who have financial responsibility for an employee's injury.


    U.S. Senate Budget Resolution Axes Medicaid Cuts, Nearly Triples Global Fund Money
    It was an extremely tight vote, but the U.S. Senate has approved a new budget resolution that would reject President Bush's proposed $14 billion in cuts to Medicaid over the next five years. The budget would also increase U.S. funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria to $800 million -- $500 million more than the president requested. The Senate's resolution still has to be reconciled with the U.S. House of Representatives' own budget resolution, however. The House version still includes the Medicaid cuts.

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      HIV/AIDS OUTSIDE THE UNITED STATES

    India's Parliament Passes New Patent Law; Generic Drug Distribution May Be at Risk
    India's Parliament has passed a highly controversial bill that will change the country's patent laws to prohibit the domestic production of low-cost, generic versions of patented drugs -- including HIV medications. Although the legislation isn't expected to impact the cost or availability of currently available generic HIV meds from India (which are used by an estimated half of all HIVers receiving treatment in the developing world), many advocates are worried that the move could seriously hurt the ability of the world's poor to receive newer medications.


    Chinese Province Announces New Mandatory HIV Testing Policy
    In the latest sign that China's new efforts to fight HIV aren't quite on the right track, authorities in one province have announced that everyone in the hospitality industry will have to take a yearly HIV test -- and that if they test positive, they would technically no longer be allowed to keep their jobs. Although the move is a tacit acknowledgement that the hospitality industry -- which includes hotel employees, beauty salon workers and nightclub employees -- plays a role in China's sex industry, the mandatory testing policy has many advocates concerned about possible stigma and discrimination.


    Thrush in People on HAART May Be a Sign of Treatment Failure
    In limited-resource areas where CD4 count and viral load tests aren't readily available, doctors can use a different method to gauge whether a person's HAART regimen is working: examining the mouth. In a Spanish study, oral candidiasis (also known as thrush) was found in more than 90% of people whose HAART regimens were no longer working. This abstract of the study provides a clinical overview of the results. (Web highlight from AIDS Patient Care and STDs)

    For an easier-to-read summary of the study results, read this news article from Reuters Health. (Note: Free registration at Medscape is required to read this article.)


    Britain's HIV Epidemic Started From More Than One Person
    How did HIV first arrive in the United Kingdom -- did it spread from a single person? Not quite, British genetic researchers say. Instead, it looks like there were six separate "chains" of transmission in the mid-1980s that spurred the country's epidemic of HIV-1 subtype B, the most common strain found on the island nation. The researchers also say that the country's drop in HIV infections during the early 1990s was caused by a reduction in risky sex, not by the advent of antiretroviral drugs. (Web highlight from BBC News)


    Ethiopians Flock to New, Toll-Free HIV/AIDS Hotline
    A new toll-free hotline set up to provide Ethiopians with HIV information has been inundated with calls since it began last week, officials say. The service, known as Wegen AIDS Talkline, is accessible for free by telephone; it already receives between 1,800 and 2,200 calls every day.

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    Connect With Others at
    The Body's Bulletin Boards

    "Positive Denial"
    (A recent post from
    the "Women With HIV" board)

    "I've been positive since 1992 and have been in denial since then. I chose to 'ignore' my result until 2004 and just put it at the back of my mind. I finally decided to go to a doctor -- not because I was sick, but to get my viral load taken. I've been on Combivir and Viracept for the past eight months, taking a total of 12 pills a day. My problem is how to swallow these bloody things. Is there an easier way to drink these pills? Someone mentioned to me that once you start taking medication, it weakens your system even more. Is this true?"
    -- Anonymous

    Click here to join this discussion thread, or to start your own!

    Art From HIV-Positive Artists
    Image from the March 2005 Visual AIDS Web Gallery
    "Thoughts on Eastern Pines," 2001; Charles Drees
    Visit the March 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists!

    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.