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April 20, 2005

In This Update:
  • Living With HIV
  • HIV Treatment
  • HIV/HAART-Related Health Problems
  • HIV Transmission & Prevention
  • HIV, Religion & Scandals
  • HIV/AIDS Outside the U.S.
  •   LIVING WITH HIV

    Heterosexual, HIV-Positive and Hunting: Where to Find a Date
    Are you an HIV-positive hetero guy or girl looking to kick your dating life into gear? There are a host of Web sites, chatrooms, events and social gatherings throughout the country where you can meet somebody new. Positively Aware offers a lengthy list of options.


    66 Years Old and Adoring Life: A Small-Town Woman With HIV Finds Love
    Janet (not her real name) was 56 when she tested positive for HIV. Now, 10 years later, the small-town resident has a new lease on life -- and a new love of her life, who she met at an HIV support group in a nearby city. That combination of small-town life and city proximity has worked perfectly for Janet, she says. "I'm happy, and I want people to know, you can have a good life. There is a chance for you to find love. You don't have to be alone."


    Over 50 and Over the Hill? Guess Again, Says AIDS Advocate Jane Fowler
    At 69, Jane Fowler is one of the few women addressing the need for a greater awareness of HIV among older people -- and for a more frank discussion about sex and old age, a topic that even many doctors feel is taboo. "We have a double stigma to live with," Fowler, who became HIV positive at the age of 55, says of older people with HIV. "The stigma of being old in a society that doesn't respect old age, and the stigma of living with a disease that is considered disgraceful." (Web highlight from Newsday.com)

    Want to learn more about the remarkable Jane Fowler? The Body interviewed her as part of our special feature on women and HIV; click here to read her personal profile.


    A New Way to Help HIV-Positive Drug Users Overcome Addictions (PDF)
    A drug called buprenorphine is beginning to gain traction as a substance abuse treatment for HIV-positive injection drug users. Researchers have found that buprenorphine is a safer alternative to methadone, a tightly regulated drug that has been found to carry a higher overdose risk than buprenorphine. A workshop for HIV healthcare providers last June discussed the use of buprenorphine in primary HIV care; this report from the Forum for Collaborative HIV Research reviews the workshop's discussions. (Web highlight from Forum for Collaborative HIV Research)

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      HIV TREATMENT

    Update on the HIV Medication Pipeline
    Quick quiz: How many HIV medications are currently in the development pipeline? Ten? Fifteen? Thirty? Keep on going: As this chart from Treatment Action Group shows, there are dozens of meds that are in various stages of development -- and nearly 20 are now undergoing clinical trials.



    No Surprises in Updated HIV Treatment Guidelines (PDF)
    The U.S. health department has issued a relatively minor update to its HIV treatment guidelines. The most notable change has to do with the use of nevirapine (Viramune) by people who are just starting HAART for the first time. Because of liver risks highlighted in studies over the past year, the guidelines now officially recommend against starting nevirapine if you're a woman with a CD4 count above 250 or a man with a CD4 count above 400.


    Viral Load Way Down, CD4 Count... Unchanged? One Study Tries to Explain
    Some people on HIV treatment see their viral load become undetectable for a year or more, while their CD4 count remains in the 200s. The problem, according to a new study, may have several causes. For one, people with persistently low CD4 counts may be getting lower output from their thymus, the body's CD4 cell factory. For another, CD4 cells may be dying at a faster rate than usual, probably due to the continued impact of HIV, even when a person's viral load is undetectable. The researchers found, however, that many people with low CD4 counts nonetheless had immune responses to other diseases that were similar to HIVers with higher CD4 counts, suggesting that HIV treatment was still having some benefit. (Web highlight from aidsmap.com)

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      HIV/HAART-RELATED HEALTH PROBLEMS

    Strength Training Tops Steroid Treatment in Small AIDS Wasting Study
    Experiencing AIDS-related wasting and trying to decide what you should do to stop it? A recent study by U.S. researchers suggests that exercise -- specifically, resistance training -- may be a better bet than using oxandrolone (Oxandrin), a type of steroid treatment that's taken orally. In the 12-week study of 47 people with AIDS, people were given intensive nutritional intervention and 1) no other treatment; 2) 10 mg of oxandrolone twice a day; or 3) progressive resistance training. All three methods were found to help somewhat, but resistance training really shined among people whose "physical functioning" -- that is, their ability to perform everyday tasks -- had already been impaired by wasting. "Given our results and the potential toxicity of oxandrolone, it is difficult to justify the wide use of this agent for HIV wasting," the researchers concluded. This journal abstract provides more data on the study. (Web highlight from the Journal of AIDS)


    Getting to Know PCP, a Dangerous HIV-Related Illness
    Pneumocystis jiroveci pneumonia, better known as PCP (and formerly known as Pneumocystis carinii pneumonia), has long been one of the most common opportunistic infections in people with AIDS. It's much less common in the age of HAART -- at least in places where people have access to treatment -- but remains a health concern, especially among people with a low CD4 count. In fact, PCP is still the single most common life-threatening opportunistic infection for HIVers in the United States. In this detailed clinical overview, Dr. Gifford S. Leoung explains the common symptoms, preventive methods, diagnostic procedures and treatment strategies for this increasingly uncommon, but nonetheless dangerous, disease. (Web highlight from HIV InSite)

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      HIV TRANSMISSION & PREVENTION

    The New York City "Superbug": A Look Back at an Alarm That Fizzled
    Hey, remember all that hubbub over a supposedly virulent strain of HIV that was resistant to basically every HIV medication in existence? Whatever happened with that? In this detailed, well-balanced report written in late February, Bob Huff explains how the furor began and why it quickly started to peter out. He also offers some thoughts on why such a huge deal was made about this isolated HIV case in the first place.


    Men, Sex and Drugs: Where Has All the Honesty Gone?
    "The response of the HIV community to the superbug Sargasso betrayed a bankruptcy of new ideas, new strategies, new narratives," writes Daniel Raymond. "Nobody even attempted to defend Patient X, much less understand or identify with him." If the apparently false alarm over the New York City "superbug" case teaches us anything, Raymond writes, it should be that we've strayed far too much from the honesty with which gay and bisexual men used to talk to one another -- and to the world -- about sexuality.


    Recent Studies Examine Causes Behind Crystal Meth Use and Sex Risks
    Most of us are shaking our heads and wondering about the reasons behind the recent spike in crystal methamphetamine use and the resulting spread of HIV among men who have sex with men (MSM). Bob Huff of Gay Men's Health Crisis provides this straightforward, no-nonsense summary of some studies on substance use and sexual risk behavior among MSM. Could these studies help provide HIV prevention workers with insights into the reasons behind this dangerous mix of HIV risk factors?

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      HIV, RELIGION & SCANDALS

    The Church and Condoms: Will a New Pope Make a Difference?
    Life is sacred, and condoms prevent life from being conceived; therefore, condoms are bad. Seems so simple, doesn't it? That's the way many members of the Roman Catholic church see it -- and with the selection of conservative Cardinal Joseph Ratzinger as pope, it's a doctrine that's likely to continue. In this analysis, written prior to the new pope's appointment, aidsmap.com's Michael Carter examines the complex issue of condoms and HIV prevention among the world's Roman Catholics, and talks about the potential for doctrinal change in the future. (Web highlight from aidsmap.com)


    Florida AIDS Organization Exec Admits to Embezzlement
    The Broward County, Florida Human Services Department has suspended $1.5 million in federal funding for AIDS Project Florida after a former executive admitted to embezzling money from the group during his tenure. The funding freeze will lop off more than a quarter of the budget for the organization, which is one of the largest in the state and serves thousands of HIV-positive people.

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      HIV/AIDS OUTSIDE THE UNITED STATES

    Islamic Leader in Egypt Shuns Sex Education
    Teaching about the facts of life in a fundamentalist society has always been a challenge. Some just neglect to do it altogether. In Egypt, while reproductive health instruction is currently included in science classes, some teachers reportedly fail to teach it "because they are shy." Unfortunately, even the inexorable threat of AIDS has not moved some religious leaders to change their thinking. Egypt's most senior Islamic cleric has rejected the possibility of starting sex education courses in the nation's classrooms.


    Ugandan "Mama Club" Helps HIV-Positive Mothers Cope With Stigma in Health Care
    It would be an understatement to say that it's hard to be an HIV-positive mother in Africa. Even in Uganda -- widely credited as one of the developing world's great success stories in the fight against HIV -- moms with the virus have to cope with constant stigma, even in the very health centers that are supposed to give them support and treatment. But some mothers are starting to fight back: The AIDS Support Organization of Uganda has formed a support group called Mama Club, which is aiming to give HIV-positive moms relief from the discrimination they face, as well as much-needed assistance for themselves and their children. (Web highlight from New Vision, Uganda)

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    Connect With Others at
    The Body's Bulletin Boards

    "Help With
    Cost of Meds"

    (A recent post from the
    "HIV Treatment" board)

    "How does a regular person pay for the cost of HIV meds? I make a good income (but let's be realistic), have insurance, but cap out on prescriptions after the first month. Cost runs between $1,000 to $1,400 a month. Where can I go for help, as I do not qualify for assistance on the ADAP program?"
    -- Anonymous

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

    "Deceived by Lover, Now I'm Positive!"
    (A recent post from the
    "Just Tested Positive" board)

    "I was deceived by my lover. [I thought] we both were tested ... However, he never really did get tested, or he lied about his results because he became sick with PCP in December and then told me that he had AIDS. Now, I've tested positive. I started an online journal to deal with my fears, thoughts, etc. The whole story is on there, feel free to read and comment. It's part of my therapy that I need, plus I feel obligated to share my story."
    -- Ronnie

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

    Art From HIV-Positive Artists
    Image from the April 2005 Visual AIDS Web Gallery
    "Mummy," 1984; John Lesnick
    Visit the April 2005 Visual AIDS Web Gallery to view this month's new collection of art by HIV-positive artists!

    Clinical Trials Now Enrolling for Kaposi's Sarcoma Treatment

    HIV positive and diagnosed with Kaposi Sarcoma (KS)? If you live in Los Angeles, there are two open clinical trials on experimental KS treatments that may interest you. One study will investigate the use of oral valproic acid; the other will examine the potential benefits of halofuginone ointment. Both studies will last for 24 weeks.

    Interested? Fill out our clinical trial application form. If you qualify for either of these studies, or for another clinical trial that may be of interest to you, you'll be contacted with more information!