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May 25, 2005

In This Update:
  • Living With HIV
  • Drug Use & HIV
  • HIV Treatment
  • HIV Prevention & Testing
  • HIV/AIDS Funding in the U.S.
  • HIV/AIDS Outside the U.S.
  •   LIVING WITH HIV

    Daddy Dearest on the Down Low: Why Some Men Have No Choice
    Why do some men hide their homosexuality and marry women? It's because of homophobia, writes Carlos Perez, a Hispanic, openly gay man. He is intimately familiar with the so-called "down low," both from his own choice to avoid that life and, astonishingly enough, from his father -- who has lived most of his life on the down low. In this telling personal essay, Carlos discusses the pressures to "play it straight" that are placed on too many men, including his father, who was born in Cuba and later emigrated to the United States.


    Meditation Tips for Those Seeking "Balance," "Inner Peace" or Just a Break
    Feeling tense? Consider meditation. Although it involves a lot of touchy-feely terms like "harmonious" and "inner being," many people have found it truly helps them regain a sense of calm and peace -- and that's something that everyone, HIV-positive people included, can certainly use a lot more of. Read these tips from Revs. Ron Kolb and Mark Shepherd on how to make meditation a fulfilling part of your day.


    Andrew Sullivan: Is HIV No Longer Scary?
    Andrew Sullivan has become a well-known talking head on all sorts of politically conservative matters. On his blog, though, he touches on other topics -- like his own experiences living with HIV and taking meds. Although he's been on a treatment holiday for several years, Sullivan is once again considering HAART. In his view, HIV treatment has become so convenient and so successful that, when it comes to HIV prevention, "the current strategy of scaring people to death won't work." (Web highlight from AndrewSullivan.com)


    Hold On, Mr. Sullivan: The HIV-Positive Life Isn't so Fab
    After reading Andrew Sullivan's rosy picture of life with HIV (and on HAART), syndicated columnist Joe Perez felt he had to respond. In this column, he tosses a hefty dose of reality at Sullivan's contention that living with HIV is such a breeze that the scare tactics traditionally used to encourage HIV prevention just don't hold water anymore. (Web highlight from Rising Up)

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      DRUG USE & HIV

    Why Do HIV-Positive Substance Abusers Not Fare as Well as Sober HIVers?
    Believe it or not, the reasons why HIV-positive people who use illegal drugs tend not to fare as well as clean and sober HIV-positive people are not that clear. Some say that the drugs themselves hurt the immune system and accelerate HIV disease progression. Others note that HIV-positive drug users are less likely to report any medical problems -- or to even be tested for HIV -- until they fall gravely ill. Still others say that drug use makes people less likely to adhere to their HIV meds. And, as we noted in last week’s update, some say that drug users get shortchanged on HIV medical care because of stigma and discrimination. Daniel Raymond reviews these reasons in this overview from ACRIA Update, and notes that regardless of the cause, the end result is the same: Substance abusers are not benefiting from the same successes in the HAART era as non-abusers.


    The New Yorker's Take on the Crystal Meth Epidemic, the Internet and HIV
    Mainstream U.S. media is tripping over itself to cover the crystal meth-HIV connection among men who have sex with men. In this up-close report, correspondent Michael Specter visits Los Angeles, New York City and San Francisco to provide a personal viewpoint on the intersection of crystal meth use, the Internet and HIV infection among men who have sex with men. (Web highlight from The New Yorker)

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      HIV TREATMENT

    Tipranavir Receives Tentative Nod From Expert Panel; FDA Approval Likely
    A U.S. Food and Drug Administration (FDA) advisory panel "cautiously" supported approval for the protease inhibitor tipranavir (Aptivus) in combination with ritonavir (Norvir) for use by HIV-positive people with drug resistance. The panel voted 11-3 to back the drug for use in the United States, but also called for more data from long-term studies into tipranavir's effects on the liver and cholesterol levels. The FDA is expected to make a final decision on tipranavir by June 22.


    The Ins and Outs of HIV Treatment for People With Multi-Drug Resistance
    Options for so-called "salvage" or "rescue" patients -- words used to refer to HIV-positive people who are resistant to most available meds -- continue to expand. The picture isn’t all rosy, of course. But since the introduction of HAART, the incidence of treatment failure has actually been falling. Plus, there is a bevy of new drugs flowing through the antiretroviral pipeline, and doctors' ability to individually tailor HAART regimens is improving. This comprehensive report of recent research on managing treatment for people with multi-drug resistance, written by Dr. Keith Henry, provides the latest word on this difficult subject. (Note to healthcare professionals: Free CME/CE credit is available for reading this article!)


    Get the Facts on HIV Treatment and Pregnancy
    If you're HIV positive and pregnant -- or thinking of becoming pregnant -- how will you know when to start HIV treatment? If you're on treatment now, how long should you continue your current regimen? Though you should talk about these issues in detail with your HIV doctor, this fact sheet from the U.S. Department of Health and Human Services provides basic answers to some of the most commonly asked questions from HIV-positive moms-to-be.


    Human Cells Can "Silence" HIV Genes
    Many plants and insects have a secret weapon when it comes to battling viruses: Their immune systems are primed to analyze a virus's genetic materials and then design a counterattack that "silences" key sections of the virus's genetic code. Now, researchers have discovered that humans have the same ability -- but that, wily as ever, HIV has figured out a way around it. However, now that researchers have the blueprints for how HIV prevents itself from being "silenced," they hope they can turn this knowledge into a new type of treatment.

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      HIV PREVENTION & TESTING

    New York City Panel Proposes Overhaul of HIV Testing, Prevention Efforts
    The New York City Commission on HIV/AIDS has published a draft report that recommends significant changes to the way that HIV is tested and reported in the city, which is home to about 100,000 HIV-positive people -- many of whom have no idea they’re infected. The proposed changes include better access to HIV testing, particularly for minorities and underserved people; an increase in condom distribution within prisons, schools and nightclubs; an expansion of needle-exchange programs; more detailed reporting on people’s viral load and drug resistance; and, perhaps most controversially, routine HIV screening for anybody who visits an emergency room.

    To get a sense of official reaction to this draft report, click here. You can also click here to read the report in its entirety.

    Want to comment on the new proposal? The New York City Department of Health and Mental Hygiene is encouraging everyone to come forward with their thoughts on the draft report. You can provide your comments by filling out this online form, e-mailing comments@health.nyc.gov or snail-mailing a letter to HIV/AIDS Commission Report, 125 Worth Street, CN 28, New York, NY 10013. The deadline for comments is June 13.

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      HIV/AIDS FUNDING IN THE U.S.

    As Washington, D.C., AIDS Services Reach Crisis, a Politician Sets an Ultimatum
    The Whitman-Walker Clinic -- the largest HIV health center in the Washington, D.C., area, catering mostly to uninsured HIV-positive people -- is woefully short on cash. It's so strapped, in fact, that for the first time ever, it was unable to pay its employees on time, and the clinic announced recently that it may need to cut back on services. A potential scandal over the clinic's billing methods might also require the cash-dry clinic to pay millions in reparations. (Web highlight from The Washington Post)

    Meanwhile, a number of other nonprofit AIDS agencies in the U.S. capital have been woefully underpaid for the services they provide, leading many of them to cut back on HIV-related services as well. Who's to blame? According to one politician, it's the fault of Washington, D.C.'s own health department, which owes these organizations millions of dollars in unpaid reimbursements. The politician gave the city health department a "48-hours-or-else" ultimatum to devise a plan to reimburse the funding-starved agencies. The ultimatum was recently extended by five days to give the government more time to figure out how to pay its overdue bills.

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      HIV/AIDS OUTSIDE THE UNITED STATES

    Condom Use Low, Casual Sex High Among MSM in Chinese Province
    China is just beginning to realize how far it needs to go to stop HIV from spreading out of control. In a recent survey of 220 men who have sex with men (MSM) in Shenzhen, which is on the Hong Kong border, 33% of respondents said that they "never or seldom" use condoms, 61% said they engage in anal sex, 7% said they engage in oral sex and 74% said they have had sex with strangers. In response, health officials have placed posters in some areas of the city to promote condom use.


    Vitamins Are Not an Effective HIV Treatment, UNAIDS Director Insists
    The back-and-forth over the role of vitamins in treating HIV continued this week, as the director of UNAIDS emphatically said that vitamins are not a valid treatment for HIV. He went so far as to say that people who support vitamins as HIV treatment are "charlatans" and are "going to kill people" -- a thinly veiled jab at Matthias Rath, a vitamin salesman who has publicly opposed the use of antiretrovirals, as well as South African Health Minister Tshabalala-Msimang, who has long stated that changes in diet could be even more effective than antiretrovirals at treating HIV. It is, of course, indisputable that antiretrovirals have saved the lives of millions worldwide. (Web highlight from the Mail & Guardian Online)

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    Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!
    Robert Mintz, winner of a TheBody.com 2005 HIV Leadership Award
    Meet Robert Mintz, one of 10 inspiring people with HIV who have won a 2005 HIV Leadership Award from TheBody.com!

    As a drill sergeant for both male and female units during his military career, Robert, a veteran of the Vietnam War, chose to inspire his charges through example rather than intimidation. When he was diagnosed with AIDS in the mid-1980s, he once again chose to inspire people through example by sharing his status openly and becoming an advocate for others living with HIV.

    Want to meet all 73 winners of TheBody.com's 2005 HIV Leadership Awards? Click here!

    Connect With Others at
    The Body's Bulletin Boards

    "No Meds"
    (A recent post from the
    "Gay Men With HIV" board)

    "I have been poz since 1989 (probably got infected in 1983, but I wasn't tested until 1989), and I took HIV meds for about three years (between 1990 and 1994). I stopped back then because my doctor thought I'd be fine. He was right; I have been fine. My viral load is less than 100 and my CD4 count is between 800 and 1,100. Is anyone else 'going without' like I am? I have some viral load. Should I be taking meds?"
    -- Poz 20 Years

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

    Art From HIV-Positive Artists
    Image from the May 2005 Visual AIDS Web Gallery
    Untitled, 1997;
    Sarawut Chutiwongpeti
    Visit the May 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists!