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July 28, 2005

In This Update:
  • Breaking Research From IAS 2005
  • IAS 2005: Key Links
  • HIV Transmission
  • HIV Treatment
  • HIV/HAART-Related Health Issues
  • HIV/AIDS Policy & Scandal in the U.S.
  • HIV/AIDS Outside the U.S.
  •   BREAKING RESEARCH FROM IAS 2005

    This week's newsletter is chock-full of updates from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment (IAS 2005), which concluded on Wednesday in Rio de Janeiro, Brazil.

    Although the conference lasted only three full days, some of the research and other issues discussed there will be analyzed for weeks to come. Use The Body's IAS 2005 home page as your starting point for news and analysis of the conference's key studies and other events!

    Regards,

    Bonnie Goldman
    Editorial Director, The Body

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      IAS 2005: KEY LINKS

    Begin Your Conference Experience at Our Complete IAS 2005 Coverage Index
    A large number of groups -- including The Body's own team of established HIV experts -- are out covering this conference, but there's only one place on the Web that brings together the best of this material: The Body's complete index of IAS 2005 coverage. It's divided by topic, so you can head straight to the subject that interests you most!


    Video, Podcasts of Important Conference Interviews
    IAS 2005 is the gathering point for some of the most important HIV researchers and community leaders from throughout the world. Thanks to the magic of the Web, the words of these experts can now flow straight to you! Kaisernetwork.org provides you with free access to video, transcripts, and -- for the first time -- podcasts directly from the conference!


    Webcasts Available for Major Conference Sessions
    In addition to interviews with newsmakers in the AIDS world, many of the conference's most significant sessions are available as Webcasts. Tune in to hear some of the brightest minds in HIV discuss everything from HIV treatment access to new antiretrovirals!

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      HIV TRANSMISSION

    Possible Link Between Unsafe Sex and HIV Drug Resistance
    Unsafe sex is associated with a less-than-perfect adherence to HIV medications, which in turn is related to a greater likelihood of having an antiretroviral-resistant strain of HIV -- and of transmitting that drug-resistant strain to other people, according to a University of North Carolina study. Dr. Mark Holodniy reports for The Body from IAS 2005.


    Could Gay Marriage Be a Key to HIV Prevention?
    A recent, federally funded study in Arizona found that many men who have sex with men (MSM) in Tucson -- especially older, white MSM -- were having risky sex, resulting in an increased number of HIV cases in the city. "Many [MSM] say they simply did not want to live beyond 60 years old ... due to the pervasive belief that older men are not sexually attractive or valued," the study said. An editorial in the Arizona Daily Star responds with a thought-provoking idea: "Creating a stable, legal way for homosexual people to form solid, long-term families can help ... in the fight against risky behavior," the editorial says, suggesting that the legalization of same-sex marriage could be an important step.


    Pill Could Revitalize HIV Prevention in U.S., Advocate Says
    A great deal of controversy and protest has swirled around "Project T," a series of studies that hopes to figure out whether high-risk HIV-negative people can protect themselves from HIV infection by taking tenofovir (Viread). But that controversy -- which has mostly been over whether sex workers in poor countries who join the study will receive free medical care if they become HIV positive -- has made it harder for people in developed countries, like the United States, to see the studies' potential value. However, as Duncan E. Teague of AIDS Survival Project explains, HIV prevention in the United States needs a powerful new tool -- and "The T," if it proves successful, may be able to provide it.


    New York Times Urges Harm Reduction in U.S. Prisons
    The United States should use harm reduction techniques to stop HIV transmission and needle sharing in prison, rather than indulge in the "pervasive denial of drug use and sex behind bars," according to this editorial from The New York Times. Harm reduction methods include methadone maintenance, distribution of condoms, and HIV testing and education for inmates.

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      HIV TREATMENT

    Human Growth Hormone May Help Improve Immune Strength
    Over the past several years, researchers have discovered tentative signs that human growth hormone (hGH) -- which is used by some HIVers to reduce the effects of wasting -- could also have immune benefits. Intriguing, early data from two small studies lends new support to this theory. The studies found that hGH therapy further improved the CD4 count and thymic mass of people who were already on HAART, although the treatment appears to carry a risk of side effects such as lipid abnormalities (which can lead to diabetes) and carpal tunnel syndrome. Dr. Margaret Hoffman-Terry reports for The Body from IAS 2005.


    Atazanavir Safe and Effective During Pregnancy, Study Finds
    New HIV medications tend to come out on the market before researchers know much about their safety or effectiveness in pregnant women. A small U.S. study presented at IAS 2005 took a closer look at pregnant women and one of these newer meds, atazanavir (Reyataz), and found that regimens containing the drug appeared to work well, with no major problems for the mother or child. Three of the eight babies born during the study (all of whom were HIV negative) had a slight increase in bilirubin levels, but the abnormality was quickly corrected when deemed necessary. (Web highlight from aidsmap.com)


    Researchers Reveal a Potentially New Class of HIV Medication
    German and British researchers have discovered signs that a new type of molecule, called a capsid assembly inhibitor, may help prevent HIV from infecting a person's cells. The inhibitor, which is still an extremely long way from being developed as a drug, tries to prevent HIV from shedding a protein shell it needs to rid itself of before it can become infectious. (Web highlight from BBC News)

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      HIV/HAART-RELATED HEALTH ISSUES

    For Hepatitis C Treatment, 48 Weeks May Be Better Than 24
    How long should people infected with both HIV and hepatitis C receive hepatitis C treatment: 24 weeks, or 48? A small Italian study presented at IAS 2005 says that 48 is best, at least when it comes to certain varieties of hepatitis C virus. The researchers calculated that, after 48 weeks of treatment, people who had hepatitis C genotype 2 or 3 were over five times more likely to be hepatitis C negative -- and to remain that way for six months -- than people who had received 24 weeks of treatment. (Web highlight from aidsmap.com)


    Anemia Risk With AZT May Depend on Specific Factors
    Anemia, a known side effect of AZT (zidovudine, Retrovir), may be more common in certain situations, according to the results of a large study presented at IAS 2005. The study found that AZT appears more likely to cause anemia when it's NOT taken as a part of Combivir (AZT/3TC) or Trizivir (AZT/3TC/abacavir), or when a person is starting AZT with a high viral load or low hemoglobin level. (Web highlight from aidsmap.com)

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      HIV/AIDS POLICY & SCANDAL IN THE UNITED STATES

    California May Switch From Coded to Names-Based HIV Reporting
    California could lose as much as $50 million annually in federal HIV funds if it does not switch from a reporting system that assigns people an anonymous code to one that actually uses those people's names. California, like some other states, originally set up a code-based system to protect HIVers' privacy, but many now say the system has become a "bureaucratic morass" -- and, more importantly, the U.S. Centers for Disease Control and Prevention doesn't consider coded HIV reporting to be as accurate as confidential names-based reporting, which is slowly but surely being implemented by a growing number of states.


    California Doctor Indicted for Pocketing $1M While Short-Changing HIVers
    California physician Dr. G. Steven Kooshian has been indicted by a federal grand jury on charges of deliberately underdosing his HIV and hepatitis patients, but billing insurance companies for the full amount of the medications -- and pocketing the difference. The indictment said Dr. Kooshian bilked insurance companies and Medicare out of $1.2 million between 1995 and 2001.


    The Medicare Drug Plan: Not a Bed of Roses
    In less than half a year, the U.S. Medicare system will begin to offer prescription drug coverage to all of its beneficiaries. Seems like a godsend for HIVers, right? Maybe not: While better drug coverage is certainly a good thing, many aspects of Medicare's drug plan could potentially do more harm than good. Health policy expert Jeffrey S. Crowley explains.


    My Week as an AIDS Activist in the U.S. Capital
    What's it like to attend a huge AIDS rally in Washington, D.C.? Tracy Bruce was one of hundreds of people who took part in AIDSWatch, an annual weeklong event in which activists visit their representatives and senators to lobby for AIDS issues. "The opportunity to speak with these people provided an 'I'm off my ass and doing something about this!' feeling," she recalls. "This was an experience I won't easily forget."

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      HIV/AIDS OUTSIDE THE UNITED STATES

    AIDS: A Greater Threat Than Terrorism?
    A Council on Foreign Relations report authored by Laurie Garrett -- a former Pulitzer Prize-winning health reporter -- says the AIDS pandemic is a greater threat to international security than terrorism because it weakens economies, government structures, military and police forces, and social structures.

    To read the full report (a 72-page PDF), click here.


    Triple-NRTI Therapy May Save Lives in Developing World, Expert Says
    Ever since a study two years ago found that the triple-NRTI pill Trizivir (AZT/3TC/abacavir), when taken by itself, doesn't work as well as a regimen of Trizivir + efavirenz (Sustiva, Stocrin), the whole idea of triple-NRTI therapy has been questioned. At IAS 2005, the issue found new life in a vigorous debate. One of the speakers at the debate, Prof. Brian Gazzard, boiled it down: triple-NRTI therapy might not be an attractive option in countries where plenty of other meds are available, but in most places in the developing world, he said, it's a totally different story. "Everyone in this audience who was convinced that triple nukes should be discarded has a moral obligation to go away from here and make sure that three million people are treated by 2005, because a much worse option than triple nukes is no treatment at all," Gazzard said. (Web highlight from aidsmap.com)


    Why HIV Treatment Access Isn't Easy to Achieve
    The good news is that every day, more people in the developing world receive access to HIV treatment. The growing availability of generic HIV meds is one huge reason, as is the growth of programs set up to distribute those meds. But many meds are still not as cheap as people need them to be, and developing countries often don't have the money, staff, training or equipment to set up, and maintain, huge HIV treatment programs. Bob Huff takes a critical look at these issues, which help explain why improving HIV treatment access is often a lot more complicated than it seems.


    Heroin Use Contributing to HIV Spread in Eurasia
    HIV is spreading among heroin users who live along drug-trafficking routes that lead out of Afghanistan and through other Eurasian countries, a researcher warned at IAS 2005. The number of people with HIV is rising in Belarus, Iran, Moldavia, Tajikistan, Ukraine and other countries along the drug trafficking route from Afghanistan to Eastern Europe.

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    Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!
    Matthew Seymour, winner of a TheBody.com 2005 HIV Leadership Award
    Meet Matthew Seymour from Dallas, Texas, one of 10 inspiring HIV-positive people who have won a 2005 HIV Leadership Award from TheBody.com!

    Matthew was diagnosed with HIV shortly before taking the Texas bar exam. But the virus didn't slow him down a bit: He now devotes his life to acting as a legal advocate for indigent HIV-positive people and terminally ill people living in rural areas of northern Texas.

    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 More Meds?"
    (A recent post from the
    "Living With HIV" board)

    "I am sure there is some way around this issue, but I just need to vent. I have no health insurance and have now been dropped from my state's ADAP ... as my income is too high. This means I am now responsible for all my meds, which works out to around $1,200/month -- not to mention labs, tests and all that. I can't get another job, can't afford private insurance and certainly cannot afford the meds. GRRRRRRRRRR"
    -- Anonymous

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

    "Alone in DC"
    (A recent post from the
    "HIV in the Military" board)

    "[I'm an active-duty] Navy guy looking for other military guys in my area to hang out with and talk about things. I have been diagnosed [HIV positive] for three years and dealing pretty well. I can be of some help to others, considering I am [a medical officer]."
    -- Anonymous

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

    Art From HIV-Positive Artists
    Image from the July 2005 Visual AIDS Web Gallery
    "Radical Faerie Series," 1995;
    Albert Winn
    Visit the July 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The July 2005 gallery is entitled "The Male Gaze."