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September 1, 2005

In This Update:  
  • From the Editor
  • HIV JournalView: The Latest Research
  • Complications of HIV & HIV Treatment
  • HIV Medications
  • HIV Transmission
  • U.S. HIV Policy
  • HIV Outside the U.S.
  •   FROM THE EDITOR

    We're just beginning to understand Hurricane Katrina's full, terrible impact, but its effect on the HIV community is clear. Thousands of HIV-positive people and their loved ones, as well as many AIDS organizations and care providers, live and work in the area Katrina devastated this week. Not only have their lives been disrupted; the continuity of HIV care throughout the region is now at risk.

    The advocacy group AIDS Alliance for Children, Youth & Families has established an emergency fund aimed at assisting the thousands of HIV-infected people and care providers who are in the area affected by Katrina. Although The Body cannot endorse any particular organization or fundraising effort, if you're interested in donating to AIDS Alliance, you can visit this page. (The Network for Good has also compiled this partial list of general relief organizations.)

    As fate would have it, a major AIDS conference that occurs every fall, the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), was slated to take place in New Orleans in September. Because of the hurricane, this year's conference has been rescheduled; it will now take place in Washington, D.C., from Dec. 16-19. If you were planning to attend this conference, please visit the official ICAAC Web site for more information.

    Regards,

    Bonnie Goldman
    Editorial Director, The Body

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      HIV JOURNALVIEW: THE LATEST RESEARCH

    In the latest issue of HIV JournalView, The Body Pro's monthly recap of important, recently published studies on HIV and HIV treatment, Dr. David Wohl gives us the lowdown on new research about ...

    • HIV treatment and hypertension. Researchers looking at an all-male population find a link between long-term use of HIV medications and the development of systolic hypertension.
    • Managing "hyperlipidemia" (high cholesterol or triglycerides). A new study suggests that taking statins, a family of lipid-lowering drugs, is more effective than switching HIV medications. Meanwhile, another study warns that statins and efavirenz (Sustiva, Stocrin) may interact, and that doctors may need to adjust statin doses as a result.
    • Flu shots. Scientists find even more proof that, if you have HIV, annual flu vaccination is a good idea -- period.
    • Lipodystrophy in the developing world. Experts predicted it, and now a study has proven it: Thanks largely to widespread access to d4T (stavudine, Zerit), which is available as an inexpensive generic drug in developing countries, body fat changes are on the rise -- as are the health problems associated with them.

    To read all about these studies and more, read this month's HIV JournalView on The Body Pro, The Body's sister site for healthcare professionals!

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      COMPLICATIONS OF HIV & HIV TREATMENT

    Frequently Asked Questions About Hepatotoxicity (Liver Damage)
    Liver damage is a potential side effect of several HIV medications, as well as diseases like hepatitis C, which more than a third of HIVers live with. This brief fact sheet from the U.S. health department explains some of the basics about how HIV-positive people can develop liver damage (which doctors call "hepatotoxicity"), and what some of the symptoms are.

    To learn more about liver damage in people with HIV, check out The Body's library of articles.


    HAART Does Not Reduce Risk of Anal Cancer Precursor
    Unexpectedly, a new San Francisco study has found that men who have sex with men and who take combination HIV therapy (known as HAART) appear more likely to have grade 2 or 3 anal intraepithelial neoplasia, a precursor to anal cancer, than people who aren't on HAART. A whopping 95% of 354 men in the study were found to have anal human papillomavirus, which has also been connected to anal cancer. The study didn't find a direct link between HAART and anal cancer; the researchers noted that there could very well be an unrelated cause. However, at the very least, the researchers said it appears likely that HAART can't protect people from developing anal cancer, even though it's well known for its ability to protect HIVers from a host of other opportunistic infections. (Web highlight from aidsmap.com)


    The Basics on Bone Problems in People With HIV
    How can you tell whether you're developing a bone disorder? How are bone disorders treated, and what can you do to make sure your skeleton stays as healthy as possible? This fact sheet from the U.S. health department answers some of the most frequently asked questions people may have about osteonecrosis, osteopenia and osteoporosis -- all of which are types of bone problems that sometimes affect people with HIV.


    Tattoos and Hepatitis C: A Prison Epidemic?
    Tattooing is common in U.S. prisons, but it's not quite the same experience as it is on the well-known TV show Oz: In prison, the needle is often a sharpened guitar string, the ink tends to be made up of melted checker pieces, and the makeshift tattoo gun may not be easy to sterilize -- which can increase a person's risk of getting a bloodborne infection like hepatitis C. Peer educator Ronald F. Day says there's been a lot of denial among prison health officials and medical professionals about the extent of this problem, but that it's time to finally start doing something about it.

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      HIV MEDICATIONS

    To Start or Not to Start? CD4 Percentage May Provide Guidance
    It's generally accepted among HIV specialists that if someone has a CD4 count above 350, there's usually no need to begin taking HIV medications. But could there be cases in which a person with a CD4 count over 350 can still benefit from an early start to HIV treatment? According to a large new study, a person's CD4 percentage may be able to help make that decision. The U.S. study found that HIVers with a CD4 count of 350 or higher, but with a CD4 percentage below 17%, were at a much higher risk of HIV disease progression than people with the same CD4 count but a higher CD4 percentage. Looking at CD4 percentage did not seem to help if a person's CD4 count was below 350, however. The findings support what many HIV physicians have been saying for some time: It's not just the CD4 count or viral load that matters when deciding whether to start treatment; it's the CD4 percentage as well. (Web highlight from aidsmap.com)


    It Takes Two: Adherence Counseling for Mixed-Status Couples
    In a mixed-status relationship, the HIV-positive partner is more likely to take his or her meds on time when the HIV-negative partner gets involved, according to a recent study. In a clinical trial involving people with less than 80% adherence, New York researchers discovered that couple-focused intervention -- in which both partners were counseled on how to support and communicate with each other -- noticeably improved adherence, at least over the short term.

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      HIV TRANSMISSION

    HIV Treatment Reduces Risk of Transmitting Virus to a Steady Partner by 80%
    Researchers in Madrid have found evidence to support what many people have long believed: Effective HIV treatment can greatly reduce a person's risk of transmitting HIV. In a study of 393 mixed-status Spanish couples in a steady relationship, the HIV-negative partner contracted HIV 2% of the time in the era since combination HIV therapy (HAART) became available in 1996, compared to 10% of the time before HAART existed. The researchers warned, though, that the reduced risk would probably be negated if mixed-status couples relaxed their usual HIV prevention methods. (Web highlight from aidsmap.com)


    AIDS-Related Death Rates Among U.S. Inmates Have Dropped Significantly
    The AIDS-related death rates of inmates in U.S. jails and state prisons have significantly decreased, according to new figures from the Bureau of Justice Statistics. AIDS-related illnesses in jails reportedly claimed the lives of eight out of every 100,000 inmates in 2002, down from 20 per 100,000 in 1988. In state prisons, AIDS-related death rates dropped from 100 per 100,000 inmates in 1995 to 15 per 100,000 in 2000.



    The Slippery Search for an HIV Vaccine: Why Can't We Find the Cure?
    HIV has proven itself a far more difficult adversary to overcome than many vaccine researchers first expected. Although 34 different vaccine candidates are currently being studied, several scientific roadblocks have kept an effective vaccine frustratingly out of reach. In this article, published in the Aug. 25 issue of the New England Journal of Medicine, University of Michigan Medical School professor Howard Markel, M.D., Ph.D., explains these roadblocks. (Web highlight from the New England Journal of Medicine)

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      U.S. HIV POLICY

    ACLU Pushes for Medical Marijuana Research in United States
    In the raging debate over medical marijuana, it's becoming harder and harder to separate the politics from the science. One of the reasons for this, however, may be that there's so little science to go around: There's a dearth of objective evidence that can prove or disprove marijuana's effectiveness in easing severe nausea, neuropathy pain and other complications of HIV or HIV medications. The American Civil Liberties Union (ACLU) has deeply criticized the U.S. government for contributing to this lack of evidence; as it explains on this Web page, the group has challenged the U.S. Drug Enforcement Administration's opposition to privately funded, government-approved scientific research that could help marijuana win approval as a prescription medicine. The page also includes additional information on this issue, resources and a link to a petition opposing the federal stance on medical marijuana research. (Web highlight from the American Civil Liberties Union)

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      HIV OUTSIDE THE UNITED STATES

    HIV Stigma and the Limits of Treatment
    It's easy to overlook the devastating impact of HIV stigma in the developing world, considering how desperately people need access to the HIV medications that will simply keep them alive. But although we're beginning to make progress against the physical effects of HIV infection in such regions of the world as sub-Saharan Africa, Dr. Oni Blackstock reports that the psychological impact of infection there is as terrible as ever. (Web highlight from the New England Journal of Medicine)


    HIV and AIDS on the Rise Among Indigenous Australians
    AIDS diagnoses among indigenous Australians more than doubled from 2000 to 2004, and HIV diagnoses were not far behind, according to an annual surveillance report. AIDS diagnoses among indigenous people jumped from 1.5 per 100,000 people in 2000 to 3.6 in 2004, and HIV diagnoses increased from 3.7 per 100,000 to 5.2 in the same period. By comparison, AIDS diagnoses actually decreased among the non-indigenous Australian population, from 1.2 per 100,000 people in 2000 to 0.8 in 2004.


    Argentina, Brazil Vow to Co-Produce Generic Antiretrovirals
    The health ministers of Argentina and Brazil have announced a plan to work together to produce generic HIV medications. While providing little information about the agreement, including how soon production might begin, the two countries say they will start by sharing information, technology and expertise. Brazil, in particular, has often threatened to break pharmaceutical companies' patents to produce less-expensive versions of HIV medications, but has never done so.

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    Also Worth Noting

    Ryan White CARE Act
    Stay Informed as
    Reauthorization Heats Up

    The Ryan White CARE Act is one of the most important laws in the United States for uninsured people living with HIV. This fall, for the first time in five years, the Ryan White CARE Act is up for reauthorization -- meaning the entire law is being revisited, which could result in major changes in the way the act works and funding is doled out.

    What are some of the biggest issues facing this year's reauthorization, and how might they impact you? Visit The Body's main page on the Ryan White CARE Act reauthorization for background, news, policy statements and more!

    The Faces of HIV Care
    Meet the Winners of TheBody.com's 2005 HIV Leadership Awards!

    Jacqui Pitt, winner of a TheBody.com 2005 HIV Leadership Award

    Devoted Torrance, Calif., HIV nurse Jacqui Pitt does it all -- clinical research, patient care, counseling, professional training -- and she does it with a style and grace that has won her the respect of her peers and the love of her patients. "Too many patients are treated as an illness, and not as a whole person," she says.

    We're honored to present Jacqui as one of 10 outstanding HIV nurses who have won a 2005 HIV Leadership Award from TheBody.com! To meet all 73 award winners in our nine award categories, click here.

    Connect With Others
    A
    t The Body's Bulletin Boards

    "Black Woman With Full-Blown AIDS Looking for Friends"
    (A recent post from the
    "Women With HIV" board)

    "Just four months ago I found out I have gone to full-blown status, after being HIV positive for ... 13 years. Considering I am only in my early 30s ... I have lost out on so much in life, yet I have gained a lot. I'm an African-American woman who manages to work full time and run a business. Just looking to really connect with some people for Internet chat, hanging out and travel[ing]. ... All these years the only people that [knew I was] sick were my ex-husband, who is negative, and my mom. I just need some folks to be around that I can be myself [with]."
    -- Caramel

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

    Writing Contest
    Win $500 for Sharing
    Your Story!
    Poster for the Positively Negative writing contest
    Are you between 14 and 22 years old, living in the United States, and have something to say about how HIV has affected your life? The Hear Me Project is sponsoring the Positively Negative HIV & AIDS 2005 Story Writing Contest for U.S. youths. The winning writer will receive $500 and have his or her story adapted for an upcoming HIV prevention education film!

    To learn more about the contest or download an entry form, visit the Hear Me Project at www.hearmeproject.org.