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October 19, 2005

In This Update:
  • Living With HIV
  • HIV Treatment
  • HIV-Related Complications
  • HIV-Related Scandals
  • HIV Prevention & Transmission
  • HIV Outside the U.S.

    HIV Positive and Hate Your HMO? You're Not Alone
    When Carlos A. Perez lost his job at a Chicago AIDS organization, he also lost his excellent health insurance plan. Though thankfully he found a new job, his new health plan -- covered by an HMO -- wasn't even remotely as good. In this story, Perez recalls some of the worst moments, when ignorance and red tape came together to cause a maddening amount of frustration.



    No HIV Meds on Weekends? Researchers Investigate
    Researchers in Boston, Mass., and Uganda are exploring an HIV treatment strategy that would allow people to take a break from their medications every weekend. Their theory is that such a strategy could reduce the cost of treatment by 30 percent, lessen side effects and improve people's overall quality of life. Early signs are positive: A small, 48-week pilot study conducted in Boston found that the strategy, called "Five On, Two Off" or FOTO, was successful in 23 out of 26 people who tried it -- their viral load remained suppressed, and they reported feeling better overall. Although three people experienced a viral load rebound, when they resumed their daily regimen, their viral loads were suppressed again.

    For HIVers With Impaired Memory, an Electronic HIV Medication Nag
    For many HIVers, keeping track of all the meds they need to take can be a pain. Some people with advanced HIV disease may also have short-term memory problems, which makes remembering doses even harder. Is there anything these people can do to help them take their meds on time? Johns Hopkins University researchers have found that a pocket-sized electronic device may be able to lend a hand. The portable Disease Management Assistance System, nicknamed "Jerry" by users, gives electronic-voice reminders, flashes a light and informs the user of the exact dosages and medications he or she needs to take at a given time.

    Which Meds Don't Get Along? Recent Research on Drug-Drug Interactions
    HIV treatment is complicated enough, with more than 20 approved medications that can be combined into dozens of different regimens. Complicating things even further, though, is that many HIV medications can interact with one another in often-unpredictable ways. As the number of available HIV meds and possible combinations continues to grow, researchers are struggling to discover and understand all the ways in which these drugs can affect one another. Some of the world's top drug-interaction researchers gathered in Québec, Canada, earlier this year to discuss the latest findings; Mark Mascolini provides this review.



    Heart Disease and HIV: A Clinical Review
    The connection between HIV and an increased risk of heart disease was established years ago. Why this is the case, and whether certain HIV medications also play a part, is still being studied. In this clinical overview, which is part of an online textbook on HIV/AIDS, several University of California-San Francisco physicians describe recent studies on the various heart problems that some HIV-positive people may experience, and talk about what can be done to reduce the risk. (Be warned: This article contains a lot of medical terminology.) (Web highlight from HIV InSite)

    Genital Tract May Be a "Sanctuary" for Hepatitis C Virus in Coinfected HIV-Positive Women
    In HIV-positive women who are coinfected with hepatitis C, their hep C virus appears to concentrate within the genital tract, a small U.S. study has found. The findings may help explain why HIV/hepatitis C-coinfected women appear somewhat more likely to pass hepatitis C on to their babies during labor than women who only have hepatitis C. At the moment, though, the findings are just a curiosity; no recommendations for prevention or treatment have stemmed from the study. (Web highlight from

    Four-Year Treatment Break Reverses a Woman's Med-Related Fat Gain, but Not Fat Loss
    Can a treatment break reverse the fat gain and fat loss associated with HIV medications? As many experts already know, the answer is yes and no. British doctors recently reported on the case of one HIV-positive woman who had experienced both types of body fat changes while on HIV medications. The woman had developed fat accumulation in her breasts, waist and back, as well as significant fat loss in her arms and buttocks, after taking 3TC (lamivudine, Epivir) + d4T (stavudine, Zerit) + indinavir (Crixivan) from 1997 to 2000. After stopping treatment for four years, the woman's fat gain was almost completely reversed, but her fat loss was nearly unchanged. The docs' recommendation? Physicians should try to prevent fat changes from happening in the first place, by prescribing newer HIV meds that currently appear not to cause such side effects. (Web highlight from



    Serono to Pay $704 Million Settlement for Price, Marketing Fraud of Serostim
    The Swiss biotechnology company Serono has agreed to pay US$704 million and admit to conspiracy charges in order to settle a U.S. government investigation into the company's sales and pricing practices of its drug Serostim (somatropin), which is used to treat AIDS-related wasting. The U.S. government had charged that Serono bribed doctors to prescribe Serostim -- including the offer of an all-expenses-paid trip to France for physicians who wrote extra prescriptions of the drug. The government also accused Serono of inventing a "body cell mass" test that falsely found evidence of wasting in many HIV-positive people.



    Who Needs Condoms When You've Got a Safety Manual? It's HIV Prevention, the U.S. Government Way
    Provocative columnist Jim Pickett recently went to the U.S. government's huge, annual HIV prevention conference, where every attendee was given a gift bag. The bag contained a free safety manual chock-full of useful advice -- not about safe sex, mind you, but about safety: how to fall properly, how to lift heavy objects, how to hold a telephone correctly. Think that's odd? How about the fact that the gift bag didn't contain a single condom -- even though it was an HIV prevention conference. Not that Pickett is surprised; after all, he writes, "This is a government-run conference, by the watch-out-for-condoms Centers for Disease Control and Prevention."

    Arab Americans and HIV Prevention
    HIV and homosexuality are challenging topics for many traditional ethnic communities to address. They are particularly dicey for many Arab Americans. What are some of the obstacles to effective HIV prevention for Arab Americans, and why don't we know more about HIV in this community? In this detailed review, researcher Mary Salome talks about the current state of HIV prevention in the Arab-American community. Her overview includes profiles of some HIV prevention programs and interviews with several Arab Americans. (Web highlight from HIV InSite)

    California's Governor Eases Syringe Exchange Laws
    California Governor Arnold Schwarzenegger recently signed into law a bill that AIDS advocates say will likely lead to an expansion of needle-exchange programs throughout the state, which will no doubt reduce the number of new HIV and hepatitis C infections. Unfortunately, he also vetoed a bill that would have allowed state funds to be used to purchase clean needles for those programs, but advocacy groups -- like the San Francisco AIDS Foundation, which put out this release -- say that one out of two ain't bad.



    No Degrees of Separation: A Blogger's Close-Up Look at HIV in Uganda
    Many AIDS experts throughout the world hold up Uganda as Africa's shining example of how successful an anti-HIV campaign can be. But how many of these people have actually been there, seen what daily life is like for Ugandans and experienced the devastating impact HIV continues to have on its people? Kevin Sites, an international war correspondent, has; he recently posted this blog, which includes video footage and a photo essay. (Web highlight from Yahoo! News)

    The Lost Children of AIDS
    Approximately 12 million AIDS orphans live in Africa. George W. Bush's President's Emergency Plan for AIDS Relief program and many other well-meaning programs are intended to alleviate some of these orphans' misery. But do they? Helen Epstein went to Africa to find out. (Web highlight from The New York Review of Books)

    Bush Administration Policies Undermine the Global AIDS Fight, Health Expert Warns
    The administration of U.S. President George W. Bush has emphasized the importance of abstinence over any other form of HIV prevention, and has refused to provide funding to any organization that fails to officially denounce sex work. That stance has put many developing countries, including the African nation of Kenya, in a very difficult position, writes public health expert Paula Tavrow. "Refusing to adhere to this new requirement [to denounce sex workers], the Brazilian government returned $40 million to the U.S. Treasury. Unfortunately, [organizations] in Kenya are too cash-strapped to reject money. Instead, they are quietly ending their prevention programs for sex workers, even though experts believe these activities are vital for combating AIDS." (Web highlight from the Baltimore Sun; free registration required)

    Also Worth Noting
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    Ryan White CARE Act
    The Reauthorization Fight
    Has Only Begun

    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!

    Want to take action now? Click here to send a letter to your U.S. senators and representatives urging them to increase funding for the Ryan White CARE Act.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the October 2005 Visual AIDS Web Gallery
    "Baby," 1997; Brian Buczak
    Visit the October 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "Manner of Solitude."

    Connect With Others
    t The Body's Bulletin Boards

    "Let the Meds Begin!"
    (A recent post from the
    "Living With HIV" board)

    "I am 27 years old and have been positive for nearly two years now. I am very successful for my age, travel nonstop for work and have just purchased my second home. ... Recently, I ... discovered that my CD4 has dropped significantly! [My primary care doctor urged me to] see my HIV specialist ASAP and begin meds. I've been putting off the appointment all week. ... I'm just so overwhelmed. This new step makes it all very 'real' to me now. I'm petrified! ... Is this normal? I have been very strong and confident thus far! What can I do? Do meds really mean it's the beginning of the end?"
    -- Anonymous

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

    "Lost My Best Friend"
    (A recent post from the
    "Gay Men With HIV" board)

    "[I'm] struggling through losing someone I spent 18 hours a day with for 10 years -- the last four taking care of him as he got progressively sicker. ... We were soulmates with almost nothing in common, from different age cohorts, and different ethnicities, but always had a vision of the other in the back of our minds. ...

    "I stayed by his side, while his family ignored him. ... I was not invited to the funeral, and have not heard from one of them once he was cremated. ... I've tried to remember him through my own private ceremony, sent his remaining drugs to Guatemala ... and remember him every minute of every day. ...

    "I'm only 44, but feel like I'm a 93 year old widower. The pounds are shedding off, and people are approaching me and finding me attractive again, but ... I can't imagine being with someone who isn't just like the same beautiful, young, Hispanic man with danger in his eyes, but the most beautiful heart on earth. ...

    "I'm looking for others who have experienced some or a couple of elements of my grief, and would like to contact me during my mourning. It's so hard after fighting and taking care of someone 100 hours a week to find meaning in the mundane nature of life now.
    -- Ron in Tampa

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