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November 2 , 2005

In This Update:
  • HIV Treatment News
  • HIV Treatment Research
  • HIV & Health Care
  • Crystal Meth
  • HIV/STD Prevention & Transmission
  • HIV/AIDS Policy & Activism
  • HIV Outside the U.S.

    U.S. Approves More Convenient Form of Kaletra
    A new, more convenient form of Kaletra (lopinavir/ritonavir) has been approved by the U.S. Food and Drug Administration. The new Kaletra pills, which come in tablet form, don't have to be refrigerated, don't have to be taken with food and can be prescribed as two pills twice a day or four pills once a day. The older form of Kaletra was generally taken as three capsules twice a day or six capsules once a day.



    CCR5: A New Treatment Option for People With Drug Resistance?
    HIV drug researchers are always searching for new meds that can help people who, because of HIV drug resistance, are running out of treatment options. The best of the new meds in development are those that attack HIV in a way that's different from all current HIV medications. A type of drug known as a CCR5 inhibitor is one of these new meds. CCR5 inhibitors are in the same general family of drugs as the fusion inhibitor T-20 (enfuvirtide, Fuzeon), but are different enough that they may be able to work against HIV where all other existing meds fail. In this article, Search for a Cure's David Scondras explains how these CCR5 inhibitors work -- and discusses how they may even hold promise as an HIV prevention tool as well.

    Despite Their Promise, Another CCR5 Inhibitor Takes a Hit
    For the second time in a month, an experimental CCR5 inhibitor has slipped off the development pipeline. Just last week, we highlighted the death of aplaviroc, a CCR5 inhibitor that was headed into final-stage studies -- until researchers found it caused potentially severe liver problems. This time, the stricken CCR5 drug is vicriviroc, which was in an earlier stage of development. Side effects aren't what did vicriviroc in, however; instead, a phase 2 study has been halted because the drug doesn't appear to work very well. (Web highlight from

    Why HIV Ain't What It Used to Be
    A new study has found HIV may have become weaker in the United States since the early days of the epidemic. But how did this weakening occur, and what does it mean for the future of HIV treatment? John James of AIDS Treatment News takes a closer look at these issues.

    High Efavirenz Concentrations May Be Behind Prolonged Psych Side Effects
    Although many people experience mental side effects after they start taking efavirenz (Sustiva, Stocrin), until recently it was assumed that these side effects usually go away after a short time. In a small study on this issue, however, Spanish researchers have found that many people experience side effects from efavirenz for a year or more -- and that there may be a specific reason why they do. Levels of efavirenz in the blood appear to be much higher than normal in people who experience long-term side effects, the researchers found. If the results hold up to further study, they could provide a strong rationale for the use of regular tests to monitor the level of efavirenz in a person's bloodstream. (Web highlight from

    Protein Found in St. John's Wort May Help Suppress HIV
    Early tests show that a protein found within the herbal supplement St. John's wort may have anti-HIV properties. In lab tests conducted on HIV-infected brain cells, the researchers found that the protein somehow managed to slow HIV's rate of replication. The findings do not mean that St. John's wort itself should be used to treat HIV; for one thing, the supplement is known to reduce the effectiveness of HIV meds, and for another, the HIV-fighting protein in St. John's wort occurs in concentrations far too low for it to have any antiviral effect. However, the early findings raise hope that researchers may have stumbled on another new type of HIV treatment -- and one that may be able to cross the blood-brain barrier that so many HIV meds have difficulty breaching. (Web highlight from HealthDay News)

    Deadlines Fast Approaching for 2006 Retrovirus Conference
    Planning to go to the United States' most important HIV treatment conference of the year, the 13th Conference on Retroviruses and Opportunistic Infections? Better make sure you meet your application deadline! The conference may not begin until Feb. 5, 2006, but some deadlines have already passed, and others are quickly approaching. Check out this deadline schedule to ensure you send your application(s) or abstract submission(s) on time.



    Are you an HIV-positive person who has developed HIV drug resistance? The American Academy of HIV Medicine (AAHIVM) wants to hear about your experience! Click here to take AAHIVM's sponsored drug-resistance survey.

    HIV healthcare professional? AAHIVM has a survey for you as well! If you treat people with HIV drug resistance, click here to share your experiences with AAHIVM.



    Information and Resources on the New Medicare Prescription Drug Plan
    In just two months, the U.S. government will roll out a new prescription drug benefit for people on Medicare. Called "Part D," the new policy is aimed at providing more complete drug coverage to Medicare recipients, but in many cases the plan has left people with more questions than answers. What do people with HIV need to know about the Medicare drug plan, and what steps do they need to take to make sure their meds are covered? What will happen to those with "dual eligibility" -- able to receive benefits through Medicare and Medicaid? Use The Body's collection of articles and resources to find the answers you need.

    New United Kingdom Guidelines Give Thumbs-Up to Transplants for HIVers
    After many years of being excluded from transplant lists because of their status, HIV-positive people in the United Kingdom have finally been officially welcomed back into the fold. New guidelines developed by the British HIV Association and the UK and Ireland Liver Transplantation Centres unequivocally state that transplants are OK for many HIV-positive people. A brief summary of the guidelines is available in this article. (Web highlight from

    To see the guidelines in their entirety, visit this page from the British HIV Association.



    Where the Meth Is: U.S. Report Outlines a Widespread Epidemic
    Crystal methamphetamine use isn't a phenomenon anymore: It's become popular everywhere in the United States, from remote towns in the Appalachian mountains to trendy clubs in Seattle, Wash. As this collection of excerpted reports from the U.S. Drug Enforcement Agency show, there is a huge range of places throughout the country where meth is produced and distributed, and several different methods that people use to make it.



    Myth vs. Reality: The Truth About Post-Exposure Prophylaxis for HIV
    Think that post-exposure prophylaxis -- also known as PEP, or drug therapy for people who have just been exposed to HIV -- is a breeze? Think again: Anyone who's taken PEP can tell you it's no walk in the park: It's inconvenient, expensive and can cause uncomfortable side effects. In this interesting article, a PEP health worker explains away some of the myths about PEP, and a gay man named Steve recaps his 28-day experience with PEP after a high-risk sexual exposure to HIV.

    Antiretrovirals in a Tube? HIV Entry Inhibitors May Be Turned Into Microbicides
    Two pharmaceutical companies have agreed to license four experimental HIV entry inhibitors to a global initiative that's trying to develop microbicides, which many hope will eventually become a revolutionary new tool for HIV prevention. The agreements mark the first time that pharmas have joined the international effort to develop microbicides, which has primarily been led by private foundations and non-governmental organizations. (Web highlight from the San Francisco Chronicle)

    HPV Vaccines: Worth All the Hype?
    Can the end of cervical cancer be near? Most cervical cancers are caused by the sexually transmitted disease human papillomavirus (HPV). An experimental HPV vaccine has shown promising results, leading to a glut of hyped-up media coverage. But is this the real story?'s Edwin J. Bernard warns that the media has failed to address the very real limitations of the experimental HPV vaccine. For one thing, the vaccine won't actually prevent all types of cervical cancer. And what about gay men: HPV causes anal cancer, too, but where are the vaccine trials for that? In addition, an HPV vaccine would be most effective when given to children before they start having sex -- an idea that's caused an uproar among advocates of abstinence education, who say this would only encourage promiscuity. Finally, Bernard notes, HPV vaccines have mostly been tested only on young, sexually active women in rich countries. That's great, but the vaccine can't really help this group of women, since many may already have HPV. What about the people who can benefit the most from a vaccine: children and people with low incomes -- particularly people in developing nations, where more than 80 percent of deaths from cervical cancer occur? (Web highlight from

    While the Global HIV Pandemic Rages, the U.S. Epidemic Simmers
    At last, mainstream media in the United States is beginning to understand that, although the HIV pandemic abroad is an undeniable tragedy, we have a growing HIV problem at home as well. "This is the Catch-22 of HIV today, in Oregon and nationwide," writes the editorial staff of The Oregonian, one of the country's largest newspapers. "It's hard to reduce the stigma of HIV and put U.S. infection rates in a global perspective, while simultaneously conveying the seriousness of the virus." New HIV prevention strategies are needed to adjust to a changing epidemic in the United States, this editorial concludes. (Web highlight from The Oregonian)



    U.S. Congress Considers Medicaid Cuts; AIDS Activists Call for Protests
    A federal budget package being voted on next week by the U.S. House of Representatives includes heavy cuts to the country's Medicaid program, which could have a major impact on people with HIV. The proposed package would allow states to add a range of charges and co-pays, as well as permit states to kick people off of the Medicaid program if they're unable to pony up. The San Francisco AIDS Foundation has released this call to action encouraging everybody -- whether they're on Medicaid or not -- to protest the proposed Medicaid cuts.

    Looking for a more thorough explanation of the proposed Medicaid cuts? Check out this fact sheet (PDF) from the Henry J. Kaiser Family Foundation.

    Why I Ride: Confessions of an HIV-Positive Biker
    Sherman Johnson admits that he didn't deal with his HIV diagnosis in a healthy way. "I did not talk about it with anyone except my doctor. It was my dirty secret," he explains. An AIDS organization in Chicago, Test Positive Aware Network, helped him become a more open, confident person, however -- and led him to participate in a grueling, two-day, 160-mile AIDS bike-a-thon. "It was a way to give back to agencies that had been fighting for me before I knew how to or appreciated fighting for myself," Johnson writes in this personal story. "Many times, I wanted to give up. For people who live with HIV/AIDS, giving up means death. Therefore, it is not a viable option. I finished the ride, but I continue riding."



    Ready to Hit the Books? In Uganda, You'd Better Pass Your Virginity Test First
    It's hard for women in any developing country to get a free college education. So when a Ugandan Parliament member announced his support of college scholarships based on virginity tests, he made it likely that more than a few women will jump at the opportunity. If it gains traction, the virginity requirement will become part of an ongoing trend within the Ugandan government to promote abstinence instead of safe sex programs, thanks to backing from pro-abstinence religious groups and First Lady Janet Museveni. (Web highlight from BBC News)

    From Harming to Helping: Iran Does an About-Face on Injection Drug Use
    In a shocking policy shift, the theocratic Iranian government is offering inexpensive, clean needles and methadone programs for heroin users in an attempt to counteract an upsurge in HIV rates. A recent study found that HIV rates among heroin users in Iran had jumped from 5 percent to 25 percent. The Iranian government jailed hundreds of thousands of drug users after the Islamic revolution; however, fearing that HIV could spread to the general population through heterosexual sex, the country has clearly begun to relax its policies. (Web highlight from The Washington Post)

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    Visual AIDS
    Art From HIV-Positive Artists

    Image from the November 2005 Visual AIDS Web Gallery
    "Drag Queen Spaceship (element),"
    2005; Curtis Carman
    Visit the November 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "On the Road -- A Tribute to the Campaign to End AIDS."

    Want to learn more about the Campaign to End AIDS, which is staging a major four-day event in Washington, D.C., beginning Nov. 5? Click here!

    Visual AIDS
    t The Body's Bulletin Boards

    A Positive Home
    Test -- and Disbelief

    (A recent post from the
    "I Just Tested Positive" board)

    "I'm a 30-year-old gay male. ... I did a home test after an unsafe experience less than two months ago. Came back positive -- I was surprised because I just assumed I was being a hypochondriac like usual. I have been running the gamut of emotions, as you can imagine, but dealing. I have yet to make an appointment with my general practitioner. I think I will call tomorrow; I guess it feels so certain to me if I call him. I am sure he will be great. ... I guess I just feel alone. I told one friend and she was great. I just can't get over feeling like such an ass for getting this in 2006! I know that is silly, but [I] can't get it out of my mind."
    -- confusednewbie

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

    Conventional vs. Non-Conventional Treatment
    (A recent post from the
    "HIV Treatment" board)

    "A lot of articles suggest boosting the immune system with "herbs and vitamins." Are these safe and do they really work? I asked my doctors, but they both say that, by law, they are not allowed to comment on natural supplements. Is anyone out there using non-conventional methods to assist with HIV/AIDS?"
    -- worriednyc

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

    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.