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November 9, 2005

In This Update:
  • HIV Treatment News & Research
  • HIV in Prison
  • Crystal Meth
  • HIV-Related Health Issues
  • HIV/STD Prevention & Transmission
  • HIV & the Law
  • HIV/AIDS Policy & Activism

    Looking for the Latest, Greatest Advice on Fat Loss (Lipoatrophy)?
    Last Tuesday, HIV specialist Dr. Joel Gallant hosted a live chat at The Body to answer dozens of questions about HIV-related fat loss (lipoatrophy). This was one of our most informative, interesting chats yet! During the hour-long Q & A, Dr. Gallant discussed everything from the differences between "lipodystrophy," "lipoatrophy" and "wasting," to the lipoatrophy risks associated with some HIV meds, to the steps one can take to stop or reverse the effects of lipoatrophy. Check out our chat transcript for the full story!

    TMC114 Offered to U.S. HIVers Who Are Running Out of Treatment Options
    An expanded access program has been launched in the United States for the not-yet-approved protease inhibitor TMC114, a drug that has generated a lot of buzz among researchers for its ability to work well in people who have already developed resistance to many HIV medications. Expanded access has become a normal step for many HIV meds as they near U.S. approval, once studies have shown that the drug is safe and effective enough to warrant offering it to people who are running out of treatment options.

    Americans With HIV Are More Likely to Die if They're Poor, Study Says
    It's well known within the HIV community that poor HIV-positive people in the United States have less access to healthcare services, including HIV medications, than wealthier HIV-positive people. Now, a massive new study adds proof. U.S. researchers found that between January 1996 and December 2000, 585 (20 percent) of the 2,864 study participants died. People who had no accumulated financial assets were found to be 89 percent more likely to die than those with more wealth, and people with less than a high-school education were 53 percent more likely to die than those with at least a high-school education. The study also noted that people with low incomes are more likely to have HIV in the first place than wealthier people.

    U.S. Releases Updated Pediatric HIV Treatment Guidelines
    The U.S. health department has updated its HIV treatment guidelines for children for the first time since March 24. The new guidelines include a range of updated drug information, including notes on the new protease inhibitor tipranavir (Aptivus), as well as info about new formulations of FTC (emtricitabine, Emtriva) and Kaletra (lopinavir/ritonavir).

    French Study Questions Interaction Between Atazanavir and Antacids
    A new study has cast doubt on earlier findings that suggested that atazanavir (Reyataz) levels dropped in people who were also taking antacids. The study of 92 people from two French clinics found no significant difference in atazanavir levels between HIV-positive people taking an antacid and HIV-positive people who were not. Although not conclusive, the results still contrast with previously released findings on HIV-negative people, which did find a drug-drug interaction between atazanavir and antacids. (Web highlight from



    For This HIV-Positive Prisoner, No Such Thing as "Health Care for All"
    Think HIV medical care in the United States is top of the line? If you're a prisoner, that's often far from the case. "I was seen by a nurse practitioner who told me to pick out my HIV meds from the pictures on a wall chart," one anonymous prisoner recalls. "I said, 'This one, that one, and that one,' and she just gave me the meds I picked." That was just one of what turned out to be a series of hellish experiences for this HIV-positive inmate, who recounts his story here.

    HIV Care in U.S. Prisons: The Potential and Challenge
    One out of every four people living with HIV in the United States is in prison, experts estimate. That must mean we're concentrating our best efforts at HIV treatment on the prison system, right? Not so much; if anything, HIV care in prisons is more inconsistent than it is outside the walls, especially for minorities. In this report, two University of North Carolina physicians explain the critical problems with health care for inmates with HIV, and discuss some of the major challenges that the system must try to overcome.



    Crystal Meth Use Drops Among Gay Men in San Francisco
    For the first time, San Francisco health officials say they've spotted a downward trend in the use of crystal meth -- a drug that is widely believed to make people more likely to engage in risky sex and spread HIV. Surveys from the Stop AIDS Project, a prevention campaign in San Francisco, show that the number of men who reported using crystal meth in the previous six months dropped from 18 percent in last half of 2003 to 10 percent in the first half of 2005. Reaction to the news is mixed, however; although some experts see the survey results as a good sign, others question its accuracy and wonder whether it will really have an effect on HIV rates in the city, which have also been dropping.

    Treating Crystal Meth Dependency: One-on-One With a Substance Abuse Counselor
    How do substance abuse counselors help people addicted to crystal meth? How is meth addiction different from other kinds of drug addiction? Yves-Michel Fontaine, a substance abuse counselor in New York City, answers these questions and more in this recent interview.



    U.S. Advances on Organ Transplant Access for HIV-Positive Patients
    It's still hard for many HIV-positive Americans who need an organ transplant to get one. But in the medical world, at least, attitudes about organ transplants for HIV-positive people have been changing since the mid-1990s, when dramatic advances in HIV treatment began to turn HIV into a chronic disease instead of a death sentence. As part of an ongoing pilot study, researchers at the University of California-San Francisco have performed more than 30 organ transplants in HIV-positive people and found no evidence indicating a lower survival rate than for HIV-negative transplant recipients. California recently became the first state to prohibit insurers from denying coverage for organ transplants based only on a person's HIV status.

    Arizona: Court Rules HIV-Positive Woman Must Receive State-Funded Liver Transplant
    An administrative law judge has ruled that an HIV-positive Phoenix, Ariz., woman cannot be denied a state Medicaid-funded liver transplant on the basis of her health status. "The medical evidence overwhelmingly shows right now that people with HIV have just as good of a survival rate after a transplant as people without HIV," said Jen Sinton, a lawyer with Lambda Legal. "It's potentially life saving for [the female patient in question], and we believe it's a victory for other patients in the Arizona Medicaid system."



    U.S. Syphilis Rates Continue to Rise, While Gonorrhea Rates Continue to Fall
    The U.S. Centers for Disease Control and Prevention (CDC) released brand-new information on the number of people infected with sexually transmitted diseases (other than HIV) in the United States, and the results are a mixed bag. Although gonorrhea rates have hit a record low, the CDC announced, syphilis rates have risen for the fourth consecutive year, particularly among men who have sex with men. Some experts consider syphilis rates to be a potential marker for HIV transmission rates as well, but researchers say the rise could also be due to the natural life cycle of syphilis and to increased screening efforts.


      HIV & THE LAW

    U.S. Supreme Court Nominee Helped Write Opinion Urging Firing of Employees With AIDS
    In the 1980s, Samuel Alito (then the U.S. Deputy Assistant Attorney General, now a Supreme Court nominee) helped write a U.S. Department of Justice opinion that employers could legally fire people living with AIDS because of a "fear of contagion, whether reasonable or not," the Washington Post reports. The opinion said the firing would be legal because discrimination based on "insufficient medical knowledge" was not banned by federal laws protecting disabled people. In a 1986 Post article, Alito was quoted as saying, "We certainly did not want to encourage irrational discrimination, but we had to interpret the law as it stands ... and it does not regulate what a private employer can do if he has a fear of a contagious disease." Terje Anderson -- executive director of the National Association of People With AIDS, which opposes Alito's nomination to the Supreme Court -- said, "We urge the U.S. Senate to carefully examine the record of Judge Alito and to reject his narrow and hateful willingness to allow irrational fear and hatred to become enshrined in law ... People living with HIV/AIDS need to know that the court system will protect our right to live free from discrimination."

    HIV-Positive Man Gets 21 Years for Not Disclosing Status to Women Before Sex
    A 34-year-old Washington, D.C., man has been sentenced to 21 years in prison for having unprotected sex with women without mentioning that he was HIV positive. Four of the man's partners -- including a 15-year-old girl -- were later diagnosed with HIV. The man, Sundiata Basir, even married one of the women (she was 17 at the time) and still never disclosed his status to her. "I was in complete denial," Basir said unapologetically in his defense. "I didn't want to believe I had it." Basir has fathered a total of seven children with various women; none of the children are HIV positive. (Web highlight from The Washington Post)



    Hundreds of AIDS Advocates Rally on Capitol Hill, Hold "Die In" at White House
    Hundreds of AIDS advocates came together on Capitol Hill on Nov. 8, calling for the U.S. Congress to reauthorize the Ryan White CARE Act, which funds AIDS prevention and treatment activities nationwide. The rally was organized by the Campaign to End AIDS, which earlier this month launched 10 caravans that held rallies in more than 100 cities. The caravans converged in Washington, D.C., on Nov. 5 to begin "Four Days of Action to End AIDS," which included a "die-in" demonstration in front of the White House at which several people were arrested. After the Nov. 8 rally, advocates met with lawmakers to discuss the CARE Act, which expired in September. Last year, CARE Act programs received $2 billion in federal funding. The Senate and House are expected to vote on CARE Act reauthorization bills in early 2006.

    Considering a World AIDS Day Event? Check Out This Advice!
    World AIDS Day 2005 is right around the corner -- only about three weeks away, in fact! If you work for an AIDS organization, or would like to involve your school, church, synagogue or other community group in the effort to call global attention to HIV on Dec. 1, take a look at these ideas for how you can plan a memorable event.

    HIV Medical Group Receives $1.5 Million Humanitarian Prize
    The Conrad N. Hilton Foundation has awarded a $1.5 million humanitarian prize to a widely respected organization that provides HIV care to people in need throughout many parts of the world. Boston, Mass.-based Partners in Health (PIH) trains local people in Haiti, Peru, Mexico, Guatemala, Russia, Rwanda and inner-city Boston to provide basic health care and HIV medications to HIV-positive people, pregnant women and people infected with malaria. Today, PIH provides help to about 1 million Haitians annually. PIH Director Paul Farmer said the award will allow his group to "bring more people on board to provide decent health care to everyone in need."

    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the November 2005 Visual AIDS Web Gallery
    "Slick Roads," 1978; Sean Earley
    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."

    Visual AIDS
    t The Body's Bulletin Boards

    "He's Positive, I'm Negative ... For Now"
    (A recent post from the
    "My Loved One Has HIV" board)

    "About six months ago we found out that my boyfriend [who I've been dating for] a year was HIV positive. I was negative. ...

    "When his test came back positive and mine was negative I was almost angry at myself. I didn't deserve to be OK if he wasn't. We had unprotected sex for a YEAR. How could I be OK?

    "I am still in shock. It is so unreal. I can't get him to go to a doctor to see if he needs meds yet. He just wants to ignore it and let it kill him. I can't stand it. ...

    "I just don't know what to do to help him. I can't say it's all going to be OK because, realistically, it's not. He has a fatal disease with no cure. I try so hard to reassure him that I am not going anywhere but he still expects me to run any minute.

    "Is anyone else here going through, or have you gone through, a similar situation? What do I do? How can I make him believe that I love him and we're in this together?
    -- Jenni

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

    "Mortality and Rich vs. Poor"
    (A recent post from the
    "HIV Treatment" board)

    "I just read an article about low-income [HIV-positive] people dying more than rich, educated [HIV-positive] people. I am on Medicaid and unemployed (my doctor recommended I apply for disability). I have a private doctor who prescribed AZT, Sustiva and Truvada, all covered through Medicaid. Is there something else I should know [about], or be using, that is not available to me because I am not rich? I do remember a buzz going around that a "famous" person is still alive for so long because he is rich and has better health professionals. Can that be true?"
    -- Anonymous

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

    Medicine Recycling
    Your Unused HIV Meds
    Can Save Lives in Africa!

    The Starfish Project

    Got unused meds sitting around in your cabinet? The Starfish Project at NewYork-Presbyterian Hospital collects extra antiretrovirals and other HIV-related medications, which they ship to healthcare providers in Nigeria. They accept both opened and unopened bottles, as long as they are not expired. The project pays for all your shipping costs. Contact Starfish through or by calling (212) 746-7164.

    To learn more about recycling your unused HIV meds, visit The Body's collection of articles!

    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.