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December 7, 2005

In This Update:
  • Living With HIV
  • HIV Treatment & Care
  • HIV-Related Health Problems
  • Making a Difference
  • HIV Testing & Transmission
  • HIV Vaccines
  • HIV Outside the U.S.

    HIV Is a Part of Me, but It Doesn't Define Me
    "HIV does not define me," says outspoken AIDS advocate Jim Pickett. Although he's embraced his role as an HIV-positive public speaker, few things make Pickett angrier than being treated like he's little more than a walking virus. Sadly, plenty of people treat HIVers this way, rather than as -- well, actual people. "The last thing I am is some pitiable creature to be looked down on, to feel sorry for, to immortalize in velvet," Pickett writes. "I'm no victim, hon, I want no one's pity."

    HIV-Related Hospitalizations in U.S. Are Down by Half Since 1995
    Given the sobering news that HIV rates are holding steady or increasing in much of the United States, it's nice to hear something good from time to time. The latest good news comes in the form of a report from the U.S. health department, which revealed that HIV-related hospitalizations have dropped by a whopping 53 percent in the United States since the introduction of modern HIV treatment. The report states that HIV-related hospital admissions have gone from an all-time high of 149,000 in 1995 to an all-time low of 70,000 in 2003. It also noted that the rate of AIDS-related deaths in U.S. hospitals declined heavily over the same period, from 12.5 percent in 1995 to 8.5 percent in 2003. (Web highlight from the U.S. Agency for Healthcare Research and Quality)

    Thanks to Better Treatment, Number of HIVers in California Jumps by 40%
    About 151,000 HIV-positive people now reside in California, way up from 108,000 in 1998, according to a new University of California report. Although that might not seem like a cause for celebration to some, most people familiar with the epidemic beg to differ: "The consequence of improved survival among persons with AIDS is a rapid and sustained increase in the number of persons living with AIDS," explained George Lemp, the director of the University of California's Universitywide AIDS Research Program.



    Ten Things You Can Do to Adhere to Your Medication Schedule
    It's not always easy to remember to take all of your HIV meds on time. During the rush and stress of the holiday season, it can be even harder. Is there anything you can do to help ensure you never miss a dose? HIV advocate Frank Pizzoli provides these 10 useful tips.

    One Person Develops Severe Liver Problems on Maraviroc Trial, but Maraviroc May Not Have Played a Role
    It's been a rough season for the experimental class of HIV meds known as CCR5 entry inhibitors. Since October, two of the inhibitors that were furthest along in development -- aplaviroc and vicriviroc -- have already stumbled off the pipeline. Now, the maker of maraviroc, one of the most promising CCR5 inhibitors, has revealed that an HIV/hepatitis C-coinfected person involved in a maraviroc study developed severe liver problems while taking the drug. So far, experts believe that it's unlikely the liver problems were caused solely (if at all) by the maraviroc, but they're taking steps to alter the trials just to be safe.

    Does Crystal Meth Use Increase the Risk of Developing Drug-Resistant HIV?
    Experts widely agree that crystal meth use makes unprotected sex -- and HIV transmission -- more likely. But could there also be a link between crystal meth use and HIV drug resistance? On the surface, the idea makes sense: People who use club drugs are often considered less likely to stick to their HIV treatment regimens, which can lead to drug resistance. But where's the proof? So far, there's been almost no research to prove or disprove a relationship between crystal meth and HIV drug resistance. However, a recent, small survey by the International Association of Physicians in AIDS Care suggests that there's reason to believe that such a relationship exists.



    U.S. Anal Cancer Rates Sharply Up Since HIV Epidemic Began
    The number of people in the United States who have been diagnosed with anal cancer has increased by nearly 67 percent since the beginning of the HIV epidemic, from 0.6 to 1.0 cases per 100,000 people, according to a new study. Contrary to many people's assumptions about anal cancer, women actually make up the majority of anal cancer cases, although the proportion of cases among men has steadily increased over the years. The study also noted that anal cancer survival rates have increased steadily since the HIV epidemic began, although early diagnosis and treatment were more likely among men than women. (This is probably because gay men are told to get regular anal pap smears if they are having receptive anal intercourse. Women are almost never given the same warning, and many are not even aware of the risks of unprotected, receptive anal sex.) (Web highlight from



    Sending Hope Around the Globe, One Bottle at a Time
    What can six people accomplish with a small budget and a lot of determination? Working out of a small New York City office, the staff of Aid for AIDS has sent $15 million worth of unused HIV meds from the United States to developing countries. They receive donated pills from HIV-positive people and medical professionals, then pass the pills on, free of charge, to about 600 clients in 35 countries. They're especially focused on helping HIV activists and community leaders, effectively providing treatment while simultaneously helping to work for international policy change. Recognizing the importance of monitoring the health of its clients, Aid for AIDS has begun a new fundraising effort called Campaign For Life, in which donors cover the cost of CD4 and viral load testing for individual Aid for AIDS clients. (Web highlight from the Downtown Express)



    N.Y. Health Officials Urge More Aggressive HIV Testing, Notification in U.S.
    After two decades of stigma and fear, the United States should finally be ready to treat HIV like any other infectious disease, New York City health officials say. In a recent editorial published in the New England Journal of Medicine, the officials urged the country to overcome privacy and discrimination concerns, and to stop being squeamish about HIV prevention. They called for government distribution of condoms and clean needles (two things the Bush administration has been averse to), more thorough reporting of people's progress on HIV treatment, and notification/testing for all people who may have been exposed to HIV by someone who's just been diagnosed.

    For Lying About His HIV Status, This Man Got 10 Years in the Joint
    When Nevada resident Dennis Guerra Jr. was asked by his partners why he had so many doctor's visits, he gave them an answer: He had stomach cancer. Unfortunately, he was lying -- and he was arrested for it. On Dec. 6, a judge sentenced him to a maximum of 10 years in prison for failing to disclose his status to his girlfriend and a former male lover. "He did not have the heart and soul to tell me he had the AIDS virus," wrote Guerra's male ex-partner in a letter to the court. "He is a liar and an unforgivable bastard." (Web highlight from the Reno Gazette-Journal)

    Drug Abuse and HIV/AIDS
    Since the earliest years of the HIV pandemic, the spread of the virus has been tied to drug abuse. Not just injection drugs, which can lead people to get HIV through sharing unclean needles, but also through club drugs or even alcohol, since these can lower people's inhibitions and lead to unsafe sex. Want to learn more? The U.S. National Institute on Drug Abuse has put together this online brochure explaining the link between drug abuse and HIV, and discussing some of the prevention and treatment methods used to help sever that link.



    Collaboration Will Seek to Develop HIV Vaccine Adapted From Measles Vaccine
    GlaxoSmithKline (GSK) and France's Institut Pasteur will collaborate on the development of an experimental HIV vaccine, which will fuse the virus' genes onto an existing measles vaccine. GSK says it's optimistic that the approach will be successful because the measles vaccine provides long-lasting immunity. The European Union will support the project with about US$6.4 million. Scientists will conduct the research at four centers in Belgium, France and the United Kingdom.

    Even an Imperfect HIV Vaccine Can Save Millions of Lives, Report Says
    We like to think of an ideal HIV vaccine as something that'll instantly stop the spread of HIV throughout the world. But do we really need a vaccine to be 100 percent effective in order to save lives? Not even close, according to a new report from the International AIDS Vaccine Initiative (IAVI). IAVI says that, even if a vaccine were only partly effective, and were only given to a portion of the world's population, it would still cut the number of new HIV infections by a third or more per year. When you combine that with better HIV education and condom promotion, you're potentially talking about a tremendous number of saved lives, the report suggests. (Web highlight from the International AIDS Vaccine Initiative)



    Worldwide, Ceremonies and Protests Mark World AIDS Day
    World leaders, advocates and HIV-positive people marked World AIDS Day by calling for "far stronger" action to fight the pandemic. In Cambodia, the government distributed free condoms and cell phone games to raise awareness. In Russia, advocates marching in Moscow said that stigma has hampered prevention efforts and helped the disease to spread in the country. In India, students in the city of Agartala dressed as skeletons bearing messages to fight the pandemic. Members of the Belarussian Youth Union in Minsk, Belarus, formed the word "AIDS" with candles. World AIDS Day ceremonies in Swaziland -- where an estimated 38 percent of adults are infected with HIV -- were canceled by the king because they conflicted with a traditional ceremony. However, in nearby Lesotho, King Letsie III called on all citizens of the country "to know their status so that they can be able to manage their lives and receive treatment."

    Get the complete story on this year's World AIDS Day, and learn more about what you can do to make a difference in the fight against HIV, by visiting The Body's World AIDS Day pages.

    "Miss Positive 2005": Russian Women, Battling Stigma, Show That Living With HIV Can Be Beautiful
    Half a million Russian women may have HIV, but only 37 have entered a Miss Positive competition. Given the enormous stigma still attached to HIV in Russia and Eastern Europe, those 37 women were extraordinarily courageous. And considering the huge obstacles that HIV-positive people face in this region of the world, it may be no surprise that only one of the three pageant winners -- Svetlana Izambayeva, a 24-year-old hairdresser -- actually arrived to collect her prize. (Web highlight from The Globe and Mail)

    MSF Urges Drug Companies to Boost Development of Low-Cost Antiretrovirals for Children
    The international medical aid group Medecins Sans Frontieres (MSF) urged drug companies to scale up the development of low-cost HIV medications that are suitable for children. The organization said the lack of "child-friendly" versions of HIV meds was a major reason that half of all infants born with HIV die before reaching the age of two. "In the absence of child-strength pills that combine all needed drugs in one tablet, medical staff and caregivers are often forced to crush combination pills meant for adults," Rachel Thomas, the medical coordinator of an MSF project in Kenya, said. This method can be ineffective and dangerous, because administering too small a dose can lead to drug-resistant strains of the virus, while overdosing can cause serious side effects.

    Also Worth Noting

    Did You Know?
    Today in HIV/AIDS History

    On Dec. 7, 1995, the U.S. Food and Drug Administration approved Invirase (saquinavir hard-gel capsule), the first protease inhibitor. The approval marked the beginning of the modern era of HIV treatment (also called the "HAART era"), in which HIV treatment regimens consist of meds from two or more classes. Over the past 10 years, HAART has transformed HIV from a likely death sentence into a chronic illness -- at least for those of us fortunate enough to have access to the meds.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2005 Visual AIDS Web Gallery
    "Light II," 1997; Rebecca Guberman
    Visit the December 2005 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "The Damaged Narcissist"; it's curated by British photographer Richard Sawdon Smith.

    Connect With Others
    t The Body's Bulletin Boards

    Small-Town Doc vs. Large-Town Doc
    (A recent post from the
    "Living With HIV" board)

    "I live in a small town in middle America and have a public job. My HIV doc is some 45 miles away in a larger city. I would like to have a general practitioner here in my town, but am concerned about sharing my status with anyone here -- even though medical offices are supposed to honor medical privacy. My question is, should I just get a local doctor and not worry about the status disclosure, or should I still drive 90 miles round-trip when I need a doctor other than my HIV doc?"
    -- Anonymous

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

    The Drugs Work!
    (A recent post from the
    "Gay Men With HIV" board)

    "I recently started taking Sustiva and Truvada after my numbers dropped significantly in October. I was very hesistant and wasn't prepared to enter the next stage ... in this disease. I was fortunate not to encounter many of the horrific side effects I heard about. ... Starting the drugs was a major battle of my mind over matter. I celebrated my birthday in November and went on a two-week drinking binge, which I'm fully aware isn't the best accompanying diet for these intense drugs!

    Fortunately, I simmered down and visited my doc last week to get my latest test results! My liver and kidneys look great! My CD4 has more than doubled and my viral load has dropped to 458! The first time in the two years of dealing wiith this disease that my viral load didn't end in 'thousand!'

    "I know it doesn't mean I'm cured or that I'm free to do what I damn well please, but it has given me a shimmer of hope that things will be OK, or at least they're not as bad I think. I just hope that this is the first of a plentitude of good news in this new stage of my disease!"
    -- exitrow

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

    Ryan White CARE Act
    The Reauthorization Fight
    Has Just Begun

    The Ryan White CARE Act is one of the most important laws in the United States for uninsured people living with HIV. For the first time in five years, the Ryan White CARE Act is up for reauthorization -- the entire law is currently 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 impacting the reauthorization, and how might they impact you? Visit The Body's main page on the Ryan White CARE Act reauthorization for background info, 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.