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December 14, 2005

In This Update:
  • Living With HIV
  • HIV Treatment & Side Effects
  • Chat Transcript: Time to Change HIV Meds?
  • HIV-Related Health Problems
  • HIV in the News
  • HIV Testing, Transmission & Prevention
  • HIV/AIDS Policy & Funding in the U.S.
  • HIV Outside the U.S.
  •   LIVING WITH HIV

    Ten Things You Can Do to Reduce Holiday Stress
    Ah, the holiday season! The joy! The cheer! The shopping! And -- for a great many of us -- the stress! Whether it's dealing with family, going to parties, paying the bills, finishing up work before the holidays or just coping with the daily stresses of living with HIV, this time of year can wear down even the heartiest of us. Sometimes, though, just a few quick, small steps are all you need to take to maintain your sanity. Holistic health counselor Gary Rosard offers this list of 10 simple things you can do to reduce your stress levels.


    Scientists Spot a Possible Reason Why Some HIVers Are Nonprogressors
    What is it about long-term HIV nonprogressors that makes them so different from most people with HIV? Experts have floated various theories, but none have been proven. The latest theory comes from researchers in Spain, who studied 271 people, including 60 who have been living with HIV for more than 15 years, but whose HIV disease has not progressed. The researchers found that nonprogressors were more likely to have a genetic variation in a specific type of coreceptor -- a molecule on the outside of a cell that HIV needs to connect to in order to infect the cell. This variation may make it harder for HIV to gain a foothold inside a person's body, the researchers believe. If the findings can be confirmed, they may provide drug developers with a new target for HIV medications. (Web highlight from aidsmap.com)

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      HIV TREATMENT & SIDE EFFECTS

    HIV Treatment and Heart Attacks: What's the Real Story?
    It's no secret that long-term use of some HIV medications can potentially increase the risk of developing heart disease, at least for a small percentage of people. The question is: Just how much of a risk is it, and if you're on HIV meds, what can you do to lessen that risk? Search for a Cure's David Scondras boils it all down in this bottom-line summary. His analysis: The heart risks of HIV treatment are not nearly as alarming as some people might fear.


    Does Atazanavir Truly Not Cause Fat Loss?
    Atazanavir (Reyataz) has been billed as one of the only protease inhibitors that doesn't cause fat-related problems, such as lipodystrophy, high cholesterol or high triglycerides. But do we really know that for sure? Take lipoatrophy (fat loss), for instance: Although short-term studies suggest that atazanavir is indeed a fat-friendly drug, Dr. Michael Dubé, one of the world's most renowned lipodystrophy researchers, warns that we don't yet know what atazanavir's long-term effects on fat loss might be. (Web highlight from aidsmap.com)


    The Challenges of Discharging HIV-Positive Prisoners
    For HIV-positive people in U.S. prisons, a pivotal moment comes when they're about to be released: How can healthcare workers ensure that after these inmates are set free, they continue to receive the care they need for HIV, as well as other problems such as hepatitis C, mental illness or chemical dependency? In this overview, Dicxon Valderruten of the Osborne Association, a prison rehabilitation group, discusses the challenges that often face recently released men and women with HIV, and reviews some of the steps that healthcare workers can take to help these men and women stay healthy after they return to their communities.

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      CHAT TRANSCRIPT: IS IT TIME TO CHANGE HIV MEDS?

    To Change (HIV Treatment Regimens) or Not to Change: Q & A With Dr. Paul Sax
    There are many reasons why someone might want to change HIV medications, including side effects, drug resistance and a rising viral load. The question is: Should you change meds? Last week, HIV specialist Dr. Paul Sax helped dozens of HIVers answer this question during a live chat on The Body! If you missed the chat, don't worry: A transcript of this informative Q & A session is now available!

    This live chat was sponsored by Gilead Sciences, Inc.

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      HIV-RELATED HEALTH PROBLEMS

    Blood Testing May Be as Effective as Biopsy in Gauging Liver Damage
    Up to a third of HIV-positive people also have hepatitis C, a virus that can cause severe liver damage over time. A liver biopsy -- in which a small piece of the liver is removed for examination -- is the most common method doctors use to figure out the health of a person's liver, but the process can be uncomfortable and carries its own health risks. However, a small new study suggests that a far less invasive technique may be just as effective as a biopsy: blood testing. The test works by looking for certain markers of hepatitis C-related liver damage in a person's blood. If it holds up to further study, it could potentially allow people with hepatitis C -- whether they're HIV positive or not -- to avoid biopsies entirely. (Web highlight from aidsmap.com)


    Diagnosis and Treatment of Anal Cancer in Men Who Have Sex With Men
    Although it's rare, anal cancer is becoming increasingly common among men who have sex with men (MSM) in the United States. Among HIV-positive MSM in particular, it may be over 70 times more common than among the general population. That makes learning about anal cancer and human papillomavirus (HPV), a virus that causes anal cancer, more important than ever for MSM and their healthcare providers. Dr. Stephen E. Goldstone, an HIV specialist at the Mount Sinai School of Medicine in New York City, recently gave a talk about the diagnosis and treatment of HPV-related anal cancer. Tim Horn summarizes Dr. Goldstone's talk in this article. (Web highlight from The PRN Notebook)

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      HIV IN THE NEWS

    Four People Arrested in Miami for HIV Med Scam
    In what investigators say is "only the tip of the iceberg," four people in Miami -- two of them doctors -- have been arrested and charged with cheating Medicaid, which is funded by U.S. taxpayers, out of millions of dollars worth of HIV-related medications. Allegedly, the scam involved recruiting people on Medicaid, many of them poor or homeless, to come to clinics and receive bogus prescriptions that were billed to Medicaid. The medications reportedly never got to the people they were prescribed for; instead, they were diverted to a Miami pharmacy and resold at a profit. (Web highlight from The Miami Herald)

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      HIV TESTING, TRANSMISSION & PREVENTION

    New York, San Francisco Report Spike in False Positives From OraQuick Oral HIV Test
    Two major U.S. cities have reported a recent jump in the number of false-positive results from the OraQuick oral HIV test. Although the rapid oral test is usually 99 percent accurate, public health officials from San Francisco and New York City both say that, lately, the accuracy rate has been quite a bit lower. In response to these reports, the U.S. Centers for Disease Control and Prevention is recommending that all positive results from a rapid oral test be immediately confirmed with a rapid blood test, which has had no reported accuracy problems. There have been no complaints of false-negative test results from the oral test.


    Microbicides: How -- And When -- Will They Work?
    The promise of vaginal microbicides is an alluring one, especially in the developing world: a revolutionary new tool that women can use to protect themselves from HIV, regardless of whether they can get their partner to use a condom. But how would a microbicide actually work? Can it really prevent HIV as well as a condom? How far away are we from having a microbicide that's effective? Get the answers in this overview by microbicide advocate Anna Forbes.


    Taking HIV Prevention Into the 'Hood
    Through the Friend-to-Friend Network, Dr. Margo Bell and the staff of Chicago HIV Risk Reduction Partnership for Youth are reaching what may be one of the groups at highest risk for HIV: poor youth of color. Dr. Bell figures if they won't come to her, she'll go to them -- right to their living rooms, in fact. Bell's team of outreach workers and volunteer Community Peer Educators discuss HIV and sexually transmitted diseases, demonstrate condom use, offer a peer HIV testimonial and distribute pamphlets and safer-sex kits. Her biggest challenge is funding, but Dr. Bell is committed to advancing the Friend-to-Friend Network. After all, she says, if her team doesn't reach these young people, who will?


    Latinos and HIV: An Epidemic Waiting to Burst?
    HIV may not be as large a crisis in the United States' Latino community as it is among African Americans, but Latinos are still infected with HIV at a much higher rate than whites. Why are Latinos more at risk -- and why are they less likely to get effective health care? David Munar has some ideas. He's the Associate Director of the AIDS Foundation of Chicago and a first-generation Colombian American. In this interview, he offers his expert views on how, and why, HIV is impacting the U.S. Latino community.


    New Los Angeles Web Site Helps Newly Diagnosed People Tell Partners to Get Tested
    Since its launch in San Francisco last year, InSPOT.org has become a popular way for people who have been newly diagnosed with HIV to let their partners know they may have been exposed to the virus. Now, Los Angeles is following in the footsteps of the city by the bay. L.A. officials and AIDS Healthcare Foundation have announced the launch of the city's own InSPOT Web site, www.inSPOTLA.org, where residents who have been diagnosed with HIV or other sexually transmitted diseases can send free, anonymous e-cards encouraging their recent partners to be tested as well. As with the San Francisco site, people can use InSPOTLA no matter where in the United States they live. (Web highlight from AIDS Healthcare Foundation)

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      HIV/AIDS POLICY & FUNDING IN THE UNITED STATES

    ADAP Waiting Lists Continue in Nine States
    The latest report on AIDS Drug Assistance Programs (ADAPs) in the United States has found that a dangerous situation continues in many U.S. states, with 1,579 HIV-positive people on waiting lists for medications in nine states. A total of 21 states have implemented some type of cost-containment measure that restricts access to treatment, whether it be a waiting list, reduced drug coverage, copays or other steps. The report, written by the National Alliance of State and Territorial AIDS Directors, also warns that extended funding to support people being helped by the President's ADAP Initiative, an emergency fund established in mid-2004, will run out in late December or early January.


    Minnesota Threatens to Drop People From ADAP for Overdue Copays
    One of the states particularly under stress due to ADAP funding difficulties is Minnesota. The state's ADAP is so cash-strapped that it's now threatening to drop HIV-positive enrollees who have fallen behind on their drug copayments. In an effort to keep the program afloat, officials launched a cost-sharing policy that required ADAP enrollees to pay between $1 and $3 for each of their prescriptions, up to a maximum of $20 per month. Minnesota's ADAP has already dropped three people who racked up a total tab of $3,000, and is warning that it may drop another eight people who owe a total of $4,000 ($500 to $1,000) each. Critics say that being dropped from ADAP is too severe a penalty for recipients who cannot afford the fees.


    Housing Access Can Lower HIV Rates, Improve Health of Low-Income HIVers, Report Says (PDF)
    Access to subsidized, affordable housing for low-income Americans can reduce the number of people with HIV and increase the likelihood that HIV-positive people will receive the care they need, according to a report from the National AIDS Housing Coalition. "Recent studies that examine the relationship of housing status to HIV prevention and care show strong correlations between improved housing status and reduced HIV risk, improved access to medical care, and better health outcomes," the report states. In addition to housing for all low-income people with HIV, the report recommends that housing services be integrated into existing HIV prevention and treatment programs.


    Medicare Drug Plan Deadline Nears; What Do You Need to Know?
    About 20 percent of people receiving HIV treatment are on Medicare, and will need to pick one of the new Medicare prescription drug plans by January 2006. Picking a plan is especially important for people who are on both Medicare on Medicaid, since Medicaid will stop covering meds for these "dual-eligible" people in early 2006. A two-page fact sheet from the Kaiser Family Foundation provides a brief overview of the Medicare drug program -- helpful background for anybody who's still looking to get a handle on his or her drug plan options.

    Want more information on the new Medicare prescription drug plan, also known as Part D? Visit The Body's collection of articles and resources.

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      HIV/AIDS OUTSIDE THE UNITED STATES

    HIV-Positive Iraqis Face a New Type of Challenge
    During the rule of Saddam Hussein, HIV-positive Iraqis and their families sometimes found themselves under quarantine, completely isolated from society and treated by the government almost as though they did not exist. The post-Hussein era, unfortunately, does not yet appear much brighter. HIV-positive people living in Iraq today still face crushing stigma and discrimination. Take 31-year-old Kadhumya Shanin, who got HIV from her husband and who now lives in a hospital room with her 5-year-old, HIV-negative son. Since her husband's death, Shanin has had no access to lifesaving HIV meds, nowhere to go and no means of support, because everyone she knows now rejects her. (Web highlight from The Washington Times)

    To learn more about the oppressive conditions faced by HIV-positive Iraqis in the post-Hussein era -- a group of people who are considered "perhaps the loneliest and most unfortunate minority ... trapped in a society that can do little to help them or understand their situation" -- read this summary of a recent Newark Star-Ledger article.

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    Also Worth Noting

    Did You Know?
    HIV/AIDS Fact of the Week

    Sub-Saharan Africa has just over 10 percent of the world's population, but is home to 60 percent of all people living with HIV.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2005 Visual AIDS Web Gallery
    "Lust for Oneself," 2002; Luna Luis Ortiz
    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
    A
    t The Body's Bulletin Boards

    "Just Diagnosed Positive"
    (A recent post from the
    "Gay Men With HIV" board)

    "I am 29 years old. At the end of November ... I was diagnosed [HIV] positive. My family doesn't know I am gay. I just feel I disappoint my family. I have so many questions. I am wondering how much HIV status [will affect my] daily life, physical appearance, and when I should start medication, since I don't have a HIV doctor now."
    -- max_max

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

    "If/When to Disclose"
    (A recent post from the
    "Women With HIV" board)

    "I've been positive for almost two years, celibate for as long. I just met a man whom I like. ... I'm debating if I want to stay celibate until I remarry. I'm currently separated from my husband (divorce pending), who infected me. I don't know if and when I should disclose my status. We've only known each other for about two weeks. I don't want to seem dishonest, [and] I also don't want to subconsciously sabotage what could develop because of my failure to disclose. But on the other hand, if I am considering celibacy, then what? ... I've read other posts on this subject, but I'm still at a loss as what to do. Any thoughts?"
    -- sanguine

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

    Ryan White CARE Act
    Join the Push for
    Reauthorization!

    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.