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December 21, 2005

In This Update:
  • Breaking Research From ICAAC 2005
  • Living With HIV
  • Rapid HIV Testing
  • HIV Reporting
  • HIV Transmission
  • HIV in the News
  • HIV Treatment & Care
  • HIV Outside the U.S.

    The 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2005) took place from Dec. 16-19 in Washington, D.C. Although little in the way of earth-shattering developments in HIV research was reported at this conference, there were a number of interesting studies on treatment strategies, new antiretrovirals and other issues. Visit The Body's ICAAC 2005 home page for the latest news; coverage will continue to come in over the days and weeks to come! Here are some early highlights:

    New Once-Daily Kaletra Tablet: Good News on Adherence, Diarrhea
    Earlier this fall, a new form of Kaletra (lopinavir/ritonavir) was approved by the U.S. Food and Drug Administration. The new Kaletra is a tablet that can be taken once a day, does not have to be taken with food, and does not have to be refrigerated; the older Kaletra was a capsule that had to be taken with food, required refrigeration and was usually taken twice a day. Two studies presented at ICAAC 2005 offer additional promising information: In one study, people appeared more likely to adhere to once-daily Kaletra than twice-daily Kaletra. In the other study, researchers found that a once-daily dose of the new tablet appeared less likely to cause gastrointestinal problems -- particularly diarrhea -- than a once-daily dose of the old capsule. Dr. Paul Sax reports.

    Brecanavir, a Protease Inhibitor in Development, Is Found Safe and Effective in Small Study
    Not all protease inhibitors are created equal. "Non-peptidic" protease inhibitors, like tipranavir (Aptivus) and TMC114 (a drug in development), are especially intriguing for researchers, since they often work well even in people who have developed resistance to existing protease inhibitors. A drug called brecanavir is one of the newer non-peptidic protease inhibitors to enter the development pipeline. As Dr. Ben Young reports, a small, preliminary study presented at ICAAC 2005 found that brecanavir appeared to be effective and well tolerated through 24 weeks of therapy.

    A Once-a-Week HIV Medication? New NRTI May Have a Chance
    Although it's still in very early stages of testing, a new NRTI called elvucitabine may hold the potential for a dosing schedule that is less frequent than once a day. The drug has a long half-life, which means it takes many days to completely clear out of a person's bloodstream. A small study presented at ICAAC 2005 showed that elvucitabine lowered viral load just as well when it was taken every other day as when it was taken once a day. Researchers also think that the drug remains in the bloodstream so long that a once-a-week dose is not entirely out of the question, although elvucitabine will initially be developed as a once-a-day drug. (Web highlight from

    For more breaking research from ICAAC 2005, click here!



    White, Female, and Coping With AIDS
    As we all know, HIV can infect anyone. But many white, middle-class women in the United States still feel that there's no way they could possibly get HIV. Lucy Falcon learned the truth the hard way: Four years ago, as she was laying in her hospital bed, semi-conscious, the realization hit her that she had AIDS. At the time, she couldn't believe it: "How could this happen to me?" she asked herself. "I had recently divorced my high-school sweetheart of 20 years, and we had two children. I could count the men I had been with on one hand. ... I am not the 'face' of AIDS, am I? Well, yes, I am. ... That was four summers ago, and I am as strong, independent, and content as I have ever been."

    Ten Things You Can Do to Enhance Your Emotional Well-Being
    Not filled with good cheer this holiday season? For many people, this time of year can be an emotional drag, whether you're living with HIV or not. Breaking out of the holiday blues is no easy feat, but there are a few deceptively easy steps you can take to improve your emotional well-being -- and your quality of life as well. Psychologist J. Buzz von Ornsteiner explains.



    Survey: Would You Participate in an HIV Clinical Trial?
    Without clinical trials, much of what we've learned about HIV and HIV treatment would never have been possible. But clinical trials can't work without people like you! In preparation for an upcoming, HIV-related study, the clinical trial recruiting firm NCERx would like your thoughts on how to spark people's interest in participating in these important studies. Please take a few minutes to complete this anonymous survey.



    Rapid Oral HIV Tests Are Not Enough to Confirm a Diagnosis, CDC Says
    Earlier this month, news broke that several major U.S. cities (including Los Angeles, New York and San Francisco) had reported a sudden jump in the number of false-positive results from the OraQuick rapid oral HIV test, which is used at many clinics throughout the country. In response, the U.S. Centers for Disease Control and Prevention (CDC) has issued this reminder that a rapid oral HIV test should not be considered the final word on a person's HIV status. If a rapid oral HIV test comes up positive, the CDC says, it should be confirmed with a more accurate, non-rapid HIV test (like the traditional Western Blot test).

    San Francisco Plans to Immediately Follow Rapid Oral HIV Tests With Rapid Blood Tests
    One of the cities that reported a spike in false-positive results from the OraQuick rapid oral HIV test is San Francisco. Although several testing centers in the city have stopped using the test (see next story), San Francisco as a whole has no plans to stop using it; a top city AIDS official said that, even with the rash of false positives, health officials are still confident in the overall accuracy of the rapid oral HIV test. But San Francisco officials have proposed immediately giving a person a rapid blood test if his or her rapid oral HIV test comes back positive. If both the oral and blood tests are positive, "then it is highly likely that the person is HIV positive and we can say that to the client," an official said. (Web highlight from the Bay Area Reporter)

    Six U.S. Testing Sites Discontinue Use of Rapid Oral HIV Test
    In the wake of an increase in false-positive results, at least six HIV testing sites in Los Angeles, New York City and San Francisco have discontinued use of the OraQuick rapid oral HIV test, and have switched to the OraQuick rapid blood test. Not all testing centers in these cities have stopped using the oral test, however; some health officials continue to defend the test's overall accuracy. Interestingly, the false-positive problem does not appear to be a nationwide phenomenon, nor is it even a citywide phenomenon: Some HIV testing centers in affected cities have reported a jump in false positives, while others have not. Investigations are underway to determine the potential cause of the sudden increase in false positives at the affected sites, but at the moment there are many more questions than answers.



    Major California AIDS Organizations Give OK to Names-Based HIV Reporting
    California is one of the few U.S. states that haven't yet switched from a code-based system of HIV reporting to a names-based system, which will be required by the U.S. government starting in late 2006. Many AIDS advocates and organizations in California have been opposed to using names-based reporting, saying it would compromise people's privacy and make people avoid getting tested for HIV. But under the threat of losing $50 million a year in federal AIDS funding, the prominent organization San Francisco AIDS Foundation, as well as several other large AIDS organizations in California, have decided to drop their opposition to a names-based system. The decision clears the way for California to adopt names-based reporting early next year. (Web highlight from the Bay Area Reporter)

    With Federal Money at Risk, Illinois Will Add Patient Names to HIV Tracking System
    California isn't the only state due to switch over to names-based reporting: Illinois has announced it will start tracking HIV cases using patients' names in January 2006. Currently, a person who tests positive for HIV in Illinois is assigned a code number when the case is reported to the state public-health system. State officials expect that beginning in 2007, the federal government will add HIV data -- and not AIDS cases alone -- to its formula for apportioning money under the Ryan White CARE Act, which funds services for low-income and uninsured patients. If the federal funding formula change occurs, only states conforming to the U.S. Centers for Disease Control and Prevention's standard of names-based tracking would have their HIV cases counted, and would be eligible to receive federal assistance.

    Want to learn more about the difference between code-based and names-based HIV reporting, and get the lowdown on your own state's policies? Visit The Body's collection of articles and resources on the reporting of HIV test results.



    Black AIDS Institute to African-American MSM: Why Don't You Give a Damn?
    Forty-six percent of African-American men who have sex with men (MSM) in five U.S. cities are living with HIV, according to a U.S. report released earlier this year. Even more alarming is that a majority of these men don't even know they have HIV. "Forty-six percent isn't a catastrophe. It's genocide!" says the Black AIDS Institute. Yet there seems to be virtually no public reaction from African-American or gay advocacy groups, the institute says. In this open letter, the Black AIDS Institute criticizes the gay African-American community for doing so little to talk about its exploding HIV epidemic. "What will it take?" the group writes. "How many Black gay men have to get infected, get sick and die before we -- not CDC, not the Congressional Black Caucus, not the large AIDS organizations, but us -- mobilize and take action?"

    Also worth reading: In this interview, Black AIDS Institute's founder and director, Phill Wilson, talks in depth about the fight against HIV in the African-American community and the challenges that lie ahead.

    Biology, Culture Make Women More Vulnerable to HIV Than Men, Experts Warn
    Biology is not the only reason that women are more susceptible to HIV infection; many women are also less able to prevent HIV due to cultural, social and economic factors, particularly in developing regions such as Africa, said experts at the 14th International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa, which took place recently in Abuja, Nigeria. "Nearly 60 percent of infections at the moment are in women, most of them in younger women," Helen Jackson, the United Nations Population Fund's HIV/AIDS advisor for southern Africa, said at the conference. Financial dependence makes it difficult for women to negotiate condom use, or to refuse sex if they suspect their partner is infected. Monogamy does not always protect women, either. "Among women surveyed in Harare, Durban and Soweto, 66 percent reported having one lifetime partner, 79 percent had abstained from sex at least until the age of 17. Yet 40 percent of the young women were HIV positive," according to a UNAIDS report published this month.



    After Three-Year Exile, AIDS Quilt Will Head Home to San Francisco
    More than three years after the AIDS Memorial Quilt left San Francisco -- the city in which it was born -- an agreement has been reached to bring it back. A settlement between the Names Project Foundation, an Atlanta-based organization that owns the quilt, and Cleve Jones, the man who created the first panel of the quilt in 1987, will allow Jones to bring 35 blocks of the quilt (including that original panel) back to San Francisco.



    U.S. Veterans Affairs Dept. Launches Site for HIV-Positive Vets and Their Healthcare Providers
    The U.S. Department of Veterans Affairs (VA) has launched a new Web site to help HIV-positive U.S. veterans and their healthcare providers learn more about HIV treatment and care issues that are specific to veterans and VA care facilities. The site, which was developed in collaboration with the University of California-San Francisco, features news, tools, overviews and other important resources. (Web highlight from the U.S. Department of Veterans Affairs)

    When Prisoners' Health Is a Public Health Issue: HIV Care in New York State Prisons
    "There is a public health emergency in New York State prisons," says HIV/hepatitis C prison advocate Romeo Sánchez. In this article, Sánchez explains that high rates of HIV and hepatitis C, a lack of healthcare oversight, poor medical training, no statewide standards for care and inadequate transitional services conspire to create a dangerous health situation for New York inmates, as well as the communities into which they are released.



    Fighting HIV Stigma, One Person (and One Photo) at a Time
    In Zambia, as in many African countries, the stigma of living with HIV is still devastating, even though HIV infection is extremely common. Being open about one's HIV status in these countries is often a surefire way to become a pariah overnight: avoided by friends, ignored by relatives and treated as though everything one touches is contaminated. But for Elizabeth Chama Senkwe, going public about her status was essential -- for herself, her family and her people. "My husband said, 'Are you ready to be stigmatized?' but I wanted my relatives to go to the doctor and to tell people about what HIV is and how to avoid it," Senkwe said. Her story is one of many in a new book about HIV in Africa created by award-winning Spanish photographer Pep Bonet. (Web highlight from BBC News)

    For more information about Bonet's book, click here.

    90 Million Girls Worldwide Missing Primary School Education Because of HIV, Pregnancy, Other Factors
    About 90 million girls worldwide are not receiving a primary school education, compared with 25 million boys, because of factors that include HIV, early marriage and teen pregnancy, according to a UNICEF report. Poverty, war, natural catastrophes and traditional gender roles are other factors that keep girls out of school, according to the report, titled "Gender Achievements and Prospects in Education." A lack of education puts girls at greater risk for contracting HIV and other diseases, as well as becoming victims of violence, abuse, poverty and exploitation, the report says.

    Clinton Foundation to Help Ukraine Ramp Up Its Battle Against HIV
    Former U.S. President Bill Clinton signed an agreement with Ukrainian Health Minister Yuri Poliachenko under which the Clinton Foundation will help the country scale up its fight against HIV. The agreement will expand the role of the foundation in Ukraine by establishing a training and mentoring program for HIV specialists, improving the country's drug procurement process and increasing access to care and treatment programs for HIV-positive injection drug users. The Ukrainian government and the Clinton Foundation in 2004 signed an agreement giving the country access to the foundation's reduced-price HIV medications and diagnostic tools. Some experts estimate that about 1 percent of Ukraine's population, or 500,000 people, is living with HIV.

    Also Worth Noting

    Did You Know?
    HIV/AIDS Fact of the Week

    The new Medicare prescription drug plan, also known as "Part D," kicks in on Jan. 1, 2006 -- that's less than two weeks from today. This date is especially important for people who are eligible for assistance from both Medicare and Medicaid. If you're one of these "dual-eligibles," your Medicaid drug assistance will be replaced with a Medicare prescription drug plan on Jan. 1; if you haven't already picked a plan, you'll be assigned to one automatically.

    Don't let the new year come and go without arming yourself with the facts and ensuring you get the best possible drug coverage! Visit The Body's "Medicare Part D" page for the latest overviews, resources and news.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2005 Visual AIDS Web Gallery
    "Visible Symbol of Beauty," 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
    t The Body's Bulletin Boards

    "At a Crossroads With
    Kids -- Please Help"

    (A recent post from the
    "My Loved One Has HIV" board)

    "I had three children with my ex-husband, who became HIV positive after we divorced. He told me in confidence, and I got myself educated on the disease and am comfortable with it. ... The problem is he is now dating someone, and it is getting pretty serious. Our children are little, and he and I have not discussed when or if we will ever tell the kids of his condition. He gets very upset whenever I try to talk to him about it. I leave it alone because I know how sad he is about having HIV. ...

    "[A] discussion came up about him and his new girlfriend and them living together. I said, 'You are going to tell her about your condition, right?' He said, 'No, I don't have to tell her anything, I am being safe and using condoms.' Well, I said, 'I am not going to let my children be a part of some hidden secret you are keeping from this woman.' It got really bad from there. I just want to teach my children right from wrong and bring them up with good decisions. ... [My] lawyer said it is not in the best interests of the children that their father is with another woman and not disclosing. ...

    "I am so distraught. [My ex] actually said he would give up his kids rather than tell [his girlfriend]. I know deep inside he is afraid [that] if he tells her, she will leave him. ... I feel like I am being backed in a corner. Should I give in and let him have the kids with her and keep this secret? It seems wrong to me. ... It has been three years since his diagnosis and I thought he would come to terms with it by now; I certainly have. ... What can I do? He is really insane about it."

    -- Anonymous

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

    Ryan White CARE Act
    Join the Push for

    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.