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February 1, 2006

In This Update:
  • HIV Treatment
  • Living With HIV
  • HIV News & Views
  • HIV Transmission
  • HIV Prevention & Education
  • HIV-Related U.S. Policy Issues
  • Making a Difference
  • HIV Outside the U.S.

    An HIV Treatment Icon Speaks His Mind: An Interview With Joseph Sonnabend
    The HIV community has more than its share of heroes, but for many HIVers and healthcare professionals, none are as noteworthy as Dr. Joseph Sonnabend. The recently retired maverick physician was one of the first doctors in New York City ever to treat people for HIV, and established himself as one of the most highly regarded people in HIV health care. In this wide-ranging interview, Dr. Sonnabend chats with Bob Huff of Gay Mens Health Crisis about HIV treatment, resistance testing and the right way to provide care to HIV-positive people.

    Sign-on Campaign Demands SMART Continuation; Deadline Feb. 3
    Last month, researchers announced they were stopping enrollment for the SMART study, a huge international trial that was hoping to find out whether a certain type of HIV treatment interruption (stopping treatment when CD4 count tops 350 and starting again when it drops below 250) could give people an occasional break from their meds. Although this particular strategy appeared to be a failure, many AIDS advocates are worried that people might get the wrong idea about SMARTs cancellation, and assume that theres no point in studying treatment interruptions further. The Center for AIDS Information and Advocacy, for instance, has circulated this sign-on letter demanding that SMART be continued: "This large, diverse, multinational study could still provide answers to valuable questions, even now that only the viral suppression arm remains," the letter reads. If youre interested in signing on to the letter, the deadline is Friday, Feb. 3; organizations and individuals alike are welcome to sign.



    Remembering HIV in the 1980s: How Stigma Made a Bad Situation Worse
    Ask any long-term survivor or veteran AIDS advocate what it was like to be HIV positive in the 1980s, and you're likely to hear a story that's dramatically different from the situation in much of the country today. If it weren't horrible enough that a then-untreatable disease was claiming thousands of lives, the stigma associated with the virus -- and the stigma of being gay -- combined to create a terrible situation. Houston advocate Tori Williams remembers just how awful those days were, especially for the gay community: "We wore t-shirts that said, 'Louie, Don't Shoot!' in response to a mayoral nominee who told the media that his solution to the AIDS problem would be to 'shoot the queers,'" she recalls.

    Prisoners and HIV: What You Can Do
    Are you a current or former prisoner living with HIV, or an advocate who may need to provide help to people who have been imprisoned? Given how spotty HIV care in U.S. prisons can be, there may be a lot you need to do to ensure that you (or your clients) get the best possible care. If you're a prisoner, that means taking every opportunity to educate yourself and seek out support. If you're an advocate, it means taking the extra step to improve your organization's services for current and former inmates. Laura McTighe of AIDS Treatment News offers more advice.



    How Does Oregon's Assisted Dying Law Affect the Rest of the U.S.?
    In January, the U.S. Supreme Court rejected an attempt by the federal government to strike down an Oregon law legalizing doctor-assisted death for terminally ill people. The court's decision is great news for advocates of the law in Oregon, but what effect could it have elsewhere in the country? Barbara Coombs Lee, president of Compassion and Choices, an organization that strongly supports the law, explains.



    AIDS Is Leading Cause of Death for Young, Black Women in U.S.
    AIDS is the most common cause of death among African-American women in their late 20s and early 30s, researchers say -- but you'd never know it from how little public attention the issue receives. "Part of what's staggering is that most Americans -- including young women, and young black women in particular -- are unaware of this fact," said the head of public policy for the American Foundation for Aids Research. "How we've got there is probably the result of some neglect in recognising who's really at risk in this country." (Web highlight from BBC News)

    In Palm Beach, African-American HIV Rates Are Higher Than Usual
    Black Palm Beach County residents are more likely to be infected with HIV compared with blacks nationally and statewide. By Dec. 31, black residents comprised 15.1 percent of the county population but 64 percent of county AIDS cases. Nationally, blacks represented 12.3 percent of the population but 40 percent of AIDS cases in 2003, according to official U.S. statistics. A top health official in the county said that homophobia and stigma complicate a difficult situation: "We have to talk about it openly so we get to the point where it becomes a manageable, treatable disease," she said.

    Sex Workers and the Spread of HIV: What's the Real Story?
    How much of a role do sex workers really play in HIV's spread? Sex workers have historically been blamed for being a source of HIV infection, but the reality may be different. Unfortunately, it's hard to know for sure either way: In much of the world, sex work is illegal, heavily stigmatized and given little attention by public health officials or researchers. Still, there is much we do know about the intersection between HIV and sex work throughout the world. HIV treatment educator Luis Scaccabarrozzi provides an overview.



    What Does HIV Prevention Have to Do With Yogurt? More Than You Might Think
    Researchers are working on a whole range of ideas on how to help people avoid HIV infection. One of the more unexpected ideas involves yogurt -- at least indirectly. An international team of scientists have revealed that they may be able to take a bacteria that lives naturally in yogurt and turn it into an HIV fighter. According to a recent study, the researchers were able to engineer the bacteria to pump out a protein that binds to HIV and prevents it from infecting a person's mucous membranes. It's only been proven in lab studies, though; the next step is to see if the modified bacteria can work in people. If it does, it could result in the development of a new type of microbicide (a gel or other product that can prevent the sexual transmission of HIV). (Web highlight from Brown University)

    The Australian radio program PM recently interviewed one of the researchers involved in this study to talk about its findings. Click here to read the transcript.

    HIV Prevention in New York City's Sex Club Circuit
    New York City, long famed for its nightlife, is teeming with private sex parties and sex clubs: Roughly 70 of them operate in the city. HIV prevention efforts at these gatherings have been tried off and on throughout the years; last year, the AIDS group Positive Health Project said that it had begun its own efforts to do so. The agency now supplies condoms and HIV prevention information to eight private parties. In helping educate people at these parties, health experts have expressed surprise at just how ignorant many people remain about HIV. Believe it or not, many younger men "are still foggy about HIV transmission," said one health worker.



    Mass. Governor Pushes for On-Demand HIV Testing for Suspects Accused of Sexual Assault
    Massachusetts Gov. Mitt Romney has filed a bill that would require "on-demand" HIV testing for suspects accused of rape or sexual assault if the survivor requests it. The bill would allow survivors to request the test if the alleged assailant has been indicted for, or formally charged with, the crime. The bill also would require the state's Office of Victims Assistance to form a proposal for keeping testing information confidential. Some lawyers and AIDS advocates are criticizing the measure, saying it would take away suspects' privacy rights, while doing little to provide useful information to rape and sexual assault survivors. Massachusetts is one of five U.S. states without such a law in place.



    New Amex Credit Card Will Donate 1% of Charges to Global Fund
    In late January, rock star Bono joined American Express and three leading fashion companies to launch Product RED, a business partnership aimed at increasing global spending to fight HIV. One of the centerpieces of Product RED is American Express' new "RED Card," which plans to draw on the spending power of "conscience consumers" in wealthy Western countries. One percent of money that customers spend on the card will be donated to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    For much more on Product RED, visit the campaign's official Web site.



    Time to Break the Logjam on Ryan White, Advocate Says
    Thanks largely to a pair of Supreme Court vacancies and a devastating hurricane on the Gulf Coast, much of the U.S. Congress' other work was put on hold during the second half of 2005 -- including some important work related to helping people with HIV. For instance, the Ryan White CARE Act, which sets many of the rules for who receives federal HIV-related funding (and how much they get), expired back in September 2005, and has yet to be reauthorized. As Jeff Graham of Georgia's AIDS Survival Project explains, there is still an awful lot that America's government officials need to do on the HIV front in 2006 -- not only in his home state, but throughout the country as well.

    Treating the World's HIV-Positive Children
    It's been about 10 years since the United States began to virtually eliminate the risk of mother-to-child HIV transmission and save the lives of many HIV-positive children in the United States, thanks to regular testing of pregnant women, specialized treatment procedures and the introduction of combination HIV therapy. But while HIV among children is almost a non-issue in developed countries, thousands upon thousands of children continue to die in poor countries because they can't get access to the same meds we've come to take for granted. What the heck is going on, and how do we bridge this inexcusable treatment gap? Pediatric medicine expert Dr. Mark W. Kline offers this analysis.

    In Developing Countries, When to Switch Depends on What You Can Switch To
    In resource-rich countries like the United States, doctors have plenty of tools at their disposal to figure out whether a person needs to switch HIV meds, including resistance testing and frequent CD4 count and viral load tests. Rich countries also offer HIVers plenty of options as far as what meds to switch to. In much of the developing world, doctors are not so lucky: Regular lab tests are an expensive luxury (and in many cases aren't even possible), and there may not be many other meds available. So how can a doctor in a developing country figure out whether someone needs to switch treatment? Bob Huff of Gay Men's Health Crisis examines the issue.

    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2004 Visual AIDS Web Gallery
    "House of Cards," 1986;
    Ken Goodman
    Visit the Visual AIDS Web Gallery to view a monthly collection of art by HIV-positive artists! The image above is from the December 2004 gallery.

    The February 2006 Web Gallery is also available: It's entitled "Nineteen Penises" and is curated by David Humphrey.

    Connect With Others
    t The Body's Bulletin Boards

    For Newly Diagnosed Parents, the World Is Falling In
    (A recent post from the
    "I Just Tested Positive" board)

    "Both my wife and I have just learned that we are HIV positive. It was a routine blood test. ... We are of course upside-down with lots of tears. Our 14-year-old daughter looks at us like all is lost. It's only day one."

    -- Anonymous

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

    HIV/Hepatitis C-Coinfected and Looking for Others to Talk To
    (A recent post from the
    "Gay Men With HIV" board)

    "I've been HIV positive and hepatitis C positive for more than a year now ... and finally feel like I'm sorta OK with it. I never really got freaked out by the whole thing -- I wasn't happy or anything like that, but I didn't get angry or upset, really. I just kinda hunkered down and got in touch with how I felt about it. Now I feel like I want to talk to others who are in my situation [so I can] start to get back to a more normal sense of self ... if that makes any sense at all. So are there any other coinfected people out there who want to share their experiences?"

    -- esjayem

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


    Last week's e-mail update included a story about a medication being developed by Bristol-Myers Squibb Company and Gilead Sciences, Inc., that may allow people to take an entire HIV treatment regimen -- efavirenz (Sustiva, Stocrin) + FTC (emtricitabine, Emtriva) + tenofovir (Viread) -- in a single pill taken only once a day. The story incorrectly stated that a study had found that the once-daily pill was more likely to reduce a person's viral load than a more traditional regimen that consists of several pills taken more than once a day.

    In fact, the study did not examine the once-daily pill; no studies have yet compared the pill to other HIV treatment regimens, and the pill itself remains in development. The study in question did examine a regimen consisting of the three once-daily medications that are being combined into the new pill, but the meds were taken seperately, not as a single pill.