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February 8, 2006

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

    Interviews, Profiles, Podcasts and More: The Body's African-American HIV/AIDS Resource Center
    Want to know what the United States' African-American leaders have to say about the growing HIV epidemic among black people? Want to meet some of the courageous HIV-positive African Americans who are speaking out about a disease that remains heavily stigmatized? Want to know what you can do to make a difference? To mark this year's National Black HIV/AIDS Awareness Day, The Body has launched a brand-new African American HIV/AIDS Resource Center filled with articles, podcasts, one-on-one interviews and resource listings. The center offers an inside look at the stark reality behind the staggering statistics, as well as the progress that's being made by African Americans with HIV and their advocates. (This resource center was created with support from Reyataz.)

    Towns, Cities Throughout U.S. Observe National Black HIV/AIDS Awareness Day
    No public health crisis should have only a single day devoted to it, but better one day than none. Feb. 7 marked the sixth annual U.S. National Black HIV/AIDS Awareness Day, which is held to urge greater public awareness of the worsening epidemic among African Americans -- and to encourage African Americans to get tested for HIV, learn more about how HIV is transmitted, get involved in local HIV programs and get access to treatment if they're HIV positive.

    HIV Rates Among Blacks in New York City "Startling"
    AIDS advocates in the African-American community have been sounding the alarm for years, but only now is the media starting to take notice: The New York Times reported over the weekend that black people in New York City are becoming infected and dying at "startling rates." New statistics, released at the end of 2005, show just how frightening the situation has become: Not only is HIV alarmingly common among black New Yorkers (one in five black men between the ages of 40 and 49 is living with HIV), but African Americans are also far more likely to die from HIV than their white counterparts -- nine times as likely if they're women, six times if they're men. City health officials say a radical rethinking of anti-HIV efforts is needed to make a dent in this worsening crisis.

    For more on the steps that top New York City health officials have proposed to help stem the city's tide of HIV infection and AIDS-related deaths, read this article, which we also summarize in the "HIV-Related U.S. Policy Issues" section of this newsletter.



    Even in the 1980s, Middle-Aged Women Got HIV
    Jennifer Newcomb-Fernandez's mother was infected with HIV in 1986, at a time when people believed it was virtually impossible for a middle-aged, non-drug-using woman to get the virus. "My mother was so ashamed of her disease she couldn't even tell her children. For years after her death, I would lie about how she died. I would mutter 'cancer' when people asked. The obvious grief on my face stopped them from asking more." Newcomb-Fernandez's personal story shows just how much stigma impacts all the people affected by HIV in the United States -- but it also shows how tragedy has the power to ultimately transform a person's life for the better.

    Hormone Supplement May Reduce Depression in Some HIVers
    A new report suggests that supplements of DHEA, a steroid that occurs naturally in people, may alleviate the symptoms of minor depression in HIV-positive patients. DHEA, or dehydroepiandrosterone, is an unregulated steroid-like dietary supplement used for a variety of purposes. Some believe that DHEA supplements can help build muscles, reduce abdominal fat, improve blood sugar levels and fight aging.

    Want to learn more about DHEA? Check out this fact sheet from AIDS InfoNet.



    Experts Debate Role of HIV Treatment Interruptions in Wake of SMART Study Cancellation
    HIV treatment holidays: Are they dead, or just resting? That's been a heated topic of discussion at one of the biggest HIV-related medical conferences of the year, the 13th Conference on Retroviruses and Opportunistic Infections, which has taken place from Feb. 5 to Feb. 8 in Denver, Colo. It was only a few weeks ago that the SMART study, the largest-ever clinical trial to examine a type of HIV treatment interruption, was unexpectedly stopped when researchers discovered that the specific type of interruption strategy explored by the study appeared to cause more harm than good. The revelation has left many scientists and AIDS advocates debating the merits of treatment interruptions, and wondering just how much of a role they should have in an HIV-positive person's care.

    Want to learn more about the SMART study and the reasons why it was cancelled? Read this Q+A fact sheet from the U.S. National Institute of Allergy and Infectious Diseases.

    Hepatitis C Drug in Development Appears Highly Successful in Clinical Trial
    A 12-person study on VX-950, an experimental drug to treat hepatitis C infection, found that when the drug is combined with existing hepatitis C meds, it reduced hepatitis C viral load to undetectable levels within 28 days in all of the people who received it, without causing any severe side effects. The current "gold-standard" hepatitis C treatment regimens are generally successful only around half the time. If VX-950 holds up to further scrutiny (there are some concerns that hepatitis C can develop resistance to it), researchers hope it will result in more potent, less toxic regimens that only need to be taken for three months, as opposed to the six-to-11-month course of therapy usually prescribed to people with hepatitis C.



    Small Study Suggests That HIV Med Combination May Prevent Rectal HIV Transmission in Monkeys
    Monkeys injected with a version of Truvada (tenofovir/FTC) appear to be completely protected from infection with HIV, according to the results of a small pilot study presented at the 13th Conference on Retroviruses and Opportunistic Infections. Each day for 14 days, the monkeys were injected with the modified Truvada formulation and then exposed rectally to SHIV, a monkey-human HIV hybrid; Truvada treatment continued for four weeks after the last exposure. The six monkeys that received the drug injections did not become infected with SHIV, while nine monkeys used in a previous experiment eventually all became infected. Studies are now underway to see whether these findings may apply to humans as well.

    U.S. Pediatricians' Group Urges Doctors to Push for Needle-Exchange Programs
    Needle exchange has been proven countless times to help prevent new HIV infections, yet the U.S. government remains intransigent in its refusal to condone the practice. However, although Congress has banned federal funding for needle-exchange programs, 36 states and the District of Columbia have instituted such life-saving programs. Perhaps needle-exchange might become more widely accepted if more groups did what the American Academy of Pediatrics did this month: The organization released a policy statement in which it urged all pediatricians to publicly voice support for needle-exchange programs to curb the spread of HIV among injection drug users.

    Vancouver's Safe-Injection Site Doesn't Cause More Drug Use, Studies Find
    One of the chief arguments against needle-exchange programs has been that they encourage unsafe behavior and condone the use of illegal drugs. But for years now, Vancouver, Canada has operated a facility that not only offers needle exchange -- it actually helps drug users inject their drugs safely right on the premises. It's the end of the world as we know it, right? Wrong: Two newly published studies say that Vancouver's supervised-injection site has not exacerbated drug use among its clients, and it has not enticed former injection drug users to relapse. "It's no secret that when this facility opened there were many people who expressed the fear that this would make drug use in the community worse," said a co-author of one study. "Certainly the results to date are very encouraging."

    Rare Chlamydia Strain May Increase Men's HIV Risk in U.S.
    A strain of chlamydia called lymphogranuloma venereum (LGV), which is rarely seen outside Africa and Southeast Asia, appears to be spreading among men who have sex with men in the United States, increasing the risk of HIV transmission, according to health officials and specialists. U.S. health officials have confirmed 27 diagnoses of LGV since last year, but specialists say the actual number of LGV cases in the United States is unclear because it is difficult to diagnose and few clinics and laboratories are able to test for the strain. The disease can be treated with antibiotics, but if it goes undiagnosed, it can cause severe stomach problems and even genital or rectal disfigurement, which can put men at a much higher risk for contracting other sexually transmitted diseases, like HIV.

    For more information on LGV, including a description of possible symptoms, visit The Body's collection of LGV articles.



    State of the Union: Bush Urges Ryan White Reauthorization, Pledges Support for Anti-HIV Efforts Among Blacks
    U.S. President George W. Bush talked about domestic HIV issues during his State of the Union address on Jan. 31, as he called on Congress to reauthorize the Ryan White CARE Act and increase funding for AIDS Drug Assistance Programs so that states can eliminate waiting lists for HIV-related medications. Citing the disproportionate impact of HIV on African Americans, Bush also said he would lead a nationwide effort to work with black churches and faith-based groups to "deliver rapid HIV tests to millions, end the stigma of AIDS and come closer to the day when there are no new [HIV cases] in America."

    Bush's New Budget Proposal Boosts Funding at Home and Abroad
    Less than a week after President Bush's State of the Union speech, the White House released its proposed fiscal year 2007 budget -- a budget that includes funding increases for some HIV-related efforts at home and abroad. The proposed budget includes approximately $4 billion for the fourth year of the President's Emergency Plan for AIDS Relief. Of that funding, $300 million would go to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Bush's budget proposal also includes $188 million for a new Domestic HIV/AIDS Initiative, $95 million of which would be provided through the Ryan White CARE Act for treatment and outreach and $93 million for increased testing among high-risk people.

    Despite Proposed Funding Increases, AIDS Advocates Are Still Concerned
    President Bush's budget proposal "falls short of what is needed to respond effectively to this country's growing and changing epidemic," said the prominent U.S. AIDS advocacy group AIDS Action in a statement. Although Bush's pledge of new funding is most welcome, AIDS Action says, it is not enough to offset the growing strains on the country's ability to provide treatment to HIV-positive people who need it.

    New York: Overhaul Urged for Laws on AIDS Tests and Data
    New York City's Health Commissioner, who has been among the most vocal critics of the city's HIV testing regulations, has released a set of proposals that would overhaul HIV testing consent and medical privacy laws in New York. Developed in the 1980s, the state laws were meant to shield the identity of patients and encourage testing when the disease and HIV/AIDS patients were greatly stigmatized. The commissioner, Dr. Thomas Frieden, says that the city's strict privacy rules are an obstacle to testing and make it harder to help HIV-positive people find effective treatment. Among other steps, he's pushing for HIV testing to become a routine part of medical care; to allow verbal instead of written consent to HIV testing; and to allow public health officials to consult directly with patients and their doctors.



    Slow, Solo Crossing of the Atlantic Is One Man's Response to World's AIDS Crisis
    Armed only with a 24-foot boat he constructed with his bare hands, 41-year-old New Yorker Victor Mooney is getting ready to do something that most other people would never even consider: Row himself across the Atlantic Ocean. The reason? To increase awareness about HIV prevention -- and, he hopes, to raise a million dollars for the global fight against HIV. It's not just activism that drives him, though; Mooney lost a brother to AIDS in 1983, and has another brother who's living with the virus. Mooney, a Roman Catholic, is a supporter of abstinence but is out to promote all aspects of HIV prevention. HIV "is too serious to restrict to one set of beliefs," he said. "This is killing blacks, whites, Latinos. People understand that." Mooney's eight-month, 8,000-mile journey is set to begin off the coast of Senegal sometime in March. (Web highlight from The New York Times)



    U.S. to Permit HIV-Positive Foreigners Into Country for Gay Games
    Most people are probably unaware that the United States still has harsh laws that forbid people with HIV to enter the country. (If you're wondering why it's been more than 15 years since the United States hosted an International AIDS Conference, now you know.) Every now and then, though, the U.S. government issues temporary waivers permitting HIVers to stay here legally. The Gay Games 2006 (an Olympics-style event held specifically for non-straight people) are the latest example of this temporary benevolence: The U.S. government has announced that foreigners taking part in the games, which will take place this summer in Chicago, are allowed to do so even if they have HIV. This actually marks the second time such a waiver has been granted; the same thing occurred in 1994 for the New York City Gay Games. (Web highlight from The Advocate)

    ADAP Waiting Lists Drop to 954 People, but Now Exist in 10 States
    The number of HIV-positive people unable to receive medications because they're on an AIDS Drug Assistance Program (ADAP) waiting list stood at 954 as of Jan. 18, according to the latest ADAP Watch. That number marks a sharp decrease from the 1,579 individuals on waiting lists two months earlier. However, the number of states instituting waiting lists increased from nine to 10 with the recent addition of Indiana. A growing number of states have also capped the number of individuals who can receive T-20 (enfuvirtide, Fuzeon) through ADAP, and funding for many programs remains tight.



    Brazil to Hand Out 25 Million Free Condoms During Carnival Festivities
    The parties! The costumes! The food! The debauchery! The ... condoms? The Carnival season is fast approaching, and some governments are taking steps to ensure that HIV transmission isn't a part of the festivities. In Brazil, for instance, the government plans to distribute 25 million free condoms to merrymakers -- more than double the 11 million condoms it gave out last year. That might seem like a lot of rubber, but it's just a drop in the bucket compared to the 1.5 billion condoms Brazil plans to distribute during the course of the year.

    U.S. Provided HIV Treatment Access to 471,000 in 2005, Report Says
    Nearly half a million people worldwide received free HIV medications from the United States in 2005, according to a Wall Street Journal report. U.S. officials point to the numbers as proof that the Bush administration is making significant efforts to help HIV-positive people in developing countries; the United States hopes to get treatment to an additional 400,000 people before the current fiscal year ends.

    Also Worth Noting

    Profiles in Courage
    Inspiring Stories From HIV-Positive African Americans

    Mel Byrd
    Nobody knows that Mel Byrd has HIV. Not because he's afraid to tell anybody, he says -- it's just that there's nobody to tell.

    A self-described loner, the thoughtful, well-spoken systems engineer from Texas has always turned inward for solace and understanding. Whether it was dealing with intense racism as a black kid growing up in rural Texas, or coping with an HIV diagnosis that blindsided him even though he realizes he should have known better, Mel has always kept his own counsel, looking to himself for the healing he needed.

    But lately, as he has come to terms with his HIV status and his situation in life, Mel has started to come around: "More and more recently, I've felt very much that I don't want to be anonymous anymore," he says.

    So Mel contacted The Body and offered to share his story. We're honored to present it, along with 10 other profiles in courage, in our new African-American HIV/AIDS Resource Center.

    Breaking Research
    Get the Latest Developments
    From CROI 2006

    CROI 2006: Denver, Colo.; Feb. 5-8, 2006
    Check in at The Body beginning Thursday, Feb. 9, for in-depth, expert coverage of one of the most important HIV-related medical conferences of the year: the 13th Conference on Retroviruses and Opportunistic Infections (CROI 2006). Our team of top HIV physicians will provide recaps and explanations of key studies presented at the conference, including new developments in HIV medications, treatment strategies, HIV prevention and the management of HIV-related health problems. Bookmark our CROI 2006 home page and check back often for the latest research!

    Connect With Others
    t The Body's Bulletin Boards

    How Do I Maintain Hope When I've Got Major Drug Resistance?
    (A recent post from the
    "Living With HIV" board)

    "I have been taking meds for three years now, and phenotype and genotype testing has shown I have extreme resistance. I think I may have one regimen that may work, and it would include Fuzeon. ... I'm just trying to remember we are not guaranteed any amount of time on this planet, and to keep on plowing forward [while] keeping the right attitude. If anyone has resistant virus and has been or is going through what I am, it would be nice to hear from you."

    -- breathe

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

    My HIV Meds Are Working, But for How Long?
    (A recent post from the
    "I Just Tested Positive" board)

    "Nothing has been "normal" for me since Aug. 23, 2005 at 9:30 a.m., when I was diagnosed. My HIV was discovered by accident. .... Long story short, my first set of labs came back with my CD4 count at 280 and my viral load at 86,000. My doctor recommended I start meds. ... It took me two weeks to take the prescription to the pharmacy. ... My second labs on Oct. 31 were CD4 count 330 and viral load undetectable. My third set of labs on Feb. 16 were viral load undetectable and CD4 count 651! My doctor told me ... to go live my life, but be careful and take my meds! He said that there is nothing wrong with me and I am perfectly healthy. ... So what happens now? Just keep taking my meds and living? How long will this last? I keep waiting for the other shoe to drop, so to speak. I feel so very blessed that my numbers are the way they are, but is it just a fluke?"

    -- hellfire72

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

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2003/January 2004 Visual AIDS Web Gallery
    "I've Known Rivers," 2003;
    Kenneth Mitchell
    Visit the Visual AIDS Web Gallery to view a monthly collection of art by HIV-positive artists! The image above is from the December 2003/January 2004 gallery.

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