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March 1, 2006

In This Update:
  • U.S. HIV Policy & Medicare Coverage
  • HIV Treatment
  • Complications of HIV & HIV Treatment
  • HIV Rates in the U.S.
  • HIV Prevention & Testing
  • HIV Outside the United States
  •   U.S. HIV POLICY & MEDICARE COVERAGE

    Ryan White Reauthorization Bill Submitted; Advocacy Group Responds
    At long last, the U.S. Senate is finally moving toward reauthorization of the Ryan White CARE Act, the law that funds medical care and treatment for more than half a million low-income or underinusred people with HIV in the United States. This week, a bill to reauthorize the act was submitted to the Senate -- and AIDS advocates were quick to respond. The AIDS advocacy group AIDS Action Council issued this statement criticizing some of the significant changes proposed in the Ryan White reauthorization bill, which include a new formula for government AIDS spending and a modest increase in funds for AIDS Drug Assistance Programs.

    Some of AIDS Action's concerns have been echoed in a statement by the American Academy of HIV Medicine, a large membership organization for HIV health providers. While the academy hails this renewed effort to reauthorize the act and approves of some of its provisions, it also expressed concerns about changes in funding and HIV reporting methods.

    For much more on Ryan White reauthorization -- from background info to the latest news and statements -- be sure to check out The Body's collection of articles and resources.


    Having Trouble With Medicare Part D?
    Since its launch in January, the new Medicare prescription drug plan has been riddled with problems. Complaints abound about people having trouble getting their prescriptions filled, being forced to shell out exorbitant copays or receiving spotty drug coverage. Have you had any trouble getting access to the HIV-related meds you need since your Medicare drug plan started? Read this message from AIDS Action Council explaining who you should contact, and what you should tell them.

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      HIV TREATMENT

    Stopping Medications in an Emergency: A Guide for People With HIV
    There are many lessons we can take away from Hurricane Katrina, but for people with HIV, one of the most important is this: There are some critical things you need to know if, for any reason, you suddenly find yourself evacuated from your home and running out of your meds. Read this brief guide from The Center for AIDS for some important tips.


    Avoiding HIV Treatment Scams, Denialism and Misinformation
    They infest your e-mail accounts, sully the Web and clutter up the shelves of bookstores: Misleading, potentially dangerous theories about HIV medications and so-called "cures" for AIDS. Unfortunately, denialism and conspiracy theories about HIV are common -- they're an easy way for some people to create hard-and-fast answers where none truly exist. To help you be aware of potentially harmful HIV/AIDS information, The Center for AIDS has put together this fact sheet on misleading books and Web sites, along with a list of tips on how to evaluate the trustworthiness of the information you read.


    Immune-Based Therapy and Therapeutic Vaccines: A Long Way to Go
    HIV medications will no doubt remain the primary method of HIV treatment for years to come. But two experimental treatment methods -- known as immune-based therapy and therapeutic vaccines (both of which try to strengthen the body's immune system, rather than attack HIV directly the way HIV meds do) -- continue to be studied. As Dr. Keith Henry reports for The Body, there is still much that researchers have to learn before immune-based therapies are ready for prime time.

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      COMPLICATIONS OF HIV & HIV TREATMENT

    Cardiovascular Risk and Antiretroviral Therapy
    First, the bad news: Evidence clearly suggests that HIV-positive people taking HIV meds may be at an increased risk for developing heart problems. Next, the good news: The rate of heart problems in HIVers has actually decreased during the last couple of years. This is probably thanks to the use of newer medications and more aggressive management of some of the main causes of heart disease in people with HIV -- such as smoking, hypertension and lipid (cholesterol/triglycerides) levels. In this article, The Body's Dr. Pablo Tebas reviews the latest studies on this critical issue from the 13th Conference on Retroviruses and Opportunistic Infections.


    Does Tenofovir Cause Kidney Problems? New Studies Suggest Little Effect, if Any
    A range of studies presented at the 13th Conference on Retroviruses and Opportunistic Infections sheds relatively little new light on a vexing question: Does tenofovir (Viread) increase a person's risk for developing kidney problems? As Dr. Ben Young reports for The Body, the largest studies indicate that tenofovir has little to no effect on the kidneys, but there may be groups of people who are at higher risk. The bottom line: Anyone taking tenofovir or Truvada (tenofovir/FTC) should make sure that their doctor keeps an eye on their kidney function, just in case.


    Lymphoma and HIV: It's OK to Receive HIV Meds at Same Time as Chemotherapy, Study Finds
    For many years now, doctors have been skittish about prescribing HIV meds to a person who has both HIV and lymphoma. One of their main concerns has been that the drugs used to treat lymphoma might dangerously interact with HIV medications. However, according to a relatively small study conducted by German researchers, these fears are unfounded: HIVers with non-Hodgkin's lymphoma who continued taking HIV meds while on chemotherapy appeared to do just as well as HIV-negative people who only received chemotherapy. (Web highlight from aidsmap.com)


    Cancer and HIV: Studies Investigate Potential Links
    Does having HIV put you at greater risk for cancer? The answer, based on a number of studies, seems to be yes. But how much of a risk remains an ongoing question. As Dr. Mark Wainberg reports for The Body from the 13th Conference on Retroviruses and Opportunistic Infections, researchers are still trying to determine whether cancer somehow develops differently in people with HIV -- and if so, how. Studies are also being done to figure out whether HIV medications can slow or prevent the occurrence of cancer in people with HIV.

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      HIV RATES IN THE UNITED STATES

    Latina Immigrants Are Rapidly Becoming the New Face of HIV in California
    When we talk about HIV in the United States, it's easy to be numbed by numbers: For instance, it's old news by now that the number of Hispanic women with HIV has been rising in California. But when you take a closer look at the faces behind those numbers -- as the Los Angeles Times recently did in a report on Latina immigrants -- you can begin to understand why HIV remains such a pervasive, devastating problem in the United States. This is especially true among Latinas, for whom the virus still carries a crushing amount of stigma and fear. (Web highlight from the Los Angeles Times; free registration required)


    Radio Series Examines HIV in Washington, D.C.
    It's a cruel irony that, of all of the cities in developed countries that have been hit hard by HIV, one of the hardest hit is the capital of the most powerful country in the world: Washington, D.C. In late February, a D.C.-area radio news station produced a series of brief reports on the capital city's epidemic. Segments in the series (which are available in RealPlayer and MP3 formats) examine some of the underlying reasons behind the spread of HIV through the city; the increasing number of black women with HIV; the stigma of HIV in black communities; the challenges of negotiating condom use; President Bush's efforts to fight HIV; and efforts to prevent and treat HIV in Washington, D.C. (Web highlight from WTOP)


    On Long Island, HIV Numbers Reflect a Shifting Trend
    Although the number of people newly diagnosed with HIV has been dropping on Long Island, N.Y., since 1995, the overall number of people living with HIV in the area continues to rise -- and the demographics of the disease are changing. Over the last few years, African Americans and Latino/as have comprised a larger number of new HIV cases, as have young people, women and men who have sex with men. Since many HIVers are also poor, their growing numbers have some health officials worried that public hospitals, health facilities and nonprofit groups may find it harder and harder to support them with dwindling government funds.

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      HIV PREVENTION & TESTING

    "How I Joined the Sex Police"
    As a gay man coming of age in the 1970s, sex clubs were an important part of Mark Milano's sexuality. But as an AIDS activist in New York in the 1990s, his view changed dramatically: Since then, Mark has discovered just how difficult it can be to toe the line between being an advocate for sexual freedom and an advocate for safer sex in the city's sex clubs. In this fascinating article, he recounts how he tried -- and failed -- to stop unsafe sex in New York City's gay sex clubs.


    In Florida, Experts Recommend HIV Testing for Everyone
    At a recent medical conference in Florida, experts urged health care professionals to make HIV testing a routine part of medical care for all of their patients. HIV testing is still not part of standard medical care in the United States, and many doctors don't ask their patients to get tested for HIV, especially if they don't "appear" to be at risk for HIV because of their age or other factors.


    Tenofovir for HIV Prevention: Worldwide Studies Seek Some Answers
    With an effective HIV vaccine still just a glimmer on the horizon, and with HIV rates holding steady or growing in many parts of the world, the need for new HIV prevention methods is obvious and urgent. Over the past few years, researchers have seen tantalizing clues that some HIV medications -- which are taken by people who already have HIV -- may have the potential to help HIV-negative people avoid infection in the first place. One HIV medication in particular has received a lot of attention as a possible HIV prevention tool: tenofovir (Viread). In fact, a global series of clinical trials -- including sites in Atlanta and San Francisco that are enrolling HIV-negative men who have sex with men -- is now underway to figure out whether tenofovir can be safely used for just such a purpose. To learn more, read this overview from the U.S. Centers for Disease Control and Prevention.

    For additional news and info on the investigation of tenofovir as a potential tool for HIV prevention, read this collection of articles compiled by The Body.

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      HIV OUTSIDE THE UNITED STATES

    Africa Struggles to Spend Billions in AIDS Funding
    Although for years the focus on fighting HIV in Africa has been on getting rich countries to donate massive amounts of money and resources, now that the cash is finally coming in, another problem has become increasingly clear: Many countries aren't capable of handling all that funding. Disorganized government departments, fledgling community groups and unstable health care systems are all causing bottlenecks in spending that prevent resources from getting to where they're most needed, experts say. These problems help explain why, although global AIDS funding has jumped from $250 million a decade ago to more than $8 billion last year, barely 10 percent of Africans in need of HIV meds are receiving them.


    Clamoring for Circumcision, Men Stampede Clinic in Swaziland
    Circumcision has recently gained popularity in Swaziland, following the publication of a 2005 study showing that circumcised men in Africa are about 60 percent less likely than uncircumcised men to contract HIV from women during unprotected sex. In fact, men at an overbooked clinic in Mbabane were so eager to undergo the procedure that there was a stampede. Swaziland has the world's highest adult HIV rate -- 40 percent -- and one of the world's lowest circumcision rates. Scientists believe circumcision's value may be that it removes foreskin tissue that contains cells easily infected by HIV. The Family Life Association of Swaziland hopes the trend will inspire Swazi men to practice safe sex, but others are concerned that men could view circumcision as enough protection that they can safely forego using condoms.


    Schools Teach Survival to Africa's AIDS Orphans
    Thirteen-year-old Cinisile Mamba's parents died of AIDS before they could teach her how to raise crops on drought-stricken farmland -- a skill that can be as valuable as life itself in Swaziland, where Cinisile lives with her three younger siblings. Thankfully, Cinisile is getting a second chance: She and 24 other AIDS orphans are learning lessons in farming, personal hygiene, money management and HIV prevention through a UN program in Swaziland. The program has also set up similar schools in Kenya, Mozambique, Namibia and Zambia, and plans to ultimately teach 30,000 orphans. Swaziland has the world's highest HIV rate, and aid workers believe the epidemic has orphaned up to 100,000 Swazi children.

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    Also Worth Noting

    Movers and Shakers
    African-American Leaders
    Speak Out About HIV

    Sheryl Lee Ralph
    In Sheryl Lee Ralph's eyes, the HIV epidemic is eerily similar now to what it was two decades ago, except that the faces have changed: then, AIDS was known as a "gay disease"; now, it's one of the most urgent health crises facing African Americans. "What I experience now is the same sort of silence that I heard 20 years ago, when guys were dying on Broadway," says the highly successful actress and singer. "It's the same silence. The same unwillingness to talk openly about this disease."

    Among the countless celebrities who have spoken out about AIDS over the years, it was Ralph who was chosen last year to receive the United Nations' first-ever Red Ribbon Leadership Award in honor of her outstanding, outspoken activism since the beginning of the epidemic. She's also starring in a one-woman show, Sometimes I Cry: The Loves, Lives and Losses of Women Infected and Affected by HIV/AIDS, which opens this month in Los Angeles.

    The Body's interview with Sheryle Lee Ralph is one of many we've conducted with some of the most prominent African-American movers and shakers in politics, AIDS activism and entertainment. This "Movers and Shakers" feature is just one small part of The Body's new African-American HIV/AIDS Resource Center!

    Connect With Others
    A
    t The Body's Bulletin Boards

    Just Started Dating Again; Disclosure and Rejection
    (A recent post from the
    "Living With HIV" board)

    "My husband died five months ago of AIDS. I have been HIV positive for two years now. ... [When] he passed away, I figured that I would not have anyone else in my life. But recently I came across someone that I was interested in getting to know. ... But I knew that I had to tell this person about my status, because you can't start anything on lies and secrets. So last night, I told him, and he told me that he couldn't get involved with me because he has two daughters, and he and their mother don't really get along, and she would use this as an excuse to get back at him and not let him see his kids. ... I know that it's better to know now that he has issues ... [but I'm afraid] that it will be like this every time I tell someone that I am interested in. I can't deal with recurring heartbreak. Is the only option to just find someone that is positive like me? How do you deal with the pain?"

    -- moonstarchild

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

    Can't Get HIV Treatment in Indiana
    (A recent post from the
    "HIV Treatment" board)

    "I'm absolutely amazed with health care in this country. I have relocated to Indiana; I live on a low budget here. I applied to receive medication ... after two months of trying to get into their [HIV treatment] programs here, I am ... getting nowhere. In the interim I have run out of my meds, which I was provided while living in another state. ... It should be criminal to deny anyone health care in this country; it should be a right, not a luxury! ... I wonder how many have died lost in a mountain of paperwork and bureaucracy. ... I would love some guidance, feedback, suggestions [on] what the heck I can do to stop this, not only for myself, but for all the others who would have to face this stress."

    -- Anonymous

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

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the March 2006 Visual AIDS Web Gallery
    "Fear," 1998; Nancer LeMoins
    Visit the March 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The newly launched March 2006 Web Gallery is entitled "Anti-Bodies"; it's curated by Michael Sappol, a curator-historian at the U.S. National Library of Medicine.