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March 29, 2006

In This Update:
  • HIV Policy in the U.S.
  • HIV Treatment & Health Complications
  • HIV Transmission & Prevention
  • HIV Outside the U.S.

    Medicare Nightmare: An Update on the New Prescription Drug Plan
    As most everyone knows by now, the rollout of the United States' new "Part D" Medicare prescription drug plan has not gone smoothly. Many people with HIV have been mistakenly forced to pay considerably more for their meds than they should, and some have been wrongly barred from receiving certain HIV meds. In this in-depth report, John James of AIDS Treatment News explains what has gone wrong with the Medicare prescription drug plan, and what you can do about these problems if you're currently signed up.

    U.S. Begins Testing Radio Tracking to Prevent Counterfeit Drugs
    Selling drugs is one of the world's most lucrative businesses -- and so is drug fraud. The more expensive the drug, the more alluring it is to counterfeiters, and HIV meds are among the more expensive drugs on the market today. Cases of counterfeit HIV meds have popped up in the United States over the past few years, but the government and drug companies are beginning to use technology to fight drug fraud. One method involves putting radio frequency tags on drug packaging -- a strategy that may curb counterfeiting but has also raised concerns among privacy advocates. John James of AIDS Treatment News provides the details.

    The HIV med Trizivir (AZT/3TC/abacavir) is about to be used to test this new radio-frequency method of anti-counterfeiting. Trizivir is listed by the National Association of Boards of Pharmacy as one of the 32 drugs most prone to counterfeiting and "diversion," which happens when a shipment of drugs is stopped before it gets to its destination (usually somewhere in the developing world) and resold elsewhere at a higher price.



    HIV Treatment With a Single Medication: Is There a Future for "Monotherapy"?
    Modern HIV treatment, which combines three or more meds into a regimen, has transformed HIV into a chronic, treatable disease. We've come an awfully long way from the earliest years of HIV treatment, when only a single drug was available, and success rates were extremely low. Yet lately, researchers have begun to wonder if it might be worthwhile to consider resurrecting the single-drug approach. Is there really a place for "monotherapy" in today's world of HIV treatment? Bob Huff investigates in this report for San Francisco AIDS Foundation.

    Possible Interaction Between Addiction Treatment Drug and Atazanavir + Ritonavir
    A drug known as buprenorphine, which is increasingly being used as a step-down drug for people recovering from heroin addiction, may interact with a combination of the HIV meds atazanavir (Reyataz) + ritonavir (Norvir), researchers have found. Doctors in Connecticut have reported three apparent cases of interactions between these drugs, which has caused side effects like grogginess and dizziness. (Web highlight from

    Coinfection With Hepatitis Viruses and HIV
    Hepatitis is one of the most common coinfections among HIV-positive people: Experts estimate that more than a third of all HIVers also have hepatitis C (which is most commonly spread through shared needles), and that between 70 and 90 percent of HIVers have at some point been infected with hepatitis B (which can be spread through unprotected sex). All these facts make it critical for HIV-positive people and their doctors to learn as much as possible about the effect these viruses have on each other and on HIV treatment. This in-depth resource for health professionals, written by a University of California-San Francisco physician, provides a detailed overview of diagnosing and managing HIV/hepatitis B and HIV/hepatitis C coinfection. (Web highlight from HIV InSite)



    CDC Expands Studies to Test Tenofovir, FTC as HIV Prevention Pills
    A third U.S. city will join Atlanta and San Francisco in a major study to test whether certain HIV medications can prevent HIV as well as they can treat it. The U.S. Centers for Disease Control and Prevention (CDC) made the decision after seeing positive, long-term results from a monkey study involving an injected version of two HIV meds: tenofovir (Viread) and FTC (emtricitabine, Emtriva), which are sold together in a combination pill, Truvada. The injected meds completely protected all six of the monkeys who received them before repeated rectal exposures to a monkey-human form of HIV. The studies in Atlanta and San Francisco are currently testing only one of the two drugs, tenofovir, in HIV-negative men who have sex with men.

    For more on the potential use of tenofovir to prevent HIV infection, read The Body's collection of overviews, news articles and research reports.

    Black Men More Likely to Have Genital Herpes Virus, Alabama Study Finds
    African-American men are almost twice as likely as white men to be infected with type-2 herpes simplex virus, according to a new U.S. study. The study results may help explain why HIV rates are so much higher among African Americans than other ethnic groups, since experts say that people who are experiencing a genital herpes outbreak may be much more likely to become infected with HIV during unprotected sex. (Web highlight from

    Nucleic Acid HIV Test Detects Infections Earlier Than Standard Screening
    Experts currently recommend waiting at least two months after an HIV exposure before getting tested. But over the past few years, The Body and others have been reporting on a type of screening called "nucleic acid testing," which can spot HIV infection weeks earlier than standard HIV tests. The use of nucleic acid testing is slowly increasing in the United States, and is already changing the HIV prevention landscape by diagnosing people as quickly as possible after they've been infected. People tend to be at greatest risk for passing HIV to others during the earliest ("acute") stage of infection, when HIV viral load temporarily spikes and most people don't even know they have HIV yet.

    To learn more about recent research on nucleic acid testing, read this summary from The Body's Dr. David Wohl. The summary is part of a special year-end edition of HIV JournalView, a monthly publication for health professionals produced by The Body Pro. (U.S. doctors and nurses can earn CME/CE credit for reading this article.)



    WHO's Final "3 by 5" Report Notes Failures and Successes
    The final tally is in: The World Health Organization (WHO)'s "3 by 5" plan to treat three million HIVers in the developing world by the end of 2005 failed even to reach the halfway point. A total of 1.3 million HIV-positive people in poor countries were receiving meds through the program when 2005 ended, the WHO says in a new report. Although the initiative fell short of its ambitious goals, the WHO notes that the situation in the developing world has improved by leaps and bounds since just a couple of years ago, and that the help it provided in 2005 saved between 250,000 and 350,000 lives. Still, only about 17 percent of HIV-positive children under age 15 in developing countries who urgently needed meds were receiving them, and less than 10 percent of HIV-positive pregnant women were getting HIV meds that would help prevent them from passing HIV on to their babies.

    Portugal Lifts Ban on Gay Men Donating Blood
    While the United States has only begun to consider changing its policy barring gay men from donating blood, Portugal -- a conservative Catholic nation -- announced that it has removed gay men from a list of people who are prohibited from donating blood. While the ban's premise was that men who have sex with men are at a higher risk of having HIV and hepatitis B, a spokesman from Portugal's National Blood Institute said that HIV is actually now more widely spread among heterosexuals. Gay groups welcomed the change but said they would wait to see how it was enacted.

    Portugal's decision may help the United States move toward its own policy change. As The Body reported in last week's newsletter, the U.S. Food and Drug Administration plans to review the country's lifetime blood-donation ban for any man who has had sexual contact with another man since 1977.

    Ugandan Musician Encourages HIV Tests Among Former Child Soldiers
    Samite, a Ugandan singer and instrumentalist, uses his music to reach former child soldiers in Uganda and encourage them to get tested for HIV. Many child soldiers and refugees -- the legacy of years of civil strife in Uganda -- are HIV positive. In an interview with National Public Radio, Samite describes how, by speaking with three young girls, he learned of about 130 girls who were victims of rape and abuse and wanted to be tested for HIV.

    HIV Epidemic in Ukraine Accelerating Because of Human Rights Abuses, Report Says
    According to this recently released Human Right Watch report, Ukraine is home to the worst HIV epidemic in Europe and one of the fastest growing epidemics in the world. Most people at risk for HIV or living with HIV in Ukraine are involved in sex work or injection drug use -- two populations that are largely marginalized. Through research and interviews, Human Rights Watch found that these people face continual physical and psychological abuse by police, who have little worry that they'll face any consequences for their actions. Human Rights Watch also found that when HIV-positive Ukrainians or people who were at risk for HIV tried to access health care, they were widely discriminated against -- some were even turned away from hospitals. Hopefully, this comprehensive report will do something to improve an increasingly horrifying situation. (Web highlight from Human Rights Watch)

    Also Worth Noting

    Profiles in Courage
    Inspiring Stories From HIV-Positive African Americans

    Shelton Jackson
    HIV has not slowed Shelton Jackson down one bit. If anything, it's made him work harder, strive farther and accomplish more in the first 28 years of his life than he ever could have imagined while growing up in Newark, N.J., as the son of two drug addicts.

    Jackson, a poet, author, activist and founder of a publishing firm, needed years to come to terms with his HIV status, but once he finally did, it was as though his life opened up before him. "You have to make the decision whether you want to live or die," Shelton says. "If it's 'I wanna live,' then take the steps in order to keep yourself healthy, and not just live, but live the life that you wanna live."

    The Body is proud to present this one-on-one interview with Shelton Jackson, along with 12 other profiles in courage, in our new African-American HIV/AIDS Resource Center. Stop in and browse through interviews, personal perspectives, podcasts, resource listings and more!

    Connect With Others
    t The Body's Bulletin Boards

    "A Neg Woman Can Have a Baby With a Pos Guy -- I Should Know!"
    (A recent post from the
    "My Partner Has HIV" board)

    "Three years ago ... I met the man of my dreams. ... Almost one year into the relationship we talked about getting married and starting a family. Then [he was diagnosed with HIV]. ... The next day I got tested and could not believe I was neg. ... I knew I loved him more than anything and that I was not going to let this thing called HIV stop us having the life we both wanted. ...

    "We took a year looking into our options [for having a baby], and the only one we had was for him to go on meds, bring his viral load down to undetectable, have unprotected sex and do a lot of praying. We did this under the close supervision of a wonderful doctor and ... eight weeks ago I gave birth to a healthy baby boy, and both he and I are still neg. I truly feel blessed."

    -- charlie30

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

    "Just Tested Positive, And I Still Can't
    Believe It"

    (A recent post from the
    "I Just Tested Positive" board)

    "My ELISA and Western Blot tests are positive. ... We are still waiting for my partner's Western Blot [results]. I haven't got the luxury to tell my family; due to several health problems, it would kill them. ... I try to keep my mind busy with practical matters that may occur from now on, and I have to be quite concentrated at my job (although I am not sure how I managed to make it so far). It seems like I live another person's life and still haven't managed to realize that this is gonna be my life from now on. ..."

    -- Anonymous

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