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April 5, 2006

In This Update:
  • HIV Transmission & Prevention
  • HIV Treatment
  • Complications of HIV & HIV Meds
  • HIV News & Views
  • Living With HIV
  • HIV Policy in the U.S.
  • HIV Outside the U.S.

    Jim Pickett: Too Vulgar for a Faith-Based AIDS Conference?
    A part of him must have seen it coming: Jim Pickett, one of the United States' most colorful, outspoken experts on HIV prevention, was invited to speak at an AIDS conference organized by World Vision International (WVI), an international Christian organization. To his credit, Pickett was hopeful it would end well. But it never even began: Days before he was about to speak to college-age conference attendees about the future of HIV prevention, his invitation was rescinded. "It wasn't that I was a big gay ssssssuper fag, they assured me," Pickett fumes. "It was that I used graphic and obscene language in my columns and they were real concerned that if one of the attendees Googled me and read the filth I pander in they would think WVI endorsed me and my potty mouth." To say the least, Pickett isn't buying their explanation -- or their decision to have the conference omit the views of a gay man who happens to be an expert on HIV prevention methods that don't merely encourage heterosexual abstinence and faithfulness.

    Big Drop in HIV Diagnoses Among MSM in San Francisco; Officials Consider Lowering Estimates
    San Francisco's rate of new HIV infections among men who have sex with men (MSM) is down by almost half in the last four years, according to a U.S. Centers for Disease Control and Prevention study released in June 2005. As a result, San Francisco health officials may cut the official estimate for the number of people in the city who become HIV positive each year. A draft recommendation is proposing the official annual HIV rate for the city be lowered from 1,084 to 976 -- with 87 percent of those new infections occurring among MSM. "It hasn't changed that much," admitted Dr. Willi McFarland, an epidemiologist who works for the city health department. "[B]ut the fact is, we've reversed a trend." (Web highlight from the San Francisco Chronicle)



    Are You an HIV Treatment Veteran With Questions? The Body's New Forum Has the Answers
    Visit The Body's brand-new "Ask the Experts" forum on issues for treatment-experienced HIVers! Dr. Eric Daar, a top HIV specialist who has been doing HIV research and treating people with HIV for the past three decades, has joined The Body's team of talented experts. He's on hand to answer your questions about what to do when your HIV treatment options are limited -- whether because of drug resistance, side effects or other problems.

    HIV Medications in Development: A Detailed Overview
    The past several months have seen a deluge of new research on HIV meds in development, including a number of highly promising drugs that appear to work well in people who have already developed resistance to many existing HIV meds. In this detailed overview on The Body Pro, The Body's sister site for health professionals, Dr. Edwin DeJesus highlights a smorgasbord of important research on new HIV meds, including studies presented at February's 13th Conference on Retroviruses and Opportunistic Infections. (Note to health professionals: Free CME/CE credit is available for reading this article!)

    Development of DFC, an Investigational NRTI, Is Discontinued
    The development of an investigational NRTI, DFC (dexelvucitabine, formerly D-D4FC or Reverset), has been discontinued due to concerns that the drug may cause damage to the pancreas, according to an announcement by Incyte, the company that had been developing the drug. Incyte said that researchers conducting a new study of DFC found that an "unacceptably high" number of people taking the drug developed severe hyperlipasemia (high lipase levels), which can serve as a warning sign for inflammation of the pancreas.

    Indian Drug Company Gets OK to Sell Generic AZT in United States
    The U.S. Food and Drug Administration has given the thumbs-up to an India-based drug company to sell a generic capsule form of AZT (zidovudine, Retrovir) in the United States. Although AZT is usually taken in tablet form (a generic version of the tablet was approved in the United States last year), the approval of the generic capsule should increase the options for HIVers in the United States seeking AZT at a lower cost than the brand-name version.



    New Pill for Thrush May Be Better Than Existing Treatments, Study Suggests
    Oral candidiasis (thrush) continues to be a problem for HIV-positive people with low CD4 counts. The most common treatments for thrush are the antifungal medications fluconazole (Diflucan) and itraconazole (Sporanox), but they're so widely used that some medical experts have become concerned about the spread of resistance. A new thrush treatment, however, may help alleviate those concerns: A new study has found that an antifungal pill in development, posaconazole, is as safe and effective as fluconazole -- and may even do a better job of helping people avoid a thrush relapse. (Web highlight from

    There's plenty more to learn about thrush and its treatments. Visit The Body's collection of articles for overviews and the latest research on candidiasis and other fungal infections.

    Lactic Acidosis and HIV Meds: What's It All About?
    Some of the possible side effects of HIV meds are well known; others are not. Take lactic acidosis, for instance: It's a rare, but potentially serious, side effect that sometimes occurs in people who have been taking nucleoside/tide reverse transcriptase inhibitors (NRTIs) like 3TC (lamivudine, Epivir), AZT (zidovudine, Retrovir) or the combination meds Combivir (AZT/3TC) and Trizivir (AZT/3TC/abacavir). If left untreated, lactic acidosis can potentially damage a person's liver, pancreas, bones, muscles, or the nerve endings in a person's hands and feet. To learn more about lactic acidosis, check out this fact sheet from Treatment Action Group.

    For more information about lactic acidosis and related complications, check out The Body's collection of articles.



    Advocacy Groups Charge Schering-Plough With Racial Discrimination for Excluding Blacks From Hepatitis C Trial
    Two advocacy groups have charged Schering-Plough with discriminating against black people by excluding them from the phase 2 clinical trial of a new hepatitis C drug in development. The hepatitis C epidemic in the United States is arguably more severe among African Americans than whites: Not only are African Americans more likely to have hepatitis C than whites, but traditional hepatitis C medications are less effective for African Americans. According to the two advocacy groups, the drug company is barring black people -- whom Schering-Plough classifies as "hard to treat" -- from participating in the trial in order to produce a more favorable outcome. "The bottom line is that African Americans have been left out of this study to make the drug look good," said Judith Dillard of Community HIV/AIDS Mobilization Project. Bob Consalvo, a Schering-Plough spokesperson, countered that the company consulted with medical experts and decided it was "more prudent and scientific[ally] valid" to restrict African Americans' involvement in the trial until the efficacy of each dose of the drug could be tested. Consalvo said that black people would be involved in another part of the trial.



    Treating Grief Like a Bruise in Need of Healing
    "We are conditioned by society, religion, and custom to 'handle' grief 'appropriately,'" says herbalist and AIDS advocate Sue Saltmarsh. "But what if the customary five-stages-of-grief approach doesn't work? What if you are stuck in depression or anger, unable to reclaim the joy of your life because you are bruised by grief?" In this article, Saltmarsh talks about one way people can try to "heal" this type of hurt.



    ADAPs Nationwide Continue to Suffer; Waiting Lists Persist, Annual Report Finds
    As of June 2005, 134,000 HIV-positive people in the United States -- that's about one out of every four Americans receiving HIV care -- were enrolled in an AIDS Drug Assistance Program (ADAP), but another 800 people are on waiting lists because ADAPs can't afford to provide them with the meds they need, according to a comprehensive annual ADAP report from Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors. The waiting lists persist despite a 10 percent increase in the national ADAP budget in 2005. "The need for HIV-related medications continues to outstrip their availability," the report says. If no changes are made to the current ADAP funding system, programs "will continue to have to make difficult trade-off decisions between serving more people with less services or serving less people with more services."

    California Assembly Unanimously Approves Names-Based HIV Reporting
    The California Assembly has voted 67-0 to approve a bill that would implement a confidential names-based reporting system for new HIV cases in the state, bringing the system one step closer to reality in California. Most U.S. states have already switched from code-based reporting to names-based reporting, many of them recently spurred to do so by the U.S. Centers for Disease Control and Prevention, which has threatened to yank federal HIV/AIDS funding for states that don't make the transition. Although many advocates and health officials say names-based reporting is more reliable and accurate than code-based reporting, the practice is still somewhat controversial; some HIV advocates believe that names-based reporting will compromise HIVers' privacy, despite assurances that names will be kept strictly confidential.



    In Russia, the HIV Epidemic Is a Youth Epidemic
    The exploding HIV epidemic in Russia is mostly hitting people who are barely as old as the epidemic itself, statistics show. A United Nations official recently noted that more than 80 percent of HIV-positive people in Russia are under age 30 -- a shockingly high rate compared to developed countries in North America and Western Europe, where about 30 percent of all people with HIV are less than 30 years old. Russia's rate of new HIV cases has nearly doubled in the last five years, with 1.4 million people (1 percent of the country's entire population) now believed to have the virus, a United Nations official said. Official estimates from the Russian government, however, are less a third of that estimated by the United Nations.

    Microbicides on the Global Scene: An HIV Prevention Revolution in the Works
    Thousands of African women are taking HIV prevention matters into their own hands as participants in large-scale microbicide trials. Women across the globe struggle with HIV prevention in cultures where they are often marginalized and unable to negotiate condom use with their partners. Microbicides, however, may help empower women, since they can be used by women without the knowledge of their partners. This month, Cape Town, South Africa, will host Microbicides 2006, a conference at which the latest studies on microbicides will be presented. The London School of Tropical Medicine calculates that a microbicide that is 60 percent effective against HIV, and used by only 20 percent of women in developing countries, could still prevent 2.5 million HIV infections in three years. (Web highlight from Cape Argus, a Cape Town newspaper)

    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the April 2006 Visual AIDS Web Gallery
    "Bifurcacion," 1992;
    Freddy Borges Borges
    Visit the April 2006 Visual AIDS Web Gallery to view a newly launched collection of art by HIV-positive artists! This month's gallery is entitled "Diving Into the Archive"; it's curated by painter David Spiher, a gallery reviewer for Gay City News.

    Connect With Others
    t The Body's Bulletin Boards

    Stigma, Discrimination and Fear: A Middle-Eastern HIVer in America
    (A recent post from the
    "Gay Men With HIV" board)

    "I have known about my status for over three months now. ... It's been a good road so far ... But [I] still have one overriding fear: I am from the Middle East and my parents still live there. I can't leave the U.S. ... because the draconian U.S. immigration laws prevent non-U.S. residents with HIV from returning to the U.S. I am so afraid that something will happen to them and I won't be able to go see them. I [also] can't tell them about my status because their mindset [on] HIV is just one of pure horror, fear and prejudice. It's funny that I am not afraid for myself, but for them, and the fact that my status will crush them totally. Is that a normal feeling?"

    -- cassiusp

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

    Disclosing to My New Boyfriend: Take the Risk, or Break Up Instead?
    (A recent post from the
    "I Just Tested Positive" board)

    "I am an HIV positive [woman who] just met a wonderful HIV-negative man. ... I just wanted to have a little fun, but the guy ... is a real catch, and we have kissed but have not had sex yet. The man is digging on me so bad. I am a real catch too, besides the fact that I am HIV positive. I don't know how to bring it up without hurting him or making him get mad at me for leading him on. My ex advised me to maybe tell him that I was getting back with [my old boyfriend]; maybe that will be better than disclosing that I was positive. ... Should I lie to him about getting back with my ex or just gamble on disclosing my status?"

    -- kitty1

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

    Join a Study!
    Featured Clinical Trial
    of the Month

    What's Being Studied?
    A comparison of four different HIV treatment regimens in people who are starting HIV meds for the first time:

    1) atazanavir (Reyataz) + ritonavir (Norvir) + Epzicom (abacavir/3TC)

    2) atazanavir + ritonavir + Truvada (tenofovir/FTC)

    3) efavirenz (Sustiva, Stocrin) + Epzicom

    4) efavirenz + Truvada

    Who's Eligible?
    People who:

    • are HIV positive, at least 16 years old, and live anywhere in the United States or Puerto Rico

    • have never taken HIV meds for longer than a week (although there are some exceptions)

    • are not resistant to any HIV meds

    • have had a viral load over 1,000 within the last 90 days

    Who's Sponsoring It?
    The U.S. National Institute of Allergy and Infectious Diseases

    How Can You Learn More?
    Click here for a more detailed description of the study; scroll to the bottom of the page to find out how to contact the study site nearest you.