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April 19, 2006

In This Update:
  • HIV Treatment
  • Women & HIV
  • Complications of HIV & HIV Meds
  • Reminder: Lipoatrophy Chat on April 26
  • HIV-Related Policy & Activism
  • HIV Prevention & Testing
  • HIV News & Views
  • HIV Outside the U.S.

    HIV Health Providers Burning Out From Increased Workloads, Flat Funding, Research Director Says
    It's undeniably wonderful news that people with HIV are now living longer, healthier lives than ever before. But in the United States, the way that funding for HIV care is doled out has generated a different kind of crisis: an HIV health care shortage. Health workers caring for HIV-positive people are "burning out" from increased workloads as HIVers live longer but funding remains stagnant, said Dr. Michael Saag, director of the Center for AIDS Research at the University of Alabama-Birmingham, in this recent interview on National Public Radio's "All Things Considered," which is available for download as a podcast. According to Dr. Saag, who was one of the first U.S. physicians to treat HIV-infected patients, nurses and social workers are working longer hours without overtime "out of just a love for what they do and a commitment to the cause." He added, "I'm concerned about the future of my clinic because I don't know where the next wave of nurses, where the next wave of doctors are going to come from."

    How to Make Sense of HIV Clinical Trial Results
    Ever wish you could figure out for yourself whether an HIV-related study was important, or what the results of the study actually mean, instead of waiting for a newsletter like ours to translate all the medical-ese? You can -- and many people with HIV already have. There's a lot of terminology to digest and some key tips to keep in mind, but anybody can learn how to interpret the results of clinical trials. In this detailed overview, medical writer Liz Highleyman explains the nuts and bolts.

    New Expert at The Body's Fusion Inhibitor Forum
    Got questions about T-20 (enfuvirtide, Fuzeon), the only HIV fusion inhibitor? Whether you're worried about side effects, looking for injection tips or trying to figure out if T-20 should be a part of your next regimen, The Body's "Ask the Experts" Forum on T-20 can help provide the answers you need. Nurse practitioner Carol Salisbury is the forum's new resident expert; stop in anytime to ask her your questions!


      WOMEN & HIV

    Most HIV Meds Don't Increase Risk of Pregnancy Complications, Study Finds
    HIV-positive women taking HIV medications during pregnancy are not at an increased risk for having a stillbirth or giving birth to underweight babies, according to a new University of Miami study. However, the 999-woman study did find that one class of HIV meds -- protease inhibitors -- increased a woman's risk of having a premature baby. (Web highlight from

    The Gender Factor: Why Women Have Become the Center of the Global HIV Pandemic
    Although many people still inexplicably believe that HIV is a gay man's disease, the fact is that women are increasingly the face of HIV today: More than 88,000 women in the United States alone are living with AIDS, and HIV is the number one cause of death for African-American women between the ages of 25 and 34. Globally, more than half of all people with HIV are women. The question is: Why are HIV rates increasing so quickly among women? There's no easy answer, but this summary from AIDS Community Research Initiative of America provides some possibilities: Ignorance, misinformation, deception, sexual violence and disempowerment all play a role, this article says.



    Will HIV Meds Raise Your Cholesterol? Depends on Your Race, Study Suggests
    Race and ethnicity may have an impact on the cholesterol and triglyceride levels of HIV-positive people on treatment, according to a massive analysis of hundreds of U.S. clinical trials. The study found that African-American HIVers tended to have healthier levels of cholesterol and triglycerides than white or Hispanic HIVers. The study also noted that the use of protease inhibitors, particularly those that are boosted with ritonavir (Norvir), had an effect on a person's triglycerides and cholesterol levels -- but that this effect, too, was different depending on a person's race or ethnicity. (Web highlight from PLoS Medicine)

    Avoiding Metabolic Problems: Dietary Advice for HIV-Positive People
    If you're HIV positive, is there anything you can do to lower your risk of metabolic problems such as body fat changes, heart disease and diabetes? The truth is, there's no "silver bullet" that can guarantee you'll avoid metabolic problems. But there are some steps you can take to lessen your risk, particularly when it comes to your diet. This article from Test Positive Aware Network includes helpful dietary tips and a detailed chart of safe and unsafe foods for people at risk for metabolic problems.



    The Date: Wednesday, April 26, 2006

    The Time: 6 p.m. Eastern Standard Time/3 p.m. Pacific Standard Time

    The Chat: Lipoatrophy -- the loss of fat in certain parts of the body -- may be one of the most difficult issues for people with HIV. Join us for this chat on lipoatrophy with one of the most experienced HIV specialists in the United States! Dr. Cal Cohen, research director of the Community Research Initiative of New England, will answer questions from HIV-positive people who are dealing with, or worried about, this potentially disfiguring health problem. He'll talk about ways to avoid or alleviate symptoms, and will discuss the latest research.

    To sign up for an e-mail reminder about this chat, or to presubmit a question you'd like Dr. Cohen to answer, click here! You can also read a transcript of our last lipoatrophy chat, featuring Dr. Joel Gallant, by clicking here.

    This live chat is sponsored by Gilead Sciences.



    AIDSWatch 2006: Sign Up Now to Be a Part of the Year's Biggest AIDS Advocacy Event
    For three days in May, Washington, D.C., will be the site of a large nationwide gathering of thousands of people. Its purpose: to pressure American leaders to improve funding and support for HIV-positive people in the United States and throughout the world. Want to join the effort? There's still time to register for AIDSWatch 2006, the largest annual AIDS advocacy event in the United States. From May 8-10, registrants will meet with officials, take part in public rallies and train on how to be more effective advocates. Visit this page to sign up or get more information. (Note: The online registration form says the deadline was April 15, but The Body has confirmed that late registrations are still welcome. Registration is free, but attendees need to make their own travel and hotel arrangements.) (Web highlight from the National Association of People With AIDS)



    Anyone Who Is Hospitalized Should Receive Routine HIV Testing, Study Suggests
    Should people be routinely tested for HIV if they've been admitted to a hospital? A recent U.S. study suggests that doing so could help ensure that previously undiagnosed HIV-positive people stay as healthy as possible. The 243-person study, which is summarized in this abstract, found that people who tested positive during routine testing after being hospitalized generally had a lower CD4 count and higher viral load than "outpatients" -- that is, people who go to a hospital for health care but don't have to stay there overnight. The study found that half of the hospitalized people who tested positive during routine HIV testing would never have been diagnosed if the testing policy had not been in place, putting their future health in danger. (Web highlight from Mayo Clinic Proceedings, a medical journal)

    In this related editorial, noted HIV physician/researcher Dr. Judith Feinberg writes that it's long past time for the United States to expand the use of HIV testing. She points out that there are still an estimated 250,000 Americans who have HIV and don't know it. "By involving physicians and other health care professionals more intensively in testing and prevention efforts, it is hoped that the health care professional-patient bond will have a greater influence on stemming the epidemic," Dr. Feinberg says. She also suggests that more widespread testing may be the only way the United States can begin to bridge the widening racial gap in HIV rates.

    Routine HIV Testing Should Be Implemented Across U.S., Opinion Piece Says
    Clearly, the routine HIV testing bandwagon is taking on more and more passengers. This recent opinion piece by Robert Bazell, NBC News' chief science and health correspondent, also calls for routine testing to be implemented across the United States. He argues that the "pathetic" application of tests for the virus is a "big reason" that 40,000 Americans become HIV positive each year and 14,000 die from AIDS-related causes. The "biggest obstacle" to increased HIV testing is "inertia" stemming from 1985, when the first HIV tests became available and no effective treatment for HIV existed, Bazell writes. "It is time," he says, "to realize that AIDS has become another treatable contagious disease, at least in this country, and we can do a lot more to wipe it out."



    Months After Katrina, New Orleans AIDS Services and HIVers Continue to Struggle
    AIDS organizations and government agencies are still struggling to provide services in the aftermath of Hurricane Katrina. All HIV service providers in the area were shut down for several weeks after the hurricane, and many are still closed. Those that managed to reopen have faced losses in staff, compromised facilities and inadequate resources. Meanwhile, the massive migration of people out of New Orleans has created its own set of problems: Many HIVers who left the city had no access to medical care or HIV treatment for a time, and some of those who stayed behind are forced to travel 60 to 90 miles out of the city if they want to see specialists.

    For more information about how Hurricane Katrina has impacted the Gulf Coast's AIDS community, as well as a listing of resources for people affected by the hurricane, click here.

    HIV-Positive, African-American Activist Struggles With Racial Disharmony
    Keith Green found out he had HIV when he was a senior in high school. Since then, he has been on a quest to discover how best to live with HIV as a gay, African-American man. Now an AIDS activist with the Chicago AIDS organization Test Positive Aware Network, Green is the author of a monthly column on HIV, his life and issues of race in the United States. In his latest piece, Green tackles the prickly issue of race relations. He asks: "How will we ever achieve social justice for all in this country and abroad if at the core of who we are, we don't have trust for people who are not of the same race or nationality as we are?"

    New York City Takes Steps to Improve Care for HIV-Positive Inmates
    New York City health officials have unveiled a new series of efforts intended to improve HIV screening and health care for HIV-positive inmates. One of the new initiatives is a computerized medical screening process for inmates arriving at New York City jails, which officials say will make it easier for workers to access inmates' medical histories and process requests for specialized care. Another major benefit of the computerized system is that it will allow the city to maintain medical records for repeat offenders, since each inmate will have a unique, permanent identification code. The city also plans to expand the use of rapid HIV testing and to launch a pilot program in one jail on Rikers Island in which every HIV-positive inmate is assigned a patient care coordinator.

    Many People in All Racial Groups Believe in HIV Conspiracy Theories, Study Finds
    As the media has often reported, a fair number of African Americans believe that HIV was created by the government and is being used specifically to kill non-white people. What the media doesn't tell you, though, is that African Americans aren't the only people who believe this: A survey of approximately 1,500 people conducted in Houston, Texas, has found that nearly one out of every five Latinos, and a slightly lower percentage of whites, believe that HIV is part of a genocidal government conspiracy. Those rates aren't much lower than the 27 percent of African Americans who said they believe in the conspiracy theory. By contrast, less than 10 percent of Asian Americans in the survey believed HIV was a government conspiracy. (Web highlight from the Journal of AIDS)



    Brits Infected With HIV & Hepatitis C Through Contaminated Blood Continue Fight for Justice
    In the early 1980s, nearly 1,350 people in the United Kingdom were infected with HIV or hepatitis C after they received contaminated blood products from the country's National Health Service (NHS). "One minute I was feeling elated about being cured of leukemia, thinking I had my whole life ahead of me again. The next I was told I was HIV positive and my world came crashing down," recalls Gary Kelly, one of the contaminated blood recipients. The British government eventually compensated most of the victims by offering an average one-time payment of £45,000, plus a monthly allowance of about £300 for life. Two decades later, all but about 400 people who accepted government settlements have died. The survivors, many of whom now live in extreme poverty, relying on state benefits and grappling with illness, feel that they accepted settlements far too small to last a lifetime. In this article, some of these people tell their stories. (Web highlight from The Observer)

    Meanwhile, survivors of the British NHS blood products scandal are pushing the Department of Health to issue new, one-time payments of up to £750,000 each and to increase their monthly allowances. They say that initial settlements were calculated on the assumption that they were facing imminent death, a belief that was widely held in the early years of the HIV epidemic. Their new case comes amid growing outrage at an announcement that government paperwork crucial to the case has been mysteriously shredded.

    Combination of Methods Can Prevent Most Cases of Malaria in HIVers
    It's bad enough that HIV and malaria are among the two most devastating diseases in the developing world, but in people with HIV, malaria is both more common and more deadly. That's why results from a large new study in Uganda are so encouraging: Researchers have found that a combination of steps can cut malaria rates in HIV-positive people by as much as 95 percent. The recipe for malaria prevention had three ingredients: HIV meds, a standard antibiotic and insecticide-treated mosquito nets for a person's bed. The antibiotic itself had the greatest impact: It cut malaria cases by 76 percent in people with HIV. The additional effect of HIV meds is likely because the drugs strengthen a person's immune system, the researchers say. (Web highlight from Reuters)

    "Iran" and "Free Condoms": Two Phrases You Wouldn't Expect to Read Side by Side
    Iran has surprised many with its unexpectedly pragmatic focus on preventing HIV in prisons. The highly conservative nation is doing something that few other countries -- and certainly not the United States -- have done: Iran is providing free condoms and syringes at detention centers. Government clinics throughout Iran are also reportedly providing free HIV testing and HIV treatment for those who are brave enough to come forward in a country where social stigma against people with the virus is stifling. Officially, an estimated 12,000 Iranians are HIV positive. Outside estimates have ranged as high as 70,000, however. (Web highlight from The Kansas City Star)

    Saving Young Lives in Africa, One Person at a Time
    Amid the HIV tragedy that continues to unfold in Africa, it's important to remember that in many ways, we are making progress, even if it's one person at a time. Take Kemiso Ntope, for example: She's an 11-year-old girl living in a pediatric hospital in Botswana, where two years ago she became the first child to receive free HIV meds from her country's government. Enid Vázquez of the Chicago AIDS organization Test Positive Aware Network recently met Kemiso in a trip to this hospital; Vázquez recalls her experience in this article.

    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the April 2006 Visual AIDS Web Gallery
    Untitled (Clock #2), 1989;
    Geoff Schmit
    Visit the April 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The April 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

    Recently Diagnosed
    and Confused
    About Safe Sex

    (A recent post from the
    "Living With HIV" board)

    "I found out that I had HIV about eight months ago, and since then, I haven't got any help. I have been too scared. ... I have started to [date] someone, but [am] so scared to tell him, and I don't know much myself. I know I can't have sex without using something, but what about the rest? Can anyone tell me what I can [and] can't do? I know it sounds silly, but I really don't know."

    -- Anonymous

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

    Special Report
    On HIV-Related Gut Problems

    Cover Image of 'The HIVer's Guide to Coping With Diarrhea & Other Gut Side Effects'
    Are you living with HIV and coping with problems like diarrhea, nausea, heartburn or stomach pain? These "gut" problems are the most common side effects experienced by people with HIV. Although people often like to make fun of gut problems, they're no fun at all to live with -- and they can make it hard for an HIVer to take their meds as prescribed.

    That's why The Body created "The HIVer's Guide to Coping With Diarrhea & Other Gut Side Effects." This free booklet is chock full of useful information, advice and personal stories that will tell you everything you need to know about these difficult health problems. Check it out online, or ask your HIV doctor or AIDS organization for a free print copy!

    (Clinics/AIDS organizations: You can order free print copies of this booklet by clicking here!)