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May 3, 2006

In This Update:
  • HIV Treatment
  • Complications of HIV & HIV Treatment
  • HIV Transmission
  • Youth & HIV Prevention
  • HIV & Crystal Meth
  • News & Views
  • HIV Outside the U.S.
  •   HIV TREATMENT

    Single-Pill, Once-Daily HIV Drug Regimen Submitted for FDA Approval
    The drug companies that produce efavirenz (Sustiva, Stocrin) and Truvada (tenofovir/FTC) have asked the U.S. Food and Drug Administration (FDA) to approve a new pill combining those two drugs into one medication. If approved, the new medication would become the first in the United States that would contain two HIV drug classes within a single, once-daily pill. An FDA decision on the pill is expected later this year.



    Many ADAPs Overpay for HIV Meds, Report Finds (PDF)

    At the same time as some U.S. AIDS Drug Assistance Programs (ADAPs) have been forced to put people in need of HIV meds on waiting lists because of funding shortages, many ADAPs are unwittingly being overcharged for their HIV meds, a new study has found. The report, written by the U.S. Government Accountability Office, took an in-depth look at how each of the country's 52 ADAPs are organized and funded, as well as how they pay for their HIV meds. Investigators found some unsettling results: For instance, the report noted that of the 10 most commonly prescribed HIV meds, Delaware's ADAP overpays for all of them, while Oklahoma's ADAP overpays for nine and Kentucky's ADAP overpays for eight. In addition, a mind-boggling 49 of 52 ADAPs reported paying a higher price than they were supposed to for at least one HIV med (and often many more). The report blames inadequate reporting and a lack of government oversight for the problems. (Web highlight from the U.S. Government Accountability Office)

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      COMPLICATIONS OF HIV & HIV TREATMENT

    TheBody.com Exclusive: Lipoatrophy Q&A With Dr. Cal Cohen
    What's the difference between "lipoatrophy" and "lipodystrophy"? Which HIV meds are most likely to cause you to lose fat in your face, arms or legs? What can a person do if he or she has already developed lipoatrophy? Top HIV specialist Dr. Cal Cohen answered these questions and many more in a live chat at TheBody.com last week. Click here to read the full transcript!



    Abacavir Hypersensitivity: Could the Trigger Be in Your Genes?

    One of the more dangerous side effects of abacavir (Ziagen, one of the drugs in Combivir and Trizivir) is called "hypersensitivity reaction" -- an allergic reaction that hits about 8 percent of people, but only during the first couple of months after they begin taking abacavir. Hypersensitivity reaction can cause a range of severe, flu-like symptoms, including a sudden fever, vomiting and a skin rash. In fact, the symptoms are so flu-like that doctors sometimes have a hard time figuring out whether abacavir is truly the cause -- which may result in some people stopping abacavir when they don't need to. However, Canadian researchers are investigating whether a genetic test might help: Such a test would look for markers in a person's genes that appear to make him or her much more likely to develop abacavir hypersensitivity. (Web highlight from aidsmap.com)


    Light Sensitivity More Common Among People on HIV Treatment, Study Finds
    People who are taking HIV medications are twice as likely to be sensitive to light than HIV-positive people who aren't on HIV treatment, according to a new study by U.S. and Brazilian researchers. The study, an examination of skin disease among 897 HIV-positive people at an urban clinic, also found that several types of skin problems were common among HIVers: 18 percent had folliculitis, an inflammation of hair follicles anywhere on the body that can cause rashes, pimples and itching; 12 percent of people had genital warts; and about 11 percent of people had seborrheic dermatitis, a flaking of the skin and the cause of dandruff.


    Cytomegalovirus and HIV
    Cytomegalovirus (CMV) used to be one of the major causes of illness and death in people with HIV before the modern era of HIV treatment began. Although it's less of a concern now (at least in developed countries), it can still be a dangerous and frightening disease in people with a low CD4 count who are not on medications. If left untreated, CMV can lead to serious problems such as blindness and nervous system damage. Fortunately, in addition to HIV meds, many treatments for CMV are now available. This detailed overview by a pair of University of California-San Francisco physicians explains the basics of CMV diagnosis and treatment. (Web highlight from HIV InSite)



    HIV/Hepatitis B Not an Obstacle to Liver Transplants, but Timing May Be Critical
    Evidence continues to mount that liver transplants can be safe in people who are coinfected with HIV and hepatitis. In fact, a new study suggests that such transplants can be so successful that doctors should consider doing them more often, and earlier, than they currently do. In the study, which followed 35 people with HIV and hepatitis B, only four people ended up receiving liver transplants -- but all four survived the operation and suffered no complications afterward because of their HIV or hepatitis B infections. Unfortunately, 10 people in the study died before they could get transplants, raising concerns that some doctors may not be referring their patients for transplants early enough. (Web highlight from 365Gay.com)

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      HIV TRANSMISSION

    HIVers in United States Often Choose Abstinence After Diagnosis
    A new U.S. study has found that a fair number of HIV-positive people avoid having sex after they've been diagnosed with HIV. Of the 1,339 study participants, deliberate abstinence from oral, anal or vaginal sexual intercourse was reported by 11 percent of HIV-positive men who have sex with men (MSM), 18 percent of HIV-positive women and 18 percent of HIV-positive heterosexual men. Researchers found that MSM were more likely than women or heterosexual men to choose abstinence out of a desire to protect others, and suggested that the lower abstinence rate among MSM was due to lower stigma in the gay community than in society at large. (Web highlight from The Advocate)

    To read an abstract of the original study, click here.


    The Latest on Microbicides: Highlights From the Microbicides 2006 Conference
    Last week, researchers and advocates gathered in South Africa for the world's largest conference on microbicides, which are being billed as one of the great new hopes for HIV prevention. The conference ended last Wednesday with an impassioned plea to the world's political leaders and drug companies to provide better funding and support for microbicide development, which has received only a limited amount of official backing to date. The aim of the conference was to review the world's progress in producing microbicides, which have been in development for 15 years; read this article for a summary of conference highlights.

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      YOUTH & HIV PREVENTION

    Teens Speak Out About Sex, Relationships and Learning to Love Themselves
    Brian grew up in a town where he felt isolated as a gay teen. "I wanted to know what it felt like to be taken care of by another man, to be held, and most of all for another man to see me, all of me, and love what he saw." Brian's not alone. Many young people in the United States struggle with feeling out of place, unloved and lonely, and some try to offset these feelings by engaging in behaviors that can put them at risk for HIV.

    Scott Fried, who himself became HIV positive after having unsafe sex when he was young, tackles self-esteem as a prevention issue in his speaking tours and books. His newest book, My Invisible Kingdom: Letters From the Secret Lives of Teens, presents a cross-section of the thousands of letters from young people who have written to Scott after hearing him speak or reading his books.

    The collection includes a letter from Claudia, a 16-year-old who learned the power of controlling her sex life: "I was lying there actually considering [whether or not to have sex] when it struck me! I realized that he did not care at all, at all, about getting to know me. So I said, 'Thank you, but no.' I remember how valuable I felt that day. I think I remember I felt sacred that day."

    Scott aims to empower his young audiences and readers to love themselves and take their lives into their own hands. Alisa, age 17, writes, "Right now, there is only one thing I know for sure. Feeling like your life is over and wanting to let go or just quit is okay. The thing that isn't okay is giving in to that urge. Overrule the unfairness with love, compassion and a willingness to live."

    To read more letters or learn about Scott Fried, click here.

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      HIV & CRYSTAL METH

    Crystal Meth Little Used by Gay Men in Britain, but More Popular Among HIVers
    Crystal meth use is far less common among gay men in the United Kingdom than some people might believe, although it is more frequent among gay HIVers, a new survey has found. The survey results suggest that meth use in Britain hasn't increased over the past few years. In addition, only 1 percent of gay men in the United Kingdom regularly use crystal meth, and only 3 percent have used it within the past year, suggesting that meth use is not a major contributing factor in the spread of HIV in the United Kingdom. Meth use appeared more common among HIV-positive gay men and gay men in London, but most Londoners who used it did not do so regularly. (Web highlight from aidsmap.com)


    Disagreement in California Over Funds to Address HIV/Meth Use Link
    Attempts to increase funding to address the link between crystal meth and HIV have hit a roadblock in California. Although state AIDS agencies are looking for millions of dollars to support HIV and meth-use prevention efforts among gay men, legislators are dragging their feet, and even some gay/lesbian community leaders have been ambivalent about their support. Part of the problem, some say, is a disagreement over how additional funding should be spent. "It is not a question of commitment," said John Laird, who is the head of the State Assembly's budget subcommittee and a member of the Lesbian, Gay, Bisexual and Transgender Legislative (LGBT) Caucus. "It is what is the best strategy to address the problem?"

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      NEWS & VIEWS

    U.S. Secretary of State Charged With HIV Discrimination Against Foreign Service Applicant
    An HIV-discrimination lawsuit has been filed against U.S. Secretary of State Condoleezza Rice because of her department's policies regarding HIV-positive employees. Lorenzo Taylor says that an outdated policy denied him employment as a Foreign Service officer solely because he is HIV positive. Even though he is highly qualified, Taylor's application fell victim to the State Department rule that no HIV-positive person can become a Foreign Service officer, since they may be assigned to work in a country with a poor health care system. Taylor's lawsuit points out that the U.S. Rehabilitation Act requires all employers, including the federal government, to make reasonable adjustments for health-related issues on an individual basis as long as the job requirements can still be fulfilled. (Web highlight from The Advocate)


    Getting It Right: Being Smarter About Clinical Trials
    Even when researchers have the best intentions, clinical trial results aren't always reliable. Small mistakes in the way studies are set up, conducted and analyzed can cause bias, or a skewing of the results. What can researchers do to remove as much bias as they can from their studies, to ensure that clinical trial results are as reliable as possible? That's what the U.S. National Institutes of Health set out to discover in a recent meeting. This detailed article summarizes the recommendations that came out of this major discussion among researchers.
    (Web highlight from PLoS Medicine)

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      HIV OUTSIDE THE UNITED STATES

    HIV and Hepatitis in Europe: Border Crossings and Buried Bombs
    It's easy to assume that Western Europe and North America have similar HIV epidemics -- after all, they are the world's richest regions, where access to HIV treatment and good medical care is more the rule than the exception. But Europe's epidemic is a very different beast, in large part because so many HIV-positive people emigrate from nearby countries in Eastern Europe and Africa, where HIV is spreading like wildfire. In this captivating summary of a recent AIDS conference in The Netherlands, Mark Mascolini discusses the driving forces behind the HIV epidemic in Western Europe, and what some researchers are proposing to stem it. He also reviews research on lipodystrophy, HIV med side effects and new antiretrovirals.

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    Also Worth Noting

    Podcasts
    African Americans Talk About Living With HIV

    Michelle Lopez
    Michelle Lopez
    As part of our African-American HIV/AIDS Resource Center, The Body asked HIV-positive African Americans throughout the country: How have your relationships with family friends changed since you were diagnosed? Click here to hear what they had to say!

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the May 2006 Visual AIDS Web Gallery
    "Stolen Time," 1996; John Dugdale
    Visit the newly launched May 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The May gallery is entitled "The 'Me' You See"; it's curated by Reed Massengill, a widely published writer and photographer who specializes in male nudes.

    Connect With Others
    A
    t The Body's Bulletin Boards

    How Can I Prepare Myself for Treatment?
    (A recent post from the
    "HIV Treatment" board)

    "I expect to be starting HAART within a few weeks (my doctor proposes Epzicom + Reyataz + Norvir). Is there anything I can do to prepare myself before I start, and since my numbers aren't so bad (650/15,000), should I try to talk him out of the Norvir, which I understand is responsible for the worst side effects? (I'm also [hepatitis C positive], expecting to start treatment late summer.)"

    -- JimDandyinLO

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

    KNOW HIV/AIDS
    HIV Awareness Ad Campaign Blankets the United States

    KNOW HIV/AIDS Advertisement
    (Click on the image to download
    a PDF of this poster)
    One of the largest HIV education efforts in the United States is the KNOW HIV/AIDS campaign. Created through a partnership between the media conglomerate Viacom (which owns many TV and radio stations) and the healthcare advocacy organization Henry J. Kaiser Family Foundation, KNOW HIV/AIDS mission is to spread HIV awareness through a massive media campaign, which often features major celebrities. Interested in seeing (and hearing) some of the campaigns television, radio and outdoor ads? Click here!