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May 24, 2006

In This Update:
  • Living With HIV
  • HIV Treatment
  • News & Views
  • AIDS at 25
  • HIV Transmission
  • Hepatitis
  • HIV Outside the U.S.

    Most HIV-Positive Gay Men Don't Regret Disclosing to Friends and Family, Study Says
    HIV-positive gay men rarely regret telling their family and friends that they have HIV, a new U.S. study has found. The 76-person survey, which included gay men ranging in age from 21 to 61, found that 75 percent of the men felt little or no regret at having revealed their status. When the men did express regret, it was usually over telling their immediate family (especially parents), rather than their friends. Still, for guys who are worried about what might happen if they disclose to the people who are closest to them, this small study may offer some much-needed peace of mind.

    Using Natural Therapies to Make HIV Treatment Even More Effective
    There's no arguing that HIV medications have transformed HIV into a chronic disease for the millions of people who have access to treatment. But if you're lucky enough to have this access, that doesn't mean you should let the meds do all the work for you. There are plenty of simple, all-natural things you can do to help boost your immune system and improve your overall well-being. JoAnn Yanez, a doctor of naturopathic medicine, provides a slew of useful tips in this article.



    HIV Doctors and HIV-Positive People Have Different Perceptions of Treatment, Survey Finds (PDF)
    A nationwide survey of HIV-positive people and HIV doctors has found that the two groups of people often have very different views about HIV treatment. The 13-city survey of 152 HIV doctors and 399 HIV-positive people yielded a trove of interesting results: For instance, although HIV-positive people on treatment were much more likely than doctors to say that they were "very satisfied" with their current regimen, HIVers also were much less optimistic about their long-term health: 59 percent of HIV-positive people said they expected to live a normal life span, compared to 72 percent of HIV doctors who felt the same way about their patients. The survey also found that, although the majority of HIVers felt they had an "equal partnership" with their doctors when it came to making treatment decisions, less than half of HIV doctors felt the same way. The survey also showed a huge perception gap in how much HIVers know about HIV: Virtually every HIV doctor said that the majority of their patients often don't understand what they're being told about HIV and HIV treatment; two-thirds of HIVers, however, said that they almost always understood what their doctors told them.
    (Web highlight from the Journal of the International Association of Physicians in AIDS Care)

    Treatment Interruptions: SMART or Stupid?

    It's been several months now since the HIV treatment world was turned on its head by the cancellation of a single study. Known as SMART, it was one of the largest studies ever to investigate any kind of HIV treatment strategy -- and many people were hopeful that it would find value in a certain type of "structured treatment interruption," in which HIVers start or stop taking their meds when their CD4 count reaches a certain level. SMART met an early demise, however, when researchers found that people who used this strategy developed AIDS-related illnesses at a much higher rate than people who remained on meds continuously. SMART's cancellation has led to a lot of hand-wringing and confusion over why it went wrong, and what it bodes for the future of HIV treatment interruptions. In this analysis, Tim Horn and Mark Milano take another look at why the SMART study was cancelled -- and what lessons, if any, can be learned from the results.

    If you're interested in a more technical breakdown of this landmark treatment interruption study, read this summary by Treatment Action Group's Richard Jefferys.

    Integrase Inhibitors: The Next Wave of HIV Medications?
    For people who are running out of HIV treatment options due to drug resistance, a new class of HIV meds in development is generating a lot of excitement. The class, integrase inhibitors, fights HIV in a different way from current drug classes, like protease inhibitors and nucleoside reverse transcriptase inhibitors. Early studies suggest that these drugs may be effective in HIV-positive people with multidrug resistance. HIV treatment educator Donna Kaminski explains how these new drugs work, and what the latest research suggests their chances are for successfully making their way to your pharmacy one day.


      NEWS & VIEWS

    U.S. May Be a Global AIDS Leader, but It's Doing a Bad Job at Home, Report Says
    Over the past few years, the United States has transformed itself into a leader in the fight against HIV in developing countries. It's a wonderful evolution for this country, to be sure -- but is the United States also giving the amount of attention it should to HIVers within U.S. borders? A new report from the Open Society Institute says no: It accuses the United States of failing to fulfill its commitments to fight HIV at home. At the same time the United States pushes for lower HIV infection rates and better access to treatment overseas, HIV rates within the United States have remained stagnant, and more than half of the Americans who need HIV meds are not receiving them, the report says.


      AIDS AT 25

    AIDS at 25: The Path Ahead
    Ask your average American about HIV today, and he or she will probably tell you either that HIV is still a death sentence, or that the country's HIV problem has simply gone away. The majority of Americans remain blind to the critical problems caused by decreased HIV funding in the United States. It seems that many people have forgotten -- if they ever truly knew -- the United States' own tortured history with HIV. The astonishing social reforms and medical advances of the past 10 years in HIV are taken for granted. In this article chock full of interviews with prominent AIDS advocates and journalists, David Foucher explains why we must remember our past if we're to win the fight against HIV in the future. (Web highlight from EDGE)

    At 25th Anniversary, AIDS Still Presents Challenge for Black U.S. Leaders
    While some black leaders are vocal about stopping the spread of HIV in their communities, others have remained woefully silent. For religious, political and civil rights leaders who already have a full-time job struggling against epidemics of poverty, crime and discrimination, HIV is the last battle many of them want to fight. For them, it raises too many issues that are still taboo: extramarital sex, intravenous drug use and men having sex with men. There are signs that the tide is turning, however. One of the standard-bearers of the HIV awareness movement is Jatrice Martel Gaiter, president and CEO of Planned Parenthood of Metropolitan Washington, D.C. In her view, religious leaders have a responsibility "to preach about this from the pulpit, to write about it, to have an AIDS ministry." Considering the epidemics growth in black communities, HIV is becoming harder and harder to ignore, and a growing number of black leaders are calling on their peers to join the fight. (Web highlight from Newsweek)

    Meet Dr. Peter Piot, Virus Hunter
    "If we've learned anything in 25 years," says Dr. Peter Piot, the director of UNAIDS, "it's that communities can take control of [HIV]. Our role isn't to rescue them. It's to support them." Piot was a young researcher living in Belgium when he first heard about the five young men in Los Angeles who died of a mysterious immune disorder in the summer of 1981. Since then, the number of HIV-positive people globally has grown to 40 million, but Piot is as confident as he's ever been that AIDS can be beaten. He has been at the forefront of HIV research and international advocacy for more than 20 years, and has struggled to overcome denial and inaction from many international leaders, as well as a shocking lack of money for UNAIDS programs throughout the 1990s. Piot had a breakthrough at the turn of the millennium, when he reframed HIV as an economic and security issue for the international community -- and motivated an explosion of funding and awareness. The challenge now will be "making the money work, as Piot puts it, so that treatment and prevention efforts can gain more traction in the developing world. (Web highlight from Newsweek)



    San Francisco Becomes First to Drop Written Consent Requirement When Testing People for HIV
    San Francisco, Calif., on May 16 became the first city in the United States to require only verbal consent from people to be tested for HIV at public clinics and hospitals. Requirements were dropped for written consent and pretest counseling in hopes of making the testing process easier. The decision comes on the heels of an announcement from the U.S. Centers for Disease Control and Prevention, which plans to release new HIV testing recommendations in June that suggest exactly the steps San Francisco has now taken. Pretest counseling still will be provided at San Francisco's public clinics and hospitals for anyone who requests it.

    Often at Odds, Wide Range of Groups Come to Agreement on Researching Sex
    It's no secret that sexual health issues are a minefield in the United States: From HIV prevention to abortion to sex education, it's almost impossible to get major advocacy groups to agree on just about anything. That's why it came as surprising news this week when 18 groups, ranging from the pro-choice Guttmacher Institute to the conservative U.S. Conference of Catholic Bishops, announced that they had agreed on a set of specific aspects of sexual health that needed in-depth, scientific research -- and declared that they wanted to continue discussions to see if they can find more points to agree on.

    New AIDS Vaccine Clearinghouse Launches on Web
    The AIDS Vaccine Advocacy Coalition (AVAC) has launched the AIDS Vaccine Clearinghouse, a source of HIV vaccine information available on the Internet. "The AIDS Vaccine Clearinghouse is a virtual AIDS vaccine community where researchers, advocates, community members, policy makers and the media can go for information, updates and interaction with others," said Mitchell Warren, executive director of AVAC. With more than 30 HIV vaccines now in development throughout the world, the need for a single, comprehensive source of reliable information on the subject will only continue to grow. (Web highlight from the AIDS Vaccine Advocacy Coalition)

    For more of the latest news and research on HIV vaccines, be sure to check out The Body's collection of articles. You can also read about the development of vaccines meant to treat HIV, rather than prevent it, by clicking here.



    New Research on Hepatitis C Drugs in Development
    Although hepatitis C was discovered not long after HIV, there are far fewer medications available to treat hepatitis C than HIV. Unfortunately, although the hepatitis C meds that we do have are often lifesavers, they frequently have more side effects and lower success rates than anybody would like. On the plus side, however, researchers are hard at work devising new, more effective drugs to treat hepatitis C infection. Tracy Swan of Treatment Action Group updates us on the latest studies in this recap from the 13th Conference on Retroviruses and Opportunistic Infections.



    AIDS and a Lost Generation: Children Raising Children
    Africa is rapidly becoming a continent of orphans. Every day, 9,000 Africans become HIV positive and another 6,500 die from AIDS-related causes -- that's the equivalent of an entire village being wiped from the map every 24 hours. In every country and every city, the story of the epidemic varies, but the theme remains the same: The efforts now underway to increase HIV education and access to treatment are not enough. The burdens of AIDS orphans are a stark example: As more parents die from AIDS, their children are thrust into the roles of caregiver and breadwinner for the family, responsibilities for which they are greatly unprepared. Eventually, if the global response to HIV doesn't include helping these children of a lost generation, they may succumb to the same fate as their parents, leaving another African generation orphaned to begin the cycle again. (Web highlight from The Independent)

    What Do Women Really Need? More Control Over Their Sex Lives, Melinda Gates Says
    Eighty percent of women newly infected with HIV are practicing monogamy within a marriage or a long-term relationship, writes Melinda French Gates, co-chair of the Bill & Melinda Gates Foundation. This shatters the myth that marriage is a natural refuge from AIDS. And it shows that, more than two decades into the epidemic, our fight against AIDS has failed to address the unique circumstances of women. According to Gates, the so-called ABCs of HIV prevention -- abstain, be faithful and use condoms -- all depend on the cooperation of the male partner. "For millions of married women, abstinence is unrealistic, being faithful is insufficient and the use of condoms is not under their control, she writes. The Gates Foundation is working to put prevention tools into the hands of women by funding microbicide research, but current investment is only about half of what advocates say is needed. And even if a microbicide were to be developed, too many developing countries lack the infrastructure needed to bring it to the women who need it most. In this article, Gates outlines the work she feels must be done on behalf of the world's women, and calls on governments, non-governmental organizations and businesses to step up to the plate for womens health. (Web highlight from Newsweek)

    If you'd like to read more about the work of the Bill & Melinda Gates Foundation, click here to visit the organization's Web site.

    Also Worth Noting

    Profiles in Courage
    Inspiring Stories From HIV-Positive African Americans

    Joyce McDonald
    Joyce McDonald is an artist in many senses of the word. A talented painter and sculptor, Joyce's works often capture in stark relief the gamut of emotions she's experienced throughout her colorful life. Joyce is also a weaver of words: Not just as a poet or a songwriter (she is both), but also as coordinator and speaker for her church's AIDS ministry.

    Yet, more than anything, Joyce's life has become its own work of art. Her story of prostitution, drug abuse, motherhood and redemption -- as well as her battle with HIV and hepatitis, which she very nearly lost 15 years ago -- is as much a work of art as anything she's created with paint, pen or clay.

    The Body is honored to present this one-on-one interview with Joyce, 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!
    Share Your Story!
    Under 25 and Affected by HIV? Tell MTV Your Story
    (Deadline June 15)
    HIV Turns 25: Use Your Voice to Fight HIV

    If you're a young person whose life has been affected by HIV -- and if you're reading this newsletter, it almost certainly has -- MTV wants to hear from you. Grab a video camera and put together a three- to five-minute snapshot showing how HIV has affected your life. Send your video to MTV, and it may be used for a 30-minute special MTV will air this summer to commemorate the 25th anniversary of HIV.

    Interested? Click here for more information on how to produce and submit your entry! The deadline for entries is June 15.

    Connect With Others
    t The Body's Bulletin Boards

    Support on the Web Has Helped Me Cope
    (A recent post from the
    "I Just Tested Positive" board)

    "I did a home HIV test a few days ago and it was positive. ... I was scared, confused, and really wanted to just curl up and die. I thought about my mom and family a lot, and things that I thought I wouldn't accomplish in my life. I am 33 years old, college educated, a white-collar male, very low risk. ... One mistake was all it took. While frantically doing research on the net regarding HIV/AIDS I came across this site and believe it or not, a slight weight has been lifted off my shoulders. The posts revealed to me that I am not alone, and that people can live happy, productive lives, and this is not necessarily a death sentence. I go see my physician tomorrow to do an official test -- and will expect that will be positive too. Knowing what I know already, the news should be a tad easier to swallow. Thanks again for the encouraging posts."

    -- gogreen

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

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the May 2006 Visual AIDS Web Gallery
    "Mirror and Clock," 2003; Peter Cherone
    Visit the 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.