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June 7, 2006

In This Update:
  • AIDS at 25
  • HIV News & Views
  • HIV Treatment
  • Complications of HIV & HIV Meds
  • HIV/STD Transmission
  • HIV Outside the U.S.
  •   AIDS AT 25

    "I Knew Patient Zero"
    Dr. Michael S. Gottlieb didn't know it at the time, but when a 31-year-old man (also named Michael) was admitted to his hospital in 1981 with fever and weight loss, he was meeting the person who would become the first officially reported case in the global AIDS pandemic. Twenty-five years later, Michael has long since died, but Dr. Gottlieb is still treating people with HIV. On the 25th anniversary of his first published report, he takes a moment to look back on his first AIDS patient, on the tragedies and triumphs of the past quarter-century, and on the mixed hopes he holds for the future. (Web highlight from the Los Angeles Times)

    To read Dr. Gottleib's 1981 report, which later become known as the first officially reported cases in the AIDS pandemic, click here.


    In U.S., HIV Meds Have Saved "Three Million Years of Life," Report Says
    We don't need a report to tell us that HIV medications save lives, but some academics couldn't help but wonder: Just how much life is being saved? A new U.S. government-funded study crunched the numbers. Researchers added up the amount of time that HIV meds have extended the lives of HIV-positive Americans since 1989. The total: 2.8 million years.

    As another researcher points out, 2.8 million years could be just the tip of the iceberg if HIV prevention and testing were improved worldwide: "If we address systematically the barriers to testing, care and prevention, then future modelers will describe the next 15-year period as having saved hundreds of millions of life-years, not just in North America but around the globe," writes Sten H. Vermund in this Journal of Infectious Diseases editorial.


    The Black Face of HIV in the United States
    "In 2006, AIDS in America is a black disease," says Phill Wilson, executive director of the Black AIDS Institute. "The only way for AIDS to be over in America is for AIDS to be over in black America, and the only way to stop AIDS in black America is for black people to take ownership of the disease and mount a mass black mobilization." Wilson and his organization are making sure that, as we commemorate 25 years of AIDS, the African-American story doesn't get lost in the din. The group has published this 80-page report, called "AIDS in Blackface: 25 Years of an Epidemic," which features testimony from 25 U.S. activists who are tackling HIV head-on. They include church leaders, artists, grassroots civil rights advocates and members of the press. The report not only reflects on the past; it also looks to the future, calling for the expansion of prevention strategies, improved access to treatment and an end to the stigma surrounding HIV and sexual diversity in the black community.

    Click here to download a PDF of the full report.

    The Black AIDS Institute report features some of the same leaders who appear in The Body's African-American HIV/AIDS Resource Center, including Kenyon Farrow, Sheryl Lee Ralph and Ron Oden. Click here to read about these leaders and others who work tirelessly to change the way that black America deals with HIV.


    (Turning Your) Back to Injection Drug Users
    "Media coverage of AIDS has always neglected [injection] drug users and those who sought to help them," writes Maia Szalavitz in this opinion piece. "Even in this 25th Anniversary blitz, [injection] drug users are given little more than a quick mention and very little recognition is given to the activists who worked so hard to get the clean needle message out when it was most urgent." Szalavitz corrects this oversight by lauding harm reduction activists from the United Kingdom, The Netherlands and the United States. She points to the U.S. government's rejection of needle exchange programs as a prime culprit in the spread of HIV, and calls attention to the impact of harm reduction programs, or lack thereof, on poor communities, people in prison and minorities. (Web highlight from The Huffington Post)

    To read more about injection drug use and harm reduction, browse The Body's collection of materials.


    Audio Webcast: After 25 Years, Perspectives on Living With HIV
    The National Public Radio program "Talk of the Nation" recently asked its listeners and prominent members of the HIV community to talk about how HIV has impacted their personal and professional lives -- and you can listen to the program online! Featured guests included Drew Tillotson, a psychologist whose partner, Archie Harrison, died in 1988, a decade after he became one of the first people ever to receive AZT (zidovudine, Retrovir); Andrew Moss, an epidemiology professor; and Noerine Kaleeba, the founder of Uganda's AIDS Support Organization. A streaming audio file of the show is available, as well as an archived broadcast from 1982 about the disease that, at the time, was known as little more than a "frightening medical mystery." (Web highlight from National Public Radio)

    You can listen to many more Webcasts and other reports on the 25th anniversary of AIDS by browsing The Body's library.

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      HIV NEWS & VIEWS

    As UN Special Session on HIV/AIDS Ends, Countries Adopt Watered-Down Declaration
    When the United Nations gathered five years ago for a special session on HIV/AIDS, it was a historic moment: For the first time, the world's leaders had come together and laid out a vision for beating back the tide of HIV. Last week, the United Nations held its second-ever special session on HIV/AIDS, and the results appear much less remarkable. Held in the shadow of realizations that many countries -- including the United States -- have failed to fulfill the pledges they made in 2001, this year's special session was heavily criticized by many activists as a disappointing display of politics as usual. While some officials praised the final declaration on fighting HIV/AIDS adopted by the United Nations, the New York Times said it was only a "political blueprint, not a plan of action."

    Want to watch Webcasts of key meetings and discussions at the UN special session? Many of the session's highlights are available online, courtesy of kaisernetwork.org; click here for a full listing.

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      HIV TREATMENT

    Latest Research on Drug Resistance and Options for Treatment-Experienced HIVers
    Although researchers are continually making new discoveries about HIV drug resistance, our understanding of the topic remains incomplete. For instance, each time a new medication is approved, it takes years to understand its resistance profile. In this report from two recent European conferences, Drs. Bonaventura Clotet and Cal Cohen review some of the latest research on HIV drug resistance, including its impact on recently approved medications. They also look at some drugs in development that will provide new options for HIVers with multidrug resistance. (Note to U.S. doctors, nurses and pharmacists: Free CME/CE credit is available for reading this article!)

    Looking for background info on HIV drug resistance and resistance testing? Check out The Body's special report.


    Changing HIV Medications: What the Research Shows
    How can you know whether it's the right time to change your HIV treatment regimen -- and if it is the right time, what should you switch to? As more meds become available and we learn more about side effects and resistance, the answer to this question has grown a lot more complicated. In this clinical overview, a team of New York HIV physicians recaps what researchers have learned about why, when and how people with HIV should switch their medications. (Web highlight from HIV InSite)



    Adjusting (Emotionally) to a Change in Your HIV Meds

    When you're faced with the prospect of changing your HIV treatment regimen, it's easy to get lost in the medical issues: side effects, viral load, resistance and so on. But there's another important aspect to switching meds that you shouldn't ignore: your emotions. Starting a new regimen may carry some new emotional baggage with it, or can reopen wounds that you thought had been closed when you first began taking meds. Counselor Gary R. McClain explains some of the emotional issues that may arise when you switch HIV meds, and offers advice on how to cope.

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      COMPLICATIONS OF HIV & HIV MEDS

    Serious Heart Condition More Common in HIVers, Whether on Treatment or Not
    Although combination HIV therapy dramatically lowers an HIVer's risk of developing a wide range of HIV-related illnesses, it can't protect from all of them, a large French study points out. The study found that people with HIV may have a higher-than-usual risk for developing an uncommon, but dangerous, heart condition known as pulmonary arterial hypertension (PAH) -- and that HIV medications don't seem to do anything to reduce that risk. Even so, the overall risk that an HIV-positive person will develop PAH is only one in 200, the study found, and there are drugs available to treat it. (Web highlight from aidsmap.com)


    Hepatitis C Doesn't Worsen HIV Disease or Hurt Success of HIV Meds, Large Study Finds
    Although HIV is known to make hepatitis C infection more severe, hepatitis C does not have the same impact on HIV, according to the results of a huge U.S. study. The seven-year study of more than 10,000 HIVers across the United States found that having hepatitis C did not increase an HIV-positive person's likelihood of developing an AIDS-related illness or dying. It also found that, during their first 12 months of HIV treatment, the CD4 counts and viral loads of HIV/hepatitis C-coinfected people were similar to those of people with HIV alone.

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      HIV/STD TRANSMISSION

    Los Angeles: Syphilis Rates Jumped by 40% in 2005
    Syphilis rates in Los Angeles County, Calif., skyrocketed in 2005, according to a new report by county health officials. The number of new syphilis cases in the City of Angels jumped by more than 40 percent in 2005, the report found. Increases were noted across the board: Although the largest increase in cases was among men who have sex with men (matching nationwide trends), new cases rose dramatically among women, blacks and Latinos, and more modestly among whites. The numbers suggest that unsafe sex is on the rise in Los Angeles, which may be putting people at risk for other sexually transmitted diseases, such as HIV.


    Prevention for Positives: What's It All About?
    The Los Angeles syphilis report drives home a point that many HIV prevention experts have been making for years: Safe sex is just as important for HIV-positive people (if not more so) as it is for HIV-negative people. If you have HIV, safe sex doesn't just mean protecting others from HIV -- it also means protecting yourself from sexually transmitted diseases like syphilis and gonorrhea. The Center for AIDS has more information and advice in this fact sheet on "prevention for positives."

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      HIV OUTSIDE THE UNITED STATES

    African Countries Take a Serious Look at Male Circumcision
    Five African countries -- Botswana, Lesotho, Swaziland, Tanzania and Zambia -- are in talks with UNAIDS about making circumcision more accessible to men as part of HIV prevention efforts, following a major study last year that showed male circumcision could reduce a man's risk of becoming infected with HIV by 60 percent. Less than 20 percent of men in southern Africa, where HIV prevalence is highest, are said to be circumcised. Helen Jackson of the United Nations Population Fund said estimates show that 3.7 million infections and 2.7 million deaths could be avoided over the next 20 years by using male circumcision as a means of prevention.


    AIDS in Thailand: An Audio Slide Show
    Science may have made extraordinary gains against HIV in the past 25 years, but in countries like Thailand, those gains often don't mean a thing. This sobering report, part of National Public Radio's special feature on AIDS at 25, shows that many people with AIDS in Thailand are faced with a situation disturbingly similar to people with AIDS in the United States 20 years ago: Only 60 percent of Thais in need of HIV treatment are actually receiving it, and HIV stigma is still common. As a result, thousands of people with AIDS are left to waste away in Thai hospices with scant hope of recovery. (Web highlight from National Public Radio)

    The full National Public Radio report is available online; it includes audio slide shows documenting the AIDS epidemic in other regions of the world, including India, Russia, South Africa and San Francisco, Calif.


    AIDS Is Leading Cause of Death in Caribbean, UNAIDS Report Says
    AIDS-related illnesses are the leading cause of death for people ages 15 to 44 in the Caribbean, according to a new UNAIDS report. Accounting for 27,000 deaths in 2005, the Caribbean is still one of the regions of the world most affected by HIV, second only to Africa. UNAIDS estimates that there were 330,000 HIV-positive people living in the Caribbean at the end of 2005, and that fewer than one in four people who needed HIV medications was receiving them. Still, the news isn't all bad: while countries like Guyana are in the grips of a serious epidemic, the Bahamas, Barbados, the Dominican Republic and Haiti are all showing signs of slowing the progress of HIV.


    HIV Prevalence in Tijuana Rising Rapidly, Researcher Says
    As many as one out of every 125 adults in Tijuana, Mexico has HIV -- three times the rate of the rest of the country, according to University of California-San Diego (UCSD) researcher Steffanie Strathdee. In a recent interview (which you can listen to online), Strathdee said that since the 1990s, HIV rates among injection drug users in Tijuana have tripled and HIV rates among female sex workers have increased nearly tenfold. Strathdee attributes much of this increase to Tijuana's location on a major drug-trafficking route and its poor, marginalized migrant population. In an attempt to curb the upward trend of HIV, UCSD has donated a customized van to serve as a mobile testing and prevention clinic in neighborhoods with high levels of drug use and sex work.

    To listen to an MP3 of this interview, click here.

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    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the June 2006 Visual AIDS Web Gallery
    "Mask 3," 1994; Karl Michalak
    Visit the newly launched June 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! The May gallery is entitled "Magick Eyes"; it's curated by Malik Gaines, an independent critic and curator, and Alex Segade, a film and video director.

    Connect With Others
    A
    t The Body's Bulletin Boards

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

    "I was tested last week, and on Friday my doc called and told me that I was HIV positive. I was floored. Here I was, a straight male with no history of drug use and a relatively short list of female sexual partners, and I have HIV. I've been freaking out all weekend. I've only told two people, the girl that I'm pretty sure I got this from and a close friend. I've taken two more tests, and my lab is doing another test on the original sample for confirmation. I'm clueless as to what my next steps should be. I'm going out of my mind trying to figure out when I should tell my parents and my close friends. I don't want to tell anyone until I'm 100% sure of the results. Anyway, at this point I feel that I'm going to die a slow and lonely death."

    -- ace


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

    Late Presenter Seeking Info on AIDS-Related Illnesses and Meds
    (A recent post from the
    "I Just Tested Positive" board)

    "I [was just] diagnosed in the last week. I had been feeling fairly rough the last few years, but I put it down to being severely overworked and having a few issues in my personal life. ... It turns out my CD4 count was less than 10, and my viral load in excess of 700,000. My follow-up visit ... started with the discovery that I had the onset of Kaposi's sarcoma. Has anyone else had this, and been successfully treated for it? Does it disappear completely with the introduction of HAART? I have also been experiencing what I found out was peripheral neuropathy. Has anyone else had symptoms of this, which they have been successfully treated for?

    "I am due to commence therapy in the next day; however, my mind is in a complete whirl. I am opting for Truvada/Reyataz/Norvir, but wondered if I should be opting for Truvada/Sustiva instead. ... Has anyone else commenced therapy with similar labs to myself, and on these combos? If so, what did you think of each one? What are the side effects like? Also, do you make a complete recovery, and go on to lead a normal lifestyle?

    "I'm sorry if I'm asking so many questions, but I'm sitting here at the moment wondering which way to turn. I feel I'm at a crossroads, and a little guidance and help would be very much appreciated."


    -- Gary in Scotland


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

    Get Involved
    Help Choose the Winning Script
    for a Nationwide Contest!
    Scenarios USA: Kids Creating Social Change

    Scenarios USA and Rap It Up are looking for volunteers to help choose the winner of a nationwide public education contest -- and they want you to help!

    The contest, organized by Scenarios USA in partnership with BET and The Kaiser Family Foundation, asked people to submit a short film script on the following topic: "What's the REAL DEAL on growing up in the age of AIDS?" If you'd like to be a part of the committee that selects the winning script, all you need to do is sign up online by June 13. Anybody in the United States is welcome to join the committee!

    Interested? For more information, click here.