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June 28, 2006

In This Update:
  • Living With HIV
  • HIV Treatment
  • Drug Resistance Chat on July 10
  • News & Views
  • HIV-Related Complications
  • HIV Testing & Prevention
  • HIV Outside the U.S.

    Once, When We Were Heroes
    "There is bravery here, still, living all around us," writes longtime AIDS activist Mark King. "But the bravest time was many years ago." In this heart-wrenching, first-person story, Mark brings us back to the 1980s and early 1990s, when the specter of death loomed over the HIV community -- and when countless people showed astonishing strength in the face of a destructive epidemic. "My most courageous self, the best man that I'll ever be, lived two decades ago during the first years of a horrific plague," Mark recalls.

    10 Years After Son's Death, Longtime Survivor in Utah Worries We Haven't Learned Our Lesson
    Cyndy Archuletta knows all too well how devastating ignorance and prejudice can be: Because her doctor assumed that she wasn't even at risk for HIV, she was never tested -- and her son paid the ultimate price. Cyndy was infected through a contaminated blood transfusion in 1983 and later gave birth to a son. When he entered a Salt Lake City hospital in 1994, Cyndy had to force doctors to test him for HIV -- and when his results came back positive, she knew that she was positive as well. In 1995, her son died from a bacterial infection he caught at a swimming pool. Even now, years after her diagnosis and her son's death, Cyndy and her daughter (who was born before Cyndy was infected) continue to face ignorance and stigma. And as media attention has declined with the release of newer, more effective HIV meds, Cyndy, who is now 49, worries that today's younger generations aren't paying enough attention to HIV. "If there's anything you can do in your power to be safe, be safe," she pleads. (Web highlight from The Salt Lake Tribune)



    U.S. Approves 26th HIV Medication: TMC114 (Darunavir, Prezista)
    The U.S. Food and Drug Administration (FDA) has approved a new protease inhibitor, TMC114 (darunavir, Prezista), which has been developed specifically for people who have already developed resistance to many existing HIV medications. TMC114 will be taken twice a day, and must be boosted with ritonavir (Norvir). This is the first new HIV medication to be approved by the FDA since the protease inhibitor tipranavir (Aptivus) was given a green light in June 2005. A total of 26 HIV medications have now been approved in the United States.

    What's so Great About TMC114? The Body Talks With Dr. Cal Cohen
    The Body interviewed Dr. Cal Cohen, one of the lead researchers who investigated TMC114 (darunavir, Prezista) in clinical trials, to get his take on some of the key questions surrounding this new HIV medication: Why should we be so excited about TMC114? What side effects can it cause? How is it likely to change the way HIVers with multidrug resistance are treated? Tune in to our 18-minute interview or read the transcript!

    For more on this important new HIV medication, browse through The Body's collection of articles and fact sheets.

    U.S. HIV Drug Pricing -- and What You Can Do About It
    Activists and international organizations have done an amazing job reducing the costs of HIV meds in the developing world. But what about drug prices in the United States? HIV meds -- heck, all meds -- are growing more expensive with each passing year, and it's becoming ever more difficult for AIDS Drug Assistance Programs and other health providers to cover the costs. So what can we do about it? Project Inform explains.

    Some HIV Meds May Be Available Free of Charge in the U.S.
    Did you know that many HIVers in the United States can get their ritonavir (Norvir) for free? Or that some of the latest drugs in development, including the newly approved TMC114 (darunavir, Prezista), may be available at no charge to people with severe drug resistance? Through what's known as "Expanded Access Programs," many drug companies provide their HIV meds for free to people in the United States who need them most. Read this article by Project Inform for more information.



    HIV Positive and Multidrug Resistant? Join Our Chat on July 10!
    Join HIV treatment advocate Nelson Vergel for a live chat at The Body on Monday, July 10. For one hour beginning at 3:30 p.m. Eastern time (12:30 p.m. Pacific), he'll be answering questions about treatment options for HIVers with multidrug resistance. He'll also talk about new drugs in development and tips on healthy living for treatment-experienced HIVers.

    Nelson, the founder of, is one of the leading advocates in the field of multidrug resistance. He has been HIV positive for 23 years; his HIV is resistant to most currently approved medications, but his viral load recently dropped to undetectable on a combination of new drugs in development that are being tested in a clinical trial.

    Want to submit a question to Nelson in advance? Click here!


      NEWS & VIEWS

    Gates, Buffett Get Serious About Charity; Global Anti-HIV Efforts May Benefit
    When Bill Gates, one of the richest men in the world, says he's going to leave his day job at Microsoft and focus on spreading health care and education to the world's poor, there's reason to rejoice. When Gates and his wife Melinda specifically cite the creation of effective microbicides and an AIDS vaccine as two of their primary goals, there's reason for the HIV community to let out a cheer. And when Gates is joined by another multibillionaire, Warren Buffett -- who has pledged to give some $30 billion to Gates' foundation -- it's enough to make one hope that perhaps the tragic inequalities in the world may finally be comprehensively addressed by people who demand results.

    Since the announcements by Gates and Buffett over the past week, the U.S. media has exploded with coverage, comments and editorials. As David Leonhart wrote in the New York Times: While Buffett could have used his mountains of cash to form his own university or create a new foundation, thus "engag[ing] in a little competitive philanthropy," he "made the point that giving away money should be more about results than ego."

    To read many more editorials and opinion pieces about Gates' and Buffett's announcements, click here.

    And for a more detailed recap of Gates' and Buffett's announcements, click here.



    Should Everyone With HIV Get an Anal Pap Smear? Medical Experts Aren't Sure
    Although anal cancer is more common in HIV-positive people (especially men who have sex with men) than HIV-negative people, experts aren't sure whether anal Pap smears should become a routine part of health care for people with HIV. A new study by U.S. researchers confirms that HIVers are at a higher risk for developing pre-cancerous cells in the anus. However, there's still debate over how likely it is that these pre-cancerous cells will ever become anal cancer. Experts also aren't sure about the effectiveness of existing treatments for pre-cancerous anal cells. As a result, the jury is still out on anal Pap smears: Although it may well be better to know than not to know (which is why anyone who's worried can request a test), scientists are reluctant to recommend routine anal Pap smears for everyone with HIV. (Web highlight from

    To read the abstract of this study, which appears in the July 15 issue of Clinical Infectious Diseases, click here.



    HIV Stigma Persists in Bible Belt, Despite Orgs' Efforts
    HIV stigma still festers across the part of the U.S. South known as the Bible Belt. Stephany Washington, executive director of the Alabama-based AIDS organization Homeward Bound, says that many people in the area refuse to even talk about HIV, which makes testing and prevention especially tough. "The hiding of the disease is what kills [people] faster than the actual disease," she said. In addition, many businesses in Alabama don't allow AIDS organizations to do outreach in their establishments. Although Homeward Bound and other groups are undaunted, they realize that they can't fight HIV alone: They need the cooperation of a community that, 25 years into the epidemic, remains mired in the prejudices of the past. (Web highlight from Columbus Ledger-Enquirer)

    HIV Still on Rise in U.S. South as Education Lags Behind
    Why is HIV spreading so rapidly through the southern United States? Four reasons: "poverty, drugs, hopelessness and a lack of access to sex education," according to a recent newspaper report. Tom Robertson, HIV coordinator for Alabama's Calhoun County Health Department, said when he visits local schools to teach ninth-grade health classes about the epidemic, he is "appalled by what they don't know." He said some students "still think [HIV] is spread by mosquitoes," adding, "In the 25 years of this epidemic, we're still answering the same questions. And it's not the ignorance of the South. It's the lack of information." The problem is worst among minorities: Blacks in Alabama comprise 26 percent of the population and 70 percent of new HIV cases, according to the advocacy group AIDS Alabama. "[HIV/AIDS] is becoming a disease of the disenfranchised," one Alabama clinic director said.

    Rapid HIV Test Helps More People Find Out Their Status: Study
    Experts have been saying it for years, and now a massive new study has proven it: Where rapid HIV tests are available (instead of the older, slower tests), people are more likely to get tested. Back in 2003, the U.S. Centers for Disease Control and Prevention (CDC) launched a plan to distribute nearly 800,000 rapid HIV tests to communities and prisons throughout the country. In a detailed report on the plan's success, researchers confirmed that people are more likely to seek testing if there's a quick and easy way to do so -- and that the CDC's distribution plan may have helped people learn about their diagnosis who wouldn't have done so otherwise. Studies show that nearly one-third of people who undergo conventional HIV testing (which takes about two weeks) never return for their results, but that if test results are available within a half hour, people are more likely to wait for them.

    To read the full CDC report, click here.

    Florida Churches Open Their Doors to HIV Testing
    The push to expand HIV testing in the United States to the general population has even stretched to churches in Florida. On June 25, 15 churches in Broward County offered free HIV testing for their congregants after the pastor's sermon. Jim Brown, pastor of one of the churches, said that HIV stigma is lessening, but not enough. "In too many places, we treat HIV and AIDS like it's some kind of sin, instead of a disease," he said. "That's part of what we are trying to change." According to the health department, some 100 new cases of HIV/AIDS are reported in Broward County each month. In 2004, the U.S. health department reported that Fort Lauderdale led all major U.S. metropolitan areas in new cases.

    Black, Latino Women Increasingly Getting HIV While in Committed Relationships
    It's good to see the media finally starting to pay attention to a complicated problem in the United States: Many black and Latino women are becoming HIV positive and developing AIDS because, even though they traditionally haven't been seen as having much of an HIV risk, they're in a committed relationship with partners who are at risk. According to AIDS activists like Alicia Avalos of Women Alive, most of the HIV-positive women she encounters were infected by their husbands or longtime boyfriends. One of the reasons, she says, is that a growing number of these men have spent time in prison, where they learn risky behaviors that they continue after they're released. California is mired in debate over a proposal to require HIV testing for all California inmates -- not only when they're released, but also before they even enter prison, so they can get treatment and care. A recent study in Georgia pointed out that most HIV-positive men in prison were infected before they were incarcerated.

    Addressing the spread of HIV among women has become a calling for actress, singer and producer Sheryl Lee Ralph, who recently spoke with National Public Radio about her one-woman show, "Sometimes I Cry," which tells the stories of several HIV-positive women from an array of cultural backgrounds and walks of life. Click here to listen to this interview, which Sheryl did with Ed Gordon for his "News & Notes" program.

    The Body also had a chance to talk with Ms. Ralph earlier this year, when we interviewed her for our African-American HIV/AIDS Resource Center. You can read the full transcript of that interview by clicking here.

    Washington, D.C., Greets HIV Testing Day With Massive New Campaign
    We desperately need to ramp up HIV prevention efforts throughout much of the United States, but few areas are in as great a need as Washington, D.C., which has one of the highest HIV rates of any city in the country. That's why it's encouraging to see something like what happened on Tuesday, June 27, when D.C. kicked off National HIV Testing Day by introducing an ambitious citywide campaign to test more than 400,000 men and women. Organizers plan to distribute rapid HIV tests at no cost to health facilities throughout the city, and the city itself has pledged $8 million to help provide services such as counseling and medical referrals.



    HIV on the Rise Among Iranian Drug Users
    HIV is much more common in Iran than previously estimated, Iranian health ministry officials report -- and they say a large increase in injection drug use is to blame. Iran is believed to have between 2 million and 3.5 million regular drug users -- with about 2 percent of those being HIV positive. The Iranian government has been surprisingly progressive in some of its HIV prevention efforts: For instance, it recently launched a campaign to provide cheap, clean needles and methadone programs for drug users, and it hands out free condoms and syringes at detention centers. However, drug addiction is steadily growing at a rate of 8 percent a year, and Iran says that injection drug use remains the main cause of HIV infection. Officials have warned that the number of infections could more than double by the end of next year if no immediate action is taken. (Web highlight from Agence France-Presse)

    Also Worth Noting

    Lipoatrophy Center
    Personal Stories From HIV-Positive People With Lipoatrophy

    Ford Warrick
    At first, Ford Warrick wasn't bothered by the facial changes he experienced after years on HIV meds; as a fitness enthusiast, he felt they were masked by his already muscular frame. What did bother Ford were the comments of neighbors, friends and clients in the southern U.S. city where he has lived for the past 12 years. So after much research, he and his partner took a medical vacation in Rio de Janeiro, Brazil, where he underwent a treatment that isn't available in the United States.

    The Body's interview with Ford Warrick (available as a transcript and a podcast) is part of our newly launched Lipoatrophy Resource Center, your most comprehensive source on the Web for the latest news and information about this difficult side effect. Visit the center for news, research updates, overviews, comparisons of facial fillers, tips on how to get insurance coverage for lipoatrophy surgery and compelling accounts of what it's like to live with lipoatrophy.

    Connect With Others
    t The Body's Bulletin Boards

    Starting Treatment With an "Intense" Regimen
    (A recent post from the
    "I Just Tested Positive" board)

    "Hi. [I'm] kinda scared [because I'm] about to start treatment. My doctor wants to use an induction/maintenance strategy starting with an intense, four-drug, Kaletra (lopinavir/ritonavir)-based regimen along with Combivir [AZT/3TC] + Viread [tenofovir]. Can you tell me side effects with these? Also, is facial lipoatrophy a side effect of this [regimen]? Any help would be great."

    -- Anonymous

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

    Abnormal Liver Test; Should I Switch Meds?
    (A recent post from the
    "HIV Treatment" board)

    "I've been on Combivir [AZT/3TC] and Crixivan [indinavir] for 10 years -- no side effects and good numbers. However, my last physical indicated I should follow-up with a liver panel in two months; it was slightly elevated. When is it time to consider changing meds?"

    -- Anonymous

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

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the June 2006 Visual AIDS Web Gallery
    "Isis Rising," 1998; Fran Lewis
    Visit the June 2006 Visual AIDS Web Gallery to view this month's collection of art by HIV-positive artists! This month's gallery is entitled "Magick Eyes"; it's curated by Malik Gaines, an independent critic and curator, and Alex Segade, a film and video director.
    Upcoming Event
    AAHIVM to Announce
    Resistance Survey Results
    AAHIVM logo

    Save the date! In Manhattan on Tuesday, July 18, the American Academy of HIV Medicine will announce findings from a national survey of HIV-positive adults and HIV doctors on the topic of HIV drug resistance. A panel of prominent AIDS experts, including Dr. Howard Grossman and Dr. Martin Markowitz, will speak at the event, and will be available to answer questions from people who attend.

    Want to attend? Call Lauren Graham of the GCI Group at 212.537.8037, or e-mail her at The event will take place at Housing Works Bookstore Cafe from 11 a.m. to 1 p.m., and a light lunch will be served.