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November 1, 2006

In This Update:
  • HIV Treatment
  • Making a Difference
  • HIV Transmission
  • HIV & Immigration
  • HIV Outside the U.S.
  •   HIV TREATMENT

    Exclusive Podcast: Dr. Ben Young Discusses the Latest in HIV Management
    What do some of the world's top HIV clinicians think about today's most critical issues in HIV management? The Body recently sat down with Dr. Ben Young to discuss the latest trends in first-line HIV treatment, multidrug resistance, and the health complications associated with HIV and HIV meds. Read the full transcript or download a podcast to hear opinions on HIV straight from the expert's mouth!

    Our interview with Dr. Young is just one of several we conducted with prominent HIV clinicians as part of a new, regular feature from The Body. Click here to listen to all of our recent interviews!


    Study Suggests ADAPs Should Not Be "First-Come, First-Served"
    Did you know that many U.S. AIDS Drug Assistance Programs (ADAPs) provide HIV meds not to low-income people whose health is most in danger, but simply to those who manage to sign up first? It's true; depending on the state, an ADAP -- which provides HIV meds to low-income HIVers who may not otherwise be able to afford treatment -- may be a "first-come, first-served" service. However, at least a few researchers have wondered whether enrolling people in an ADAP based on their CD4 count might be a better use of resources. A new study in Massachusetts has found that -- surprise! -- doing so would help more of the state's sickest HIVers. It also would help far more minorities, the study found.


    Exposure to HIV Meds in Womb Does Not Affect Child's Mental Development, Researchers Say
    Good news for HIV-positive mothers: A small Canadian study has concluded that the use of HIV meds during pregnancy does not appear to damage a child's mental development. Researchers compared 39 children exposed to HIV meds in the womb with 24 children born to HIV-negative mothers. After controlling for drug and alcohol use by the mothers, there were no significant differences between the two groups of children, leading the researchers to suggest that substance use is "a stronger predictor of a poor neurodevelopmental outcome" in babies than use of HIV meds. (Web highlight from aidsmap.com)


    U.S. Releases Rewritten HIV Treatment Guidelines for Children
    Revised HIV treatment guidelines for children have been released by the U.S. Department of Health and Human Services. The revision -- a near-complete rewrite and reorganization of the guidelines -- includes adjusted recommendations regarding the use of HIV medications by HIV-positive children.


    Tipranavir Still Active in Face of Major PI Mutations, Study Notes
    One of the main goals in developing new HIV meds is to provide new options to people who have developed resistance to existing meds. The protease inhibitor tipranavir (Aptivus) is one of these new options; approved in the United States last year, it has shown effectiveness in people who are already resistant to other protease inhibitors. To investigate this further, a recent study closely examined four major mutations that make HIV resistant to the majority of protease inhibitors. As The Body's Margaret Hoffman-Terry, M.D., reports, the researchers found that these four mutations don't have much of an effect on tipranavir, supporting the drug's use in people with protease inhibitor resistance.

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      MAKING A DIFFERENCE

    Youths Can Win $2,500 in HIV Writing Contest
    Are you between the ages of 14 and 22 and living in the United States or Canada? Do you have a story to tell about HIV? The HEAR ME Project wants to hear from you! The project is looking for fiction or non-fiction stories of five pages or less about "personal vulnerability" to HIV. Submit your story online or via mail by Dec. 1, 2006, and you'll be eligible for a $2,500 cash prize. Contest judges include Spike Lee, Hilary Duff and Forest Whitaker. Click here for complete contest details. (Web highlight from the HEAR ME Project)

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      HIV TRANSMISSION

    Microbicides May Offer New Prevention Options to Receptive Sex Partners
    The "ABCs" (abstain, be faithful, use condoms) of HIV prevention are irrelevant for millions of women throughout the world who lack the power to negotiate the terms of their sex lives. That's one reason why the development of microbicides carries so much hope. The same goes for men and women who are usually the receptive partner during anal sex, and whose partner doesn't use condoms. Microbicides could put the power of HIV prevention into the hands of female and male receptive sex partners with just a simple cream, foam, or gel that can be inserted vaginally or rectally when condom use isn't possible. This article from the San Francisco AIDS Foundation describes how microbicides work, what candidates are in clinical trials and why there is an urgent need for more financing.


    Methamphetamine Use and HIV
    Imagine a drug that made you feel invincible. Now imagine the impact that would have on your condom use. Some HIV-negative crystal meth users feel that they can't possibly become infected with HIV, and some HIV-positive users come to believe they don't need to take their HIV meds to stay healthy. A recent study of 3,000 gay men in San Francisco found that meth users are three times more likely to have HIV than non-meth users. Meth's ability to undermine a person's general health and harm the brain can also be a major problem in HIV-positive meth users.

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      HIV & IMMIGRATION

    U.S. Immigration and HIV: The Real Deal
    The U.S. immigration process is a sea of red tape, paperwork and delays. Imagine trying to navigate it when you also have HIV! One of the most embarrassing facts about U.S. immigration policy is that for nearly 20 years, people living with HIV have been officially banned from entering the United States, with some limited exceptions. The U.S. Congress has long held that HIV is a "dangerous, contagious disease" and that lifting the ban would harm public health and put financial burdens on the country. Activists, public health agencies, UNAIDS and the International Organization for Migration have all condemned the ban. This article from AIDS Community Research Initiative of America outlines the history of the HIV ban and how it impacts visitors, immigrants and refugees.


    One Woman's Story of HIV and Immigration, From Honduras to the U.S.
    When doctors in Honduras told 18-year-old Maria that she and her baby girl were "HIV positive," she didn't know what the term meant. Maria had a rare blood-clotting disorder and had received blood transfusions as a child. Her daughter died in the hospital soon after her diagnosis. Facing discrimination and lack of treatment in her village, Maria came to the United States. Click here to read the story of how she fought for political asylum -- and won.

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      HIV OUTSIDE THE UNITED STATES

    Global HIV Treatment Access Improves, but Long Road Still Ahead
    HIV treatment access in the developing world has grown by leaps and bounds in recent years, but even with mass mobilization by AIDS activists and immense generosity from donors, only 24 percent of the nearly seven million people who need HIV medications have access to them. Jacqui Patterson, an international health consultant, details the barriers to global treatment access and suggests solutions, including: coordination between governments, international agencies and funders; integration of treatment and prevention programs; and better HIV testing and education programs for women and girls.


    Could Free Trade Mean More Expensive HIV Meds?
    Many people are in favor of worldwide free trade as a way to level the playing field between the haves (wealthy countries) and have nots (developing countries). But could free trade actually have the opposite effect, making things like HIV treatment more expensive and harder to access in developing countries? "The drug industry's wish-list in trade agreements ... boil[s] down to rules that would extend their patents and delay generic competitors from entering the market," writes activist Robert Weissman. Weissman discusses the ins and outs of free trade agreements and how global AIDS activists are fighting to ensure the availability of generic HIV meds.


    Young South African Women Often Seek Out Risky Sex
    The dire situation of women in South Africa's KwaZulu-Natal province shows just how urgently an effective microbicide is needed. High-risk sex is common among the young women in KwaZulu-Natal: While some girls are forced to sell sex to put food on the table, others do so to buy a cell phone or new clothes. Some girls forego condoms in order to become pregnant and be eligible to receive a monthly social grant of US$24. Even girls who plan on marrying well are throwing caution to the wind: "I have heard, during my discussion groups at schools," an HIV educator said, "that young men ... coax virgins into having anal intercourse as a means of maintaining their virginity." Researchers are hopeful that microbicide studies being held within KwaZulu-Natal will soon yield a microbicide that can reduce the transmission of HIV to women. (Web highlight from PlusNews)


    The Forgotten Children of Africa: Three Stories From Swaziland
    Nkhosibona, Thembelani and Xolani are three Swazi children whose lives have been deeply touched by HIV. Nkhosibona's father died of AIDS three years ago, and his mother is HIV positive. Nkhosibona's HIV status is unknown because there isn't enough money to take him for testing. Thembelani, on the other hand, has been diagnosed with HIV, but he isn't on HIV meds yet. His parents doubt whether he ever will be because, his father says, "[the clinics] want you to be very, very sick -- be bed-ridden first," before they'll provide treatment -- and the family can't afford to pay for his treatment. The third child, Xolani, is on HIV meds, but is not taking the syrups designed for children like him. Instead, he takes adult pills that are cut in half, because his father found it too difficult to get the syrup doses correct in their dark hut -- and because the measurement markings on the syringe have rubbed off. (Web highlight from BBC News)


    Leprosy Emerging as Health Problem in People on HIV Treatment in Developing World
    As HIV meds become more readily available in developing countries, an unexpected side effect has begun showing its spots: In some HIVers, treatment is awakening dormant leprosy infections. As HIV meds help rebuild a person's immune system, newly produced white blood cells carry bacteria from dormant leprosy infections to the skin of a person's face, hands and feet. Only 12 such cases have been reported in medical literature since 2003, but experts believe the number is likely to increase in the developing world, where 300,000 new leprosy cases were reported last year and 38 million people are living with HIV. "[This new co-infection] is not a matter of concern for public health," according to the World Health Organization, since leprosy can be treated with free antibiotics. However, those added pills could be a burden for HIVers, who are typically already taking three HIV meds a day -- some of which interact with one of the main drugs used in leprosy treatment. (Web highlight from The New York Times)

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    Also Worth Noting

    In Memoriam
    Maxwell Lawton, 50

    Maxwell Lawton

    The Body is saddened to announce the passing of Maxwell Lawton, an HIV-positive artist from Washington, D.C. We met Maxwell earlier this year when we profiled him for The Body's Lipoatrophy Resource Center; in his interview, Maxwell told us about his miraculous recovery from death's door in 1992 and the dedicated steps he took in recent years to offset the loss of fat in much of his body. Although metastatic melanoma ultimately took Maxwell's life last month, his story lives on as a testament to the strength of HIV-positive people to persevere even when the odds seem stacked against them. For more on Maxwell's life, including a story about a painting he once created that generated a worldwide storm of controversy, click here.

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the November 2006 Visual AIDS Web Gallery
    "Colored Chicks," 1995;
    Joel Wateres
    Visit the newly launched November 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "Hot Chicks and Others"; it's curated by Rocío Aranda-Alvarado, the curator at Jersey City Museum, where she organizes exhibitions of contemporary art featuring work by both established and emerging artists in the New Jersey and New York region.

    Connect With Others
    A
    t The Body's Bulletin Boards

    My Partner Is Positive and Won't Tell Anyone
    (A recent post from the
    "My Loved One Has HIV" board)

    "My partner (in a stable, non-monogamous relationship) simply can't bring himself to tell anyone, even his closest friends, that he is positive (diagnosed almost a year now). I am willing to let him be the one who tells them, but I wonder if other folks in this situation have any advice. Do I bring the subject up? Do I push? Do I wait for him to decide that the time is right?"

    -- gayguyinsf

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

    What Counts As "Safe" in a Mixed-Status Gay Relationship?
    (A recent post from the
    "My Loved One Has HIV" board)

    "[I've been in a mixed-status] relationship for a couple of months now, and while I generally feel comfortable with my partner's HIV status (he is the poz), every now and then I still get worried. I was thinking we should share experience on safer sex and see what's working for all of us. ... I've decided it's an OK risk to do unprotected insertive oral. All other things are protected. ... We love kissing and I usually have bleeding gums when I brush, so that's another thing that worries me. ... Any of these things sound like too much risk? Any other magnetic relationships out there to share what they find safe?"

    -- Anonymous

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