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December 13, 2006

In This Update:
  • HIV Policy in the U.S.
  • HIV Treatment
  • Living With HIV
  • Complications of HIV & HIV Meds
  • HIV Transmission
  • HIV Outside the U.S.
  •   HIV POLICY IN THE UNITED STATES

    Ryan White CARE Act Reauthorization Passes U.S. Congress
    After being held up for a full year due to disagreements between Republican and Democratic senators, the long-awaited reauthorization of the Ryan White CARE Act finally appears to be near. Both houses of the U.S. Congress have now approved a compromise bill to renew the act, which funds HIV-related support and treatment programs throughout the United States. In the compromise, legislators essentially agreed not to make any fundamental changes to the act -- including a highly controversial revision proposed by Republicans that may have dramatically shifted funds from urban areas to rural areas.


    Hundreds on Waiting Lists for Free HIV Treatment in United States
    Although the U.S. Congress has finally agreed to reauthorize the Ryan White CARE Act, many HIVers without insurance in the United States are still going without treatment because there isn't enough government funding. There are now 340 people on AIDS Drug Assistance Program (ADAP) waiting lists in three states, and other ADAPs have had to restrict the types of treatment available to low-income people with HIV. "Even with the changes in the reauthorized program, ADAPs will continue to tread water unless sufficient funding to stabilize the programs is provided," warned Julie Scofield, the executive director of the National Alliance of State and Territorial AIDS Directors, which provided the report on the current state of the country's ADAPs.

    Meanwhile, a fourth HIV-positive person has now died while on an ADAP waiting list in South Carolina. The furor is growing in that state, where AIDS activists are demanding immediate action from Governor Mark Sanford.

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      HIV TREATMENT

    Warning of Dangerous Interaction Between Ritonavir and Blood-Pressure Drug Nifedipine (Adalat, Procardia)
    The blood-pressure drug nifedipine (known by the brand names Adalat and Procardia) may cause a dangerous, and potentially life-threatening, interaction when taken by a person who's taking the HIV medication ritonavir (Norvir), which is used as a "booster" med in many treatment regimens. A report in the medical journal AIDS tells the story of an HIV-positive man from Spain who experienced kidney failure, an extreme drop in blood pressure, and other dangerous symptoms because the nifedipine he was taking interacted with the Kaletra (lopinavir/ritonavir) in his regimen. As soon as he stopped taking one of the two drugs, his condition rapidly improved, the researchers noted. (Web highlight from aidsmap.com)


    Strategies Evolve for Treatment-Experienced HIVers
    These are exciting times in HIV treatment, with new meds now being developed and approved at a rapid pace. Dr. David Cooper, a prominent HIV researcher from Australia, recently provided a rundown of the current crop of new HIV medications, and discussed the ways in which clinicians could use those new meds to help treatment-experienced HIVers keep their viral loads down and CD4 counts up. The Body's Simon D. Portsmouth, M.B.Ch.B., reports from the 8th International Congress on Drug Therapy in HIV Infection.


    Number of People Diagnosed With Multidrug-Resistant HIV May Be Slowing
    We know all too well how multidrug-resistant HIV can severely limit a person's treatment options. And it's true that the number of people with multidrug-resistant HIV keeps increasing. However, it looks like there may be at least some good news: The rate at which people are becoming resistant to multiple HIV meds is slowing down, according to new findings from a large Portuguese study. That could mean that the new generation of HIV meds is working so well that people aren't developing resistance as quickly, or as often. The Body's Simon D. Portsmouth, M.B.Ch.B., reports from the 8th International Congress on Drug Therapy in HIV Infection.

    For more research highlights from the 8th International Congress on Drug Therapy in HIV Infection, which took place last month in Glasgow, United Kingdom, click here!

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      LIVING WITH HIV

    Starting a New Life With HIV
    "[HIV is] not the end of the world. Take it as the beginning of another life," writes Lisungu Chieza. If you met Lisungu today in her work as a community educator in Toronto, Canada, you might not guess how far she's come in the 10 years since her HIV diagnosis. The Zimbabwe native and former microbiologist tested positive in 1996, and lost her husband shortly thereafter. Rejected by her in-laws, Lisungu plunged into a deep depression -- she neglected her children, gave up on her education and started skipping work. But with the help of her mother and an HIV support group, she found a new purpose in life: the fight against HIV.


    HIV Stories From Latin America: Three Women Speak About Their Struggle
    Justa Suazo, Laura Perez Ottonello and Sandra Zambrano are three Latin-American women whose lives have been turned upside-down by HIV -- but who have responded with incredible strength and resilience.
    For instance, two years after Justa, a 36 year-old woman from Honduras, was diagnosed with HIV, she joined a support group called the Association of People Living with HIV/AIDS. Now she is one of the group's national leaders. Or take Laura: Fifteen years ago, she learned that she had gotten HIV from her husband, who had been cheating on her. Today she has a three-year-old granddaughter and is president of the Uruguay Network of People Living with HIV. As Sandra explains, "The epidemic has made us stronger." (Web highlight from BBCMundo.com)


    WORLD Celebrates 15-Year Anniversary, Honors Women HIV Activists
    In 1991, a small group of HIV-positive women gathered in Rebecca Denison's living room in Oakland, Calif., to write a newsletter. Fifteen years later, the organization Denison founded, Women Organized to Respond to Life-Threatening Diseases (WORLD), is part of a dynamic, widespread movement to support and educate 20 million HIV-positive women around the world. At the XVI International AIDS Conference, representatives from WORLD connected with global activists in the conference center and in the streets, demanding treatment access, new prevention technologies and recognotion of sex workers' rights.

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      COMPLICATIONS OF HIV & HIV MEDS

    Momentum Grows for Genetic Testing to Prevent Abacavir Hypersensitivity
    More and more HIV doctors are supporting a new type of genetic test that can find out whether an HIVer is at high risk for abacavir (Ziagen) hypersensitivity reaction. Hypersensitivity reaction is a potentially dangerous allergy that some people develop soon after starting HIV treatment with abacavir, Epzicom (abacavir/3TC) or Trizivir (AZT/3TC/abacavir). But by using this genetic test, HIV clinicians can get a better idea for whether they should avoid giving a person abacavir. The latest data to back this method comes from a study conducted in the United Kingdom. The Body's Graeme Moyle, M.D., reports from the 8th International Congress on Drug Therapy in HIV Infection.


    Researchers Spot New Drug That May Help Treat Metabolic Problems in HIVers
    One of the biggest fears HIVers have today is that they will develop metabolic complications, a family of problems that include unusual fat gain (lipoatrophy/lipohypertrophy), high cholesterol, high triglycerides and insulin resistance (which can lead to diabetes). Researchers are still hard at work trying to find ways to treat these complications -- and in the latest news from Boston, doctors report some hopeful, early results from a drug called acipimox, which is already used outside the United States to treat high cholesterol and diabetes. In a small study, the Boston researchers found that acipimox had a beneficial impact on blood fats in HIV-positive men and women who had high triglyceride levels and abnormal body fat distribution. (Web highlight from Reuters Health)

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      HIV TRANSMISSION

    Male Circumcision Dramatically Reduces HIV Risk for Heterosexual Men, Studies Find
    HIV prevention experts throughout the world have been waiting with bated breath for the results of two major studies on male circumcision in Kenya and Uganda. Early results from the study were just released, and they appear to be conclusive: male circumcision cuts in half the risk that a man will get HIV from a woman during unprotected sex, the studies found. In fact, the study results were so convincing that researchers ended the study early. The results are most applicable to developing countries, where circumcision is uncommon and HIV rates are high. In hopes of curbing a sudden rush of circumcisions by unskilled people, the researchers note that the study only involved operations that were performed by trained medical professionals.

    For more information on these major studies, check out this Q & A document prepared by the U.S. National Institute of Allergy and Infectious Diseases.


    Missed Chances for Early HIV Diagnosis Abound in South Carolina
    As many readers know, the U.S. Centers for Disease Control and Prevention (CDC) now recommends that everyone between the ages of 13 and 64 be regularly tested for HIV. A new study from South Carolina showcases just how important regular HIV testing is. The study found that 40 percent of people diagnosed with HIV in South Carolina progressed to AIDS within one year, suggesting that they had been infected for many years without ever getting tested for HIV. T
    he CDC's new recommendations should help people get diagnosed much earlier, which will benefit their health and limit further HIV transmission.


    New Ad Campaign Warns of Link Between Viagra, Meth and HIV
    For a while now, AIDS activists have been frustrated that the makers of Viagra and other erectile dysfunction drugs seem to be doing little to warn men of the risks that may come with using their drugs for reasons other than doctor-diagnosed impotence. Now, a major HIV healthcare organization is taking action: AIDS Healthcare Foundation has launched an ad campaign warning that the use of Viagra with crystal meth can lead to HIV infection (by making men more likely to have unprotected sex). According to the foundation, Viagra is being marketed as a drug that can improve one's sex life -- not simply to treat a medical problem -- and is thus helping foster the spread of sexually transmitted diseases, including HIV. The ads will appear in newspapers in Los Angeles, New York City, San Francisco and southern Florida. (Web highlight from 365gay.com)

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      HIV OUTSIDE THE UNITED STATES

    Using HIV as a Weapon of War
    Sexual violence is an ancient instrument of war. With the spread of HIV, that violence has become increasingly deadly. A report from the African Commission on Human and Peoples' Rights illustrates how diabolical minds can turn HIV infection into a military strategy. According to the report, the Democratic Republic of Congo has accused neighboring countries of sending as many as 2,000 HIV-positive soldiers to Congo's eastern province to spread HIV through rape. The war in Congo is still ongoing, and Africa's human rights commission has been powerless to investigate the alleged crimes or enforce penalties. According to Amnesty International, more than 40,000 women have been raped in the course of the conflict. (Web highlight from The Lancet; free registration at thelancet.com is required to read this article)



    India's Law Against Homosexuality Faces Renewed Challenge
    Despite all of the advances the United States has yet to make in furthering gay rights, things could be much worse -- take India, for instance. A law named Section 377 effectively outlaws homosexuality in India, stating that any "carnal intercourse against the order of nature with man, woman or animal" is punishable by up to 10 years in prison. Recently, a five-year-old lawsuit against Section 377, which was originally thrown out of court, was brought up for review once again by order of the Supreme Court of India. Supporters of the law say it is used to prosecute sexual offenses against children, but it can also be used to incriminate gay adults in consensual relationships. That can only increase stigma for many gay and bisexual men -- UNAIDS believes the number to be anywhere between 5 million and 15 million -- who as a result may be extremely difficult to reach with HIV prevention information.

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    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2006 Visual AIDS Web Gallery
    "Mexican Fervor," 2005; Loreen Bryant
    Visit the newly launched December 2006 Visual AIDS Web Gallery to view our latest collection of art by HIV-positive artists! This month's gallery is entitled "The Male Portrait"; it's curated by Richard Renaldi, a photographer living in New York whose works have been exhibited widely.

    Connect With Others
    A
    t The Body's Bulletin Boards

    "The Church, Homosexuality and HIV"
    (A recent post from the
    "Gay Men With HIV" board)

    "Most churches preach that homosexuality is a sin. To those of you who are church-goers, how do you deal with the negativity of churches -- especially when you are both gay and HIV positive? I am having some trouble with this, so any thoughts would be appreciated."

    -- Anonymous

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

    "HIV at 53: How Long Will I Live?"
    (A recent post from the
    "I Just Tested Positive" board)

    "Does anybody know how long a 53-year-old male in fairly good health who just tested positve might live?"

    -- Anonymous

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

    Breaking Research
    The Latest HIV
    Research From Glasgow

    Glasgow 2006
    The 8th International Congress on Drug Therapy in HIV Infection took place last month in Glasgow, United Kingdom -- and The Body's team of experts was there to bring you coverage of the latest research! Check out our Glasgow 2006 home page for highlights and a complete index of articles!