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December 20, 2006

In This Update:
  • Living With HIV
  • HIV Treatment & Health Issues
  • HIV in the News
  • HIV Outside the U.S.
  •   LIVING WITH HIV

    Don't Rest Until You've Found the Right HIV Specialist
    At Greg Milward's first doctor's appointment as an HIVer, he was told that as long as he took his meds he'd be fine -- that he'd be "on cruise control" for the rest of his life. Then the doctor left the room. The entire consultation lasted no more than five minutes, and none of Greg's questions had been answered. Unfortunately, there are HIV docs throughout the world just like this, but luckily for Greg -- and for you -- there are also health care providers who look at HIV care as a partnership. Greg struck out on a search for a health care provider that he could trust with his health -- and his life. "I realized that ... I needed to be able to have any concerns or questions addressed without being made to feel like a fool," Greg remembers. Maybe you feel the same way and don't know what to do about it. If so, this article and tip sheet are filled with ideas and questions to get you thinking about what will help you find the best health care provider for you.


    Mental Health and HIV: Spotting Symptoms and Solving Problems
    When HIV-positive people are asked, "How are you doing?" it's a safe bet that their most recent viral load and CD4 count will be among the first things that pop into their heads. Good numbers generally mean you are doing well, but they don't show the whole picture; after all, there's no way to test how you are doing emotionally. For an HIVer, the pressures of day-to-day life can be worsened by strict medication regimens, stigma and various other health and life concerns. In this article, HIV clinician Tonia Poteat discusses three of the most common psychological issues facing HIVers: depression, anxiety and addiction. Find out about the symptoms, how to identify them, and how to seek out help -- because, Poteat reminds us, "living well with HIV means taking care of your whole self -- body and mind."

    For more information and advice on coping with the emotional effects of living with HIV, click here.

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    HIV Treatment News
    Facts about one of the latest HIV meds: dosing, safety, and efficacy
    www.oneHIVpill.com

      HIV TREATMENT & HEALTH ISSUES

    HIV or HIV Meds? New Research May Shift Debate Over Causes of Heart Problems
    For years, results from large studies have suggested that some HIV meds increase a person's risk for developing heart problems. At the same time, other research has shown that HIV itself may be at least partly to blame -- and in a newly published study, an international team of researchers has spotted what may be a direct link between HIV and cholesterol problems. The researchers found that a protein within HIV has the ability to reduce a person's HDL ("good") cholesterol levels. Their research also provides some fascinating insight into how HIV uses cholesterol to help it reproduce. (Web highlight from aidsmap.com)

    Drs. Andrew Carr and Daniel Ory are two experts on problems related to cholesterol and blood fats in people with HIV. In this analysis published in PLoS Medicine, they review the results of the HIV-and-cholesterol study and talk about the new questions it raises regarding how HIV and HIV medications affect cholesterol and related issues.


    Development Halted for Brecanavir, an Experimental Protease Inhibitor
    Although an impressive number of new HIV medications have been approved over the past couple of years (with even more nearing approval), it's important to remember that many promising HIV medications often fail to make it past the development stage. For instance, the makers of brecanavir, a protease inhibitor that appeared to work well against HIV even in people with heavy drug resistance, have announced that they're discontinuing development of the drug. The reason: Scientists were unable to put the drug into a stable, effective pill form.


    After Surgery, HIVers Generally Do as Well as Non-HIVers, Study Finds
    HIV-positive people fare just as well after surgery as HIV-negative people do, according to a large new study -- a finding that may help make surgeons and hospitals less jittery about performing operations on HIVers with good CD4 counts and low viral loads. The California study matched 332 pairs of HIV-positive and HIV-negative people who were receiving similar surgeries and then watched how well they recovered after their procedures. The researchers found that, although HIV-positive people were more likely to die in the year following surgery, that excess death risk wasn't related to the surgeries themselves. The researchers noted, however, that people with a CD4 count below 50 or a viral load above 30,000 were more likely to have complications from their surgery. (Web highlight from aidsmap.com)


    HIV May Cause Permanent CD4 Cell Damage in the Gut, Study Says
    HIV begins damaging the immune system almost immediately after infection by destroying key cells in the lining of the gut, according to new research. CD4 cells tend to live in what doctors refer to as "mucosal" tissues -- tissues that line the genitals, airways and gut, all of which are spots where new illnesses are likely to invade. The researchers found that, even if people begin HIV treatment within a few weeks of becoming infected, they still lost a major percentage of the CD4 cells in their gut -- and didn't fully recover those CD4 cells after starting treatment. However, scientists aren't exactly sure what this revelation signifies, particularly for those who have stayed healthy for years while on HIV medications.

    To read the full study, which was published in the open-access journal PLoS Medicine, click here.

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      TAKE A SURVEY ON ANEMIA

    Although HIV-positive people may experience anemia, many HIVers know very little about it. How much do you know about anemia and HIV? Share your thoughts in this quick survey brought to you by Ortho Biotech. Your responses will be kept completely anonymous.

      HIV IN THE NEWS

    In Stirring Speech, U.S. Senator Obama Calls People of Faith to Action on HIV
    Possible 2008 U.S. presidential candidate Sen. Barack Obama continues to speak out on the global AIDS crisis, emphasizing the struggle faced by African nations. In a speech at a Christian church in California on World AIDS Day, Obama told the audience, "[F]aith is not just something you have, it's something you do." Calling HIV "the greatest health crisis in human history," Obama called for a comprehensive, joint approach to prevention, including increasing access to condoms and empowering women. "We are all sick because of AIDS -- and we are all tested by this crisis," Obama said, "Neither philanthropist nor scientist; neither government nor church, can solve this problem on their own -- AIDS must be an all-hands-on-deck effort."

    Click here to read an interview Sen. Barack Obama conducted with The Body earlier this year as part of our African-American HIV/AIDS Resource Center.


    Washington, D.C., HIV Testing Campaign Shows Mixed Results
    The HIV infection rate in Washington, D.C., may be as high as 4 percent -- and new efforts to get people tested for HIV appear to have had limited success, according to a new report. D.C. health officials and HIV advocates launched a new testing campaign in June, aiming to reach 400,000 adults in the district. However, according to the report by the DC Appleseed Center for Law and Justice, fewer than 20,000 D.C. residents have received HIV tests since then. Nonetheless, in spite of criticism, officials estimate that the city is administering twice or perhaps even three times as many HIV tests as it's offered in previous years.

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      HIV OUTSIDE THE UNITED STATES

    South African Lifespans Cut Short by AIDS; Treatment Remains Elusive for Many
    Perhaps nowhere in the world is the AIDS crisis more apparent than in South Africa. The nation's average life expectancy has declined by 13 years since 1990, from 64 to 51 years, due to HIV, according to a new survey by the Medical Research Council (MRC) and the Actuarial Society of South Africa. According to Debbie Bradshaw, senior MRC researcher, infections are soaring among women ages 15 to 24, and behavioral changes and condom use have not been adopted enough to slow the epidemic. The report also highlighted just how terrible the treatment-access situation is in South Africa: Although about 230,000 HIV-positive people in the country were receiving HIV meds, 540,000 people had advanced HIV (i.e., AIDS) but were not receiving any treatment, the report stated.


    One in Five South African Men Have Committed Rape
    In some countries, simply being female can be dangerous to your health. In South Africa, rape is so prevalent that a new survey conducted by Medical Research Council shows that one in five South African men between 15 and 26 has raped a woman. The most common form of sexual violence, according to the survey, is "streamlining," or gang rape. According to police reports, almost 55,000 South African women were raped between April 2005 and March 2006. Until now, though, we've known little about the men who commit rape in South Africa. Learning about rapists is important for many reasons, the authors of the study note; one critical reason is that women who are raped are at risk for HIV. (Web highlight from The Lancet; free registration at thelancet.com is required to read this article)


    Violence Against Women and HIV: Breaking the Connection
    Chantal Mukandoli's trip from Rwanda to the XVI International AIDS Conference in Toronto, Canada, was a breeze compared to the twisted path her life has taken since 1994, when she was infected with HIV while being repeatedly raped during the Rwandan genocide. "I suffered for years before I could begin to talk openly about this," she recalls. Mukandoli is not alone: New studies suggest that women who have experienced violence -- whether in war-torn areas or through domestic violence -- may be up to three times more likely to get HIV. The International AIDS Conference last summer gave many of these women from around the world a rare opportunity to come together as a group and advocate for women's rights.


    HIV and Malaria: One of the World's Deadliest Duos?
    Malaria may make HIV even deadlier than it already is -- and having one disease may make a person more likely to have the other, according to new research. Malaria infects hundreds of millions of people every year, mostly in developing countries -- and HIVers are more susceptible to malaria because of their weakened immune systems. But this new study adds a disturbing twist: Researchers found that malaria can cause a sevenfold increase in viral load for an HIVer, which further weakens their immunities to other infections and increases their risk of passing HIV to another person. In regions where both diseases are common, like sub-Saharan Africa, researchers believe malaria may be to blame for about 5 percent of all new HIV infections, and that HIV may in turn be responsible for almost 10 percent of malaria cases.


    Brain Drain Hits Hard in Swaziland as HIV Rate Skyrockets
    "Swaziland is dying. Will the last nurse on duty please turn off the lights?" reads a handwritten note at a clinic in Manzini. The grim message offers a glimpse into the health care crisis in Swaziland, where nurses, physicians and assistants are fleeing the country in search of better working conditions. In a nation where 33 percent of the population is HIV positive -- the highest infection rate in the world -- and 20 percent of the health care positions are vacant, medical professionals often fall victim to hopelessness and exhaustion. Many have left the country in search of better pay and hospitals with medicine, proper equipment and full staffs. A recent report estimated that 38 percent of the country's nurses were themselves HIV positive, and projected that 3 to 4 percent of the nursing workforce could succumb to AIDS-related illnesses each year. (Web highlight from PlusNews)

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    Also Worth Noting

    Visual AIDS
    Art From HIV-Positive Artists

    Image from the December 2006 Visual AIDS Web Gallery
    Untitled (self-portrait), 1991;
    Robert Blanchon
    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

    "23, Newly Diagnosed and Wondering: Why Bother With Meds?"
    (A recent post from the
    "Gay Men With HIV" board)

    "Hey, I am 23, just found out I have HIV and [am] sure to start treatment soon (CD4 197, VL 19,000). I keep asking myself and god, why start? What can life have to offer me now with this virus? I have so many decisions to make, I just can't decide what is the right one. Also, being at university and the start of adulthood, what is the point! I have kept this secret to myself and am not sure who to trust with this problem. ... Telling people I was gay was bad enough; now HIV! I don't think I can cope living with what are meant to be the best years of my life with this dark cloud over me. And how will I ever meet someone I can love and love me back now! I feel like running away! But where to? Any helpful words or some direction ..."

    -- austin uk

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

    "Taking Atripla as My First Regimen"
    (A recent post from the
    "HIV Treatment" board)

    "My doctor is going to start me on Atripla -- the one-a-day pill. This will be my first regimen and I'm glad because it's only one pill a day, [but] has anyone taken this medication? I hear that some people have nightmares [while taking it]. Is that true? I'm nervous!"

    -- javi_smtx

    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!