March 21, 2007

•  THIS WEEK IN HIV

It's been a month of anniversaries and commemorations in the HIV community:

• In March of 1987 -- as the world was just starting to wake up to the scope of the HIV pandemic -- outspoken activist Larry Kramer called for the creation of a "gay army" to fight HIV. This led to his founding of the AIDS Coalition to Unleash Power, better known as ACT UP. It was this activist group that was arguably the most instrumental in getting the U.S. government and the pharmaceutical industry to pay attention to a disease that was quietly devastating gay communities in the United States. Click here to read about the 20th anniversary of Kramer's groundbreaking speech. Better yet, read this inspiring anniversary speech given by Kramer on March 13.
  
  
• One of the largest and oldest HIV organizations in the United States, Gay Men's Health Crisis (GMHC), celebrated its 25th anniversary last week. Since its inception, GMHC has evolved far beyond what its name implies, providing a huge range of HIV prevention, advocacy and treatment services aimed at helping men, women and children alike.
  
  
• Twenty years ago this week -- on March 19, 1987 -- the HIV medication Retrovir (zidovudine, AZT) became the first drug ever approved for the treatment of HIV. Now it's one of well over two dozen HIV medications on the market that have transformed HIV from an almost inevitably fatal disease into a chronic one -- at least in places where people have access to the latest treatments and good health care.
  
  
• Wednesday, March 21 -- the first day of spring in the Northern Hemisphere -- also marks the first official National Native HIV/AIDS Awareness Day in the United States. It's easy to overlook the impact of HIV on American Indians, Native Hawaiians and Alaskan Natives, given that they make up only about 1 percent of the U.S. population. But U.S. Natives have the third-highest HIV/AIDS diagnosis rate among all ethnic groups in the United States, behind African Americans and Hispanics, and HIV stigma is a major problem. For more information, visit this Web page from the U.S. Department of Health and Human Services.

•  HIV TREATMENT & COMPLICATIONS

Choosing a First-Line HIV Treatment Regimen: A Review of the Latest Research
There are many factors to consider when choosing a first HIV treatment regimen. Effectiveness, convenience, resistance, side effects -- with so much to take into account, it can be extremely challenging to choose an ideal regimen. Fortunately, knowledge is the best weapon, and new research presented at CROI 2007 may help doctors and HIVers alike in choosing a first-line regimen. The Body's Eric Daar, M.D., provides a comprehensive review of these studies.


HIV and Cancer: A Changing Relationship
We've been hearing for years now that when HIV-positive people in developed countries become sick, it's because of different illnesses today than it was 10 years ago. But what do we mean by "different"? Well, take a look at cancer, for instance: Traditional "AIDS-defining" cancers like Kaposi's sarcoma are on the decline, while cancers that weren't associated with HIV -- such as Hodgkin's lymphoma -- are on the rise. As The Body's Jeff Burack, M.D., reports from CROI 2007, new studies are exploring how, and why, the relationship between HIV and cancer is changing.

•  HIV IN THE NEWS

Most Common HIV Strain in Europe, U.S. Came From Haiti, Researchers Conclude
Research on the origin of HIV subtype B, the strain of HIV most common in Europe and North America, has found that it originated in Haiti. One person, the researchers surmise, brought the virus to the United States from Haiti sometime between 1969 and 1972. That was the "key turning point in the history of the AIDS epidemic," the researchers conclude. HIV probably came to Haiti from Africa around 1966, the study found. This helps explain why Haiti was hit hard so early in the course of the global pandemic. (Web highlight from aidsmap.com)


McCain Stumbles on Funding Condom Use to Prevent HIV
"Should U.S. taxpayer money go to places like Africa to fund contraception to prevent AIDS?" The reporter's question stumped U.S. senator and presidential hopeful John McCain last week as his campaign bus rolled through northern Iowa. "What followed was a long series of awkward pauses, glances up to the ceiling and the image of one of Mr. McCain's aides, standing off to the back, urgently motioning his press secretary to come to Mr. McCain's side," writes New York Times blogger Adam Nagourney. McCain at first said that he advocated abstinence over condoms, but then seemed to rethink his response, adding, "I haven't thought about it. ... Let me think about it a little bit because I never got a question about it before." (Web highlight from New York Times)

•  GAY MEN & HIV

Program Dedicated to Helping Gay Men Become Parents
The U.S. now boasts its first dedicated program for gay men wanting to become parents. The program, run by a well-known Los Angeles fertility clinic, has already worked with about 70 couples. "There are a lot of centers that dibble and dabble in this," noted the director. "But we are the only program for gay men that has psychological, legal, medical, surrogates, donors and patients all taken care of in one place." However, if you are HIV positive, the clinic is legally barred from using your sperm. The service also carries a hefty price tag: $60,000, on average. (Web highlight from Reuters Health)


A Sexual Health Web Site for Gay Men Offers Hot Models, Good Info and a Little Humor
It's a far cry from the typical, dour public health Web site: The California Department of Health Services runs a sexual health site for men who have sex with men (MSM), complete with affectionate, attractive male models and a sleek design. STDCheckup.org aims to educate both MSM and health care providers about the importance of routine testing for sexually transmitted diseases (STDs). The site offers information on HIV, hepatitis, herpes and other STDs, and includes an STD risk assessment. And where else can you use a virtual Magic 8 Ball for "answers" to your sexual health questions?

The Body has a lot of information on other sexually transmitted diseases besides HIV. Click here for our comprehensive list of articles and resources.


Opinion: Trauma From 1980s, 1990s Spurs High HIV Rates Among Middle-Aged, Gay New Yorkers
Why are so many middle-aged gay men getting HIV? New data released by the New York City Department of Health and Mental Hygiene show that gay men between the ages of 35 and 49 have the highest rate of new HIV infections in the city. This Gay City News op-ed article tries to explain why: It offers that a breakdown in gay society during the most fatal years of the U.S. HIV epidemic left many middle-aged gay men isolated and depressed, making them more likely to engage in risky behavior. "The problem isn't lack of information," the authors write. "Handing a 45-year-old man another safer sex brochure just isn't going to do the job." (Web highlight from Gay City News)


Crystal Meth vs. Ecstasy/Cocaine: Does One Lead to More Risky Sex Than Another?
Many HIV prevention experts warn that methamphetamine (a.k.a. crystal meth) use by gay men leads to unsafe sex -- and thus fuels the spread of HIV. But a new U.S. study suggests that the use of other illicit drugs, like ecstasy or cocaine, may be a bigger problem than the much-publicized "meth epidemic." Researchers from the City University of New York interviewed 100 gay men who attended dance clubs in New York City between 2004 and 2007. Almost all of the men who were surveyed had used cocaine or ecstasy, and 58 had tried crystal meth at least once. The study found that meth users were no more likely to report uprotected anal sex. Still, many of the meth users admitted that they associate meth use with sex and risky behavior. Many meth users in the study said the drug increased their sexual desire -- and some confessed that meth made them take risks they later regretted. (Web highlight from aidsmap.com)

•  HIV TRANSMISSION

Gonorrhea Increase in Western U.S. Could Mean More HIV Cases, Study Says
The number of gonorrhea cases has increased in eight Western U.S. states -- an increase that could signify a corresponding increase in HIV cases, according to a new study. The study found that gonorrhea cases increased 42 percent from 2000 to 2005 in the West but decreased 10 percent nationwide. Researchers aren't sure how to explain the geographical disparity, but they cited risky sexual behaviors and methamphetamine use as possible causes. The study also found that gonorrhea testing in the eight Western states increased 87 percent from 2000 to 2005, compared with a 14 percent testing increase in eight non-Western states, which might in part explain the increased number of cases. The researchers called for a greater awareness of gonorrhea in the Western United States and noted that people who have gonorrhea should be retested every three months even after they receive treatment, to make sure they haven't been reinfected.

•  HIV OUTSIDE THE UNITED STATES

Silence Surrounds HIV as Afghan Epidemic Emerges
A farmer in Afghanistan recently discovered that his 18-month-old son is the youngest HIV-positive person in his country. Officially, that makes his son a rarity: There are only 69 recorded cases of HIV in Afghanistan, and just three people have officially died from HIV-related causes. However, health officials warn that those numbers are "not even close to reality." Many risk factors for the rapid spread of HIV currently exist in Afghanistan: lack of education and government services, deep-seated stigma, mass migration, and booming opium and heroin trades. Additionally, only 30 percent of the blood used in transfusions in hospitals is screened for HIV. And, of course, ignorance about HIV is common: The farmer says that after his son's diagnosis, "I told the family ... not to kiss the child." When he was told he could indeed safely kiss his son, he burst into tears. However, the father can do little more for his son than keep his secret; there are no HIV treatment centers in the country and no HIV meds are available. (Web highlight from New York Times)


Kazakh Children Got HIV Through Unnecessary Transfusions, Scientists Say
One hundred HIV-positive children in Kazakhstan may have been infected with HIV because of their doctors' desperation, their families' ignorance and their country's poverty. Investigators working for the U.S. Centers for Disease Control and Prevention (CDC) found that the HIV-positive children were infected by tainted blood and that many received transfusions they didn't need. Now their doctors are on trial for medical malpractice. "It's insane," Dr. Michael Favorov, the Central Asia program director for CDC, said of an HIV-positive baby boy who received 25 blood transfusions. "This kid needed no blood." The Kazakh doctors, who are paid as little as $175 a month, may have prescribed the transfusions in order to collect fees of about $20 per four ounces of blood, the proceeds from which are split with the local blood bank. However, some parents may have requested unnecessary transfusions, believing that an infusion of fresh blood could make their sick child stronger. Many patients and doctors in Russia, Eastern Europe, Central Asia and parts of China and India believe that blood transfusions can cure a variety of diseases that aren't blood-related. (Web highlight from New York Times)


UNAIDS, WHO to Gambian President: Prove Your Herbal HIV "Cure" Works
Gambia's president has forced both UNAIDS and the World Health Organization (WHO) to restate the obvious: There is no cure for HIV. In January, Gambian President Yahya Jammeh announced that he could eradicate HIV infection with a mixture of herbs. Disturbingly, he also asked HIVers who want to receive his treatment to stop taking antiretroviral medications. Now, the United Nations is challenging Jammeh to demonstrate his claims scientifically. In a joint statement, UNAIDS and the WHO urged Gambia to collaborate with international experts to "assess the safety, efficacy and quality of the therapeutic intervention." In the meantime, the statement urges people with HIV to seek scientifically-tested treatments, such as HIV medications and antibiotics meant to prevent HIV-related illnesses.