 |
|
|
|
The
HIV/AIDS eNews is published by the British Columbia Persons With AIDS
Society. This publication is a compilation of various articles
collected from numerous news sources. Opinions and information
expressed are those of the individual authors and not necessarily those
of the Society.
|
|
|
|
Average Joes' weekly gathering for poz gay men invites you to join them in their 2nd Annual Pride Celebration!
When: Friday, July 31, 3.30-6pm
Where: Oasis Ultra Lounge (1240 Thurlow St)
For more information, call 604.893.2200. |
|
|
|
|
Suits, BCPWA's working mens' dinner group, is kicking off Pride with a sunset dinner cruise of English Bay.
When: Monday, July 27, 6.30pm
Where: Meet at 501 Denman Street (the Constitution Paddle Wheeler)
Tickets: $63 (all inclusive, advanced purchase required)
For more information, please call Josephine at 604.688.7246 |
|
|
|
|
|
Hepatitis C is emerging as a sexually transmitted infection, primarily in HIV-positive gay men. Frank Talk helps gay guys understand more about Hepatitis C and how people may become infected during sex.
Feel free to take a look! |
|
People need affordable housing! Little affordable housing and subsidies have created a crisis.
BCPWA Advocacy program wants to tackle this crisis. Suzan Krieger, Advocate, “If we can find housing for one person each day, we will have done a great thing.”
Advocacy now has a “housing kiosk” equipped with a housing search program, printer and guides. Drop by Advocacy during regular hours. |
BC's Big Opt Out
BC’s Big Opt Out urges British Columbians to protect their right to privacy by refusing their personal health information be subject to eHealth, the BC Government’s new system of integrated electronic health records.
Visit their website www.bcoptout.ca to learn more about eHealth and what you can do about it. |
|
|
WEDNESDAY NIGHT SUPPORT GROUP
The Wednesday evening group welcomes people living
with HIV disease, people who are co-infected with Hepatitis C, as well
as family, friends, medical or social supports of group members. The
group focuses on mutual support, empowerment, and information exchange.
Date: Every Wednesday Evening
Time: 7:00pm - 9:00pm
Location: BCPWA Lounge (1107 Seymour St, 2nd Floor) |
|
|
For more info, click here, or call 604.893.2259.
|
HEALING RETREAT
Healing retreats for HIV-positive men and women. Join HIV-positive
people from all walks of life.
Date: June 26 - 29, 2009 and September 4 - 7, 2009
Location: Loon Lake [ Map ]
Registration: Register at reception
To book an interview:
Phone: 604.893.2200
Toll Free: 1.800.994.2437 ext. 200
Bring this completed form. |
|
|
For more info, click here.
|
|
|
|
Rally aims to lift HIV travel ban
Day of action/Surrey event set for Aug. 16
June 19, 2009
An
International Day of Action is planned for this summer to help hurry
along the lifting of a U.S. travel ban on HIV-positive people.
Surrey
resident Martin Rooney has begun planning a rally at Peace Arch Park
for Aug. 16, and is encouraging others in cities along the Canada-U.S.
border and elsewhere to stage their own Day of Action.
The Obama
administration is currently in the process of addressing the outdated
ban on immigrants and travellers who are HIV-positive. The groundwork
for the change came about when former president George W. Bush signed
the President's Emergency Plan for AIDS Relief about a year ago.
The
ban was enacted in the days when HIV/AIDS was first recognized but very
little was known about it, such as its transmission or lethality.
Few
Canadians were even aware of the ban until Rooney was turned away from
the U.S. in November 2007 for being HIV-positive and chose to speak out
against the unfairness of it.
He said since being interrogated
at the border and red-flagged in the system - after years of
problem-free crossing into the States to go shopping, attend
fundraising events or vacation - his morale has dropped, his
humanitarian work has suffered and making travel arrangements has
become nightmarish. He is not allowed even brief stopovers in the U.S.
en route to other destinations.
It just doesn't make sense to
uphold this archaic ban, said Rooney, pointing out that "HIV is only
communicable in a very limited set of circumstances," and is nowhere
near as communicable as swine flu, which was declared a pandemic and
yet has no travel restrictions associated with it.
As the repeal
makes its way through the bureaucratic process, many human rights
watchers worry the issue may be lost in the monumental task of
revamping the American health-care system.
The Surrey Day of
Action rally will be on Aug. 16 at Peace Arch Park, with a
corresponding rally of Americans on the U.S. side. Organizations that
have stepped up with support include Egale Canada, Housing Works
Washington, D.C., the International Court System, Dab the AIDS bear
project and some local unions.
For more information on the rally or to become a sponsor, check out the Facebook group or see www.martinstorm.com. ©
by Caralyn Cooke, Surrey Now
|
Plans for e-Health raise huge threats to privacy for Canadians
Depression,
infertility, cancer, addiction, abortion, erectile dysfunction,
HIV/AIDS -- whatever our health issues, Canadians value the right to
choose who they share intimate health information with. This right is
now under threat. "E-Health" is coming.
June 11, 2009
Depression, infertility, cancer, addiction, abortion, erectile
dysfunction, HIV/AIDS -- whatever our health issues, Canadians value
the right to choose who they share intimate health information with.
This right is now under threat. "E-Health" is coming.
E-Health
will create a giant system of electronic health records that will
eventually be accessible across the entire country. These government
repositories of citizens' health information are promoted as likely to
make health care safer, cheaper and more efficient.
But there's
little evidence to support those claims. To the contrary, there is
growing evidence that these systems are costly privacy nightmares that
undermine even the most basic trust in patient confidentiality.
In
a technological age, no one seriously argues that medical information
should be recorded only on paper. Electronic health records can have
benefits, including the ability to quickly send information to other
health care providers who need it for your care. But e-Health isn't a
system of sending (pushing) electronic information from one health care
provider to another. E-Health pulls information from every health care
provider into a giant data distribution system available to tens of
thousands of people.
Governments have a terrible track record of
safeguarding information on a single laptop, let alone huge
concentrations of valuable, highly sensitive data that will attract
sophisticated hackers and criminals and be available through thousands
of access points.
We are told that the $5 billion (yes, that's a
"b") that we have spent on e-Health nationally will pay off in patient
safety. The typical examples are of emergency room staff accessing
medical records of someone who arrives at ER unconscious. But, a simple
medic alert bracelet conveys critical information faster and for almost
no cost , and ERs already have access to all our prescription
information through PharmaNet.
We are told that the system will
save money by creating efficiencies. But when pressed, even Canada
Health Infoway, which exists solely to promote the development of
centralized electronic health records, admits that most economic
benefits are assumed and not proven.
We are told that Canadians
support e-health and yet only 33 per cent of Canadians find it very or
somewhat acceptable to have some (core) clinical data from a patient
record stored and managed by local regional health authorities or
agencies.
And here is just a little of what we are not being
told. In the words of one renowned security expert, billions of dollars
are "being wasted on gigantic systems projects that usually don't work,
and that place citizens' privacy and safety at risk when they do."
In
the U.K., a pioneer of e-Health, more than two-thirds of the population
no longer trust the government with their personal information, after
tens of millions of records have been lost or compromised and the prime
minister's own health information was illegally accessed and given to
the media.
Privacy protections in e-Health systems have an alarming tendency to be here today and gone tomorrow.
E-Health
in Alberta started out with promises of patient consent and the ability
to keep certain medical information from being generally accessible.
Where did everyone's health information go? Into the government
databases. And where are the promises? Gone.
In B.C., we don't
even really know what our government's "promises" are. B.C.'s e-Health
law gives us a vague, unspecified ability to limit who gets to see our
medical information by use of "disclosure directives," but we don't
know what that means yet because the government hasn't said. It may not
mean very much, and even if it does, it may not last long.
A
2007 Canadian Medical Association survey showed that 11 per cent of
patients already admit to holding back information from health care
providers because of privacy concerns. Without trust, we can't get
proper health care. Trust is going to erode even further in the
e-Health system. Some people will not get the testing and the treatment
they need because of it.
Citizens have been told shockingly
little about e-Health. Government is certainly not widely advertising
the fact that e-Health is going to be part of a much larger government
information-sharing project. Bureaucrats call this the "Information
Access Layer" and acknowledge that it will link e-Health data to a vast
array of other government ministries.
No one should be afraid to
go to a doctor for fear of where their health information will end up.
And yet there is real reason for concern. A proper e-Health system must
be built on informed consent, and anyone who participates must be able
to decide for themselves what information gets shared with whom.
We
can reap all the benefits of technology that are needed to improve our
health care system without giving up our fundamental rights to privacy,
respect, consent and confidentiality. But it won't happen unless we
demand it. To start demanding, see: bcoptout.ca.
Micheal Vonn is policy director at the B.C. Civil Liberties Association.
http://www.vancouversun.com
|
Avoid unapproved home HIV test kits, could yield false results: Health Canada
Health
Canada is advising consumers not to use the Clean Testing HIV Home Test
Kit, or any HIV home test kits, as they are unlicensed medical devices
and may provide false results.
June 22, 2009
Toronto
- Health Canada is advising consumers not to use the Clean Testing HIV
Home Test Kit, or any HIV home test kits, as they are unlicensed
medical devices and may provide false results.
The Clean Testing HIV Home Test Kit, available online at cleantesting.com,
is advertised as a self-test kit to determine whether an individual has
been infected with the human immunodeficiency virus (HIV).
"This
kit is unlicensed and has not been evaluated by Health Canada for
safety and effectiveness," the federal department said Monday in an
advisory. "Inaccurate test results may fail to indicate HIV in an
infected individual or indicate HIV when none is present."
Under
the Medical Devices Regulations, home HIV test kits require a device
licence issued by Health Canada before they can be advertised or sold.
It is illegal to advertise or sell unlicensed medical devices of this
class in Canada.
Currently, there are no HIV test kits that have been authorized for sale for home use in Canada.
Health
Canada has asked Clean Testing to stop selling the device and to notify
all customers not to use the kit. The department will continue to
monitor the situation and take appropriate action. Canadians should not
purchase these products via the Internet or from any other source.
Anyone
concerned about his or her HIV status should talk to their doctor.
Those who have used these test kits should also consult their physician
to evaluate the need to conduct proper testing. As well, Health Canada
says anyone who has used a home HIV test kit should contact their
doctor for follow-up testing and counselling.
Complaints
involving home HIV test kits can be reported to the Health Products and
Food Branch Inspectorate by calling, toll-free, 1-800-267-9675.
The Canadian Press
|
Death Lurks in an Empty Cupboard
In Canada's poorest neighbourhood, bad diets hasten illness and death.
June 19, 2009
 Ken, a regular patron at Carnegie Kitchen. Photo by Chrisopher Bevacqua-Fink.
Why,
in a country as wealthy as Canada, are people going hungry? When Dr.
Graham Riches first looked into the issue of "food insecurity" in the
early 1980s, he was interested in that question. Nearly three decades
later, Riches, emeritus professor of social work at the University of
British Columbia, is still trying to find the answer.
This much hasn't changed: For millions of low-income Canadians, finding -- and affording -- nutritious food is a daily battle.
And more and more, charities are expected to meet the need.
Vancouver with No Soup Lines?
Food
charities feed the poor, and in so doing release potential pressure on
political leaders to deal with hunger in a sustainable way by changing
policies. Seen in this light, food charities might undermine true food
security, as UBC's Dr. Graham Riches argues.
What is the view
on this from the Vision team recently elected to run Vancouver's city
hall? Though Mayor Gregor Robertson was unavailable for comment, City
Councillor Kerry Jang, representing the city's homeless effort, said
the city is not concerned by the proliferation of charitable food
outlets in the Downtown Eastside.
"Charities will always
exist," he said. "Even in the richest countries and the poorest
countries you get as much charitable giving." The city's prerogative,
explained Jang, is to ensure that charitable food served in the
Downtown Eastside meets minimum nutritional standards -- something the
city is not currently doing.
"Non-profits run themselves, and
all we can do is help them ensure they get the right kind of food out
to these people. We can't mandate it. It's impossible to enforce 'you
have to give up potato chips,' right?"
When reminded that
people in the Downtown Eastside have no choice but to stand in food
lines, which can be said to undermine their right to food, Jang seemed
to understand a lack of choice to mean a lack of variety. "I know that
really what you're getting that day is what's available," he said. "I
mean choice, it's really up to the operator to provide that kind of
service... if you're feeding a lot, sometimes franks and beans is all
you can provide. You got your good protein and your roughage; I know
it's a pretty boring meal."
But should the Downtown Eastside have charitable food outlets at all? Jang laughed at the question.
"There
will always be a role for charitable donations, for charitable food.
It's just too much a part of our food supply, our food chain to be
eradicated. Once we admit that to ourselves, we can say, ‘O.K., how can
we manage that food chain better?'"
"What we've seen is the
growth of public acceptance in Canada, that hunger is an issue for
charity and not a matter of right," explains Riches. "It's complicated
because obviously there are hungry people and there's a moral right to
feed the hungry, but rights are also political, rights are also legal."
Most Canadians have plenty of healthy food to eat. In fact,
Canada is one of the world's largest food exporters. Yet the
HungerCount survey of food banks found 2.7 million Canadians -- more
than the population of Metro Vancouver -- experienced food insecurity
at some point during 2008.
In
any given month, over 700,000 people, nearly 80,000 of them British
Columbians, turn to food banks, and over three million meals are served
in soup kitchens, emergency shelters and meal programs across the
country.
Riches, who has spent much of his career pushing for
the adoption of a rights-based approach to food security, says the
proliferation of charitable food services in Vancouver's Downtown
Eastside is a strong indication that the right to food is not being
upheld in Canada.
"If you go to the Downtown Eastside," he
says, "one of the most striking things is that there isn't really a
normally functioning food economy like most of us participate in. It's
what we call a food desert; there are no grocery stores and the local
food economy is really made up of charitable food."
Riches and
others see a dark irony in this. By taking on the growing task of
feeding the hungry, they say, charitable food providers unwittingly
have helped undermine the right to adequate food in Canada -- a right
enshrined in a UN covenant ratified by Canada.
Riches says
we're not living up to that agreement as a nation. And as a result,
people may be dying in Vancouver. "You go into the Downtown Eastside
and think, 'Oh, it's the drugs that are killing everyone.' Well what if
it's not the drugs? What if it's the poor diet day after day after day
that's slowly killing people? No doctor will sign that on the death
certificate but maybe that's what's happening."
Addicted and on her own
When
Stephanie walks through the door of The Lookout Emergency Aid Society
on a rainy Thursday morning, it's as if a tornado has just spun in.
"I'm getting the fuck out of here and moving in with my sister," she
announces, looking around the room manically and rocking from foot to
foot. I'm sitting with two outreach workers in the cramped office of
Lookout's emergency shelter on Alexander Street, where three desks have
been crammed into a space the size of a walk-in closet. Stacks of beige
file folders haphazardly climb the walls.
The Lookout is just
one of the 50 or so charitable organizations tending to the Downtown
Eastside's ailing population. Life expectancy here is five to 10 years
lower than the city's average -- for women and men respectively, and
residents are considered senior citizens at 45. As a result of
widespread deinstitutionalization beginning in the 1980s and steadily
gaining momentum ever since, mental illness is prevalent throughout the
neighbourhood, and addiction and infectious disease continue to plague
a community where several thousand, including Stephanie, live with HIV
and Hepatitis C.
Stephanie's hair is a short, muddy brown, and
her blue, wide-set eyes are lined with black eyeliner, now smudged by
the rain. Stephanie has agreed to sit and talk with me, but I can tell
by the way she's fidgeting in her chair and biting at her chipped nail
polish that our conversation is not destined to be a long one.
"I'm
on disability for my HIV but it's still not enough money to eat, it's
never enough," she says, picking listlessly at a handful of soggy
cheezies.
The sores on Stephanie's face indicate possible
formication, a common sign of crystal meth addiction. Also known as
meth mites, formication is the tingling sensation likened to insects
crawling under the skin, causing addicts to scratch themselves raw,
which then breaks the skin and produces the familiar ugly, red sores.
She is 21 years old.
'You never see a fresh vegetable'
Stephanie
grew up in Surrey, but left home as a teen and eventually found herself
living on the streets of downtown Vancouver. Like most people in the
neighbourhood, Stephanie was drawn to the Downtown Eastside because of
its close proximity to most of Vancouver's social services, including
its charitable food providers.
For Stephanie, eating means
standing in food lines everyday, so like her fellow Downtown
Eastsiders, she "shops" around at the various food outlets; wandering
from the Dugout on Powell Street for 7 a.m. soup and coffee, to the
Harbour Light centre or the Franciscan Sisters of Atonement for lunch,
and then the Union Gospel Mission for dinner. It's a well-beaten path
between food providers and it certainly gets tiresome.
"I hate
waiting," she says, swivelling back and forth in her chair. "And when
you finally get your meal there's no nutrition in the food you get;
it's just spoiled meat and white bread -- you never see a fresh
vegetable."
Stephanie's frustration with poor food quality is
something that is consistently echoed by both the recipients and the
providers of charitable food alike. Though the food providers fail to
keep records, spoiled donations are a common topic of discussion
throughout the neighbourhood. The outreach workers at the Lookout
shelter, which serves breakfast, lunch and dinner, voiced their
concerns over the poor quality of donated food, though they seemed
resigned to it.
"Virtually everything we get donated has
expired," explained Heidi Klassen, Stephanie's outreach worker. "We'll
get called to pick up a donation and the vegetables are literally
blue."
Malnourished immune system
As a
registered nurse and the director of Education and Care Evaluation at
the BC Centre for Excellence in HIV/AIDS, Irene Goldstone argues that
with aggressive nutrition, the immune system can support itself longer,
postponing the need to start antiretroviral therapy. "We're putting all
this money into a pharmaceutical response to HIV without meeting
people's most basic needs," she explains. "There is such an emphasis on
just getting the pills out to people, but we also need to recognize
that the pills don't work if you're hungry."
Goldstone, who
also teaches courses to health-care professionals, always includes the
vital role played by good nutrition in her HIV course content. "We do
this to try and increase awareness and responsiveness to patient needs
in light of the realities of the Downtown Eastside," she explains.
Poor
nutritional health is one of the major contributors to sickness in
low-income neighbourhoods like the Downtown Eastside, and
socio-economic status is among the most important factors associated
with health disparities in Canada. For Stephanie, an unhealthy diet
will soon take its toll. The Hepatitis C, which limits her liver's
ability to absorb nutrients, will further rundown her immune system and
reduce her body's ability to respond to HIV-related infections. This
means increased hospital visits and additional strain on the public
purse.
The financial cost is borne by every Canadian who pays
taxes. Health-care spending in Canada is roughly $120 billion a year.
According to a 2004 study by the Health Disparities Task Group, the
poorest 20 per cent of the general public (people like Stephanie)
accounts for 31 per cent of health spending on people who aren't
institutionalized. That's double the average spent on the richest 20
per cent.
Because a fifth of health-care spending can be
attributed to income disparities alone, the study maintains that big
savings could be had by raising the health status of low-income
Canadians to middle income levels.
Stephanie's HIV and Hep C
mean she will undoubtedly incur significant health-care costs in the
future. A Simon Fraser University study estimates that each HIV
positive person will cost B.C. taxpayers $750,000 in treatment expenses
over their lifetime. But good nutrition could go a long way to reduce
those costs by keeping her healthy and out of the hospital.
Stephanie
tells me she's moving home to Surrey to go back to school and become a
youth care counsellor. Then she stands up. "Are we done here?" And
without a backward glance she whirls out of the office. An outreach
worker suddenly pokes his head in the door: "I hear Stephanie is moving
to Surrey again. Are we actually believing her?"
Falling through the cracks
With
wispy blonde hair and silver bangles lining her wrists, Ellie Schmidt's
smile is casual, but her eyes are searching, daring you to look away.
Schmidt is the nutritionist at the Downtown Community Health Centre, a
primary care clinic for people in the Downtown Eastside. She tells me
about patient she saw earlier that day.
Let's call him John.
He is in his early 60s and according to Schmidt, is "falling through
the cracks." Though he suffered two heart attacks in the past year,
John is only eligible to receive basic income assistance, and according
to the provincial government, falls under the "expected to work"
category, which requires him to be actively seeking employment.
When
the BC Liberals came into power in 2001, the number of people receiving
income assistance in the province was already on the decline -- down 29
per cent from 1995. The Campbell government tightened restrictions
further. Since 2002, over 107,000 British Columbians have dropped (or
been pushed) off welfare rolls, though studies now show that rather
than returning to the work force, many of these people have wound up on
the streets.
John teeters on the edge of joining those
homeless. He pays $450 a month to rent a room in a five-storey SRO with
no elevator. With the help of two canes, he makes the slow climb to his
fifth-floor room in "excruciating pain," says Schmidt.
For
John, the $375 a month that the government provides for his shelter
cost doesn't cover his $450 monthly rent, which means he diverts $75
from his $235 support allowance to pay rent each month. John is then
left with just $160 for all his other monthly costs, including food.
Payments fall far short
Each
year, the Dieticians of Canada estimate the cost of a healthy food
basket in British Columbia. In 2007, the last year for which data is
available, a man between the ages of 50 and 74 could expect to spend
$196.56 a month on groceries, meaning that even if John had access to
kitchen facilities in his building (which he doesn't), his $160 in
support allowance would not even cover a healthy diet, to say nothing
of his other monthly expenses.
Though John lives just a
stone's throw away from most of Vancouver's free food outlets, his
heart condition makes waiting in food lines impossible. "He's a huge,
huge cardiac risk," says Schmidt. "He can barely make it up and down
those stairs, he could have a heart attack at any time, and he simply
cannot stand in food line-ups because he just can't stand to stand."
John,
says Schmidt, "has no money to buy groceries, and even if he did have
money he can't cook because he has no access to a kitchen. He's living
with severe depression and suicidal ideations, and I would too if I
were him."
Though she couldn't do much to help John, Schmidt
did talk him through some of his, albeit limited, options. "I
encouraged him to apply for disability or persons with multiple
barriers, which would help immensely," she explains. "In a year from
now he'll be 65 and get a pension, if he can live that long."
Get in line
John's
story is a testament to B.C.'s income assistance levels are too low to
allow many low-income Canadians to purchase adequate food.
Rich
Coleman, the Minister of Housing and Social Development, was
unavailable for an interview for this article, but he has made it clear
that the province has no plans to raise income assistance rates,
telling the Vancouver Sun, "We're the payer of last resort, we're not
to be seen as an unemployment insurance program."
Other
ministries with power to affect the food budgets of low-income British
Columbians were shy about answering my questions as well.
The
Ministry of Labour and Citizens Services, which maintains B.C.'s $8 an
hour minimum wage despite protests by labour and poverty rights groups,
repeatedly brushed off enquiries.
A spokesperson at the
Ministry of Health Services told me that any questions related to food
security should be directed to the Ministry of Healthy Living and
Sport, who in turn told me that their ministry is about health
promotion, and that I should call the Attorney General.
At the
provincial level of government, the issue of food security for the
British Columbia's poorest citizens would seem to be an orphan.
[Editor's note: This is the second of two features on food security in Vancouver's Downtown Eastside. Yesterday we visited the nutrition-conscious chef of the Carnegie Kitchen.]
Related Tyee stories:
Michael Pollan, Garden Fresh
Interview with In Defense of Food author Michael Pollan.
Crucible of Poverty (photo essay)
Duane Prentice spent five years documenting lives in Vancouver's
Downtown Eastside. He urges "the courage to see things as they are."
Downtown Eastside Seeks Foreign Aid
Vancouver group asks UN to help homeless Canadians.
By Amy Juschka, http://thetyee.ca
|
Hislop hero takes home CAS hardware
Rainbow Warrior / Longtime AIDS activist Al McNutt honoured at Ottawa banquet
June 22, 2009
 Al McNutt takes questions after the release of the Supreme Court of Canada's Hislop ruling on pension benefits for gay widows.
(Marcus
McCann) On Jun 19, the Canadian AIDS Society presented their annual
leadership award to Albert McNutt, a Nova Scotia-based gay activist.
McNutt, 59, has been HIV-positive since 1986. This isn't the first time
he's been recognized for his work by the HIV/AIDS community. He is best
known for his fight against the Canadian government for Canada Pension
Plan Survivor Benefits — a case he took all the way to the Supreme
Court of Canada as a member of the so-called Hislop class.
There he and others won a partial victory that secured pension benefits
for same-sex widows in the future, but limited the back-pay owed to
survivors like McNutt. For that, he won an award with the Canadian
HIV/AIDS Legal Network.
"[AIDS activists] don't often get acknowledged for what we do," says McNutt, who started that Northern AIDS Connection Society of Nova Scotia out of his dining room in 1996.
McNutt hails from Truro, Nova Scotia, a town with a population of 12,500 people.
"I saw a need to put a face to HIV. People often wonder what it's like living with it," says McNutt.
One of the biggest challenges in educating people about HIV/AIDS is
stigma, says McNutt, and it's an issue that the Northern AIDS
Connection Society tackles head-on.
"When you look at HIV,
it's been put into a category with marginalized groups — gay men, drug
users, sex trade workers and Aboriginal people. They're not saying it's
affecting lawyers on Bat St. Mainstream society is starting to believe
that if you don't fit into one of those groups, you can't get the
disease. HIV doesn't care if you're gay or straight, male or female,
black or white, rich or poor.
 BLING. McNutt recieves the CAS leadership award Jun 19.
(Neil
McKinnon) "Back when I was diagnosed, it was considered a death
sentence. You were supposed to be dead within a year. Nowadays, HIV is
classified as a chronic, manageable disease. We have to look at those
issues through education and awareness programs," says McNutt.
Monique Doolittle-Romas, director of CAS, says more people need to be recognized for their hard work in the HIV/AIDS movement.
"Al's award is well-deserved. He's done a lot of work and been a mentor
to a lot of people. People like him are in the front line. They deliver
services, treatment support. There were the first ones to respond in
the early epidemic and they're now continuing to deliver critical
services," says Doolittle-Romas.
By Neil McKinnon, http://www.xtra.ca
|
Online map details HIV prevalence in each state
County-level
data on the intensity of AIDS and HIV cases, as well as statistics by
age, gender and ethnicity, can be found through a new HIV/AIDS Atlas
being launched today by the National Minority Quality Forum, a
Washington, D.C., group.
June 22, 2009
It's
not surprising that San Francisco is among the top 20 counties with the
highest AIDS and HIV prevalence, but a new national online map shows
the Georgia counties of Fulton and DeKalb as well as Virginia's
Petersburg County also make the list.
County-level data on the
intensity of AIDS and HIV cases, as well as statistics by age, gender
and ethnicity, can be found through a new HIV/AIDS Atlas being launched
today by the National Minority Quality Forum, a Washington, D.C.,
group.
The online tool, available at www.mapHIV.org,
contains detailed information about HIV and AIDS in all 50 states, plus
Washington, D.C., Puerto Rico and the U.S. Virgin Islands. The
information becomes available to the public for the first time in a
single location, according to the group, which helps track death and
disease in minorities and other special populations.
"For the
first time, we actually know where the patients are," said Gary
Puckrein, chief executive officer of the National Minority Quality
Forum, which has created online atlases for other diseases such as
diabetes and cardiovascular conditions.
The information helps
improve data collection and analysis, prevention initiatives, early
diagnosis and routine testing efforts in the hardest-hit communities,
he said.
"With all this talk about health care and access,
we've done a very poor job of measuring things," he said. "Because you
don't measure, you make lots of assumptions about where the disease
is."
Using the HIV/AIDS Atlas, people can search by county and
narrow their field by gender, age and ethnicity. The results will come
up on color-coded maps, with the hot spots in red and regions with the
lowest prevalence in green.
The atlas counts the number of patients relative to the population, not the overall number of patients.
"When
you do this, you begin to see the disease in different ways, and
communities pop up on the radar screen we haven't noticed," Puckrein
said.
The level of information varies, with eight states
providing state-level information and 29 states offering data at the
county level.
While New York City is the only region with ZIP
code-level data, users can view many counties by congressional and
state legislative districts. The atlas' creators stressed that it is an
evolving tool and they will incorporate new data when available.
"This, in a very graphic way, helps decision-makers to see what is
happening in their jurisdictions," said Dana Van Gorder, executive
director of Project Inform in San Francisco, who previewed the map. He
said San Francisco has data available by ZIP code that are not yet
included in the atlas.
"Data like that clearly helps states
and counties to understand exactly where their HIV and AIDS cases are
so they can respond appropriately with services," he said.
Health
experts welcomed the new tool as a way to help them increase awareness
of the disease and better direct their funds for services.
"If
you're talking about developing prevention services specifically for
women, you would want to put the services somewhere where women with
HIV are," said Wayne Steward, co-director of UCSF AIDS Policy Research
Center.
The HIV/AIDS Atlas relied primarily on 2006 data
collected from states and cross-checked the information with the
Centers for Disease Control and Prevention. The National Minority
Quality Forum partnered with the George Washington University's School
of Public Health and Health Services to collect and analyze the data.
By Victoria Colliver, http://sfgate.com
|
US Visa Laws
1. U.K. Man Barred From U.S. Entry
A
prominent HIV-positive U.K. health official was recently denied a visa
to enter the United States, preventing him from speaking at a health
conference in Seattle.
2. AIDS: Discrimination in Visa Laws Poses Risk to Those With AIDS, Rights Group Says
International
migrant workers, foreign students and political refugees are often
endangered by laws that discriminate against people with AIDS, the
advocacy group Human Rights Watch reported last week.
1. U.K. Man Barred From U.S. Entry
June 19, 2009
Paul Thorn, project director of the Tuberculosis Survival Project, was
required to seek a special visa to enter the United States because of
the nation’s policy barring HIV-positive people from entering the
country. But his visa application was denied, preventing him from
speaking as planned at the Pacific Health Summit in Seattle on June 17.
Thorn told the Seattle Times that he was forced to issue a statement to summit attendees for his
absence, which read, “The U.S. government actively discriminates
against people" who are HIV-positive, adding that if U.S. officials
want to demonstrate leadership on HIV and global health by hosting such
conferences, "then they need to accept that non-U.S. citizens with HIV
are going to need to be there and participate."
http://www.hivplusmag.com
2. AIDS: Discrimination in Visa Laws Poses Risk to Those With AIDS, Rights Group Says
June 22, 2009
International
migrant workers, foreign students and political refugees are often
endangered by laws that discriminate against people with AIDS, the advocacy group Human Rights Watch reported last week.
About
a third of the world’s countries limit the right of people with H.I.V.
to enter or stay, even if their disease is under control with drugs.
Some restrict their access to health care.
The report describes how guest workers from poor countries like the Philippines
and Sri Lanka working in wealthy ones like Saudi Arabia may be given
mandatory H.I.V. testing — sometimes without their knowledge — and
deported, often without being able to claim back wages and sometimes
after imprisonment without treatment.
The group said the visa
restrictions had led people to commit fraud or stop treatment, risking
their lives. The report detailed one study in which travelers from
Britain stopped taking their AIDS pills or tried to mail them ahead,
sometimes unsuccessfully, out of fear that they would be denied visas
to the United States if they admitted being infected, or would be
searched at the border.
Wealthy countries often deport people
without considering whether they will have access to medical care
elsewhere, the report said. South Korea, for example, has deported
hundreds of foreign workers, and some deportees from the United States,
especially those with criminal records, have been jailed without
treatment and died in custody.The International Organization for
Migration estimates 3 percent of the world’s population — 192 million
people — live outside the country where they were born.
By Donald G McNeil, Jr., The New York Times
|
Lancet Examines Obama's Pledge To Fight HIV/AIDS
The
journal Lancet Infectious Diseases examines whether President Obama is
fulfilling his campaign promises to tackle HIV/AIDS abroad and at home.
Although Obama has surrounded himself "[w]ith lauded experts … concerns
have been raised by activists that investment plans are not matching up
to the rhetoric," Lancet writes.
June 24, 2009
The journal Lancet Infectious Diseases examines whether President Obama is fulfilling his campaign promises to
tackle HIV/AIDS abroad and at home. Although Obama has surrounded
himself "[w]ith lauded experts … concerns have been raised by activists
that investment plans are not matching up to the rhetoric," Lancet
writes.
One such expert is Eric Goosby – the newly confirmed U.S. Global AIDS Coordinator –who, during his senate confirmation
hearing spoke of the principles that would guide his work as head of
PEPFAR, but "funding was not a key matter discussed," according to the
Lancet. The article examines Obama's shift from "[o]riginal funding
pledges for PEPFAR of $50 billion over 5 years … to a proposed $51
billion over 6 years, with an extra $12 billion for other global health
issues such as maternal and child health, family planning, and
neglected tropical disease" – an initiative that the White House sees
as "a more integrated approach to fighting diseases, improving health,
and strengthening health systems," but others worry it might impact
"treatment and prevention of vertical transmission."
The
article concludes: "The Global AIDS Alliance says that 'Goosby has a
unique opportunity to hold the Obama administration accountable for its
campaign promises to increase funding for prevention and treatment of
HIV/AIDS overseas'. However, Michael Weinstein, president of AIDS
Healthcare Foundation, says 'it is crucial that President Obama ensures
that Dr. Goosby has the capability and full support of the
administration to effectively lead this landmark lifesaving global AIDS
programme, and that we do not squander the steady progress that PEPFAR
has already made in the global fight against AIDS'" (Morris, Lancet
Infectious Disease, 7/09).
http://globalhealth.kff.org
|
National HIV Testing Day Is Saturday, June 27
Launched
by the National Association of People with AIDS (NAPWA) in 1995,
National HIV Testing Day mobilizes organizations and communities across
the United States to encourage early HIV diagnosis and treatment.
June 23, 2009
Launched by the National Association of People with AIDS (NAPWA) in
1995, National HIV Testing Day mobilizes organizations and communities
across the United States to encourage early HIV diagnosis and
treatment.
Of
the more than 1.1 million people living with HIV nationwide in 2006,
about 21 percent are unaware of their status, according to the U.S.
Centers for Disease Control and Prevention. In getting tested and
receiving treatment if necessary, undiagnosed HIV-positive Americans
are taking an important and responsible step in protecting not only
their own health, but also that of their current and future sexual
partners.
Help POZ spread the word. Encourage your friends and loved ones to get an HIV test on June 27. Visit our AIDS Services Directory to find a testing site in your community.
Click here to watch our National HIV Testing Day video series for firsthand HIV
screening stories and testing advice.
http://www.poz.com
|
Major U.S. Companies Unite for Domestic AIDS Campaign
On
June 23, the Global Business Coalition on HIV/AIDS, Tuberculosis and
Malaria (GBC) and a consortium of well-known U.S. companies announced a
campaign to revamp domestic HIV/AIDS programs, reinforce local health
systems and bolster prevention, testing and treatment.
June 24, 2009
On
June 23, the Global Business Coalition on HIV/AIDS, Tuberculosis and
Malaria (GBC) and a consortium of well-known U.S. companies announced a
campaign to revamp domestic HIV/AIDS programs, reinforce local health
systems and bolster prevention, testing and treatment.
The GBC’s
U.S. HIV initiative is supported by pharmaceutical company Pfizer,
which provided $1 million dollars for initial efforts in three of the
cities most affected by HIV in the United States: Washington, DC; New
York City; and Oakland, California. Through the campaign, the GBC will
work with local governments to guide companies in the private sector to
commit to the fight against HIV/AIDS. In turn, companies will help the
HIV initiative offering demographics research, message development,
marketing and mass communications, program management and other support.
In
addition to Pfizer, participating companies include Levi Strauss &
Co., Coca-Cola, BET, Facebook, Chevron, the National Basketball
Association (NBA), the Women’s National Basketball Association (WNBA),
HBO, BD, The Brink’s Company, Colgate-Palmolive Company and OraSure
Technologies.
“This campaign is about business doing what
business does best to address a virus that is hurting families,
communities and the private sector,” said John Tedstrom, CEO of GBC.
“This extraordinary commitment will make a critical difference in the
fight against HIV/AIDS. Collectively, these companies, combined with
the work of government and other advocates, have the right tools and
resources at their disposal to achieve the best possible results.”
Organizations
contributing to the U.S. HIV Initiative include the Centers for Disease
Control and Prevention, the Black AIDS Institute, the Foundation for
AIDS Research (amfAR), Black AIDS Media Partnership, the Kaiser Family
Foundation, the Congressional Black Caucus, Gay Men’s Health Crisis and
the National Black Leadership Commission on AIDS.
http://www.poz.com
|
China tries to stop spread of HIV/AIDS among prostitutes
* Story Highlights
* Some people in China believe injections or a pill can prevent infection
* Some 700,000 people have HIV in China; about 50,000 new infections yearly
* About one in 200 sex workers nationwide currently has HIV
* As China's economy has boomed, so has the sex industry
June 21, 2009
 A woman awaits customers at a Beijing barber shop in 2008. Sex workers also ply their trade in barber shops.
Bejing -- A 19-year-old prostitute working in an
apartment that doubles as a brothel said she has up to eight clients a
day.
Working
in the southern boom city of Shenzhen, a special economic zone just
north of Hong Kong, she told CNN she worries about getting AIDS, but
has her own prevention measures.
"I always use condoms or take
an injection. The medicine can prevent sexually transmitted diseases,"
she said. "Some girls do not use prevention measures, but we don't talk
about that in public."
This young woman, who would not give her
name, is part of a group that Chinese and international health
authorities are concerned could potentially spread HIV and AIDS in the
world's most populated country, so officials have stepped up efforts to
educate them about the virus and dispel misconceptions about so-called
"injections" that can prevent infection.
"I think sex work is
probably one of the most important factors for the potential of HIV
spreading in Asia and also in China. There is no doubt about it," said
Bernhard Schwartlander, UNAIDS China Country Coordinator. "One of the
things that we have seen in China is that knowledge about HIV/AIDS is very low in the general population and certainly also in the sex
work industry. That is a big, big problem," Schwartlander said.
It is estimated that some 700,000 people are living with HIV in China
and there are about 50,000 new infections every year, according to the
Chinese government and UNAIDS. The U.N. agency believes a significant
number of those new infections include sex workers.
Prostitution is officially illegal in China, but very loosely addressed
by the government. It is estimated that there are between two and four
million sex workers in China. As the country's economy has boomed, so
has the sex industry, especially in prosperous cities like Shenzhen.
Many clients flock there from Hong Kong which is just an hour away,
some of them businessmen with money to spend.
Condom use in China can range anywhere from about 20 percent to 80 percent, according to UNAIDS.
"There are misconceptions. People think that they can avoid HIV
infections by taking a pill. People think that they are not at risk for
HIV infections because they don't know anybody (who has it), because
you can't see it, you can't touch it. And clearly, this is something
that we have to change very rapidly," Schwartlander said.
Historically, HIV and AIDS have been taboo topics in China, another
reason awareness can be so low. Prevention in the gay community has
also been difficult because of traditional stigmas against
homosexuality.
But the Chinese government is now conductiPWA eNews June 26 - Google Docsng educational campaigns to inform higher risk groups, including sex workers, about how to prevent the transmission of HIV.
"After years of these campaigns, we found out through survey that
condom use is constantly increasing, especially in urban areas, the
condom use can reach 70 percent or even up to 80 percent," said Hao
Yang, Deputy Bureau Chief of the Chinese Health Ministry's Disease
Prevention and Control Bureau.
But other areas are proving
difficult. In rural parts of the country, the proportion of condom use
among sex workers is less than 50 percent, Hao said.
"When we
go to investigate in rural areas, the proportion of people with this
knowledge (of AIDS prevention) is still very low," he said. "In
addition to that, the proportion of change in their activities is also
very low, which means that the condom use rate is still low."
About one in 200 sex workers nationwide currently has HIV,
Schwartlander said. But in one part of Yunnan province in the country's
far southwest, seven percent of the sex workers -- or as many as 14 in
every 200 -- have HIV, according to UNAIDS.
"The sex workers
living in remote areas and rural areas have played an important role in
AIDS spreading. We do not have a precise figure for the proportion that
sex workers make up in it (the spread of AIDS), but we can say that
they are making up a significant proportion," Hao said.
The
government has a long-term plan to educate the general public and to
strengthen intervention in the high-risk populations, particularly sex
workers, Hao said.
When HIV initially began to spread in China,
infections were concentrated among people who injected drugs,
Schwartlander said. Campaigns among this group have been effective,
while infections among other groups have risen.
One of those
groups, Hao said, was men having sex with men, which accounts for 5.9
percent of infections, according to the Chinese Health Ministry.
A majority of the infections are concentrated among drug users, men
having sex with men, and sex workers and their clients, Schwartlander
said.
"Society and communities have been able to curb the
spread of HIV, also in sex work, and that is what we have to do,"
Schwartlander said.
As China's economy grows, it is likely the
sex industry will as well. Current estimates show that some 30 to 50
million people are at significant risk for HIV infection, Schwartlander
said.
"China is a society which is in quite a significant
transition. There is a huge increase in disparity of income between the
rich and the poor, and all these are very well-known factors that drive
the sex industry forward," Schwartlander said. "Clearly, in China, I
think that the sex industry is a rising industry. We will see an
increase in the number of sex workers due to these factors in the
future."
A 22-year-old prostitute in Shenzhen, who did not want to give her name, said she knows the risk but needs the
work.
"AIDS is the number one killer for my job. I cannot let this disease
destroy my life. This is only a short-term business. I don't have any
relatives in Shenzhen and can't borrow any money. I can only rely on
myself."
By Emily Chang, CNN
|
African women with HIV 'coerced into sterilisation'
A
media report from Namibia last week highlighted the plight of Hilma
Nendongo. A few weeks after giving birth, she was asked by a nurse:
"Oh, did they tell you that you had been sterilised?"
June 22, 2009
• Communities often reject victims, says campaigner
• Consent allegedly gained just before giving birth
Women
in Africa are being sterilised without their consent after being told
the procedure is a routine treatment for AIDS, a lawsuit will claim.
Forty
HIV-positive women in Namibia have been made infertile against their
will, according to the International Community of Women Living with
HIV/AIDS (ICW). The group is preparing to sue the Namibian government
over at least 15 cases.
Campaigners also report coerced
sterilisation in the Democratic Republic of Congo, Zambia and South
Africa, where according to one report a 14-year-old girl was told she
could have an abortion only on condition that she agreed to sacrifice
her reproductive rights.
The ICW has documented cases in Namibia
where HIV-positive women minutes from giving birth were encouraged to
sign consent forms to prevent them from having more children. Jennifer
Gatsi-Mallet, its co-ordinator in the country, said: "They were in
pain, they were told to sign, they didn't know what it was. They
thought that it was part of their HIV treatment. None of them knew what
sterilisation was, including those from urban areas, because it was
never explained to them.
"After six weeks they went to the
family planning centre for birth control pills and were told that it's
not necessary: they're sterile. Most of them were very upset. When they
went back to the hospital and asked, 'Why did you do this to us?' the
answer was: 'You've got HIV'."
Gatsi-Mallet said that some women
were now afraid to go to hospital in case they are sterilised, and
infertile women were often rejected by their husbands and communities:
"In African culture, if you are not able to have children, you are
ostracised. It's worse than having HIV."
African women aged
between 20 and 34 have a higher prevalence of HIV than any other social
group; in South Africa one in three is infected.
On average an
HIV-positive mother has a one in four risk of transmitting the virus to
her child. With the latest antiretroviral drugs, the probability can be
cut to less than one in 50. But such medical interventions are
underfunded and inaccessible to millions of women across the continent.
The
ICW accuses the Namibian government of encouraging state doctors to
sterilise HIV-positive women as a means of preventing the spread of the
virus. Its request to see the government's official guidelines has been
refused. It hopes to bring 15 or more cases to court later this year.
A
media report from Namibia last week highlighted the plight of Hilma
Nendongo. A few weeks after giving birth, she was asked by a nurse:
"Oh, did they tell you that you had been sterilised?"
Nendongo,
30, who is HIV-positive, suddenly remembered that hospital staff had
told her to sign some papers as she entered the operating room for a
caesarean section.
"It was a very big shock," she told Canada's
Globe and Mail newspaper. "I was very emotional … I wanted a sister for
my three boys, and now I can't have one."
In South Africa, cases
are being referred to the Women's Legal Centre with a view to a
possible action. Promise Mthembu, a researcher at Witwatersrand
University, said coerced sterilisations were happening in "very large
areas" of the country.
Many patients were forced to undergo the
operation as the only means of gaining access to medical services,
Mthembu told the Mail & Guardian newspaper.
By David Smith, http://www.guardian.co.uk
|
A new weapon in the war against HIV-AIDS: Combined antiviral and targeted chemotherapy
A
discovery by a team of Canadian and American researchers could provide
new ways to fight HIV-AIDS. According to a new study published in
Nature Medicine, HIV-AIDS could be treated through a combination of
targeted chemotherapy and current Highly Active Retroviral (HAART)
treatments. This radical new therapy would make it possible to destroy
both the viruses circulating in the body as well as those playing
hide-and-seek in immune system cells.
June 21, 2009
Montreal
– A discovery by a team of Canadian and American researchers could
provide new ways to fight HIV-AIDS. According to a new study published
in Nature Medicine, HIV-AIDS could be treated through a combination of
targeted chemotherapy and current Highly Active Retroviral (HAART)
treatments. This radical new therapy would make it possible to destroy
both the viruses circulating in the body as well as those playing
hide-and-seek in immune system cells.
The study was led by Dr.
Rafick-Pierre Sékaly, of the Université de Montréal. Dr. Jean-Pierre
Routy of the Research Institute of the McGill University Health Centre
(RI-MUHC) and scientists from the National Institutes of Health (NIH)
and the University of Minnesota in the United States also collaborated
on the investigation.
To date, anti-AIDS treatments have been
stymied by "HIV reservoirs" – immune system cells where the virus hides
and where existing HAART treatments cannot reach. The researchers
successfully identified the cells where HIV hides and the "stealth"
mechanisms that allow the virus to escape existing treatments. This
breakthrough opens the way towards innovative therapies that are
completely different from current approaches.
"Our results
argue in favour of a strategy similar to the one used against leukemia,
which is targeted chemotherapy, associated with a targeted immune
treatment. This would make it possible to destroy the cells containing
a virus, while giving the immune system time to regenerate with healthy
cells," says Dr. Rafick-Pierre Sékaly, a professor at the Université de
Montréal, researcher at the Centre Hospitalier de Université de
Montréal (CHUM), director of INSERM 743 and scientific director of the
Vaccine and Gene Therapy Institute of Florida.
"For the first
time, this study proves that the HIV reservoirs are not due to a lack
of potency of the antiretroviral drugs, but to the virus hiding inside
two different types of long life CD4 memory immune cells," explains Dr.
Jean-Pierre Routy, a hematologist with the MUHC, researcher in
infection and immunity at the RI-MUHC and professor of hematology at
McGill University. "There are several types of HIV reservoirs, each
necessitating a different treatment to eliminate them."
Indeed,
once the virus is hidden in these reservoir cells, it becomes dependent
on them: if the cell lives, the virus lives, but if the cell dies, so
does the virus. As such, destroying these immune cells will allow for
the elimination of the resilient or hidden parts of the virus. Existing
HAART treatments destroy the viruses circulating in the body, yet
cannot reach those hidden in reservoir cells.
"We now have
brand-new options to fight HIV," concludes Nicolas Chomont, a
postdoctoral intern at the Université de Montréal's Department of
Microbiology and Immunology and one of the co-authors of this study.
"The combination of fundamental and clinical approaches led to amazing
results that allow us to elucidate another mystery of this virus of a
thousand faces."
These new therapeutic options will require
many more years of research before they are validated and become a
reality for patients. However, this study represents an invaluable work
plan that will provide a map for many laboratories around the world.
Contact: Isabelle Kling
isabelle.kling@muhc.mcgill.ca
514-843-1560
McGill University Health Centre
Sylvain-Jacques Desjardins
sylvain-jacques.desjardins@umontreal.ca
514-343-7593
University of Montreal
http://www.eurekalert.org
|
Treatment as prevention rejected by French ministry of health
The
statement insisted that only male or female condom use could guarantee
a maximum protection against HIV and other sexually transmitted
infections, and that condoms must be used consistently during casual
sex or when the HIV status of a stable partner was not known. The
statement said there was no conclusive evidence concerning men who have
sex with men, the efficacy of antiretroviral treatment as a sole
prevention strategy or the risks of resistance if more people took
treatment.
June 19, 2009
The endorsement of treatment as prevention by the French National AIDS
Council has been dismissed by the country’s ministry of health.
In April, the National AIDS Council (Conseil National du Sida) issued a lengthy and nuanced analysis of the potential impact of greater use of antiretroviral treatment on
HIV transmission and prevention. It recommended campaigns to raise
awareness of the benefits of HIV testing and earlier treatment, and
that negative messages about side-effects and pill burden should
receive less emphasis.
The National AIDS Council is independent body of experts
(academics, clinicians, politicians etc.) who are nominated by various
parts of the government. It has a consultative role.
However a press statement issued by the Direction générale de la santé (the section of the health
ministry responsible for public health) rejected the National AIDS
Council’s analysis.
The statement insisted that only male or female condom use could
guarantee a maximum protection against HIV and other sexually
transmitted infections, and that condoms must be used consistently
during casual sex or when the HIV status of a stable partner was not
known. The statement said there was no conclusive evidence concerning
men who have sex with men, the efficacy of antiretroviral treatment as
a sole prevention strategy or the risks of resistance if more people
took treatment.
The ministry announced that a new group of experts would be asked
to reconsider treatment as prevention as part of their review of HIV
prevention strategies. The opinions of this group are likely to feed
into France’s next three-year HIV strategy.
The campaigning group The Warning denounced the conservatism of the Direction générale de la santé. They
said that the health ministry “remains silent” about the residual
infection risk associated with condom use, and did not address the
issue of the growing number of people who don't use a condom, either
some or all of the time. “They show that they still believe it is
possible to put into place a prevention strategy that takes no notice
of the choices and behaviours of individuals,” the group commented.
By Roger Pebody, http://www.aidsmap.com
|
HIV infection alone does not increase risk of diabetes
HIV
infection itself does not increase the risk if diabetes, US
investigators report in the June 19th edition of AIDS. Indeed, the
results of the research showed that at the start of the study, people
with HIV had a lower risk of diabetes than HIV-negative individuals.
June 19, 2009
HIV infection itself does not increase the risk if diabetes, US investigators report in the June 19th edition of AIDS.
Indeed, the results of the research showed that at the start of the
study, people with HIV had a lower risk of diabetes than HIV-negative
individuals.
However, this was because of the low body mass index (BMI) of
untreated HIV-positive individuals, and an improving immune status,
treatment with antiretroviral drugs, and hepatitis C virus were all
shown to increase diabetes risk in people with HIV.
“We believe that the net risk of diabetes mellitus is determined by
a complex interplay of individual factors, with the traditional risk
factors dominating the profile leading to an overall lower risk in
HIV-infected persons”, comment the investigators.
The association between HIV infection and diabetes mellitus is
poorly understood. This is partly because people with HIV have a
different prevalence of risk factors for the condition than
HIV-negative individuals.
There is however general agreement that traditional risk factors for
diabetes, such as increasing age, obesity, and race, are responsible
for most cases of the condition diagnosed in people with HIV. What is
less clear is the role of risk factors such as the use of
antiretroviral drugs and co-infection with hepatitis C virus.
Earlier research has yielded conflicting results about the risk
factors for diabetes in people with HIV. Therefore investigators from
the US Veterans Aging Cohort Study designed a case-controlled study to
determine the association between HIV and diabetes and its risk
factors.
A total of 3227 HIV-positive patients and 3240 HIV-negative controls were included in the research.
Individuals with HIV were younger (49 years vs. 51 years, p <
0.001), more likely to be men (98% vs. 92, p < 0.001), black (67%
vs. 62%, p < 0.001), and infected with hepatitis C virus (31% vs.
15%, p < 0.001) than the controls.
The baseline prevalence of diabetes was significantly lower (p <
0.001) amongst people with HIV (15%) than those who were HIV-negative
(21%).
However, the investigators found that this was entirely explained by the HIV-positive patients having a lower BMI.
Multivariate analysis that controlled for possible confounding factors
confirmed that overall people with HIV had a lower risk of diabetes (OR
= 0.84, 95% CI: 0.72-0.97).
Traditional risk factors for diabetes, increasing age, male sex,
black race and increasing BMI, were, however, more strongly associated
with the development of diabetes in people with HIV than HIV-negative
individuals.
Furthermore, the investigators’ analysis showed that co-infection
with hepatitis C virus significantly increased the risk of diabetes in
people with HIV but not those who were HIV-negative.
Treatment with combination antiretroviral therapy also increased the
risk of diabetes (OR = 1.11; 95% CI: 1.05-1.17). Treatment with drugs
from the nucleoside reverse transcriptase inhibitor (NRTI) and
non-nucleoside reverse transcriptase inhibitor (NNRTI) classes were
also associated with an increased risk of diabetes, as was the
cumulative length of exposure to antiretroviral therapy.
The researchers also found a weak association between having a CD4 cell count above 500 cells/mm3 involved a higher risk of diabetes than lower CD4 cell counts. They
hypothesise that could be because of the weight gain that accompanies
improving health status after initiating HIV therapy.
Intriguingly, neither drug nor alcohol use were not associated with
a lower risk of diabetes, a finding that the investigators struggled to
offer an explanation for.
“In conclusion”, write the investigators, “we found that HIV itself
is not associated with a higher risk of diabetes mellitus. In fact,
after adjusting for traditional risk factors, HIV is actually
associated with a lower risk. A return to a more healthy state with
increasing BMI and CD4 lymphocyte counts was associated with a higher
risk of diabetes. However, the magnitude of association with the
traditional risk factors varies between HIV infected and uninfected
persons.”
Reference
Butt AA. HIV infection and the risk of diabetes mellitus. AIDS 23: 1227-34, 2009.
By Michael Carter, http://www.aidsmap.com
|
Study Looks at Gay Men Who Seek PEP
A
new study in the journal Sexually Transmitted Infections aims to
determine a better understanding of why gay men seek HIV post-exposure
prophylaxis (PEP) and use that information to potentially develop HIV
prevention programs that reach and resonate with these men.
June 21, 2009
 A new study in the journal Sexually Transmitted Infections aims to determine a better understanding of why gay men seek HIV
post-exposure prophylaxis (PEP) and use that information to potentially
develop HIV prevention programs that reach and resonate with these men.
RELATED ARTICLES
Study: PEP Is Not 100% Effective
Study Shows PEP Does Not Boost Risky Sex
CDC Widens Access to PEP
“Failures of post-exposure prophylaxis following sexual exposure to
prevent seroconversion have been reported and are often associated with
ongoing risk exposure,” the study authors wrote. “Understanding why men
who have sex with men access PEP on some occasions and not others may
lead to more effective health promotion and disease prevention
strategies.”
The researchers undertook a qualitative study using semi-structured
interviews of 15 men who have sex with men within six months of their
initiating PEP treatment at an HIV outpatient service in Brighton,
England.
Several factors that motivated the men to seek PEP after sexual
exposure were identified: an episode that related to a particular
sexual partner and the partner’s behavior; characteristics of the
location where the risk occurred; the respondent’s state of mind, and
the influence of alcohol and recreational drug use; and the
respondent’s perceptions about the effectiveness of PEP.
“Help was sought in the light of a ‘one-off’ or an ‘unusual’ event,”
the authors wrote. “Many respondents felt they were less likely to
behave in a risky manner following PEP.”
In order for PEP to function effectively as a public-health measure,
“at-risk individuals need to be empowered to make improved risk
calculations from an increased perception that they could be exposed to
HIV if they continue their current behavior patterns,” the authors
concluded. “The concern is that PEP was sought by a low number of men
who have sex with men implying that a greater number are not using the
service based on failure to make accurate risk calculations or
recognize high-risk scenarios.”
http://www.hivplusmag.com
|
Genetic mutation could lead to HIV treatment
Early
safety trials underway. A possible HIV treatment that harnesses the
power human mutation is undergoing safety trials. Researchers are
unsure if the process will actually work, but early safety trial
results will be published in 2011.
A possible HIV treatment that harnesses the power of a
human mutation is in the midst of safety trials, bringing it one step
closer to your doctor’s office. If it works the treatment would alter
some of an HIV-positive patient’s blood to mimic a genetic mutation —
called delta 32 — that makes a small percentage of the world’s
population resistant or even immune to most strains of HIV.
“You have a needle in each arm and your blood comes out,” says Gwen
Binder, a researcher at the AIDS Clinical Trials Unit (ACTU) of the
University of Pennsylvania where the treatment is undergoing safety
trials, describing the experimental treatment process. “They spin out
your white blood cells and then they put everything [else] back in you.
So it’s not actually taking a lot of blood.”
Next the T-cells
are separated from the rest of the white blood cells. T-cells, a
crucial part of the human immune system, are HIV’s primary target.
Using a new gene therapy drug called SB-728-T researchers then modify
the removed T-cells to synthetically recreate the delta-32 mutation,
which changes the shape of the separated T-cells.
HIV is
able to infect normal T-cells because the virus fits the shape of the
T-cell’s surface — much like a lock and key. T-cells with the delta-32
mutation are malformed, missing an “innie” where HIV has an “outtie.”
The result is that HIV no longer fits the lock; it just bounces off the
cell.
“After modification of the white blood cells we expand
them by culture to get a larger dose,” says Binder. There is also a
series of tests to make sure the new white blood cells are sterile and
otherwise safe. Then, a few weeks after the blood was drawn, the
altered white blood cells are put back into the patient’s bloodstream.
Theoretically HIV will be unable to kill these altered T-cells. But
even if that theory is confirmed it isn’t clear that the process will
result in enough altered T-cells to have a noticeable effect in the
body.
“We’re modifying one percent or less of the circulating population of T-cells,” says Binder.
If the modified cells multiply inside the study participants, as they
did in the animal trials, their numbers will grow even as the virus
kills off the unaltered T-cells. The idea is that the modified cells
will be able to support a healthy immune system — or at least a
healthier immune system.
The safety trials for this new
treatment, which began in February, are expected to be completed by
December 2010, with results to be published sometime in 2011.
In addition to a new treatment there is also hope that mimicking the
delta-32 mutation could lead to a cure. About two years ago an
HIV-positive US expatriate living in Berlin received a bone marrow
transplant from a donor with the natural delta-32 mutation. Subsequent
tests have been unable to detect HIV in his bloodstream. The transplant
appears to have, for all intents and purposes, cured him. Could
SB-728-T likewise be used to create delta-32 bone marrow for other
people with HIV?
“We’re certainly not proposing using
chemotherapy in healthy individuals,” says Binder, adding that the bone
marrow transplant process is far too risky, with mortality rates
between 10 and 50 percent. To find out if the phenomenon could be
reproduced synthetically in others Binder says researchers would have
to find patients with HIV who have cancer and are already in need of
chemo and a marrow transplant.
In the meantime Binder and
the team of researchers led by ACTU director Pablo Tebas are enrolling
HIV-positive volunteers in their study at the University of
Pennsylvania. They’re starting with six people for whom antiretroviral
drugs are no longer working — people who are running out of treatment
options. If that goes well, they will enrol six more HIV-positive
volunteers with well-controlled HIV who are already on antiretroviral
medications.
There’s been no shortage of volunteers, says
Binder, in spite of the fact that participation in the study is not
without risk. Although the treatment has been used successfully in mice
and in human blood samples, this is the first time it’s been attempted
in humans.
Perhaps the riskiest part of the study will occur
when the second group of volunteers go off their antiretroviral
medications for about 16 weeks.
According to meeting minutes
of the US National Institutes of Health Recombinant DNA Advisory
Committee, “Although cogent arguments were presented suggesting that a
short interruption of [antiretroviral medication] may not pose a
significant risk, current evidence from the literature indicates that
it is not without some risk.”
The minutes also point out
that in spite of the risk the second group of volunteers will be taking
the experimental treatment that could turn out to have no benefit to
them.
“We have to be very careful in a [safety trial] to not
give patients the impression that we’re giving them a treatment or a
therapy that might help them,” says Binder. “We’re very clear that this
is just an initial phase to look at safety.”
Despite those
cautions the research team will certainly be looking for signs that the
treatment is working when the data is ready for analysis in 2010/’11.
That will include looking at how HIV infections progressed during the
trial and to what extent the altered T-cells have died out, persisted
or even flourished and multiplied.
“If the study goes well,
part of the standard clinical plan would be to move on to a phase two
clinical trial that’s designed to evaluate efficacy,” says Binder. A
phase two trial would involve up to 300 patients and, if successful,
would lead to a phase three trial with up to 3,000 participants. The
phase three trial is the final requirement for approval by the US Food
and Drug Administration (FDA).
The whole FDA approval process
takes on average of eight years which means that — if it is approved at
all — people living with HIV/AIDS could see the treatment available by
2017.
By Miriam Boon, http://www.xtra.ca
|
Negotiating a Fair Price for the Norvir Tablet
Abbott
is gearing up to release its long-awaited Norvir (ritonavir) tablet.
The company states that it will negotiate the price—which has not yet
been announced—in good faith. Nonetheless, the Fair Pricing Coalition
is already engaged in a vigilant campaign to ensure affordable access
to all.
June 23, 2009
Abbott is gearing up to
release its long-awaited Norvir (ritonavir) tablet. The company states
that it will negotiate the price—which has not yet been announced—in
good faith. Nonetheless, the Fair Pricing Coalition is already engaged
in a vigilant campaign to ensure affordable access to all.
Abbott,
the maker of two HIV drugs, Novir (ritonavir) and Kaletra
(lopinavir/ritonavir), has become the focus of community concerns about
pricing again. This fall, the company will launch a new tablet
formulation of Norvir that doesn’t require refrigeration and may cause
fewer gut-related side effects, two downsides of the current capsule
formulation.
Activists are already worried about the new drug’s price, however.
Their concern stems from Abbott’s decision, in December 2003, to raise
the price of Norvir by 400 percent. Virtually overnight, the Norvir
price for a lower dose used to boost the blood levels of other protease
inhibitors increased from $54 per month to $265 per month—the
per-patient wholesale price of the drug.
The move caused a huge uproar among the community and health care providers. An investigative report by The Wall Street Journal in January 2007, which was based on internal memos from Abbott that
were released during a law suit against the company, revealed that the
price increase was primarily a marketing tactic. The aim was to make
other protease inhibitors—notably the increasingly popular Reyataz,
commonly used with a low boosting dose of Norvir—less attractive and to
maintain the popularity of Kaletra (the price of which did not
increase, even though it contains Norvir). In turn, activists are wary
of Abbott’s pricing intentions with the new Norvir formulation.
Specifically, the Fair Pricing Coalition (FPC)—a group of HIV/AIDS
treatment activists—has issued a letter to the CEO of Abbott, asking
that the company not raise the overall price when it launches the new
formulation and to ensure that government programs retain the deep
discounts they now receive for Norvir. The FPC is encouraging
organizations, health care providers and individuals to view and sign on to the letter by June 26.
The FPC is hoping to discuss pricing issues with Abbott at the end of
June. So why issue the letter now, when negotiations haven’t even
begun? “We’re trying to make the public aware that these changes are
about to happen, and we want to convince Abbott to play fair,” explains
Lynda Dee, one of the founders of the FPC and executive director of
AIDS Action Baltimore. “We have a long history with them. What makes us
think they’ll play nice-nice with us this time?”
What Is at Stake?
Medicaid and AIDS Drug Assistance Programs (ADAPs) have remained
protected from the 400 percent price increase so far. That’s because
federal law dictates that companies can’t raise the prices of drugs
already on the market any more than a certain percentage for those
programs.
The release of a new version of Norvir will be seen as a brand new drug
in the eyes of the law, however. As a result, Abbott could potentially
charge ADAPs and Medicaid programs a much higher price. According to
the FPC, a new version of Norvir could potentially mean a 1,000 percent
cost increase for these federal- and state-funded programs, costing
them more than $50 million in additional costs per year for Norvir
alone.
With the economy hurting, and states like Arizona and California
already cutting deep into their ADAP and Medicaid budgets for next
year, such programs can ill afford such a steep cost increase. Private
insurance companies are also feeling the pinch of higher drug costs. To
compensate, they’ve been passing the increasing costs on to their
policyholders in the form of monthly premium increases, higher
deductibles and deep-pocket drug co-payments.
Abbott recently launched a co-pay program for its protease inhibitor,
Kaletra. It covers the first $50 of a person’s Kaletra co-payment each
month and an additional $100 toward the other drugs in his or her
regimen. The company does not currently have a co-pay program in place
for Norvir, however, which is another factor that has caused
consternation and mistrust among some FPC members.
Jeff Berry, the director of publications for Test Positive Aware
Network in Chicago, is concerned about the lack of a Norvir co-pay
program, not only as a member of the FPC, but also as someone dealing
with medication issues. “Right now I’m on Kaletra. If it turns out I
have to switch my regimen to another protease-based regimen, and I need
to use Norvir, then I’ll have to pay much higher co-pays, because
Norvir isn’t included in their co-pay program.”
Abbott declined to comment on any of the specific accusations and
concerns in the sign-on letter. It did, however, provide AIDSmeds with
an official statement. “Abbott has successfully worked with the Fair
Pricing Coalition in the past several years, resulting in responsible
pricing,” the statement said. “In fact, Abbott has not taken a price
increase on Kaletra since October 2007. We look forward to
communicating with the FPC in good faith, on the new Norvir tablet, as
we did with the Kaletra tablet in 2006.”
While this response doesn’t satisfy some FPC members, they are hoping
that it signals a willingness on the part of Abbott to hear community
concerns. “There’s been some bad blood in the past,” Berry says, “but I
think there’s a good opportunity for the FPC and Abbott to work
together to ensure that the new Norvir formulation is priced
appropriately, so that there is the broadest access for the most people
who need that drug, which is pretty much everyone on a protease
inhibitor.”
By David Evans, http://www.aidsmeds.com
|
Good survival for HIV patients diagnosed with non-Hodgkin's lymphoma
Two-thirds
of HIV-positive individuals with non-Hodgkin’s lymphoma are alive a
year after its diagnosis, European investigators report in a study
published in the online edition of AIDS. A low nadir CD4 cell count was
associated with poorer survival. Nevertheless, the investigators found
that in the era of combination antiretroviral therapy, over 50% of
HIV-positive patients diagnosed with a lymphoma were alive five years
later.
June 22, 2009
Two-thirds of HIV-positive individuals with non-Hodgkin’s lymphoma are
alive a year after its diagnosis, European investigators report in a
study published in the online edition of AIDS.
A low nadir CD4 cell count was associated with poorer survival.
Nevertheless, the investigators found that in the era of combination
antiretroviral therapy, over 50% of HIV-positive patients diagnosed
with a lymphoma were alive five years later.
“Our results thus support the notion that the gap in survival
between non-Hodgkin’s lymphoma patients with and without HIV is
closing”, comment the investigators.
Non-Hodgkin’s lymphoma is an AIDS-defining cancer and an important
cause of death in patients with HIV. Since the introduction of
effective HIV treatment, there has been a fall in the number of new
cases of this cancer in people with HIV, and an improvement in the
prognosis of patients in whom it is diagnosed.
Some earlier research has found that a number of HIV-related factors
influence the prognosis of patients who develop lymphoma in the era of
HIV treatment. These include a low CD4 cell count, a high viral load,
and a history of previous AIDS-defining illnesses. Prognostic factors
important in the course of the disease in HIV-negative patients, such
as age, have also been shown to affect the outcome of HIV-positive
patients.
In order to obtain a better understanding of prognosis of HIV-positive
patients who develop non-Hodgkin’s lymphoma and the factors associated
with this, researchers from the Collaboration of Observational HIV
Epidemiological Research Europe (COHERE) study group conducted a study
involving patients from 33 cohort studies.
A total of 67, 659 patients were included in the investigators’
analysis and 847 of these individuals developed non-Hodgkin’s lymphoma.
All were diagnosed with the cancer after January 1998, and none had
experience of HIV treatment before that date. Of these patients, 10%
were diagnosed with a primary lymphoma of the brain and 10% with
Burkitt’s lymphoma.
The investigators divided the patients into three groups according
to their experience of HIV treatment at the time this cancer was
diagnosed: no HIV treatment; HIV treatment for under 90 days; HIV
treatment for over 90 days.
Overall, the patients had a median age of 41 years and 82% were men.
Non-Hodgkin’s lymphoma was diagnosed in 43% of patients before they
started HIV treatment. Of the patients diagnosed with the cancer when
taking HIV therapy, 14% had been taking this treatment for less than 90
days.
Median CD4 cell count at the time non-Hodgkin’s lymphoma was diagnosed was low at only 114 cells/mm3.
This was accompanied by a high viral load (median, 181,000 copies/ml).
Viral load was, however, lower in patients who were taking HIV
treatment (less than 90 days, 126,000 copies/ml; over 90 days 121
copies/ml).
Of the 763 patients with systemic non-Hodgkin’s lymphoma, 283 (37%)
died. The proportion surviving one year was 66% with 54% alive five
years after their cancer was diagnosed.
A total of 38 of the 84 patients (45%) diagnosed with primary lymphoma
of the brain died. The proportion surviving one year was 54%, however
data were too scare to estimate five year survival.
Statistical analysis showed that a lowest ever CD4 cell count below 25 cell/mm3 was significantly associated with a poorer prognosis (adjusted hazard
ratio [AHR] = 1.64; 95% CI, 1.18-2.29). Older age at the time of
diagnosis was also associated with poorer survival, as was injection
drug use (AHR = 1.55; 95% CI, 1.08-2.21).
Diagnosis with primary lymphoma of the brain was also associated with poorer survival (AHR = 1.50; 95% CI, 1.01-2.23).
The investigators also found patients who had been taking HIV treatment
for over 90 days at the time their lymphoma was diagnosed had a poorer
outcome (AHR = 2.02; 95% CI, 1.56 – 2.61). The authors suggest that
lymphomas that develop after HIV therapy has been started are likely to
be more aggressive. For example, patients who develop the aggressive
Burkitt’s lymphoma often have a CD4 cell count in the region of 200
cells/mm3.
“In the era of combination antiretroviral therapy two-thirds of
patients diagnosed with HIV-associated systemic non-Hodgkin’s lymphoma
survive for longer than 1 year after diagnosis”, conclude the
investigators adding, “more advanced immunodeficiency is the dominant
risk factor for death in patients with HIV-associated non-Hodgkin’s
lymphoma.”
Reference
The COHERE study group. Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy. AIDS (online edition), 2009.
By Michael Carter, http://www.aidsmap.com
|
Similar rises in gay men’s HIV diagnoses seen in Western Europe, North America and Australia since 2000
A
comparative analysis of HIV diagnoses in gay men in eight
industrialised countries has found that while they decreased between
1996 and 2000, diagnoses went up by 3% a year from 2000 to 2005,
researchers report in the June 2009 issue of the Annals of Epidemiology.
June 22, 2009
A comparative analysis of HIV diagnoses in gay men in eight
industrialised countries has found that while they decreased between
1996 and 2000, diagnoses went up by 3% a year from 2000 to 2005,
researchers report in the June 2009 issue of the Annals of Epidemiology.
The researchers used national surveillance data compiled by public
health bodies in the UK, the Netherlands, France, Germany, Spain
(Catalonia only), Australia, the United States (25 states only) and
Canada. These countries were chosen as a convenience sample of
concentrated epidemics where the surveillance systems were broadly
comparable (although not identical) and did not change too much during
the period studied.
For the six countries with data from 1996 to 2000, the numbers of annual HIV diagnoses decreased by an estimated 5.2% per year.
However, for the eight countries with data from 2000 to 20005,
annual diagnoses increased by 3.3% each year. The greatest annual rises
were seen in four European countries (Germany 12%, France 11.3%, UK
9.6%, Netherlands 9.3%), whereas annual increases were below 5% in
Spain, the United States, Canada and Australia.
Taking the six countries with data throughout the period studied,
the number of diagnoses per 100,000 men in the population (i.e.
including heterosexual men) dropped from 19.1 in 1996 to 14.6 in 2000,
but increased to 16.6 in 2005.
The researchers also found that the median age at diagnosis increased from 34 to 36.
The team also collected data on reports of syphilis, and found that
in five countries there were sharp increases in reports during 2000 -
2005. They believe this suggests that there were probably increases in
risky sexual behaviour at this time, which would partially explain the
increase in HIV diagnoses. However the researchers did not have other
data that would indicate increases in risky sexual behaviour (e.g.
self-reported prevalence of unprotected anal intercourse, collected
with standardised questions in several countries).
The researchers also considered whether the increase in diagnoses
could have been due to changes in HIV testing patterns among gay men.
From the limited amount of data available, there was no indication of a
consistent trend towards increased testing.
The authors note that with the internet, international travel and
shared popular cultures, “trends in beliefs, risk practices, substance
use and protective strategies that arise in one country may well emerge
in others.” They call for more research into this resurgence in HIV
diagnoses, and for greater investment in HIV prevention.
Reference
Sullivan PS et al. Reemergence of the HIV Epidemic Among Men Who Have Sex With Men in North America, Western Europe, and Australia, 1996–2005 Annals of Epidemiology 19: 423-431, 2009.
By Roger Pebody, http://www.aidsmap.com
|
Second-Line Treatment for PCP a Viable Alternative
Neutrexin
(trimetrexate) combined with Leucovorin (folinic acid) is an effective
and safe treatment option for people who don’t respond to their first
treatment regimen for Pneumocystis pneumonia (PCP), according to a
study published in the June 19 issue of AIDS.
June 24, 2009
Neutrexin (trimetrexate) combined with Leucovorin (folinic acid) is an
effective and safe treatment option for people who don’t respond to
their first treatment regimen for Pneumocystis pneumonia (PCP), according to a study published in the June 19 issue of AIDS.
Cotrimoxazole
(trimethoprim-sulfamethoxazole [TMP-SMX]) is the most effective
first-line treatment when people are diagnosed with PCP. Unfortunately,
many people have allergic reactions to the SMX component, and up to 49
percent must switch to another treatment regimen. There are several
possible options but no consensus on what works best for second-line
therapy.
To determine the effectiveness of Neutrexin plus
Leucovorin, Charlotte-Eve Short, MD, from the Brighton and Sussex
University Hospital, in Brighton, England, and her colleagues examined
the medical records of HIV-positive patients diagnosed with PCP at
their hospital between 1996 and 2006. Complete data were available for
16 patients. Ten were male, six were female, and CD4 counts ranged from
6 to 195. All of the patients had failed Cotrimoxazole treatment.
People started second-line treatment with Neutrexin and Leucovorin
about 16 days after they initiated their first regimen, and the
combination was given for an average of 18 days.
Though five
people experienced side effects—including anemia and skin rashes—none
had to discontinue Neutrexin and Leucovorin because of them, Short’s
team found. In terms of effectiveness, 71 percent of the patients were
living 28 days—a standard indicator of long-term survival—after they
began treatment with the combination.
The authors acknowledge
that the number of patients included in the study is quite small and
that they had to rely on the treating physician’s assessment of the
drug combination’s effectiveness based on medical records. They
comment, nevertheless, that Neutrexin and Leucovorin are a viable
option for people who have failed or cannot tolerate Cotrimoxazole
therapy.
http://www.poz.com
|
|
|
