January 12, 2009

Halifax - AIDS remains a disproportionate threat to Nova Scotia’s African-Canadian community and the recent “criminalization” of the disease has made matters worse, experts say.

Larry Baxter is chairman of the Nova Scotia Advisory Commission on AIDS. He has said the province’s strategy on HIV-AIDS, announced in 2003, lacked input from black communities.

“I don’t think much has changed,” he said yesterday. “There are still issues of stigma, lack of information and lack of discussion within the community.”

Two cases in Ontario where HIV-positive men were charged after having sex with women and not disclosing their status may discourage some men from getting tested, Baxter said.

“There’s the thinking that if you don’t know, you can’t be held criminally liable,” he said.

David Divine, the James R. Johnston Chair in Black Canadian Studies at Dalhousie University, said the bigger problem is funding and attitude.

“In terms of a general movement of interest and information gathering, that most definitely has increased (since 2003),” he said.

“You can have significant sums of money available to an agency, but if the right people are not in that agency with the right attitudes … you’re not going to get anywhere.”

Divine said it’s difficult for a black person to go for an AIDS test. “They are continuously afraid of being discriminated against not only because of their colour, but because the very possibility of having HIV-AIDS carries such a profound stigma.”

The Health Association of African Canadians is making dealing with AIDS one of its focuses for African Heritage Month in February. President Phyllis Marsh-Jarvis said fear, religious beliefs and stigma play a key role in discouraging people in her community from discussing AIDS.

by Jon Tattrie, www.metronews.ca

January 13, 2009

Handout/Canwest News ServiceFile photo of Johnson Aziga, who is the first person in Canada to be prosecuted for murder in an HIV infection case for allegedly having unprotected sex without disclosing his health status.

When a Toronto man was charged last week with sexual assault for knowingly exposing his girlfriend to HIV, it seemed like the logical action for police to take, and followed the pattern of an increasing number of such cases.

It was the second charge of its sort in two weeks in Ontario, and comes in the midst of a landmark murder trial of an HIV carrier who allegedly infected several women, two of whom later died of AIDS.

But HIV advocacy groups -- and now two respected AIDS doctors -- say such prosecutions are doing more harm than good, and are calling for authorities to stop criminalizing what they consider a public-health issue.

Dr. Mark Wainberg, a Montreal doctor who headed the International AIDS Society for two years, publicly joined the anti-criminalization movement with an editorial in the journal Retrovirology last month, and admits his stance might seem "counter-intuitive."

But, like others, he argued that publicity about the scores of criminal HIV cases that have cropped up across Canada is adding to the negative aura around the disease, discouraging people from coming forward to get tested, and thus furthering the virus's spread.

The criminal law should be used when someone deliberately tries to infect another person -- through a needle prick or similar malicious action -- but not in the context of consensual sex, he said.

"We don't want to stigmatize and, in a way, you are stigmatizing HIV-positive status," said Dr. Wainberg, who received the Order of Canada for his HIV-AIDS research. "We're not doing enough to encourage testing, and decriminalizing transmission would be a step in the right direction."

Dr. Wainberg conceded that there is little empirical evidence yet that criminal cases are, in fact, keeping potentially infected people underground.

But a study about to get underway in Ontario will examine how the criminal cases are affecting people who already know they are HIV-positive, said Barry Adam, a University of Windsor sociologist and research director of the Ontario HIV Treatment Network, who is leading the survey.

Not everyone in the field, though, views the criminal cases with distaste. Dr. Robert Remis, head of Ontario Epidemiologic Monitoring Unit, said other avenues, such as counselling and public health laws should be used first on

people who exhibit irresponsible sexual behaviour. But using the criminal law is "just the right thing to do" in some circumstances, he said.

"To knowingly and sort of willfully expose someone else to a what can be a fatal disease I think is unacceptable," said Dr. Remis.

"It's beyond the limit, just like it's illegal to bash someone on the head with a stick. It just happens to be a viral stick. But it's a potentially serious assault."

Though definitive statistics are hard to find, more than 80 people -- mostly men -- have been charged in Canada with criminal offences for exposing sexual partners to HIV, according to a study about to be published in the Canadian Journal of Law and Society by Dr. Adam and colleagues.

The Supreme Court provided the legal underpinning in a 1998 decision that said someone who does not disclose he or she has HIV does not have their partner's consent for sex, making the act an assault. Darren Eke, a spokesman for Rob Nicholson, the justice minister, suggested the Harper government has no plans to change that law.

Meanwhile, prosecutions have picked up steam of late, with at least 10 in each of the last three years, said Alison Symington of the Canadian HIV-AIDS Legal Network, which is opposed to most of the cases.

In the latest case, a 29-year-old Toronto man was charged with aggravated sexual assault after having consensual, unprotected sex with a female friend and failing to tell her he was HIV-positive. Police said they believe there were other unsuspecting partners, as well.

A similar charge was laid last month against a 53-year-old man from St. Catharines, Ont.

Earlier in December, the Ontario Court of Appeal imposed a one-year jail sentence on a man convicted of aggravated sexual assault after he had unprotected sex twice with his girlfriend, and failed to tell her during their 18 months together about his HIV status. The trial judge had given him a lighter, conditional sentence.

The man had "deceived [her] throughout their entire relationship concerning a medical condition that could expose her to a life-threatening illness," the appeal judges said in bumping up the punishment.

Grabbing most attention, though, is the case of Johnson Aziga, on trial now in Hamilton, Ont., on two counts of first-degree murder after allegedly having a spate of unprotected sexual encounters with partners who never learned of his HIV infection. Two eventually died of AIDS-related cancers.

The jury saw video testimony given by one of the women, looking gaunt and emaciated, just weeks before she died.

Vancouver's Dr. Julio Montaner, another world-renowned HIV/AIDS researcher, said criminal prosecution of transmission during consensual sex is a complicated issue but he, too, said he sees little benefit from it except in the most extreme cases.

And he noted that police never charge people for passing on other infectious diseases.

"HIV is a problem but so is human papilomavirus (HPV), which leads to cervical cancer and anal cancer," he said, referring to another sexually transmitted infection. "Are we going to legally prosecute anyone who transmits a communicable disease? Is that the kind of society we live in?"

By Tom Blackwell, http://www.nationalpost.com

January 15, 2009


Eight years ago, at age 17, Michael Olsen was unceremoniously blacklisted. Now 25, B.C.’s representative to the national executive of the Canadian Federation of Students, then living in Nanaimo, was attempting to give blood for the first time.

“As soon as I was able to, and as soon as the blood drive came to my city, I was there,” Olsen recalled in a phone conversation with the Straight. “In the interview [with the nurse] there’s extra questions they ask you specifically, face to face. And one question is, ‘Have you had sex, even once, with another man any time between now and 1977?’ ” Olsen answered honestly, in the affirmative. He was brusquely informed that his blood would not be taken.

“I was told I was put on a confidential blacklist,” Olsen said. “What was worse, for me, was the nurse who interviewed me specifically was fairly unkind. She told me I lead a very unhealthy lifestyle.…It was embarrassing.…I was newly open about it [my sexuality] at that point and I was so young, and it was very frustrating for me, because I have always been very safe with my sexual life.”

Olsen had run up against a long-standing policy of Canadian Blood Services to permanently exclude men who have sex with men from donating blood (the type of sex, whether oral or anal, is not specified). When potential donors visit a CBS blood clinic, they are presented with a questionnaire in two parts; Part 1 is filled out alone, and Part 2 is done with a staff member, which is where sexual activity is raised.

A “yes” answer from a man to the question, “At any time, have you had sex with a man, even one time since 1977?” brings a lifetime ban; a similar answer to the question, “In the past six months, have you had sex with someone whose sexual background you don’t know?” brings only a six-month deferral. (Being born in certain African countries, having had malaria, cancer, or other health ailments, and the use of illegal injection drugs brings a lifetime ban, as does taking money or drugs for sex at any time since 1977; paying money or drugs for sex results in a temporary deferral.)

CBS spokesperson Ron Vezina insisted its policy is not meant to be discriminatory. “We base our decisions on science, on epidemiology,” he said in a phone conversation from Ottawa. “The epidemiology tells us that as a population risk, men who have sex with men have the highest prevalence of HIV, and that’s why they get deferred, just like other groups, like people that are born in African countries where the prevalence and incidence [of HIV] is very high.” He added that individuals who have been deferred from giving blood and do not test positive for an infectious disease can always donate at the Canadian Blood Services’ NetCAD research facility at UBC, which studies transfusion medicine. (Appointments can be booked by telephone at 604-221-5515 or email at researchdonations@blood.ca)

But with the federal blood bank often facing critical shortages—most recently last fall, when, on October 29, CBS announced that the national blood inventory had dropped by more than 40 percent in the previous two months, with only two days’ supply on hand for common blood types—is it time for the organization to rethink its policy?

Many, including Jennifer Breakspear, executive director of Vancouver LGBT community centre the Centre, think so. “The Canadian Blood Services not accepting blood from gay men has been an issue for the queer community for a number of years,” she told the Straight by phone. “It’s not specific to risky behaviours; rather, it’s ruling out an entire segment of the population.…Canadian Blood Services is in a dire need for the blood supply, and yet there may be a considerable number of gay men that would be happy to donate and are just being stopped right off the bat by their orientation.”

Rob Hughes, a Vancouver lawyer with Smith & Hughes Barristers & Solicitors, believes the CBS’s policy should be reviewed. “It is kind of discriminatory towards gay men when you have a policy in place that is focused on the gender of your sexual partner rather than specific risk behaviours that would apply equally to heterosexual or homosexual couples engaged in sex,” he noted in conversation with the Straight. “Someone who’s heterosexual but engaging with multiple sex partners in unprotected sex, I would think, would be at a higher risk of infection—and would be somebody that you’d want to exclude from the blood supply—than a gay man who’s in a monogamous long-term relationship engaging in protected sex.”

Although, according to Hughes, there might be a basis for a human-rights complaint regarding CBS’s policy—“Discrimination on the basis of sexual orientation would be something that is protected in both the Canadian Human Rights Act and the B.C. Human Rights Code,” he says—to date no such complaint has been filed.

In Quebec, however, one legal challenge against Héma-Québec, which handles the province’s blood supply, is winding its way through the courts: a small-claims suit of $1,500 filed in 2005 by Adrian Lomaga, then a second-year law student at McGill University.

According to Lomaga, now a practising lawyer in Toronto with Rachlin & Wolfson LLP, the suit has now been transferred to the Superior Court after Héma-Québec added Health Canada as a third party to the action. “It’s been placed in the trial list, and we’re waiting for a trial date, which may be another year or so,” he told the Straight by phone. Although any decision regarding Lomaga’s case would technically apply only to Héma-Québec, “in reality, because Health Canada sets down the policy for Canadian Blood Services and Héma-Québec, any type of decision, if it’s in my favour, will have an effect across Canada,” Lomaga said. Another case with potentially wide-ranging repercussions is a $100,000 suit filed in 2002 by CBS against Kyle Freeman. Freeman, in protest of the CBS’s deferral policy, sent anonymous e-mails to the blood bank claiming he was an HIV-negative gay man in a committed long-term relationship who had donated blood after lying about his sexual history. That case is expected to go to trial in the Ontario Superior Court of Justice this year.

One of the loudest voices in the call to overhaul the CBS’s policy is the Canadian Federation of Students (CFS), which in 2006 took up the issue as an official campaign. Since that time, it has taken part in stakeholder consultations with the blood bank, but to date no policy changes have been made. In June 2007, the CBS announced it had conducted a review of its deferral policy for men who have had sex with men; it decided to uphold its policy but continue investigating the issue.

“We committed a research agenda to look at this issue further,” CBS’s Vezina said. “We also made funding available through the Canadian Institutes for Health Research for someone to tackle that issue. No one to date has jumped on the bandwagon to use the funds to conduct research at the university level, so the file is open.”

What arose out of stakeholder discussions during its latest review, Vezina said, was that simply reducing deferral times for men who have sex with men is not acceptable. “Our stakeholders said, ‘Essentially, you’re asking a gay man, for the privilege of donating blood, you want me to be celibate for a year, or five years, or 10 years. That’s not the way you should be assessing risk.’ ”

Brent Farrington, national deputy chairperson of the CFS, explained from Ottawa by phone that “we felt that [a shorter deferral period] was an inappropriate gesture on their [the CBS’s] part, in the sense that our issue is with the nature of their question. They are essentially saying that the MSM [men who have sex with men] population is a dirty population, so by saying that, ‘Oh, well, if you only engaged in MSM activity five years ago and haven’t done it since, then you’re fine to give blood again,’ that just reinforces what we consider to be the draconian practice that they’re using.”

What the CFS and groups like Egale Canada (which did not return calls to the Straight) want is a behavioural approach to screening blood donors rather than a demographics-based questionnaire. That would involve asking donors details about their sex lives, such as whether they practise safe sex, and screening them accordingly.

But recent memory is still scarred by the tainted-blood scandal of the 1980s, in which more than 1,000 patients contracted HIV and 20,000 contracted hepatitis C from blood transfusions given by the Red Cross between 1986 and 1990—and after which, in 1998, Canadian Blood Services took over the national blood supply (with Héma-Québec operating in the province of Quebec). Any question of messing with a system that has operated safely for the past 10 years raises understandable fears about contaminating the blood supply.

Only Italy, to date, has adopted a behavioural-screening approach, Vezina noted, adding: “We’re all anxious for them to publish some data. I don’t think Canadians want to be a guinea pig. It’s up to us not to be on the leading edge of this policy.” Even so, Vezina said that CBS is continuing to investigate the issue, and it is scheduled to report its preliminary research to its board of directors in February.

“We are not sitting passively,” he insisted. “In the course of the past year, we’ve polled over 40,000 of our donors on what would it mean to them in terms of a new approach to screening and also gauging what that would do to our donor base. For instance, if we start asking about sexual practices, is it going to turn some people off from donating blood to have to go through those questions every time? Is it going to sideline too many from being able to donate?…If you make a change on one side of the safety coin, you’ve got to make sure that it’s a calculated measure. You can’t be implementing a new deferral that is going to wipe out 50 percent of your donors. You’re going to be in constant shortage.”

In the meantime, the CFS says it is keeping a close eye on the issue, hoping for progress. “I’m very happy that they [CBS] are evaluating their policies when it comes to the MSM deferral criteria,” Farrington said. “I mean, it’s frustrating, but I do appreciate that it’s beyond their control that the time lines are so slow.” Olsen said: “We’ve had discussions on whether or not we’d make a human-rights complaint on this, and the consideration still stands…but we’re not taking action on it specifically yet.”

In the meantime, Olsen can only shake his head whenever he hears urgent appeals for blood. “Every year, when they talk about this [blood shortages], or every time I hear it on the radio, it does frustrate me a lot,” he admitted. “I laugh, really. I find it very frustrating.”

As to how effective CBS’s screening policy is, given that it’s an honour system, it seems that Kyle Freeman is not the only man who has ever withheld information in order to donate blood. “I have a lot of friends who actually have lied for that question [about men having sex with men], and they donate blood anyway,” Olsen confessed. “A lot of people know they have clean blood, because they do get checked on a regular basis, and they know the blood is going to be screened again anyway. They just answer no to the question.”

Three Letter Plague, Steinberg says, was prompted by reading Edwin Cameron's exploration of stigma and den-ial in Witness to Aids, his personal account of his journey to testing and public disclosure. Steinberg poses two questions: why do stigma and shame prevent people - predominantly men - from taking the first step towards self-preservation by testing for HIV? And why do people who have the opportunity of accessing life-saving drugs not take up the opportunity to get treatment their government now offers?

In search of answers Steinberg journeys to a remote hilltop community in the Eastern Cape, and embarks on a quest through the trenchant themes of shame, anger, secrecy, fal-lacy and fear. The scene of his investigation is “Ithanga” (not its real name), a village of 700 mostly unemployed people and without electricity or running water.

Here Steinberg befriends the charismatic, dreadlocked, 29-year-old autodidact entrepreneur he calls Sizwe Magadla, the proprietor of Ithanga's only successful shop. “Sizwe was healthy and strong and had never tested for HIV, which puts him in a category shared by most South African men his age.” About to be married to his pregnant girlfriend, Sizwe is aware of the testing, counselling and antiretroviral treatment programme available 20 miles away in Lusikisiki, run by the legendary Dr Hermann Reuter. Yet he is reluctant to take the test.

Ambivalent about his own experiences of being tested for HIV as a young gay man at university, Steinberg recognises Sizwe's dilemma. Together the two men explore the implications of HIV and Aids for the community and discover the “architecture of shame”' - the elemental anxieties of contamination and moral panic attendant on a disease that meddles with deep metaphors and primal patriarchal cultural taboos surrounding generative fluids - blood and semen - and sex.

This book has been greeted with widespread critical acclaim for its rich description; gripping accounts of superstition, witchcraft, views on “Western” science, ancestral spirits, evocative tales and sharp studies of a range of key indicative characters - including doctors, nurses, volunteers, treatment activists, traditional healers and troubled ancestors. This is justified praise. Steinberg commands the narrative deftly, with inquisitiveness, energy, and wry self-deprecation. He thinks with the bracing scepticism of the cultural sociologist and writes with the detached coolness recommended in Greene's dictum that objectivity requires an icicle in the heart. Steinberg states clearly that he is a “lay person” and critical outsider, and that, having “lost nobody” to the epidemic, he does not write as a witness to AIDS.

The value of this book lies beyond the pleasures of its lambent prose and stylistic aplomb. What compels is the sustained, intimate, yet fractured dialogue between Sizwe and Jonny - black man and white man from utterly divergent backgrounds - who share nonetheless a recognition of the stigma of disgrace imposed upon HIV-positive people. Steinberg asks why more than two thirds of the approximately 262,000 people on antiretroviral (ARV) treatment in South Africa are women.

“Where are the missing men? Why are they so less likely to find their way to ARV treatment than women?” The answers reside, as this book startlingly reveals, in conventional notions of masculinity of which Sizwe and Jonny are victims. Testing, public disclosure, and fighting stigma require a profound re-evaluation of the inhibitions of masculinity. And this challenge to the primordial conventions of patriarchy, as the treatment statistics show, seems to be much more frightening to men than death itself.

Three Letter Plague: A Young Man's Journey through a Great Epidemic by Jonny Steinberg, Vintage Books

By Rachel Holmes, http://www.timesonline.co.uk

January 12, 2009

The AP/Washington Post on Sunday examined the impact of the President's Emergency Plan for AIDS Relief on the burden of HIV/AIDS in African countries. According to the AP/Post, "countless Africans ... will always be grateful to [President] Bush for his war on AIDS."

PEPFAR initiatives have increased the number of Africans receiving antiretroviral treatment fortyfold over the past five years by working through grass-roots organizations as well as "higher-profile charities and big state clinics," the AP/Post reports. Still of the 1.5 million Africans who died from AIDS-related causes in 2007, less than one-third had access to antiretroviral treatment. The number of new HIV cases also continues to exceed the number of people receiving treatment. In addition, the current economic downturn has caused concern about whether the five-year, $48 billion in PEPFAR funding passed last year will be delivered.

Although numerous programs cite successes achieved as a result of PEPFAR funding, several advocates disagree about how the initiative has impacted HIV/AIDS in Africa. According to the AP/Post, some advocates have suggested that the initiative overemphasizes abstinence and faith-based programs. Helen Epstein, an HIV/AIDS expert and consultant for the United Nations and the World Bank, said PEPFAR's focus on abstinence has hindered prevention efforts by failing to address certain African cultural practices involving simultaneous long-term relationships. According to Epstein, PEPFAR could achieve a greater impact if funding were directed at strengthening health care systems rather than addressing a single disease. Johanna Hanefeld, researcher at the London School of Hygiene and Tropical Medicine, added that the Global Fund To Fight AIDS, Tuberculosis and Malaria more effectively utilized HIV/AIDS programs for improving health care and training because it did not distribute funding among many different groups.

However, many experts and advocates disagree with PEPFAR's critics and believe that the initiative will have a lasting impact on the HIV/AIDS in Africa. Mark Dybul, U.S. Global AIDS Coordinator who administers PEPFAR, said, "In Africa, you can't tackle development goals unless you tackle HIV/AIDS." According to Dybul, the initiative also is a major supplier of condoms to several African countries, demonstrating that PEPFAR does not emphasize abstinence exclusively. "It's the largest international health initiative in history for a single disease," Dybul said. Francois Venter, who heads a PEPFAR-funded program at the University of the Witwatersrand in South Africa says, "PEPFAR is different" because of its emphasis on measurable targets. Josh Ruxin, assistant professor of public health at Columbia University, said President Bush and his administration "deserve a lot more credit than they received" for launching PEPFAR. "[I]t is impossible to deny the results and achievements of PEPFAR," Ruxin said, adding that he hopes President-elect Barack Obama will continue the initiative while shifting its focus away from abstinence and providing funding for programs involving commercial sex workers and abortion.

According to the AP/Post, supporters and critics alike "agree that prevention is the weakest link" among global HIV/AIDS programs and will need more emphasis in the future (Nullis, AP/Washington Post, 1/11)

http://www.kaisernetwork.org

January 9, 2009

For the first time, people living with HIV/AIDS in Afghanistan soon will receive antiretroviral therapy from the government, the Ministry of Health announced recently, IRIN/PlusNews reports. Forty of the 504 people diagnosed with HIV/AIDS in the country were selected to receive the drugs based on their medical status and need, among other criteria. It is suspected that there are an additional 2,000 to 2,500 undocumented HIV/AIDS cases nationwide.

Saif ur-Rehman, head of the national HIV/AIDS program at the health ministry, said that $50,000 has been allocated to supply the antiretrovirals and that the ministry "will allocate more in the future." The government is launching the treatment program with help from various donors, and Rehman said that the ministry expects the World Health Organization to have imported the drugs by the end of January. The drugs will be distributed at no cost in Kabul and Herat provinces initially, but more people could receive access in the future, IRIN/PlusNews reports. Consultations will be made with WHO and international not-for-profit groups to determine how the antiretrovirals are dispensed, and health care workers will be trained to oversee treatment regimens. According to health officials, Afghanistan has been slow to introduce no-cost antiretroviral therapy, and availability and access remain low. In addition, the stigma surrounding the disease makes it difficult to determine if people are accessing the drugs through the private sector. Although the number of documented HIV/AIDS cases in Afghanistan is among the lowest worldwide, there are many factors that could contribute to the spread of the disease, including a lack of awareness, conflict, the poor social status of women and rising injection drug use.

Some health care workers in the country are calling for immediate action to curb the spread of HIV, IRIN/PlusNews reports. Rehman added, "We want to tackle the existing gap between real and suspected HIV cases by 2010 so as to draw up appropriate plans and implement relevant projects." Health ministry officials and health workers have cited limited technical capacity to make use of funding and donor efforts. The national HIV/AIDS control program was launched in 2003 and has received pledges of more than $30 million up to 2013. The health ministry hopes the planned opening of a UNAIDS office in the country in 2009 will help fill the gap in national capacity (IRIN/PlusNews, 1/7).

http://www.kaisernetwork.org

January 12, 2009

While they may not develop wrinkles or liver spots, CD4 cells can show signs of premature aging. This can lead to faster disease progression in HIV-positive people, conclude the authors of a study published in the January 7 issue of the Journal of Acquired Immune Deficiency Syndromes.

Scientists have known for many years that the immune systems of elderly people are not as robust as those of younger people. One of the primary reasons for this is that as a person’s CD4 cells reproduce over many years, they slowly become less functional with each generation. Experts in genetic research call this immunosenescence.

Immunosenescence can occur much more rapidly in people with HIV, given the constant destruction and production of immune cells in response to the virus. What has remained unknown, however, is whether this premature aging of CD4 cells impacts HIV disease progression.

To explore the possibility, Weiwei Cao, MD, PhD, from the Department of Medicine at Danbury Hospital in Connecticut and his colleagues examined the CD4 cell functioning of 20 HIV-positive people with rapid disease progression and 40 people with slow progression. The study volunteers were all drawn from the Multicenter AIDS Cohort Study (MACS), and a rapid progressor was defined as progression to an AIDS diagnosis within four years of infection.

Cao’s team found that one of the fundamental signs of an “aging” cell—the loss of cell receptors called CD28—was far more likely to be present in rapid-progressors than slow progressors. Other signs of premature CD4 cell aging, such as the ratio of two types of CD4 cells, called memory and naïve cells, were less clear.

While the authors state that the cellular aging process can continue even in people on antiretroviral (ARV) therapy, they recommend that more research be conducted to determine whether—and to what degree—ARV therapy helps slow this process. They also call for studies exploring the removal of aging cells to make room for new cells, and for a therapy that may rejuvenate aging cells.

http://www.aidsmeds.com

By Keith Alcorn, www.aidsmap.com

January 13, 2009

A four-in-one antiretroviral pill is being developed by Gilead Sciences and, according to a report by Bloomberg News, is expected to enter a clinical trial by this summer.

The new pill will contain four Gilead drugs—tenofovir (Viread), emtricitabine (Emtriva), the experimental integrase inhibitor elvitegravir and a drug that boosts elvitegravir blood levels, currently called GS9350.

Gilead is negotiating with the U.S. Food and Drug Administration (FDA) on the size and scope of the trial. Not only will the study explore the effectiveness of this novel drug combination, but it will also help answer lingering questions about the safety of elvitegravir and GS9350. Elvitegravir is currently being evaluated in Phase III studies in people who are treatment experienced; GS9350 is in a much earlier stage of development.

If the study results are positive, the new pill could become an alternative to the only existing treatment that includes a full ARV regimen in one tablet, Atripla (tenofovir, emtricitabine and efavirenz).

http://www.aidsmeds.com