Naturopath's Vision Creates a Clinic in Thailand
HIV-AIDS patients benefit as member of well-known B.C. family changes their lives
December 31, 2007

Mae On, Thailand -- Laura Louie's approach to international development is unique.

For her, it's not something best left to governments and big organizations like CARE. But neither is it the exclusive purview of gazillionaires like Bill Gates and rock stars like Bono.

Writing a cheque is just not hands-on enough for the Vancouver naturopathic doctor. Maybe it's the massage training she's had, but when she considers changing the world, her view is tightly focused and one of the tenets of Chinese traditional medicine seems to inspire her thinking: "With healing, touch is so important."

It's a Tuesday morning and Louie is only a few days off the plane from Canada when she arrives at the Mae On Clinic, bright and early so she can consult with head nurse Unchalee Pultajuk before the patients start arriving for the weekly HIV-acupuncture clinic.

Louie's not billing this as a farewell tour, but essentially that's what it is.

The clinic she set up in this little village is self-sustaining now.

"They don't need me here. I worked my way out of a job," she explains.

There are no regrets her baby is walking; in fact, she's ready to celebrate.

"That was the whole point of doing our project. We train local people in our programs. This is our pilot project, so we've trained them in acupuncture and basically we've worked our way out of a job.

"But we still support them financially ... And if at some point they want more continuing education, we'll provide that for them as well. But right now, it's finished."

Mae On is a government hospital in northern Thailand, about 35 kilometres from Chiang Mai. Significantly, it's also about 200 kilometres from Southeast Asia's infamous Golden Triangle of heroin production and on the long-distance truck route from there. It only has 18 beds and there is no public transportation nearby, but it does have an HIV-AIDS program that attracted Louie.

In 2002, she was already on a sabbatical from her busy natural medicine practice in Vancouver and came to Thailand on a break from the volunteer work she was doing in India.

It was a busman's holiday and, after Louie saw the work they were doing with HIV patients at Mae On, she volunteered to help out.

Much convincing, cajoling and hands-on demonstrations of acupuncture later, the doctor got the go-ahead from the hospital director to open her own free clinic in a small outbuilding beside the hospital to treat the growing problems that patients were facing living with the side-effects of the antiretroviral drugs they were taking to treat HIV. The pain, fatigue, numbness, loss of appetite and insomnia were badly affecting their quality of life.

Before Louie could start training the nurses in acupuncture and massage and outfit the clinic to take patients, however, she needed money.

Back to Vancouver she went to hit up -- or, as the soft-spoken Louie puts it, "approach all my friends and family" -- for donations. She wasn't a registered charity, just a woman with a mission. And it was an act of faith in Louie that, when she got back on the plane, she had $30,000 in her pocket.

The clinic opened its doors to outpatients in August 2004.

Patients move from the acupuncture beds to a chair where a tuina massage completes their treatment. The traditional Chinese massage is done with bare hands -- "with healing, touch is so important" -- and Louie credits it with helping break down the "stigma" of HIV among her patients and their families.

In the small surveys done at the clinic, 96 per cent of patients claimed physical improvements from the acupuncture and 86 per cent said their quality of life has improved.

Louie, 47, comes from a well-known Vancouver family. Her grandfather, H.Y. (Hok Yat) Louie, founded IGA and London Drugs and the family still runs the companies. You can sometimes see the Chinese influence in her face and dark hair, but her tall stature probably has more to do with her Russian mother.

As a child growing up in North Vancouver, Louie travelled extensively with her parents, resulting in later life with a strongly international outlook.

She graduated from UBC in geology and worked in the field for several years before making the leap to natural medicine.

At 30 she was accepted to Bastyr University in Seattle, one of the best of the very few North American universities that train naturopathic doctors.

It was there she began working with HIV-AIDS patients and she's been doing it ever since.

One of her most famous patients in Vancouver is HIV activist and artist Joe Average and he's helping out with the Mae On project, donating paintings to the annual silent auctions she now organizes in the city to help fund the clinic.

Louie looks nothing like the socialite she could have been. Her hair is long and pulled back from her face.

Her clothes are long too -- long skirt, long scarf, long earrings and a long necklace. It's a look that works well in rural Thailand, where modesty is expected and appreciated.

At the top of her agenda now, however, is finding another Thai project.

If it can be near Mae On, so much the better because the doctor hopes to use nurse Unchalee to help do the training. She envisions a small and focused project, like Mae On, that could become self-sustaining within a few years.

Louie doesn't profess to a grandiose vision for her "development work." For her, it is simple and personal.

"I'd like to give back," she says.

By Aileen Mccabe, CanWest News Service, The Vancouver Sun

Coming Out at Islamic AIDS Conference
Toronto activist receives warm response
January 3, 2008

For Suhail Abu al-Sameed it was the first time in years he had been nervous about being out.

But for the Toronto Muslim homosexuality was something delegates at November's International Consultation on Islam and HIV/AIDS in South Africa couldn't ignore any longer.

"I was shaking, out of my element, at the end of the world," says Abu al-Sameed in an interview in his office at the Sherbourne Health Centre where he is the coordinator of Supporting Our Youth's Newcomer/Immigrant Youth Project. "I told them, 'I as a gay Muslim feel very unsafe in this room. If I ever get AIDS you're the first people I would lose. I wouldn't come to you because you don't care about me.'"

Abu al-Sameed says he was giving his speech directly in front of a table of religious scholars, who had earlier condemned homosexuality. Two of them tried to silence him by waving their arms but Abu al-Sameed continued and the result, he says, was astonishing.

"As I walked back to my chair there were people reaching for my hand, saying, 'Good work.' One very big, very serious bearded religious man put his hand on my shoulder and said, 'I'm very sorry if I said anything that offended you.'"

Even more surprising was the statement issued the next day by the religious leaders and scholars at the conference saying that although Islam does not accept homosexuality, Islamic leaders would try to help create an environment in which gay people could approach social workers and find help against AIDS without feeling unsafe.

"It's the first time a religious group has said that," says Abu al-Sameed. "They were able to put a face to homosexuality. The moment they met someone something changed drastically. I reached people from all over the world, people of authority."

Abu al-Sameed doesn't expect things to change overnight in Islamic countries but he says having religious leaders speak out is a huge first step. He says the result is being felt well beyond the conference.

"I got an email from one of the people I work with here, young, Muslim, in the closet," says Abu al-Sameed. "He was saying, 'Oh my God, you changed my life. I can do something about it."

Abu al-Sameed had attended the conference — a groundbreaking consultation that brought together Muslim community leaders, academics, doctors, relief workers and HIV-positive activists — as part of a research study he is helping to start in Toronto. The study — which springs from a group Abu al-Sameed helped found called the Muslim AIDS Project — will be called Looking For Answers: HIV and AIDS in the Muslim Community in the GTA.

"We'll be looking at attitudes," says Abu al-Sameed. "We're trying to start a dialogue with religious leaders and Muslim PHAs [people with HIV/AIDS]. We want to know if we were to start an awareness campaign would your mosque be part of it or would you say, 'No way.'"

He says that being able to point to the statement issued by religious leaders the conference will be a huge help.

Abu al-Sameed says that while numbers are still low in Muslim communities both in Canada and the Middle East, the rate of infection is growing.

"The growth rate of these numbers is the alarming thing," he says. "The prevention work has not kept up. These people are coming to Canada with a sense of immunity."

Abu al-Sameed says about 10 to 20 percent of those he works with in the Newcomer/ Immigrant Youth Project are Muslim. Not all of those are queer, but he says there are queer Muslim refugees entering Canada on a regular basis.

"Most of them are easily accepted," he says. "If you're coming from Iran or Saudi Arabia you're probably going to be accepted."

By Krishna Rau, Xtra

Free Crack-Pipe Mouthpieces To Be Distributed In B.C.
January 3, 2008

As part of the province's harm-reduction strategy, the B.C. Ministry of Health will provide crack-pipe mouthpieces to people who smoke crack.

Dr. Perry Kendall, the province's chief medical officer, said simple mouthpieces made from surgical tubing will be distributed by outreach workers through needle exchanges and other community health services as early as April.

The program is intended to cut down on the transmission of blood-borne diseases such as hepatitis C, HIV/AIDS, tuberculosis and syphilis that can be spread by smokers sharing glass crack pipes, Kendall said.

Crack smokers often have burns and sores on their lips, he said, so when users share a pipe, they will be able to use their own mouthpiece and reduce the risk of disease transmission.

Kendall said there would not likely be any age restrictions to stop minors from receiving the mouthpieces, since young drug users are the most likely to contract a disease through shared equipment.

The program is expected to be cheap to run because it will rolled into existing programs, such as needle exchanges, and it would only use a relatively small amount of cheap surgical tubing, Kendall said.

Crack is a cheap and highly addictive illegal drug made from cocaine.

www.cbc.ca

Blood Donation Policy Rankles Students
January 4, 2008

Student groups at the University of Saskatchewan have added their voices to the chorus from campuses across the country demanding Canadian Blood Services drop the "discriminatory" practice of excluding gay men from donating.

One of the questions on the agency's donor form asks whether potential male donors have had sex with another man, even once, since 1977. Even if the person is in a monogamous relationship and practised safe sex, they are ineligible to donate.

"It should be changed. It amounts to discrimination and at a time when they (Canadian Blood Services) need blood, they're not allowing perfectly healthy people to donate," said U of S Students' Union president James Pepler.

"They (CBS) are putting other people's lives in danger by being exclusionary," added Clara Lavery, co-ordinator at the U of S Pride Centre. "There are plenty of homosexual men who are in monogamous relationships and get tested regularly."

Men who have sex with men are not even the highest at-risk demographic for the HIV/AIDS virus anyway, say both Lavery and Pepler.

Women between the ages of 17 and 23, who are in a low-income bracket, are now considered most risky because of their potential link to the sex trade.

"Blood services says it is doing this because its recipients don't want blood from a gay person but there was a time when they didn't want blood from African-Americans, too," said Pepler.

"Times change so let's get with the now."

The CBS should enlighten its recipients to the fact that not all gay people need be excluded. Besides, the donor form only requires people to check a box, yes or no, and it's simple enough to choose "no," he said.

"I don't even know what the ramifications are. Is there blood donor police or something?" said Pepler. "I know a few gay men who give blood because they know they're fine."

Blood testing is done as a safety precaution regardless of who donates, anyway, he added.

Having to answer that question makes anyone who reads it assume that all gay people must carry the HIV/AIDS virus, say student groups at the University of Toronto.

Some campuses have cancelled their blood donor days as a protest, though Pepler said nothing of that sort is happening at the U of S. And no one is about to picket outside the CBS office. It's simply a concern for dignity by removing a discriminatory stereotype, he said.

The University of Regina Students' Union (URSU) will examine whether to continue student blood donor clinics.

URSU president Mike Burton said as a result of recent media interest in the issue, the students' union board of directors will discuss the matter at its meeting on Monday. Burton admitted there hasn't been a major push from students to look at the issue.

"I've been on the student union executive for two years now and I have not had a student come up to me and bring this up. It is an issue we were thinking about discussing at some point," he said.

Any decision by the board will not be made for probably a month until Canadian Blood Services and other interested groups make presentations at future meetings, said Burton.

The CBS insists the policy is not prejudicial or discriminatory, rather it is behavioural.

The agency needs to identify anyone at risk of contracting life-threatening diseases, said an agency spokesperson who cannot give blood because she spent five months in the U.K. during the mad cow disease upheaval of the 1980s.

"Every year donors from all walks of life are refused," said Lindy McIntyre, a Regina-based CBS spokesperson for the Prairie region.

"It (policy) casts a wide net that may exclude some well-intentioned people but it is a necessary precaution. It's based on scientific risk factors."

Giving blood is not a right, though it is the right of a patient to receive the safest blood possible during a transfusion, she added.

The blood agency regularly reviews its policies and most recently, in April 2007, met with representatives from national organizations for gay rights, including Egale Canada, a lobby group for lesbian, gay, bisexual and transgendered people and their families.

A decision was made to retain the MSM (men having sex with men) policy while undertaking more research on emerging testing methods, emerging pathogens, behavioural-based practices and what other agencies are doing, McIntyre said.

By Darren Bernhardt, The Star Phoenix, www.canwest.com

Chronicling the Scourge of AIDS
January 6, 2008

Roza Mukabagema was infected with HIV while caring for her infected children. She has buried two of her daughters, two more are sick and two of her five grandchildren have already tested positive.
Photo by Andrew Stawicki

Kigali–A weary, elderly woman stands against the wall of her tiny mud hut, huddling three of her grandchildren against her, squinting a bit as sunlight pours in through the doorway. The faded red letters of a French acronym – SIDA – loom large on a poster above her right shoulder, almost as if they're weighing her down.

The shutter snaps of two photographers who have come to take her picture are the only sounds that break an eerie silence. Mukandori, 72, waits patiently for them to finish their work.

She had 12 children, but only one is alive today. "Some died in war, others died of natural causes," she explains through a translator. "But when I remember the ones who died of AIDS, I still feel a deep sorrow."

Mukandori, who has just one name, is a Rwandan left to raise three of her grandchildren as a result of having lost three of her own children to a disease she calls "the scourge of all." She agreed to have her picture taken by Canadian photojournalist Steve Simon and one of his Rwandan counterparts, George Barya. The shoot was part of a unique, unprecedented effort to teach both the Rwandan and Canadian public about HIV-AIDS, a disease that has shattered Mukandori's family and so many others.

Simon is a long-time member of a Canadian photography collective called Photosensitive. The group was founded in 1990 by former Toronto Star photographer Andrew Stawicki and Peter Robertson, a former Star graphics editor. Over the years, they've dedicated themselves to non-profit social documentary projects, staging exhibits on homelessness, child poverty and literacy, to name just a few. Photosensitive's current endeavour is their third on HIV-AIDS.

"This is an emergency situation; it's urgent," says Simon, explaining that his hope for the project is that it becomes a call to action for people in the west. "I think that people, when they are aware of it and they do help, they themselves are going to feel very good about doing so.

"If this scourge of AIDS were to hit the Western world the way it's hit Africa and now Asia and other parts, there's no question that it would be pushed up in terms of priorities," he says.

Cynics may wonder whether a simple photo exhibit can really fuel social responsibility, but Photosensitive's track record speaks. A 1996 project on Toronto's Hospital for Sick Children helped raise over $100,000. And a 2005 exhibit on Ontario's first native literacy camp helped secure funding for the opening of 35 more the next year.

For Photosensitive's latest project, seven journalists were in Rwanda documenting the social impact of HIV-AIDS. One photographer took pictures of HIV-positive prostitutes on the streets of Kigali. Another photographed women who contracted HIV as a result of being raped during the 1994 genocide. Others went into anti-retroviral and circumcision clinics and chronicled the latest efforts to stem the spread of the disease.

Stawicki says the key to Photosensitive's work isn't just that it educates or informs. It's that it makes people angry. "If they're angry, maybe they'll do something."

But what makes this year's project unique, Stawicki says, is that for the first time, Photosensitive is contributing to the development of foreign professional journalists. Over the course of their time here, each of the Canadians was paired with a local photographer. The Rwandans learned how to use modern, professional cameras (donated by Photosensitive and Getty Images) to produce images that go beyond traditional news pictures in their depth, quality and resonance. Those images will appear together as photo essays in each of Rwanda's major newspapers.

Local photographer Shyaka Anastase says the Canadian help is sorely needed. "A lot of people died or left the country during the genocide, and for that reason we don't have any great photographers here in Rwanda," he says, speaking in French. Anastase explains that because of the role of media in fuelling the killings, many potential journalists have shied away from the profession. This has left the country's few remaining reporters in charge of both writing articles and taking pictures, and as a result, photography in Rwanda has suffered.

"I used to think this aspect of journalism wasn't that important," says Anastase. "But in the last few days, what I've learned has instilled in me a love for taking pictures and has made me want to really do more."

Anastase has been working with Peter Bregg, a 40-year veteran who's covered everything from the Olympic Games to parliamentary news. Bregg, photo editor at Hello! magazine, says he's impressed with how far his trainee has come in such a short time.

"He's looking now to shoot things that he wouldn't have shot before," says Bregg.

Watching the two working together in the field, it's easy to get a sense of what Bregg is talking about. He's not a heavy-handed coach – instead, he teaches by example. Every so often on a shoot, Bregg will set up at an angle or in a spot that catches Anastase's attention, and Anastase will do his best to mimic the photo. If the results aren't the same, Bregg will take the opportunity to give a quick lesson on lighting, aperture opening, and shutter speed.

"After working with Peter, I think my pictures have much more feeling," says Anastase. "I learned a lot about how to avoid making mistakes after just a few days."

Anastase says he's been so inspired by his experience with Bregg that he hopes to create an association of Rwandan photojournalists, in the hope that they might get together to plan more Photosensitive-style documentary projects.

In the meantime, a Photosensitive exhibit at the National University of Rwanda in Butare will serve as inspiration to the next generation of Rwandan journalists. Photosensitive plans to exhibit their work in to provide inspiration of a different sort – not to document, but rather to act.

"Whenever we bring AIDS to the front in Canada, it helps remind people the problem is still there," says Bregg. "And it's not insurmountable. A lot of our pictures will illustrate despair, but a lot will also illustrate hope."

Christopher Maughan accompanied photographers on the Photosensitive. project.He is an intern with the Rwanda Initiative, a Canadian and Rwandan

Toronto Star

Further to this see: http://www.rwandainitiative.ca/media/ps-2007-11-30.html

And www.photosensitive.com

New HIV Cases Drop but Rise in Young Gay Men
January 2, 2008

New York - For years he had numbed his pain and fear with drugs, alcohol and anonymous sex. But in a flash of clarity one day, when the crystal meth was wearing off, Javier Arriola dragged himself to a clinic to get an HIV test, years after he stopped using condoms.

He knew the answer before he received the results, but it was far worse than he thought: At age 29, he had full-blown AIDS.

He had planned to have a party for his 30th birthday. Instead he was thinking of hanging himself in his apartment in Hell's Kitchen.

“There were feelings of terror, like when you were a little kid and there's that thing that terrifies you,” he said. “This was it. The worst nightmare, and I brought this onto myself.”

The number of new HIV infections in men under 30 who have sex with men has increased sharply in New York City in the last five years, particularly among blacks and Hispanics, even as AIDS deaths and overall HIV infection rates in the city have steadily declined.

New figures from the city's Department of Health and Mental Hygiene show that the annual number of new infections among black and Hispanic men who have sex with men rose 34 percent between 2001 and 2006, and rose for all men under 30 who have sex with men by 32 percent.

At a time when the number of new cases among older gay men is dropping — by 22 percent in New York City during the same period — AIDS experts are bearing down on what they say is a worrisome and perplexing growth of HIV infection among young men like Mr. Arriola.

So far, they say, the significant factors feeding the trend appear to be higher rates of drug use among younger men, which can fuel dangerous sex practices, optimism among them that AIDS can be readily treated, and a growing stigma about HIV among gays that keeps some men from revealing that they are infected. There has also been a substantial increase in the number of new infection cases among young white men who have sex with men, but still that group had fewer new cases in 2006: 100, compared with 228 among blacks and 165 among Hispanics.

The rising rates for young men in New York City come as federal health officials acknowledge that infection rates nationwide, while flat, may be substantially higher than previously thought because of underreporting.

The highest rates of HIV infection nationally are among gays, blacks and Hispanics, with a recent trend toward a younger infected population mirroring New York City's experience, according to AIDS researchers, who say they are concerned that the country's infection rates over all have not declined in the past 10 years.

“It's really unconscionable that we haven't had a decrease in new infections in the past decade in the United States,” said Wafaa El-Sadr, chief of infectious diseases at Harlem Hospital Center and a professor of public health at Columbia University. “It's not anymore in the headlines; many people think it's gone away, and it hasn't gone away.”

AIDS activists and medical providers say the rates among young men could signal a new wave of the disease.

“Unless you start pulling it apart, unless you start looking at really addressing this and talking honestly, unless you start talking about it in a real way,” said Soraya Elcock, deputy director for policy at Harlem United Community Aids Center, in a neighborhood that has one of the highest infection rates in the city, “we'll be here in another 20 years having the same conversation.”

As a young, black gay man, Lynonell Edmonds says it seems like a miracle that he has not contracted the AIDS virus. Before he turned 20, he had a haunting realization: in his group of 20 close gay friends, he was the only one without HIV

Mr. Edmonds, now 25, does outreach work for the Harlem AIDS center, trolling Craigslist and other online meeting spots as a “sexpert,” encouraging men to be tested. He and a crew of outreach workers also go to gay nightclubs late at night, with a van carrying HIV tests that can be conducted on the spot. The crew parks the van, which has no obvious signs of its mission, on the street. When they go into the clubs, they make conversation and delicately inquire whether a clubgoer would like to take the test.

Mr. Edmonds said that for many gay black men there is a sense that getting the virus is almost inevitable.

“A lot of guys say, ‘I'm going to get it anyway,'” Mr. Edmonds said.

Mr. Edmonds and other gay men say the stigma of being infected with HIV is growing, and may be greater now than it was in the 1990s, when the AIDS epidemic became a unifying cause, a shared tragedy for gay men.

“I call it, ‘Don't ask, don't tell,'” Mr. Edmonds said. “People are not asking — it's like it's an offensive question.”

Kyle, who found out that he had the virus two years ago, at the age of 23, said he had grown weary of what he called “pity dates,” men who agreed to go out with him after he revealed he was infected, but had no intention of pursuing a relationship. He said that out of about 10 men he had dated in the last two years, only one — who was, at 40, the oldest — was willing to go beyond pity dates.

“They blame you and want nothing to do with you; they put you at the end of the line,” said Kyle, who spoke on the condition that his last name not be used because he said he believed his condition would hurt him professionally. “The older generation sees AIDS as a tragedy, the younger generation sees it as self-destructive behavior.”

He said he was infected by someone who did not reveal that he had the virus until after they had unprotected sex.

For Mr. Arriola, who struggled with being molested as a child, the HIV diagnosis put him at rock bottom, he said.

He continued to use drugs for several more months, but then, as his suicide plan was becoming an obsession, he called a friend who was a recovering addict. He got clean and sober, joined a 12-step group, started going to therapy and has slowly pieced his life back together.

“For me today, I've done a lot of work to accept myself. I don't drink and drug, I meditate, there's a lot of visualization of the person I want to be,” he said. “A lot of it is acceptance. I'm 32, I'm Latin, I'm gay and I have HIV And I don't feel bad about it. It's very, very important for me to not feel shame about this.”

As the face of the epidemic grows younger, city health officials acknowledge that their efforts — including a widespread condom distribution program, new investments in education programs at places including churches, and more availability of HIV testing — are falling short.

“It leaves us a little bit scratching our heads: What is it that is going on?” said Christine C. Quinn, the City Council speaker. “Something clearly is not working, and it's literally about life or death.”

The city, which has the highest number of AIDS cases in the nation, about 100,000, and one of the highest HIV infection rates, according to the health department, has made great strides in bringing down HIV rates among intravenous drug users and pregnant women. The department, which is giving out three million condoms a month in a program begun last year, has also recently announced several efforts to expand rapid testing, which provides results within a day.

The city's health commissioner, Thomas R. Frieden, said in an interview that the increasing rates among younger men was being driven by stubbornly high rates of substance abuse, involving drugs like crystal methamphetamine and cocaine, which not only reduce inhibitions but can also lead to “hypersexuality”: extended periods of sexual activity, potentially with multiple partners.

Dr. Frieden also said that another likely explanation was “treatment optimism,” and the many messages gay men receive through AIDS drug advertisements that people like Mr. Arriola can live long and normal lives.

“People who grew up watching their friends die of AIDS are a lot more careful than those who didn't,” said Dr. Frieden, who said he cared for large numbers of AIDS patients in his earlier medical practice.

He said the department was planning to begin a new HIV prevention campaign aimed at younger men, and a new marketing strategy for their condom campaign later this year. “When's the last time we saw someone with lesions walking through Chelsea and Hell's Kitchen?” said Victoria Sharp, director of the Center for Comprehensive Care, which is currently providing medical care and other services to 3,000 HIV patients at Roosevelt Hospital and in Harlem. “You don't see it, and we haven't seen it since the mid-1990s, so there is a whole generation or two who have grown up without seeing the physical manifestations.”

Health officials said they were also concerned about the growing number of patients receiving concurrent diagnoses of both HIV and AIDS, after waiting too long to be tested. And while some policymakers say more aggressive testing could partly explain the higher infection rates, experts say one in four people with HIV do not know they are infected, so the actual rates could be much higher.

Since receiving the AIDS diagnosis, Mr. Arriola, now 32, has developed a large group of sober friends, become a licensed real estate broker, repainted his apartment — all things that seemed impossible to imagine in the darkness of his drug use and when he learned he had the disease.

Then, he said he would look in the mirror and see the worthless person he believed he was. “I won't make it to 35,” he would say.

But these days, with the antiviral drugs he takes, about five pills a day, his health is good, he said. Around his apartment, he has posted upbeat messages to himself, like the one on his mirror, where he has written “thank you.”

On the refrigerator he has a list of goals: “Write a book, own New York City property, spread love, own a business (20 million), get a college degree, run a triathlon, have a family (partner, car with driver and kids) and 190 pounds (muscle).”

By Sarah Kershaw, The New York Times

Librarians in Los Angeles, San Francisco Catalogue HIV/Aids Materials
January 4, 2008

Librarians in Los Angeles and San Francisco have finished cataloguing hundreds of thousands of HIV/AIDS documents and have made the documents available to the public, the Los Angeles Times reports.

The ONE National Gay & Lesbian Archives received a $195,000 grant from the National Historical Publications and Records Commission to catalogue the materials. NHPRC also awarded a shared $170,000 grant to a library at the University of California-San Francisco and the Gay, Lesbian, Bisexual and Transgender Historical Society. It took three years for librarians to catalogue the documents.

The documents include government paperwork responding to HIV/AIDS; safe-sex pamphlets; magazines targeted toward people living with HIV/AIDS; and diaries and letters of HIV-positive people, as well as those of people who died of AIDS-related causes or who were affected by the disease. Some of the documents were donated by people living with HIV/AIDS. Some government and agency documents were scheduled to be shredded but were donated by employees. Other documents were donated by physicians who treated early HIV/AIDS patients.

According to scholars, the collections -- along with similar ones in New York and San Francisco -- will be invaluable for researchers. Richard McKay, a doctoral student in history at the University of Oxford, recently examined the documents. "A big difficulty in the history of medicine is that records are left mostly by practitioners," McKay said, adding, that it is "often very difficult" for researchers to "access the voice of the patient." He added, "These archives do a lot for that, to a greater extent than others do" (Gordon, Los Angeles Times, 1/2).

Online summaries of the collections will be available online:

http://www.oac.cdlib.org

Bill May Ease US HIV Travel Restrictions
January 2, 2008

Two American senators have introduced legislation that would make it easier for HIV-positive people to enter the US.

Democratic Sen John Kerry introduced the bill, co-sponsored by Republican Sen Gordon Smith, on Dec 14, a little over a month after the Department of Homeland Security proposed a new waiver for HIV-positive people crossing the border into the US.

Current American regulations ban all HIV-positive people from entering the US. The proposed new waiver would allow some HIV-positive people to enter for short stays, provided they bring all the HIV medication they'll need with them, prove they've got health insurance accepted in the US and promise not to engage in 'risky' behaviour.

Critics say the proposed waiver is even more restrictive and intrusive than the status quo.

"My legislation will end this draconian law," said Kerry in a statement. "The attempts to fix this law through a complex waiver system, while admirable, still don't do anything to rectify the discriminatory underlying problem."

If passed, the Kerry-Smith bill will repeal the provisions of the Immigration and Nationality Act that bar HIV-positive people from entering the US. The bill also calls for a full review of the public health considerations of travel and immigration restrictions against people with HIV.

Martin Rooney, who was recently fingerprinted and turned away from the US border after telling a customs official he is HIV-positive, says he is "hopeful but also realistic" about the bill.

"It's great the bill is on the floor," says Rooney, founder of Out in Surrey and Emperor I of the Imperial Sovereign Court of Surrey. However, he suspects the bill will be swept under the rug unless it's "tagged with a bill including something Bush wants."

Meanwhile, Rooney says a march is being planned on both sides of the border to bring more attention to the issue in March.

By Lori Kittelberg, Xtra West

In Global Battle on AIDS, Bush Creates Legacy
January 5, 2008

Washington - Dr. Jean W. Pape did not know what to expect in early January 2003, when he slipped away from his work treating AIDS patients in Haiti and flew to Washington for a secret meeting with President Bush.

Mr. Bush was considering devoting billions to combat global AIDS, a public health initiative unparalleled in size and scope. The deliberations had been tightly carried out; even the health secretary was left out early on. If President Bush was going to shock the world — and skeptical Republicans — with a huge expenditure of American cash to send expensive drugs overseas, he wanted it to be well spent.

“He said, ‘I will hold you accountable, because this is a big move, this is an important thing that I've been thinking about for a long time,'” recalled Dr. Pape, one of several international AIDS experts Mr. Bush consulted. “We indicated to him that our arms are totally broken as physicians, knowing that there are things we could do if we had the drugs.”

Nearly five years later, the President's Emergency Plan for AIDS Relief — Pepfar, for short — may be the most lasting bipartisan accomplishment of the Bush presidency.

With a year left in office, Mr. Bush confronts an America bitterly split over the war in Iraq. His domestic achievements, the tax cuts and education reform, are not fully embraced by Democrats, and his second-term legislative agenda — revamping Social Security and immigration policy — lies in ruins.

The global AIDS program is a rare exception. So far, roughly 1.4 million AIDS patients have received lifesaving medicine paid for with American dollars, up from 50,000 before the initiative. Even Mr. Bush's most ardent foes, among them Senator John Kerry of Massachusetts, his 2004 Democratic challenger, find it difficult to argue with the numbers.

“It's a good thing that he wanted to spend the money,” said Mr. Kerry, an early proponent of legislation similar to the plan Mr. Bush adopted. “I think it represents a tremendous accomplishment for the country.”

Announced in the 2003 State of the Union address, the plan called for $15 billion for AIDS prevention, treatment and care, concentrating on 15 hard-hit nations in Africa and the Caribbean. An enthusiastic Congress has already approved $19 billion.

Mr. Bush is pressing for a new five-year commitment of $30 billion. He will travel to Africa in February to make his case — and, the White House hopes, burnish the compassionate conservative side of his legacy.

Despite the effort, there are still 33 million people living with HIV, and the United Nations estimates that there were 1.7 million new infections in 2007 in sub-Saharan Africa alone. Critics, including Mr. Kerry, are particularly incensed by the requirement that one-third of the prevention funds be spent teaching abstinence, despite a lack of scientific consensus that such programs reduce the spread of HIV

When a Ugandan AIDS activist, Beatrice Were, denounced the abstinence-only approach at an international AIDS conference last year, she received a standing ovation. Paul Zeitz, executive director of the Global AIDS Alliance, an advocacy group here in Washington, says the Bush program has been hamstrung by “ideologically driven policies.”

That assessment was echoed, in more diplomatic terms, by the independent Institute of Medicine, which evaluated the program in March. It called on Congress to abandon the abstinence requirement and to lift the ban on paying for clean needles for drug addicts, among other changes.

Yet the institute concluded that, over all, the program had made “a promising start.” And when they step back, even critics like Mr. Zeitz concede that Mr. Bush spawned a philosophical revolution. In one striking step, he put to rest the notion that because patients were poor or uneducated they did not deserve, or could not be taught to use, medicine that could mean the difference between life and death.

In Haiti, about 13,000 patients are now receiving anti-retroviral drugs. That is only half the estimated 26,000 who need them, but far more than the 100 being treated five years ago. “A huge success story,” Dr. Pape says, “beyond my imagination.”

In Uganda, a country already far along on its own AIDS initiative when Mr. Bush began his, 110,000 people are under treatment, and 2 million have HIV tests each year, up from 10,000 treated and 400,000 tested before, according to Dr. Alex Coutinho, a top AIDS expert there. The money comes mostly from Pepfar, but also from a United Nations fund to which the United States contributes.

Dr. Coutinho said Ugandans were terrified that when Mr. Bush left office, “the Bush fund,” as they call it, would go with him. “When I've traveled in the U.S., I'm amazed at how little people know about what Pepfar stands for,” he said. “Just because it has been done under Bush, it is not something the country should not be proud of.”

The story of how a conservative Republican president became a crusader against global AIDS is an unlikely one. Mr. Bush ran for the White House in 2000 with what Joshua B. Bolten, his chief of staff, calls “a Republican's skepticism about the efficacy of foreign aid.” He talked of letting “Africa solve Africa's problems.” But a variety of forces conspired to put the international AIDS epidemic on the new president's agenda.

Colin L. Powell, then the new secretary of state, was deeply troubled by demographics showing that in some African nations, AIDS threatened to wipe out the entire child-bearing population — a condition that could create instability, and a climate ripe for terrorism. Just weeks into his new job, he called Tommy G. Thompson, the new administration's health and human services secretary.

“I said, ‘Tommy, this is not just a health matter, this is a national security matter,'” Mr. Powell recalled. They vowed to work together, and the president, Mr. Powell said, “bought into it immediately.” Yet, little was done at first, infuriating advocates like Mr. Zeitz.

By 2002, though, Christian conservatives, a core component of Mr. Bush's political base, began adopting the cause. Jesse Helms, the conservative Republican senator from North Carolina, declared himself ashamed that he had not done more. Bill Frist, a physician who was then a Republican senator from Tennessee, was badgering Mr. Bush about the epidemic. So was Bono, the rock star. Generic drugs were slashing the costs for treatment.

In the spring of that year, Mr. Bush sent Mr. Thompson and the government's top AIDS expert, Dr. Anthony S. Fauci, to Africa “to try to scope out anything we could do in a humanitarian way,” Dr. Fauci said.

They came back and proposed $500 million to prevent mother-to-child transmission of the disease. The president approved, Dr. Fauci said, but told them to think bigger.

“He wanted to do something game-changing,” Mr. Bolten said. “Something that, instead of at the margins assuaging everybody's conscience, might actually change the trajectory of this disease which, from the reports we were getting, was headed to destroy a whole continent.”

Mr. Bolten, Dr. Fauci and a handful of others spent eight months quietly planning. Inside the White House, Condoleezza Rice, then the national security adviser, favored the program.

But there was resistance from those who thought it “problematic to be announcing a lot of money for foreigners,” said Michael J. Gerson, Mr. Bush's former speechwriter. Opponents waged an 11th-hour attempt to strip the announcement from the State of the Union address. Mr. Bush overruled them.

With the United States about to invade Iraq, some theorized that Mr. Bush was trying to soften the nation's image. Not so, says Mr. Gerson, who calls the initiative “foreign policy moralism.” But he does see a link: “It fit a broader conception of his view of America's purpose in the world, which included not just the liberation of other people, but their treatment for disease.”

The goals were ambitious: to treat 2 million people, prevent 7 million new infections and provide care for 10 million, including orphans and other children considered at risk, over five years, beginning in 2004 when the money became available.

The prevention targets will not be measured until 2010. But Dr. Mark Dybul, Mr. Bush's global AIDS coordinator, says the program is on track to meet its goals. In addition to drugs for 1.4 million, the government says it has provided care for nearly 6.7 million people affected by the disease, including 2.7 million orphans and other children. Drugs provided to pregnant women have spared an estimated 152,000 infants from infection, the government says.

Some AIDS experts say the money could be spent more efficiently. Yet the fight is not over whether to reauthorize the program, but how. Much of the money has been channeled through American religious-based organizations, drawing criticism from people like Dr. Coutinho of Uganda, who say local control would cut costs.

Citing the current infection rate, advocates say $50 billion is needed, not $30 billion as Mr. Bush has proposed. Senator Joseph R. Biden Jr. of Delaware, the Democratic chairman of the Senate Foreign Relations Committee, is also calling for $50 billion, as is Dr. Coutinho.

“Unless Pepfar is reauthorized at a much higher level,” Dr. Coutinho said, “we are going to be in the business of playing God.”

At the White House, AIDS advocacy has become a family affair. Laura Bush made her third trip to Africa last year, and the president's daughter Jenna chronicled the life of a young HIV-positive woman in a new book.

Mr. Bush announced his trip to Africa in conjunction with World AIDS Day in November, quoting from Deuteronomy: “I have set before you life and death ... Therefore, choose life.”

On that day, the North Portico of the White House was festooned with a huge red ribbon, the symbol of the fight against the epidemic. Even Mr. Zeitz took it as a promising sign.

By Sheryl Gay Stolberg, New York Times

AIDS Patients Face Downside of Longer Life
January 6, 2008

Chicago - John Holloway received a diagnosis of AIDS nearly two decades ago, when the disease was a speedy death sentence and treatment a distant dream.

Yet at 59 he is alive, thanks to a cocktail of drugs that changed the course of an epidemic. But with longevity has come a host of unexpected medical conditions, which challenge the prevailing view of AIDS as a manageable, chronic disease.

Mr. Holloway, who lives in a housing complex designed for the frail elderly, suffers from complex health problems usually associated with advanced age: chronic obstructive pulmonary disease, diabetes, kidney failure, a bleeding ulcer, severe depression, rectal cancer and the lingering effects of a broken hip.

Those illnesses, more severe than his 84-year-old father's, are not what Mr. Holloway expected when lifesaving antiretroviral drugs became the standard of care in the mid-1990s.

The drugs gave Mr. Holloway back his future. But at what cost?

That is the question, heretical to some, that is now being voiced by scientists, doctors and patients encountering a constellation of ailments showing up prematurely or in disproportionate numbers among the first wave of AIDS survivors to reach late middle age.

There have been only small, inconclusive studies on the causes of aging-related health problems among AIDS patients. Without definitive research, which has just begun, that second wave of suffering could be a coincidence, although it is hard to find anyone who thinks so.

Instead, experts are coming to believe that the immune system and organs of long-term survivors took an irreversible beating before the advent of lifesaving drugs and that those very drugs then produced additional complications because of their toxicity — a one-two punch.

“The sum total of illnesses can become overwhelming,” said Charles A. Emlet, an associate professor at the University of Washington at Tacoma and a leading HIV and aging researcher, who sees new collaborations between specialists that will improve care.

“AIDS is a very serious disease, but longtime survivors have come to grips with it,” Dr. Emlet continued, explaining that while some patients experienced unpleasant side effects from the antiretrovirals, a vast majority found a cocktail they could tolerate. “Then all of a sudden they are bombarded with a whole new round of insults, which complicate their medical regime and have the potential of being life threatening. That undermines their sense of stability and makes it much more difficult to adjust.”

The graying of the AIDS epidemic has increased interest in the connection between AIDS and cardiovascular disease, certain cancers, diabetes, osteoporosis and depression. The number of people 50 and older living with HIV, the virus that causes AIDS, has increased 77 percent from 2001 to 2005, according to the federal Centers for Disease Control, and they now represent more than a quarter of all cases in the United States.

The most comprehensive research has come from the AIDS Community Research Initiative of America, which has studied 1,000 long-term survivors in New York City, and the Multi-Site AIDS Cohort Study, financed by the National Institutes of Health, which has followed 2,000 subjects nationwide for the past 25 years.

The Acria study, published in 2006, examined psychological, not medical, issues and found unusual rates of depression and isolation among older people with AIDS.

The Multi-Site AIDS Cohort Study, or MACS, will directly examine the intersection of AIDS and aging over the next five years. Dr. John Phair, a principal investigator for the study, which has health data from both infected and uninfected men, said “prolonged survival” coupled with the “naturally occurring health issues” of old age raised pressing research questions: “Which health issues are a direct result of aging, which are a direct result of HIV and what role do HIV meds play?”

The MACS investigators, and other researchers, defend the slow pace of research as a function of numbers. The first generation of AIDS patients, in the mid-1980s, had no effective treatments for a decade, and died in overwhelming numbers, leaving few survivors to study.

Those survivors, like Mr. Holloway, gaunt from chemotherapy and radiation and mostly housebound, lurch from crisis to crisis. Mr. Holloway says his adjustment strategy is simple: “Deal with it.” Still he notes, ruefully, that his father has no medical complaints other than arthritis, failing eyesight and slight hearing loss.

“I look at how gracefully he's aged, and I wish I understood what was happening to my body,” Mr. Holloway said during a recent home visit from his case manager at the Howard Brown Health Center here, a gay, lesbian and transgender organization. The case manager, Lisa Katona, could soothe but not inform him. “Nobody's sure what causes what,” Ms. Katona told Mr. Holloway. “You folks are the first to go through this and we're learning as we go.”

Mr. Holloway is uncomplaining even in the face of pneumonia and a 40-pound weight loss, both associated with his cancer treatment. Has the cost been too high? He says it has not, “considering the alternatives.”

Halfway across the country, Jeff, 56-year-old New Yorker who was found to have AIDS in 1987, said he asks himself that question often.

Jeff, who asked that he not be fully identified, has had one hip replacement because of a condition called avascular necrosis, the death of cells from inadequate blood supply, and needs another to avoid a wheelchair. Many experts think that avascular necrosis is caused by the steroids many early AIDS sufferers took for pneumonia.

“The virus is under control, and I should be in a state of ecstasy,” he said, “but I can't even tie my own shoe laces and get up and down the subway stairs. ”

His bones are spongy from osteoporosis, a disorder that afflicts many postmenopausal women but rarely middle-aged men, except some with AIDS. No research has explained the unusual incidence.

In addition, Jeff has Parkinson's disease, which is causing tremors and memory lapses.

He is in an AIDS support group at SAGE, a social service agency for older gay men and lesbians. His fellow group members also say they find the illnesses associated with age more taxing than the HIV infection. One 69-year-old member of the group, for example, has had several heart attacks and triple bypass surgery, and his doctor predicts that heart disease is more likely to kill him than AIDS.

Cardiovascular disease and diabetes are associated with a condition called lipodystrophy, which redistributes fat, leaving the face and lower extremities wasted, the belly distended and the back humped. In addition, lipodystrophy raises cholesterol levels and causes glucose intolerance, which is especially dangerous to black people, who are already predisposed to heart disease and diabetes.

At Rivington House, a residence for AIDS patients on the Lower East Side of Manhattan, Dr. Sheree Starrett, the medical director, said that neither heart disease nor diabetes was “terribly hard to treat, except that every time you add more meds there is more chance of something else going wrong.”

Statins, for instance, which are the drug of choice for high cholesterol, are bad for people with abnormal liver function, also a greater risk among blacks. Many AIDS patients have end-stage liver disease, either from intravenous drug use or alcohol abuse. Among Dr. Starrett's AIDS patients is 58-year-old Dominga Montanez, whose first husband died of AIDS and whose second husband is also infected.

“My liver is acting up, my diabetes is out of control and I fractured my spine” because of osteoporosis, Ms. Montanez said. “To me, the new things are worse than the AIDS.”

There are no data that compare the incidence, age of onset and cause of geriatric diseases in the general population with the long-term survivors of HIV infection. But physicians and researchers say that they do not see people in their mid-50s, absent AIDS, with hip replacements associated with vascular necrosis, heart disease or diabetes related to lipodystrophy, or osteoporosis without the usual risk factors.

“All we can do right now is make inferences from thing to thing to thing,” said Dr. Tom Barrett, medical director of Howard Brown. “They might have gotten some of these diseases anyway. But the rates and the timing, and the association with certain drugs, makes everyone feel this is a different problem.”

One theory about why research on AIDS and aging has barely begun is “the rapid increase in numbers,” Dr. Emlet said. The federal disease centers' most recent surveillance data, from 33 states that meet certain reporting criteria, showed that the number of people 50 and older with AIDS or HIV infection was 115,871 in 2005, nearly double the 64,445 in 2001.

Another is the routine exclusion of older people from drug trials by big pharmaceutical companies. The studies are designed to measure safety and efficacy but generally not long-term side effects.

Those explanations do not satisfy Larry Kramer, founder of several AIDS advocacy groups. Mr. Kramer, 73 and a long-term survivor, said he had always suspected “it was only a matter of time before stuff like this happened” given the potency of the antiretroviral drugs. “How long will the human body be able to tolerate that constant bombardment?” he asked. “Well, we are now seeing that many bodies can't. Once again, just as we thought we were out of the woods, sort of, we have good reason again to be really scared.”

The lack of research also limits a patient's care. Dr. Barrett says the incidence of osteoporosis warrants routine screening. Medicare, Medicaid and private insurers, however, will not cover bone density tests for middle-aged men.

Marty Weinstein, 55 and infected since 1982, has had a pacemaker installed, has been found to have osteoporosis, and has been treated for anal cancer and medicated for severe depression — all in the last year. He also has cognitive deficits.

A former professor of psychology in Chicago, he presses his doctors about cause and effect. Sometimes they offer a hypothesis, he said, but never a certain explanation.

“I know the first concern was keeping us alive,” Mr. Weinstein said. “But now that so many people are going to live longer lives, how are we going to get them through this emotionally and physically?”

By Jane Gross, The New York Times

Health Workers Sentenced to Prison in Kazakhstan for Criminal Negligence after HIV Outbreak Among Women, Children
January 2, 2008

Three health workers in Kazygurt, Kazakhstan, recently were sentenced to prison after being convicted of criminal negligence following an HIV outbreak among a group of children who received blood transfusions in region hospitals, Interfax News Agency reports. According to the Kazakh AIDS Center, 143 children who received blood transfusions in hospitals in the country have tested positive for HIV as of Dec. 1.

According to Interfax News Agency, Alimzhan Atambekov, former chief physician at the Kazygurt Central District Hospital, and his assistant Svetlana Nurkhanova were sentenced to two years in prison camps. The former head of the hospital's department of intensive therapy, Balgabay Tuzelbayev, was sentenced to two-and-a-half years in prison. In addition, the three medical workers have been banned from holding posts in the health care system.

Judge Serikbay Tolepbergenov, who presided over the case, said, "The rules of the sterilization of medical equipment were blatantly violated in the central district hospital" and "blood transfusions without preliminary HIV tests were registered." He added, "The suspects have not recognized their guilt, yet the court considers the evidence to be incontestable" (Interfax News Agency, 12/25/07).

In a related case, 17 health workers and health officials in Shymkent, Kazakhstan, in June were sentenced to prison after being convicted of criminal negligence following an HIV outbreak. A medical investigation conducted by CDC identified transfusions of tainted blood as the source of the Shymkent HIV outbreak (Kaiser Daily HIV/AIDS Report, 9/18/07).

http://www.kaisernetwork.org

Reporting HIV-Related Discrimination in Saudi Arabia
January 2, 2008

A human rights organization in Saudi Arabia is asking HIV-positive Saudis to report any instances of discrimination in the workplace or from the public, reports the Agence France-Presse (AFP) (afp.google.com, 1/2).

Being open about ones HIV status is rare in the conservative Muslim kingdom. However, the AFP reports, the National Society for Human Rights made the appeal earlier this week, in advance of the expected March unveiling of draft legislation that will, for the first time, spell out rights of HIV-positive people in Saudi Arabia. The new bill is expected to feature clauses about access to education, employment and travel for HIV-positive people.

According to a healthy ministry official, about 11,000 cases of HIV have been reported in Saudi Arabia since the first case in 1984.

Las August, the Saudi press reported on the health ministry's plans to test engaged couples for both HIV and hepatitis before they are allowed to marry.

http://www.poz.com

Ardea Biosciences' Lead NNRTI for HIV, RDEA806, to Enter Phase 2a Proof-of- Concept Clinical Trial
December 31 2007

Carlsbad, California - Ardea Biosciences, Inc. (Nasdaq: RDEA) today announced that the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom has authorized a Phase 2a clinical trial evaluating RDEA806, a novel non-nucleoside reverse transcriptase inhibitor (NNRTI), in patients with human immunodeficiency virus (HIV), the causative agent of AIDS.

"There is a clear unmet need for new NNRTIs that have the potential for a lower incidence of neuropsychiatric adverse effects, a high barrier to resistance, activity against resistant strains and the ability to be combined with other therapeutic agents," said Barry Quart, PharmD, President and CEO of Ardea Biosciences. "We believe that RDEA806 has the potential to offer a new option for patients with HIV and are excited to move this novel compound into Phase 2 clinical testing. We expect to obtain results from this trial in the first quarter of 2008."

The Phase 2a randomized, double-blind, proof-of-concept trial will be conducted in multiple European academic medical centers. The trial will evaluate the antiviral activity, pharmacokinetics, safety and tolerability of once daily and twice daily dose regimens of RDEA806 versus placebo in HIV-1 positive patients who are naive to antiretroviral treatment. The primary efficacy endpoint is the change from baseline in plasma viral load.

About RDEA806

RDEA806 is a novel non-nucleoside reverse transcriptase inhibitor (NNRTI) for the potential treatment of HIV infection. Based on preclinical and clinical studies to-date, Ardea believes that RDEA806 possesses several attractive properties. These include: potential for potent antiviral activity against a wide range of HIV viral isolates, including those that are resistant to efavirenz (Sustiva(R<>><>><>>), Bristol-Myers Squibb) and other currently available NNRTIs; a high genetic barrier to resistance; the potential to be administered in a patient-friendly, oral dosing regimen; limited pharmacokinetic interactions with other drugs; and the ability to be co-formulated with other HIV antiviral drugs.

About Ardea Biosciences, Inc.

Ardea Biosciences is focused on the discovery and development of small- molecule therapeutics for the treatment of viral diseases, cancer and inflammatory diseases. The Company plans to have active development programs with four new chemical entities (NCEs) in the clinic for three distinct indications by early 2008, with an additional one-to-two indications in inflammatory diseases planned for the first half of 2008.

Ardea's most advanced clinical development programs include: RDEA806, the Company's lead non-nucleoside reverse transcriptase inhibitor (NNRTI<>><>><>>) for the treatment of HIV, which entered a Phase 2a clinical trial in the fourth quarter of 2007; RDEA119, a mitogen-activated ERK kinase (MEK<>><>><>>) inhibitor for the treatment of cancer and inflammatory diseases, which is in a Phase 1 clinical trial in advanced cancer patients; and RDEA806 for gout, which is expected to enter a Phase 2 efficacy trial in the first half of 2008. Ardea also is developing a next-generation NNRTI and a next-generation MEK inhibitor, both of which are scheduled to enter first-in-human studies in early 2008.

Statements contained in this press release regarding matters that are not historical facts are "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Such statements include, but are not limited to, statements regarding: Ardea's goals, including its goal of having active development programs with four new chemical entities (NCEs) in the clinic for three distinct indications by early 2008, with an additional one-to-two indications in inflammatory diseases in the first half of 2008, the expected properties and benefits of RDEA806 and its other compounds and the results of clinical and other studies. Risks that contribute to the uncertain nature of the forward-looking statements include: risks related to the outcomes of preclinical and clinical trials, risks related to regulatory approvals, delays in commencement of preclinical and clinical tests, and costs associated with internal development and in- licensing activities. These and other risks and uncertainties are described more fully in Ardea's most recently filed SEC documents, including its Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, under the headings "Risk Factors." All forward-looking statements contained in this press release speak only as of the date on which they were made. Ardea undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made.

Source: Ardea Biosciences, Inc.

PR Newswire

Scientists Testing Vaccine For Cocaine Users
January 2, 2008

Nothing says drug addiction more than a needle and syringe. But that's exactly what a team of U.S. researchers believes can help cocaine users kick their menacing habit.

Two Baylor College of Medicine scientists based in Houston have developed a cocaine vaccine that creates antibodies that bind to the drug and prevent it from travelling from the bloodstream to the brain.

Unable to penetrate the brain, the drug can produce no high.

If the vaccine makes it through regulatory hurdles, it would be the first medication approved to treat cocaine addiction.

“It certainly is a way of combining immunology that had not been used before,” Tom Kosten, a professor of psychiatry and neuroscience at Baylor, said in a telephone interview yesterday. “We had always thought of altering the brain as a way to prevent drug abuse. This way, the drug never gets into the brain to begin with.”

Drug addiction treatment has largely been psychiatric counselling and 12-step programs. Dr. Kosten said that won't go away – any approved vaccine would be complementary to behavioural therapy.

“If it's approved in the U.S., then getting approval in Canada won't be that difficult,” he said, adding that, if all goes well, a cocaine vaccine could be available in the United States in four years.

About 50 pharmaceutical options have previously been explored for cocaine addiction.

Dr. Kosten, who has been assisted in his decade-long research by his spouse, Therese Kosten, also a psychologist and neuroscientist at Baylor, asked the U.S. Food and Drug Administration last month to allow a Phase 3 clinical trial to begin this spring, involving 300 patients at six U.S. sites. Other trials are expected in Spain and Italy.

“Because there are no treatments for cocaine addiction, it's been one of their fast-tracked programs at the FDA,” Dr. Kosten said. He is also at work on vaccines for heroin, nicotine and methamphetamine.

Yesterday, Evan Wood, co-principal investigator of the supervised injection facility evaluation in Vancouver, called the cocaine vaccine “new and provocative.”

“From a societal perspective, cocaine is one of the drugs that continue to be overlooked as one of the big problem drugs in our society,” said Dr. Wood, a physician epidemiologist at the British Columbia Centre for Excellence in HIV/AIDS.

“Crack cocaine is what is driving many of the social problems and public order problems and crime problems, particularly in the Downtown Eastside [of Vancouver].”

Dr. Wood said the “explosive HIV outbreak” in Vancouver's east side is largely attributed to heroin users switching to cocaine, which leads to “more frequent injections, more chaotic behaviour and more syringe sharing.”

Learning about the immune system is opening all sorts of “avenues and possibilities,” said Dr. Wood. “But whether this is a useful tool remains to be seen.”

Certainly, the science is intriguing.

Since cocaine molecules are so small, the immune system does not recognize them and cannot make antibodies to attack them.

To fix that problem, Dr. Kosten attached inactivated cocaine to the outside of inactivated cholera proteins.

The immune system made harmless antibodies to the combination, but also recognized the drug when it was ingested. The antibodies bound to the cocaine, preventing it from reaching the brain, where the addictive highs are generated.

In Canada, there are no hard figures on how many are currently addicted to cocaine. Studies such as the Canadian Addiction Survey, published in 2004, found that more than 14 per cent of males, and 10.6 per cent of the total population, reported having tried cocaine.

Gerald Sidel, director of Addington Addiction Treatment Centre in Montreal, said yesterday that everybody is looking for the “magic bullet” to treat addictions.

He compared using modified cocaine to treat cocaine addicts to allowing alcoholics to engage in controlled drinking.

“Certainly if there is a way of helping people, I am not adverse to that,” Mr. Sidel said in a telephone interview yesterday. “But don't treat drug addicts with drugs.”

By Lisa Priest, The Globe and Mail

New Meth Study Confirms Suspected Realities AIDS
Finds HIV+ and two-spirited men particularly at risk
January 2, 2008

A new study about crystal meth use among gay men in Vancouver confirms that use of the drug presents a serious health problem "associated with sexuality, HIV/AIDS, class and race."

But the results are unexpected, says Dr Robert Hogg, director of epidemiology and population health at the BC Centre for Excellence in HIV/AIDS.

"We knew there was a problem with methamphetamine use among gay men," says Hogg. "However, we did not know which groups experienced heavy or problematic use."

"We now understand that men with HIV, and particularly Aboriginal two-spirit men, are over-represented in our samples, indicating directions for future health care initiatives," Hogg explains.

"We also did not understand some of the specific issues surrounding the drug in the lives of men and how this intersected with their sexuality in terms of recovery services and health care providers."

Entitled "Methamphetamine Use Among Gay Men in Vancouver," the study is the second phase of a project that the Gay Men's Methamphetamine Working Group (GaMMa) started in 2004. The first was an Outreach Project that ended in September 2006.

Methamphetamine is a potent stimulant drug that many gay men use in dance clubs and during sex. It increases levels of the brain's chemicals dopamine, serotonin and the hormone norepinephrine. On the street it can have many names, including Crank, Crystal, Ice, Meth, and Tina.

Funded by Health Canada as part of its Drug Strategy, this study contains interviews with 89 gay men, which is almost three times the size of any similar study. Approximately half of the people interviewed are current users. The balance are either former users or the partners or friends of users.

Nevertheless, the results cannot be generalized to other groups because of the qualitative nature of the study. Qualitative research is more subjective and often used to develop theories by collecting, analyzing and interpreting information based on what individuals do or say, as opposed to the more structured data collected in quantitative research.

"The study was conducted at the request of the community to explore problematic methamphetamine use among gay men in Vancouver," Hogg explains. "In addition, we explored the implications for health care services for gay men who are heavy users."

"This is an in-depth analysis of a particular social group," says Francisco Ibáñez-Carrasco, the research technical assistant at the BC Person With AIDS Society, one of the study's partners. "It's quite commendable that it was done this way. It's a very solid piece of research."

The BC Centre for Excellence in HIV/AIDS also worked with the Vancouver Coastal Health Authority, AIDS Vancouver and the Downtown Eastside Youth Activities Society on the study.

"The value of this very thorough, systematic study is to confirm in a very rich way a number of things that we knew, somewhat anecdotally and from general epidemiology," asserts Ibáñez-Carrasco.

"It [accomplishes] one of the most important things that we do in science, which is to confirm a reality that we all suspect. We make this information legitimate, and easier to use by scientists and a community."

Jody Jollimore, a university graduate student who worked on the GaMMa Outreach Project, supports the research. "I read between the lines and saw it as a call for more monitoring, and more gay men's health committees that act. It shouldn't take a handful of citizens to say, 'Crystal meth is becoming a problem. Let's set up a committee.' There should be somebody who's already looking after those things, who has [his] pulse on the community, and understands gay men's issues."

Ibáñez-Carrasco believes the study is valuable in the way it presents information on "the use of methamphetamine, its relation to HIV, to First Nations persons, to sexuality, to the culture of gay men in the city. We also learned quite a great deal in terms of treatment [and] detox.

"For me," he says, "the most important part is that research processes themselves actually change the culture around the particular subject. Doing the research, aside from the results, was a great community development piece. There were all kinds of activities attached to [it] that were very successful. The issue was brought to visibility in the public arena, particularly among gay men. The participation of the community at all levels was quite impressive."

Still, Jollimore says he doesn't know how much impact the study will have on crystal meth use in the community.

"We need to do a better job of protecting gay men's mental health, and responding to those needs," he says. "We need to be more responsive to addiction issues in gay men's health. That's the first thing it leads to."

"Where does it [go] in the long-term?" he asks. "I have been reading a bit about a health organization that is solely responsible for gay men that's looking out for [their] very specific health-related needs. This report shows that there needs to be a quicker response in our community to gay men's health issues."

Ibáñez-Carrasco agrees, and hopes "that various agencies will look at the results, discuss them, and integrate them into their programming and policy."

By Douglas Boyce, Xtra West