February 7, 2007

•  NEW INTERVIEWS, ARTICLES ON AFRICAN AMERICANS AND HIV

If you're reading this newsletter, odds are you're already well aware of the massive impact that HIV has had in the African-American community. You don't need a national commemorative day to remind you of this -- but as you know, there is still an astonishing lack of awareness across the country. Wednesday, Feb. 7 marks National Black HIV/AIDS Awareness Day in the United States, and it provides all of us with an opportunity to call public attention to the urgent need for better HIV prevention and treatment efforts for African Americans, as well as the importance of fighting stigma and increasing awareness of what it means to be black and HIV positive in the United States today.

In observance of this important day, The Body has launched an updated version of its African-American HIV/AIDS Resource Center, which features new personal stories and interviews, as well as artworks by black artists with HIV. Over the upcoming weeks we'll be adding even more new content, including podcasts and a monthly audio blog from an African-American HIV prevention worker.

Meanwhile, events across the country -- and on television -- are marking National Black HIV/AIDS Awareness Day. The cable network BET has announced a new lineup of HIV-related programming, and an alliance of some of the nation's largest, most influential HIV organizations, advocacy groups and religious groups has announced a new coalition that will speak with one voice to boost HIV awareness and activism in communities of color. The official National Black HIV/AIDS Awareness Day Web site also contains info about the epidemic and a nationwide listing of events.

•  HIV TREATMENT

New Prezista Study to Focus on Women
It happens all the time: HIV medications become available even though they've only been minimally tested on women. The new protease inhibitor Prezista (darunavir, TMC114) is only the most recent example of a drug that gained U.S. Food and Drug Administration (FDA) approval with limited data on women. For a variety of reasons, including lack of access to research centers and wariness of medical professionals, it's rare for the number of women in an HIV drug trial to exceed 25 percent. But in an unusual turn of events, the maker of Prezista is looking to make amends: As part of an agreement with the FDA, it's now enrolling for a female-focused clinical trial. The GRACE trial -- which plans to study a racially diverse group of 320 HIV-positive women and 100 HIV-positive men in the United States, Canada, Puerto Rico and Mexico -- will look for differences between the way men and women respond to Prezista.

To learn about how to enroll in the GRACE study, visit this study overview on clinicaltrials.gov and click the link at the bottom of the page. To learn more about the study, you can also read this press release from Tibotec Therapeutics, the maker of Prezista.


Side-Effect Warnings Issued for Fuzeon Biojector Users
The Biojector 2000 has stirred up a lot of buzz among Fuzeon (enfuvirtide, T-20) users. The hope is that Biojector, a needle-free, carbon dioxide-powered device currently being tested with Fuzeon in clinical trials, could make Fuzeon injection-site reactions a thing of the past. Unfortunately, it appears that Biojector can cause its own family of side effects, particularly for people who have blood-clotting disorders or who are taking anticoagulants. These side effects can include long-lasting nerve pain, bruising and broken blood vessels, according to recent changes to Fuzeon's product labeling. The new labeling urges people who use Biojector to inject Fuzeon into their upper arm, abdomen (but away from the belly button) or the front part of their thigh, where side effects are less likely to occur.


Sustiva Labeling Updated With Drug-Drug Interaction Info
The Sustiva (efavirenz, Stocrin) package insert has been updated to include new information on interactions between Sustiva and several other medications. Although the information is meant for pharmacists and doctors, it doesn't hurt for HIVers to be aware of these interactions as well. The insert specifically warns against taking Sustiva with several drugs, including Vfend (an antifungal drug) or Orap (an antipsychotic medication used to treat Tourette's disorder).

•  TELL US WHAT YOU THINK!

Take The Body's New Visitor Survey
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•  HIV TRANSMISSION

Multidrug-Resistant HIV: Another Reason to Use Condoms (Whether You're Pos or Not)
Whether you’re HIV negative or HIV positive, the threat of infection (or superinfection) with multidrug resistant HIV is a continuing reminder of why it's important to practice safer sex. A recent news item from Washington state drives this point home: Four men in King County (which includes Seattle) have been diagnosed with a similar strain of HIV that is resistant to at least two HIV drug classes. All four men used crystal methamphetamine and had many anonymous sex partners, including men. "Clusters" of cases like this hearken back to late 2004, when a man in New York City was diagnosed with what was then touted as a new, highly drug-resistant, rapidly progressing strain of HIV. His diagnosis was not the harbinger of any significant outbreak, but his story -- as well as this new one in Washington -- serve as an important reminder that people across the United States are at risk for multidrug-resistant HIV. That means not only that it's important to use condoms with sex partners if you don't know their status, but also to get a resistance test if you've been recently diagnosed with HIV and haven't yet started treatment.


HIV "Hides" in Testicles, Study Finds
HIV-positive men may still have detectable levels of HIV in their semen, even if they have an undetectable viral load in their blood while on HIV meds. A new study by French scientists may explain why this happens: The researchers found that testicular tissue contains many HIV receptors and is highly susceptible to HIV infection, which may help it act as a "reservoir" for HIV. Further study, the researchers hope, might lead to drugs that can help prevent HIV transmission by suppressing HIV replication in the testes. (Web highlight from BBC News)

•  HIV OUTSIDE THE UNITED STATES

In Swaziland, Male Circumcision Is In High Demand
When the news first broke that circumcision appears to reduces a man’s risk of getting HIV during unprotected heterosexual sex by about 50 percent, many worried that few African men would volunteer for the operation. But Swaziland, a country of one million in which nearly 40 percent of adults are HIV positive, is facing the opposite problem: Hospitals are unable to provide circumcisions to all the men clamoring for the procedure. Although more doctors are being trained to offer the procedure, Swaziland's health ministry says it's waiting for guidance from the World Health Organization before it offers circumcision on a larger scale.


Rich or Poor, HIV Touches Every Corner of South African Society
The assumption that South Africa's HIV crisis is mostly rural affliction affecting poor people has been challenged by a new study, which shows that HIV rates among rich, well-educated South Africans are rising. A survey of 3,500 South Africans between 2002 and 2005 found a 34 percent jump in HIV infections among professionals, from 6.2 percent in 2002 to 8.3 percent in 2004. While the gap in HIV infections between rich and poor remains large, the surge in infections among privileged South Africans points out how pervasive the virus has become. "This could represent a whole new wave of the epidemic," says Carel van Aardt, director of the University of South Africa’s Bureau of Market Research.


Thailand Breaks Kaletra Patent in Effort to Save Lives
In a bold move, Thailand's Ministry of Public Health has declared its HIV epidemic a national emergency, allowing the country to break the patent on Kaletra (lopinavir/ritonavir) and permit the production of a generic version. Thailand currently has 580,000 people living with HIV, and the government's goal of providing universal access to care has been hampered by increasingly high drug costs. The production of generic Kaletra could save Thailand as much as million annually. The question is: Will a generic Kaletra made in Thailand work the way it's supposed to? As a Bangkok Post editorial points out, "[M]ore work must be done to show the world we are responsible leaders in public health" -- especially since Thailand's drug manufacturing factories do not currently meet World Health Organization standards, the editorial states.


President of Gambia Makes "Astonishing" HIV Cure Claim
The president of Gambia recently announced that he's been able to do what the brightest minds in medicine and science haven't: cure HIV. His claim may be ridiculous -- the only publicly reported benefits of the president's so-called cure have been a dissipation of constipation and an increase in weight -- but it's also dangerous, since such a public announcement by a respected African political figure could cause Gambians to flout HIV prevention efforts such as safer sex. Nonetheless, Gambia's president is insistent: "I can treat asthma and HIV/AIDS," he said to diplomats last month. "Within three days the person should be tested again and I can tell you that he/she will be negative." (Web highlight from BBC News)


Time for a New Generation of HIV Advocacy, Activist Says
"In many ways the most difficult part of the worldwide effort to scale up antiretroviral therapy is just beginning," writes activist Mark Harrington of Treatment Action Group. In this article, Harrington explains why, despite the steady advances of the past few years, there's a new, urgent need for organized activism to push for better HIV care -- not only in the developing world, but in the United States as well.