August 22, 2007

•  HIV IN THE U.S. NEWS

Fighting Denialists: Is It Time to Throw the Gloves Down?
HIV denialism is a small movement that's been around almost as long as HIV itself. But thanks in part to the Internet, denialism may seem more mainstream than it actually is. HIV experts and organizations have long ignored denialists and their groundless claims (e.g., HIV doesn't cause AIDS), but people throughout the world have died because they believed in denialism. Has the time come for HIV experts and scientists to publicly fight back? In a rare medical journal article on the subject, two U.S. researchers say that it's time to fight misinformation with actual science. (Web highlight from PLoS Medicine)

What's your take on HIV denialism? Have you been personally affected -- or has anyone you know been harmed -- by denialist misinformation? We'd like to hear from you. E-mail us at content@... with your thoughts; we may use them for an upcoming podcast on HIV denialism later this year!


ADAP Waiting Lists Have Silver Lining, But Cloud Remains
Although 308 people remain on waiting lists to receive HIV meds through their U.S. AIDS Drug Assistance Program (ADAP), this is among the smallest number of HIVers on ADAP waiting lists since tracking began back in 2002. The 308 people live in two states: Alaska and South Carolina. However, three other states (Alabama, Indiana and Michigan) have had to start ADAP cost-containment measures since April 1, such as a cap on the number of people who can enroll (which may lead to new waiting lists) or a limit to the drugs that are covered.

Click here to read the Aug. 16 edition of NASTAD's ADAP Watch.

•  HIV TREATMENT & COMPLICATIONS

Study Raises Warning About Taking Fixed-Dose Combo Meds if You Have Kidney Problems
Some meds in the NRTI class can cause problems for HIV-positive people who already have some kidney damage; as a result, doctors often lower the dose of these HIV meds. But fixed-dose combination drugs that contain NRTIs, such as Atripla, Combivir, Epzicom, Trizivir and Truvada, can't have their dose adjusted. If alert doctors don't remember the risk, this means an HIVer with kidney problems may end up taking a full dose of these NRTIs, which can potentially worsen their kidney health. A better bet for people with kidney problems is to take individual HIV meds instead of combo pills, so doses can be easily adjusted if need be. (Web highlight from aidsmap.com)


Is Your Hep C Treatment Working? New Testing Method Could Yield Quicker Results
Right now, HIV/hepatitis C-coinfected people who start hep C treatment have to wait 12 weeks to find out whether their meds are working. However, a new testing method may allow coinfected people to find out within one month whether their hep C treatment is working, according to a recent study. This could help coinfected people and their doctors decide much more quickly whether hep C treatment can be stopped early or whether the course of treatment needs to be extended, the researchers say. (Web highlight from Reuters Health)

Click here to read the abstract of this study, which was published in the August 2007 issue of the medical journal Gut.


Warning Issued on Kaletra Overdose Risk in Children
Doctors need to be very cautious -- and parents should be vigilant -- when dosing HIV meds for children, since an accidental overdose could potentially be deadly. In fact, the U.S. Food and Drug Administration recently issued a warning about Kaletra (lopinavir/ritonavir) after the accidental death of an infant who received an overdose of the drug. According to the warning letter, the proper dose of Kaletra for children should be calculated carefully based on body weight.

•  HIV TRANSMISSION

Washing Penis Right After Sex Increases HIV Risk Among Uncircumcised Men, Study Says
Need another reason to spend some time in bed cuddling? If you're an uncircumcised man, getting up to wash your penis right after having unprotected sex might actually increase your risk of HIV infection, according to researchers in Uganda. The study found that men who washed their penis within three minutes of sex had nearly six times the HIV risk of men who waited for 10 minutes or more. Researchers aren't sure why, but one thing is clear: "There ought to be a little time left for postcoital cuddling before you go and wash," said one of the study authors. "Don't just finish and jump out of bed."

Click here to view the abstract of the study, which was presented on July 25 at the 4th International AIDS Society Conference on HIV Pathogenesis, Treatment & Prevention in Sydney, Australia. You can also download a slide presentation of the study.


Sex Ed for Seniors: You Still Need Those Condoms
Thanks in part to Internet dating and erectile dysfunction drugs, more people over 50 are able to remain sexually active than ever before, experts say. But it looks like safer sex often isn't part of the deal: A recent survey found that many sexually active people over age 50 don't use condoms every time, even if they know they're HIV positive. Officials in New York City and south Florida have responded by handing out condoms and safer-sex materials at senior centers and assisted-living facilities.

•  WOMEN & HIV

C-Sections Riskier for HIV-Positive Women Than HIV-Negative Women, Study Finds
Although a Cesarean section was long thought to be safer than a vaginal birth for an HIV-positive woman who wanted to avoid passing HIV to her baby, the pendulum is increasingly swinging back toward vaginal birth, especially now that we have many HIV meds capable of safely reducing a pregnant woman's viral load to undetectable. A new study adds more support for vaginal birth: Researchers found that HIV-positive women who have C-sections were 60 percent more likely to experience complications from the surgery than HIV-negative women. (Web highlight from Reuters Health)

•  HIV OUTSIDE THE UNITED STATES

Burned by HIV, Spurned by Loved Ones: Asian Women Stand Up and Speak Out
When local villagers in Sri Lanka found out that Princey Mangalika's deceased husband had been HIV positive, they formed a mob, burned her house down and chased her and her two daughters out of the village. "Overnight, a virus had made us outcasts in the eyes of our own family," she said. Sadly, her story is not unique. But the United Nations tried to give her at least some sense of justice by organizing a dramatic mock court session at a recent AIDS conference. In a packed room, 20 women who have HIV or were widowed by AIDS testified about how they were denied their inheritance, expelled from their homes or separated from their children. (Web highlight from Inter Press Service)


Europe Bans Viracept Over Contamination Scandal
The European Union has suspended Roche's license to market Viracept (nelfinavir) amidst a worsening contamination scandal. The drug was recalled throughout much of the world in June (only the United States, Canada and Japan have been unaffected) after Roche said some batches were contaminated with unusually high levels of a cancer-causing chemical. Roche later admitted that the contamination isn't new; some batches of Viracept, which is no longer widely used in developed countries, had contained unacceptably high levels of the chemical since production of the drug began in 1998.

For more background on this story, read this news article from aidsmap.com.


Viracept Recall Ripples Through Developing World
If one HIV med has been contaminated, are other HIV meds safe? That's the question some HIVers in developing countries are asking themselves following the near-global recall of Viracept (nelfinavir) in June. "[M]aybe there are many drugs that we are taking without actually ensuring their quality," said one Zambian health worker. "People should know what they are taking." However, Zambia's health minister is warning people not to stop taking Viracept without first talking with their health care provider. (Web highlight from UN Integrated Regional Information Networks)

For more information on the massive impact of Viracept's recall in developing countries, read this news article.


Sex Is Now at the Top (and Bottom) of HIV Transmission in China
Injection drug use is no longer the most common way people get HIV in China. According to government sources, unsafe sex has taken the No. 1 spot for the first time since 1989. Almost half of all new HIV infections in 2005 were caused by unsafe sex, which suggests HIV is moving into mainstream Chinese society. While the Chinese government has become increasingly open about HIV, prevention efforts are continually thwarted by conservative attitudes towards sex and suspicion of activists and non-governmental organizations.