For Young Gays, Meth Use Comes with a High Risk of Contracting HIV

Seattle-area organizations are offering help to gay crystal methamphetamine users, who have a higher risk of HIV infection, according to local studies. In King County, about 10 percent of men who have sex with men have used crystal meth in a given year, Public Health-Seattle & King County reports, and usage is twice as high among MSM under age 30.

"Every time I test a meth user I feel afraid for them in the pit of my stomach," said Joshua O'Neal, who researches HIV testing at the public STD Clinic at Harborview Medical Center. "Three-quarters of all meth users I test come in and test positive. When you feel invincible, you don't care about using a condom."

"While meth affects everyone because it is so highly addictive, it's a particular problem for those in the LGBTQ community," said Arnold Martin of Project NEON, which focuses on harm reduction.

Motives for meth users range from seeking a euphoric high, boosting libido and self-confidence, to masking feelings of shame and stigma over sexual orientation. Other users said they used the drug only after being diagnosed with HIV in order to stifle hopelessness, gain energy, and forget about HIV during sex.

"Gay men use meth for the same reasons that we use any other drug; it kills the pain," said Tony Radovich, cofounder of Strength Over Speed, a peer-based meth recovery support group.

"Being gay and growing up feeling different, drugs were a good fit for me," said Jordon Duran, a former meth user who works for Gay City Health Project, a community-based HIV prevention program. "But I believe in people's ability to change."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Syringe Sharing and HIV Incidence Among Injection Drug Users and Increased Access to Sterile Syringes

Toward the goal of maximizing sterile syringe access and reducing rates of syringe sharing, between 2000 and 2003 the Vancouver, British Columbia, health authority modified its syringe exchange program (SEP) policies by shifting the focus from syringe exchange to syringe distribution. SEP services were decentralized, and the number of distribution sites was increased. Limits on the number of syringes available were removed. The health authority began requiring local health clinics to provide sterile syringes to injection drug users, and it asked IDU outreach programs to include syringe distribution in their work. IDUs were no longer required to bring in syringes to exchange, as the distribution and collection programs were separated. Also, a local organization for IDUs opened a peer-run SEP in the city's chief drug-using area.

In the current study, the team assessed the effects of these policy changes on the rate of HIV risk behavior and HIV incidence among IDUs. Multivariate generalized estimating equation and Cox regression methods were employed to examine syringe borrowing, syringe lending, and HIV incidence among a prospective cohort of 1,228 Vancouver IDUs.

When the researchers compared data from 1998 and 2003, they noted substantial declines in rates of syringe borrowing (from 20.1 percent to 9.2 percent) and syringe lending (from 19.1 percent to 6.8 percent) following the SEP policy changes. Coinciding with these declines was a statistically significant increase in the proportion of participants accessing sterile syringes from non-traditional SEP sources (P<.001).

Multivariate analyses showed the period following the change in SEP policy was independently associated with a greater than 40 percent reduction in syringe borrowing (adjusted odds ratio [AOR]=0.57; 95 percent confidence interval [CI]=0.49, 0.65) and syringe lending (AOR=0.52; 95 percent CI=0.45, 0.60), in addition to declining incidence of HIV (adjusted hazard ratio=0.13; 95 percent CI=0.06,0.31).

"Widespread syringe distribution appears to be a more effective SEP policy than do more restrictive SEP policies that limit syringe access," the authors concluded. "Efforts should be made to ensure that SEP policies and program design serve to maximize rather than hinder syringe access."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Breastfeeding Dilemma for HIV-Positive Mothers

New World Health Organization (WHO) guidelines indicating that HIV-positive mothers can safely breastfeed their babies for up to 12 months, provided mother or baby receives antiretroviral (ARV) therapy for up to one year, still need to be communicated to most new mothers in Uganda.

For the last decade, the country's policy has been to advise HIV-positive mothers on ARVs to exclusively breastfeed for three months. The new WHO guidelines were adopted during the 18th International AIDS conference in Vienna.

Dr. Elizabeth Madraa, head of food and nutrition at the Ministry of Health, acknowledged that awareness and education are needed. "We really need to come out and sensitize pregnant HIV-positive mothers very well on these new recommendations because they are still not yet convinced," she said.

Madraa said six to 12 months of breastfeeding is sufficient for providing the initial immunity a baby needs. Mixed feeding is not recommended, as it makes an infant's gut vulnerable to infection, she said.

Dr. Lydia Mungherera, executive director of the AIDS Support Organization and patron of the Mamas Club for HIV-positive women, said Uganda needs to step up efforts to educate women about the new policy. "Community nurses and midwives should be trained and any new policies should be quickly circulated," she said.

"Many [HIV-positive mothers] are not yet aware of these new guidelines, so this needs a lot of awareness raising and the training of health workers, including midwives," Mungherera said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Grant Targets S.C. Health Disparities

A recently announced $6.7 million grant will help South Carolina public health experts build on an effort to reduce diseases that disproportionately affect minority populations, including HIV/AIDS, human papillomavirus, and various cancers.

In 2005, the University of South Carolina's Arnold School of Public Health received a $7.5 million grant from the National Institutes of Health to study and reduce health disparities among African Americans. Among the grant's chief achievements have been the establishment of a virus research lab at historically black Claflin University-Orangeburg and the founding of community-based prevention, screening and treatment programs.

"We've built a level of trust, and now the community has a sense of hope in dealing with these disparities," said Saundra Glover, an associate dean at the Arnold School.

Grant-supported community advisory groups have focused much of their effort on HIV/AIDS. Local volunteers on the advisory groups help health officials understand the best ways to disseminate information. One of the most effective means of communication has been when those advisory group members, not health officials, translate the science of HIV/AIDS to communities.

Twelve women living with HIV/AIDS have been trained to discuss issues surrounding the disease with community groups, and in turn have become the trainers of others, said Shirley James, executive director of the Minority AIDS Council in Orangeburg County. The new funding should allow for an expansion of this advisory program.

The Claflin laboratory, which opened in 2,700 square feet of converted classroom space in 2007, has recently been expanded to 14,000 square feet. The lab's sophisticated equipment allows the school to tackle research usually done only at larger schools. And it has become a tool for luring potential researchers from under-represented minority groups, providing more than 100 research internships in the past three years.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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New HIV Cases 'Preventable'

In 2009, the HIV prevalence rate in England's North West was 80 diagnosed cases per 100,000 population, according to a new report by the Health Protection Agency North West and the Center for Public Health. Many of the 498 new diagnoses across Greater Manchester in 2009 "were acquired in the UK and would have been preventable," said Dr. Penny Cook, lead author of the report.

High-prevalence areas, nationally defined as more than 200 cases per 100,000 population, include the Manchester local authority (365.6), Salford (229.6), and Blackpool (203.6).

The number of patients seeking HIV treatment and care in the region rose 8 percent from 2008, to 6,238 individuals, the report said. The major modes of infection among new patients were heterosexual sex (48 percent) and sex between men (41 percent). That pattern was mirrored in the Greater Manchester area, with 250 cases tied to heterosexual sex, 202 to sex between men, 10 to mother-to-child transmission, six to injection drug use, and 29 undetermined.

"We must ensure that in this difficult economic time resources continue to be invested in prevention, since targeted health promotion campaigns save the NHS [National Health Service] a substantial amount of money in the long run by preventing infections," said Cook.

"As the NHS is transformed, prevention of sexually transmitted infections must be seen as a priority; otherwise, we risk not just higher levels of HIV but more chlamydia in young people and infections like syphilis," Cook said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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AIDS Patients Hurt by South African Strike

A nationwide civil service strike in South Africa is threatening the health of patients with HIV/AIDS, TB and other critical diseases.

The government has brought in military medics and volunteers to help keep hospitals and clinics running while health care union members picket for an 8.6 percent wage increase and a 1,000 rand (US $137) housing allowance. The government is offering a 7 percent increase plus 700 rand (US $96) in housing.

Sizwe Pamla, spokesperson for the union that represents health workers, said it had planned prior to the strike for skeleton crews to provide care for people with HIV/AIDS and others, including those needing emergency treatment. But relations with the government had broken down to the extent that laborers are heading to the picket lines instead. "This country has got millions of people with HIV who need care," he acknowledged.

"The health care service has basically broken down in large parts of the country," said AIDS activist Mark Heywood.

Dr. Ashaf Coovadia, who works at a government hospital in Johannesburg, said his HIV/AIDS clinic typically sees 60-80 patients per day, but that has declined to 20-30 since the strike began a week ago. Patients fear getting caught in the violence that has erupted between police and health workers on the picket lines. "The situation is quite volatile," he said.

Coovadia, among the non-strikers, said his staff is calling patients who are nearly out of AIDS drugs to urge them to come in. HIV and TB patients who miss a few days of medication can develop drug resistance.

"This is affecting hundreds of thousands of patients across the country," Coovadia said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Youth Risk Behavior Survey: 70 Percent of High School Seniors Have Had Sex

By their senior year of high school, more than two-thirds of Connecticut teens have had sex, but only about 59 percent of them are using condoms, according to data from the 2009 Youth Risk Behavior Survey.

"The older they get, the more sexually active they are likely to be," said Susan Yolen, spokesperson for Planned Parenthood of Southern New England. "They should be given sexually appropriate information. They need the tools to protect themselves."

The Connecticut data are drawn from a representative sample of 3,000 middle and high school students. State-level information is compiled by CDC to form a national youth risk assessment.

Connecticut's results prompted concern from health officials about teens' risk of contracting STDs, particularly chlamydia. Connecticut reported 12,000 new cases of the STD last year, said Heidi Jenkins, program director for the state public health department's STD control program.

The survey also found that, among teens who had sex:
*24.8 percent used drugs or drank alcohol beforehand.
*24.1 percent used birth control pills beforehand.
*10 percent reported having four or more partners.

For the first time, the Connecticut survey asked about verbal abuse in the context of dating. About 17 percent of teens reported being verbally or emotionally abused by a girlfriend or boyfriend. One in four teens reporting being bullied or harassed in the past year.

Some bright spots emerged in the survey. For example, teens reported they were less likely to drive drunk or smoke cigarettes. Family and social support were key to helping teens avoid behaviors such as binge drinking, drug abuse, and suicide.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Obama Seeks Boosts in Funds for AIDS Prevention, Research

In a letter sent Friday to House Speaker Nancy Pelosi (D-Calif.), President Barack Obama said he is seeking $400million from Congress to boost HIV/AIDS services and research.

The money, which is part of amendments to Obama's budget for fiscal year 2011, would be offset by decreases from CDC and the National Institutes of Health. HIV prevention, services, and research would receive about $55 million; $250 million would enhance government-run health care training programs; and the rest would supplement state high-risk insurance pools and health insurance information for consumers.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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CDC Funds Bay Area Collaborative to Deliver HIV Prevention to Asians and Pacific Islanders

CDC is supporting new HIV prevention outreach to Asian and Pacific Islander (API) men who have sex with men (MSM) in the San Francisco Bay Area. The Asian & Pacific Islander Wellness Center (APIWC), Asian Americans for Community Involvement, and Asian Health Services will collaborate on the initiative, thanks to a five-year, $1.9 million grant.

"Traditional HIV prevention programs often overlook the unique needs of the API community," said Carlos Bermudez, director of health education at APIWC. "Successful HIV prevention programs must address the complex interplay of homophobia, racism, and cultural or linguistic isolation to really get API MSM into HIV testing and reduce their risk."

To lower HIV risk at individual and community levels, the collaborative will use community and group interventions as well as counseling and HIV testing. Outreach will focus on personal stories that interweave identity, sexuality, and health.

The API community comprises more than 49 distinct ethnic groups speaking more than 100 languages and dialects. More than two-thirds of Asian Americans and half of Native Hawaiians and Pacific Islanders have never been tested for HIV. A major challenge is reaching the community with lifesaving prevention and education information.

In San Francisco, HIV rates among APIs increased 487 percent from 1990 to 2000. APIs comprise one-third of the Bay Area's general population, and high levels of HIV risk behavior have been observed among API MSM.

"We want this unique approach to have a visionary impact. We want to reduce HIV incidence and eradicate HIV-related stigma," said Lance Toma, executive director of APIWC. "Together, the API MSM community can take collective responsibility for its health."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Study Rethinks AIDS Prevalence Among Haitians

Haitian immigrants to the United States have been historically stigmatized as having introduced HIV into North America, according to Dr. Linda Marc, of the Center for Multicultural Mental Health Research at Cambridge Health Alliance, and colleagues. Haitian-born persons also have been thought to have higher HIV prevalence than other domestic groups, with Haitians included among the risk groups very early during the US epidemic.

However, previously no study has reported on US surveillance trends among Haitian-born persons, Marc and colleagues noted. The team set out to estimate AIDS prevalence among this population, with AIDS rates by race/ethnicity based on data from post-censal estimates, the American Community Survey of the US Census Bureau and the Haitian Consulates.

The researchers estimated annual AIDS cases for adults and adolescents over age 12 from all 50 states and the District of Columbia, 1985-2007, who reported Haiti as place of birth to CDC. HIV data for 2004-2007 were obtained from 34 states.

"In 2007, Haitian-born persons constituted 1.2 percent of US AIDS cases, yet accounted for 0.18 percent of the total US population based on the American Community Survey estimates, which suggests a seven-fold over-representation in the CDC AIDS surveillance data," found researchers. "However, using population estimates from the Haitian Consulate, the over-representation ranges from three- to four-fold, which is similar to the AIDS rate for blacks/African-Americans."

It is likely that Haitian-born immigrants are undercounted by the US Census, especially if they are not in the country legally, Marc and co-authors said. "The importance of having accurate denominators to estimate the AIDS rate for the Haitian population is paramount," they concluded.

The full report, "HIV Among Haitian-Born Persons in the United States, 1985-2007," was published in AIDS (2010;24(13):2089-2097).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Ohio State Funds Mix-Up Delays HIV Drug Payments

Adding to the concerns of Ohio HIV patients who receive government assistance for their medications, a recent computer glitch left at least nine people in danger of losing their insurance coverage.

Some COBRA clients who lost their jobs but whose previous insurance is extended through state-supported payments have been affected by the mix-up. A third-party insurance administrator contracted by the Ohio Department of Health (DOH) in July sent checks in some cases to the wrong address or to the right company but the wrong building. The delay placed some clients at risk of losing their insurance for lack of payment.

Katherine E. Shumate, administrator of the Ryan White Part B Program, said the DOH is looking into whether the problem is larger. "We're constantly scouring our data to make sure things are caught," she said, explaining that the new administrator is using a different, automated program to send the insurance checks.

Shumate said her department is working to ensure clients keep their insurance and has assisted those it knows have been affected by the glitch. Five of the nine known cases have been resolved, and the state is working on behalf of the others. "We're pretty relentless with arguing with insurance companies," she said.

Peggy Anderson of the Columbus AIDS Task Force said her staff helped resolve one of the cases. "By the time [the client] found out, he was very close to losing his benefits," she said. "It was down to the wire and it was very scary for him."

Ohio has made several cuts to its AIDS Drug Assistance Program, and as of Aug. 20, 148 Ohioans were on a waiting list for help.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Two Approved Cancer Drugs Fight HIV

A combination of two U.S. Food and Drug Administration (FDA)–approved cancer drugs effectively reduced HIV replication in the lab, according to a study published in the September issue of the Journal of Virology.

Most of the approved antiretroviral (ARV) drugs are quite potent when used correctly, bringing down HIV by up to a million-fold. They all have a critical weakness, however, which is that over time HIV can mutate to the point where it becomes resistant to the drugs.

Several years ago, scientists began theorizing that it might be possible to use HIV’s ability to mutate against itself. What if, they wondered, HIV could be pushed to mutate so rapidly that mistakes cropped up in the genes of every new generation of virus. Would that defective virus accumulate in such numbers that the infection would burn itself out? This process, called lethal mutagenesis, has been tested with other viruses in small rodents, and it appears that it is at least theoretically possible.

“HIV’s ability to mutate makes it difficult to target and treat,” asserted Louis Mansky, PhD, from the University of Minnesota (UM), in an announcement about his study. “We wanted to take advantage of this behavior by stimulating HIV’s mutation rate, essentially using the virus as a weapon against itself.”

Mansky, and two other UM colleagues, Christine Clouser, PhD, and Steven Patterson, PhD, began looking for FDA-approved drugs with lethal mutagenesis potential. They figured that finding approved drugs with clear safety data would speed up the research process and allow scientists to more quickly begin human testing of any drugs proved effective in the lab. Two such drugs, Gemzar (gemcitabine) and Dacogen (decitabine), seemed particularly promising.

The team found that when the two drugs were used together, at concentrations so low that neither drug was effective when used alone, the combination shut down HIV reproduction by 73 percent. Both drugs, like all other cancer chemotherapies, can have serious side effects when used at typical doses. Researchers hope that they can use doses low enough to minimize such side effects.

“Our results suggest that HIV infectivity can be decreased by combining [drugs such as Gemzar and Dacogen],” the authors commented. “Our observations support a model in which increased mutation frequency decreases infectivity through lethal mutagenesis.”

“The findings provide hope that such an approach will someday help the 33 million people worldwide who currently live with HIV,” Mansky concluded.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Wisconsin AIDS Resource Center Expands Services

The AIDS Resource Center (ARC) of Wisconsin is adding medical care services to its Green Bay facility, becoming a comprehensive one-stop center for more than 600 people living with HIV/AIDS in the region.

Mike Gifford, ARC's chief operating officer, said HIV/AIDS involves specialized needs that cannot be met by traditional health care providers. The Green Bay location, at 445 S. Adams St., already provides HIV prevention, dental care, mental health treatment, social work, and other services. Because even grocery shopping becomes complicated for patients due to dietary restrictions, the 6,000-foot-space includes a food pantry.

"Integrated health care is so vital," said Gifford. "We need to make sure that we have a system designed to address the needs of these very complex patients."

ARC forged a partnership with Prevea Health System, which is providing two physicians for the facility. Prevea President and CEO Ashok Rai said his organization now does not have to ramp up its own infectious-disease program and duplicate the services provided at ARC. "It's a big benefit to the greater Green Bay area," said Rai.

ARC has spent roughly $1 million renovating the location to accommodate the addition of medical care services.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Hepatitis C Virus Infections Among HIV-Infected Men Who Have Sex with Men: An Expanding Epidemic

Since 2000, outbreaks of sexually transmitted hepatitis C virus have been reported among HIV-positive men who have sex with men (MSM). In the current study, the authors conclude that the prevalence of HCV in this population is "high and increasing."

The setting for the research was a large STD clinic in Amsterdam, where the authors studied the prevalence and determinants of HCV among MSM.

In 2007 and 2008, an anonymous, bi-annual cross-sectional survey was administered to 3,125 patients, of whom 689 were MSM. Participants were interviewed and screened for HIV and HCV antibodies, and all anti-HCV-positive and HIV-positive persons were tested for HCV RNA. Phylogenetic analysis was used to compare HCV strains of the STD clinic patients with those isolated from MSM with acute HCV in 2000-2007. Logistic regression was used to analyze determinants of HCV infection.

HCV infection was diagnosed in two of 532 HIV-negative MSM (0.4 percent) and 28 of 157 HIV-positive MSM (17.8 percent). Among HIV-positive MSM, HCV prevalence increased from 14.6 percent to 20.9 percent during the study period. Acute HCV infection was noted among seven of 28 co-infected MSM (25 percent). Of the 28 co-infected men, only five reported any history of injection drug use (IDU).

HIV infection, IDU, fisting, and use of gamma hydroxyl butyrate (GHB) were found to be significantly associated with HCV infection. A high degree of MSM-specific clustering was found through phylogenetic testing.

"Though not statistically significant, this trend, and the relatively large population of acute infections suggest ongoing transmission of HCV in HIV-positive MSM," the authors concluded. "Regardless of IDU, rough sexual techniques and use of recreational drugs were associated with HCV infection; phylogenetic analysis supported sexual transmission. Targeted prevention, like raising awareness and routine testing, is needed to stop the further spread among HIV-infected MSM, and to prevent possible spillover to HIV-negative MSM."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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China AIDS Campaigner Detained: Activists

A Chinese AIDS activist who has lobbied for the government to compensate those who contracted HIV through unsafe blood transfusions has been detained, advocates said.

Tian Xi, a 23-year-old who contracted HIV as a boy through a blood transfusion, told fellow activists that authorities were angered by his petitioning of the government. Local officials had been urging police to detain Tian, according to the Chinese AIDS group Aizhixing and Meg Davis, the New York-based head of the rights group Asia Catalyst. Tian was ultimately seized Tuesday at a hospital in Xincai County in Henan Province and taken to an unknown location, activists said.

"Tian Xi is a sweet guy who has suffered a great deal and who cares deeply about the suffering of others," Davis said. "He is in poor health and we're very concerned about his condition in detention."

In July, Tian was held for several hours in a "black jail," or illegal detention center, while in Beijing during a trip to petition the government, said Aizhixing. Tian has worked in the past for the group, and leaders say they are "stunned" by his detention. Police in Gulu, where Tian was living, declined comment. Calls to Xincai County officials were not answered. "I asked him if there was anything we could do to help, and he replied, 'I don't think I can escape my fate,'" Davis recalled of her last conversation with Tian.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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AIDS Advocates Applaud Sen. Bill Nelson's Call for More Funding

Florida Sen. Bill Nelson (D) recently announced his support for "robust funding" of the nation's AIDS Drug Assistance Programs. As of Aug. 12, 2,937 people in 13 states were on waiting lists in the hope of accessing HIV drugs through ADAP. More than a third of those placed on an ADAP waiting list, 1,178 patients, are in Nelson's home state, according to the National Alliance of State and Territorial AIDS Directors (NASTAD).

"The Democratic leadership has been AWOL on ADAP so we thank Senator Nelson for being among the first to speak out and for urging his Senate colleagues to address this funding shortfall that is crippling ADAP and threatening the lives of thousands of Americans," said Michael Weinstein, president of the Los Angeles-based AIDS Healthcare Foundation.

Last month, the Department of Health and Human Services said it was moving $25 million to ADAP for fiscal 2010 to help patients on waiting lists. However, $126 million is needed for ADAPs to meet current needs, NASTAD says. Weinstein said $25 million "would barely cover" those on the lists.
"While President Obama recently announced a reallocation of $25 million to states that have been hit hardest by the crisis, it may not be enough," Nelson wrote in a letter to Senate appropriators. "I urge you to join me in support of robust funding for programs like ADAP that offer real hope to Americans enduring the throes of this debilitating recession."

Under a measure co-sponsored by Republican Sens. Richard Burr (N.C.), Tom Coburn (Okla.), and Mike Enzi (Wyo.), $126 million in unobligated stimulus funds would be redirected to clear the state ADAP waiting lists. The bill has not attracted support from Democrats.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Data on Proteomics Reported by Researchers at University of Amsterdam

A new study, 'Identifying potential survival strategies of HIV-1 through virus-host protein interaction networks,' is now available. "The National Institute of Allergy and Infectious Diseases has launched the HIV-1 Human Protein Interaction Database in an effort to catalogue all published interactions between HIV-1 and human proteins. In order to systematically investigate these interactions functionally and dynamically, we have constructed an HIV-1 human protein interaction network," scientists in Netherlands report.

"This network was analyzed for important proteins and processes that are specific for the HIV life-cycle. In order to expose viral strategies, network motif analysis was carried out showing reoccurring patterns in virus-host dynamics. Our analyses show that human proteins interacting with HIV form a densely connected and central sub-network within the total human protein interaction network. The evaluation of this sub-network for connectivity and centrality resulted in a set of proteins essential for the HIV life-cycle. Remarkably, we were able to associate proteins involved in RNA polymerase II transcription with hubs and proteasome formation with bottlenecks. Inferred network motifs show significant over-representation of positive and negative feedback patterns between virus and host. Strikingly, such patterns have never been reported in combined virus-host systems. HIV infection results in a reprioritization of cellular processes reflected by an increase in the relative importance of transcriptional machinery and proteasome formation.

We conclude that during the evolution of HIV, some patterns of interaction have been selected for resulting in a system where virus proteins preferably interact with central human proteins for direct control and with proteasomal proteins for indirect control over the cellular processes," wrote Dijk D. van and colleagues, University of Amsterdam.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Brunswick County Students Will Begin STD, Contraceptives Education in the Fall

On Tuesday, the Brunswick County School Board voted 3-2 to approve offering a more comprehensive sex education curriculum for middle school students.

Under a new state law signed by Gov. Beverly Perdue, school districts are required to offer more than abstinence-only sex education. Students must be taught about STDs, contraceptives, and sexual abuse prevention. It is up to each district how to implement the health education act's mandates.

The main choice before the board was whether to make sex education an opt-in or opt-out program. An opt-in approach would require parents to sign a release before a student could participate. Instead, the board voted to make it an opt-out course, so parents who do not want their child to learn about contraceptives, STDs, and sexual abuse will have to request that their students be excused.

"I know it's a touchy subject," said Bud Thorsen, who chairs the board. Ideally, parents would educate their children about sex, but many cannot be counted on to do that, he said. Schools are left to fill in the blanks, and an opt-out strategy will allow the schools to educate more children, he said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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History of Forced Sex and Recent Sexual Risk Indicators Among Young Adult Males

The authors undertook the current study to learn whether young men who have been forced to have sex are at heightened risk of sexual risk-taking and whether that risk varies according to the gender of the perpetrator.

The study was based upon data from 1,400 males, ages 18-24, who participated in the 2002 National Survey of Family Growth. This information was used to determine the prevalence of a history of forced sex and the context of each respondent's most recent experience of sexual assault. Logistic regression analyses were conducted to assess the relationship between having been a victim and having a recent indicator of sexual risk (e.g., having had sex in the past year with five or more female partners, a female drug injector or a female with HIV). Separate analyses were performed for coercion by females and by males.

Of the men, 6 percent said a female perpetrator had forced them to have vaginal intercourse; 1 percent said a male perpetrator had forced them to have oral or anal sex. The results indicated men had an elevated likelihood of reporting one or more recent sexual risk indicators if they had been forced into sex by a male (odds ratio, 6.9) or a female (3.3). Verbal and physical coercion and providing alcohol and drugs were commonly employed by female as well as male perpetrators.

"A better understanding of the pathways linking sexual victimization to sexual risk-taking among men is needed," the authors concluded. "Clinicians working with young men should screen them for victimization and provide STD testing and referrals for counseling if abuse is suspected or disclosed."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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HIV Prevention in Latvia Nearly Non-Existent Due to Multiple Reorganizations

Organizational changes and staff shortages are hampering the fight against HIV/AIDS in Latvia, a local expert there says. And both problems have been partly responsible for the lack of outreach to high-risk groups documented in a recent UNICEF report, said Iveta Skripste, a public health methodologist with the Latvian Center of Infectious Diseases. The report highlights the need for HIV prevention services among vulnerable youth in Eastern Europe and Central Asia, especially those involved with the sex trade and drug use.

Since 2008, intravenous drug use has fallen as the top mode of HIV infection in Latvia, Skripste said. Last year, 49 percent of new cases were linked to heterosexual sex, and 27 percent were acquired through drug use. "But those infected through heterosexual contacts are closely related to the community of drug users," said Skripste.

Lack of resources at both the national and local levels has hindered the effective division of labor in tackling HIV, Skripste said. The state provides prevention supplies such as HIV testing strips and disposable syringes, but local authorities have the responsibility of paying for rent, salaries, and other operational expenses for HIV prevention outreach efforts.

"In the given economic situation, the local governments have very few such employees, therefore the scope of work is much smaller than in previous years," Skripste said. Prevention efforts also have suffered from the reorganizations of several health institutions, including the liquidation of the Public Health Agency, she said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Federal Government Announces $42 Million in HIV Prevention Grants

On Tuesday, CDC announced it has awarded $42 million in grants to 133 community-based organizations (CBOs) fighting HIV/AIDS in 28 states, the District of Columbia, Puerto Rico, and the US Virgin Islands. The National HIV/AIDS Strategy unveiled last month at the White House emphasizes targeting those at greatest risk: men who have sex with men (MSM), African Americans, Latinos, and injection drug users (IDUs).

"This funding is a critical part of CDC's national HIV prevention efforts and is in line with the priorities identified in the recently released National HIV/AIDS Strategy," said Dr. Jonathan Mermin, director of CDC's Division of HIV/AIDS Prevention. "Governments on the federal and state levels cannot end this epidemic alone, and these resources will help give many communities the tools they need to fight HIV locally."

"Because community-based organizations have the cultural knowledge and local perspective to reach people who might not otherwise access HIV testing or other prevention services, partnership with these organizations represents a critical part of CDC's fight against HIV," CDC said in the release.

The average grant is approximately $323,000 per year for five years. The awards will be used for implementing effective prevention programs and increasing HIV testing and people's awareness of their HIV status. A limited amount will be given to some CBOs to help monitor impact and behavioral outcomes.

By risk group, 49 percent of the CBOs target MSM, 38 percent heterosexual men and women, 5 percent IDUs, and the remaining on combinations of these groups, CDC said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Thousands Treated to Free Concert for Knowing Their HIV/AIDS Status

More than 15,000 young people attended Saturday's fourth annual "Hip Hop for HIV" concert at Houston's Reliant Center. Though the show was free, ticket holders had to go through testing and education for HIV, syphilis, gonorrhea, and chlamydia. Clinic sites across the city offered testing to anyone ages 13-40, and Houstonians wanting to see their favorite performers for free responded enthusiastically.

"This year we are so excited because we exceeded our goal by far. We are extremely impressed that the kids came out, are comfortable with the brand Hip Hop for HIV, and are willing to be tested," said Marlene McNeese-Ward, bureau chief for the HIV Prevention Program, Bureau of HIV/STD Prevention for Houston Department of Health. The city co-sponsored the concert with 97.9 The Box FM.

Madd Hatta, host of The Box's Madd Hatta Morning Show, said the initiative benefits the community. "What I love about the program is not only do [attendees] get tested, they get educated," he said. "You have to go through the whole process and after you know your status, your access is granted."

"Hip Hop for HIV is letting the world know that the hip-hop community is taking a stand in the fight against HIV and AIDS," said rapper Bun B of UGK. "We offer our time and services and all we ask is that people get tested, become aware, and know their status so that if they are not positive, they can take the steps to remain negative. But if they are positive, then they need to know what steps to take in order to ensure a longer life."

Other performers included Paul Wall, Plies, Lloyd Banks, Dallas Blocker, the Party Boyz, Papareu, Z-Ro, and Just Brittany.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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AIDS Expert Tells China's Gay Men to Face Up to Responsibilities

Men who have sex with men need to shoulder more of the burden for preventing new HIV infections among MSM in China, the head of the China Program of the Bill & Melinda Gates Foundation said during a news broadcast Friday.

Unprotected sex between men has become the main route of HIV infection in Beijing this year, according to the city's disease control and prevention agency. By the end of 2009, HIV transmission among MSM accounted for 32.5 percent of total infections in China, according to the Ministry of Health.

HIV's spread through unprotected sex among MSM remains "one of the biggest emerging challenges" to controlling HIV, Dr. Ray Yip told CNC World, a satellite news program operated by Xinhua. Social pressures force many MSM with HIV to remain hidden, reluctant to disclose their infections, Yip said. In addition, many MSM are poorly informed about safe-sex practices.

"We need the MSM group to engage their community to take part in the intervention," Yip said. "Will they promote safe sex? Will they be promoting early testing? Will they be supporting people already with HIV? So the key is their involvement in the prevention."

The Gates Foundation has committed $50 million for HIV prevention efforts in China, where it promotes prevention services among high-risk groups and those infected, HIV screening and reducing stigma.

"We fund government programs in about 15 cities across China to work with [non-governmental organizations] who fund high-risk communities, such as MSM, to mobilize and develop their capacity to do the prevention," Yip said.

"We give away condoms and brochures in gay bars and parks, set up a free hotline, and conduct salons or lectures regularly," said Luo, head of the volunteer-led Zhitong organization, who would only give his surname. The group is supported by the foundation and local health agencies.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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South Carolina Faces HIV Inmate Segregation Lawsuit

The U.S. Department of Justice (DOJ) is preparing a lawsuit against the South Carolina prison system for segregating its HIV-positive inmates in separate dorms, The Associated Press (AP) reports.

On June 22, Jon Ozmint, director of the South Carolina prison system, received a letter from the DOJ saying the state has 90 days to cease this practice or the federal government would file a lawsuit. The state agency adopted the segregation system in 1998, when corrections officials started screening all inmates for HIV.

To read the AP article, please visit: http://www.goupstate.com/article/20100803/articles/100809921

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Global Survey: Stigma, Isolation and Discrimination Still Pervasive

HIV-associated stigma, isolation and discrimination remain pervasive problems in the United States and other parts of the world and continue to have profound effects on people’s willingness to disclose their serostatus to key individuals in their lives. This is the finding of a global survey of 2,035 people living with HIV conducted by the International Association for Physicians in AIDS Care (IAPAC) on Thursday, July 22, at the XVIII International AIDS Conference in Vienna.

Suniti Solomon, MD, director of the YR Gaitonde Center for AIDS Research and Education in Chennai, India, presented the survey results on behalf of IAPAC. The survey found that stigma, isolation and discrimination are first among unique obstacles facing people living with HIV around the world. There is no shortage of research indicating that they affect HIV prevention and testing efforts, along with initiatives to link and retain people diagnosed with HIV in care and on treatment.

“An environment of tolerance in which an individual can take an HIV test and live with an HIV diagnosis is of paramount importance to effective HIV prevention and treatment programs at local and national levels,” Solomon said. “Health care providers bear the responsibility of ensuring compassionate and nonjudgmental care of patients.

“Society—or all of us—have a responsibility to break down the barriers of stigma, isolation and discrimination that persist almost 30 years into the global HIV pandemic,” she added.

Indeed, the IAPAC survey results illustrate that HIV-associated stigma, isolation and discrimination remain pervasive issues all over the world.

The AIDS Treatment for Life International Survey (ATLIS 2010) was conducted in the same manner as a similar survey reported in 2008 at the XVII International AIDS Conference in Mexico City, which found that people living with HIV around the globe still live in fear of the societal stigma that surrounds the disease, and that some are so concerned about side effects of medication that they have chosen to stop their antiretroviral (ARV) drug regimens.

The ATLIS 2010 data reported in Vienna were based on Internet, telephone and face-to-face interviews conducted with 2,035 HIV-positive adult men and women residing in five global regions: 201 people residing in North America, 201 in Latin America, 1,133 in Europe, 200 in Asia and the Pacific and 300 in Africa. A second set of results from the survey, evaluating patient-physician communication, was also reported in Vienna.

The survey was conducted with support from Merck.

According to ATLIS 2010, Solomon reported, the emotional toll of HIV/AIDS is still considerable. More than one third of respondents (37 percent) reported strong feelings of isolation, with the highest prevalence rates in North America and Asia-Pacific. Depression was also prevalent.

Societal and cultural stigmas also continue to affect people living with HIV around the world. According to Solomon, 38 percent of respondents felt as if others were judging them. What’s more, nearly half of respondents had encountered someone who was afraid to have casual contact with them—25 percent reported that someone would not share food or drink with them, and 24 percent reported that someone would not kiss them, simply because they are living with HIV.

Forty-two percent of ATLIS 2010 participants also reported “strong concerns” about others learning their HIV status. Seventy-nine percent, for example, cited social discrimination as a reason for their reluctance to disclose. Other drivers included the impact on establishing future relationships (46 percent), impact on current relationships (42 percent), reputation (42 percent), risk of losing job (36 percent) and risk of losing family or friends (35 percent).

Though 96 percent of respondents reported having disclosed their HIV status to at least one person, Solomon’s team made some sobering discoveries. For example, 17 percent of respondents in long-term relationships had not disclosed their HIV status to their spouse or partner. In addition, 16 percent of Asia-Pacific respondents and 8 percent of Latin-American respondents had never told anyone about their HIV status.

Understandably, many respondents stressed the need for more public education around stigmas. The three most common stigmas in need of combating, Solomon reported, are: a person with HIV has or does engage in risky behavior, people with HIV or AIDS should be avoided, and HIV is easily transmitted through normal everyday activities.

“Despite great strides, 29 years into the HIV pandemic, HIV-associated stigma, isolation and discrimination persist,” Solomon said in her concluding remarks. “Addressing these challenges can benefit individual, community and public health.”

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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China Details Plan to Fight Co-Infection of HIV and TB

The Ministry of Health has released a brochure warning health authorities that TB has become a leading cause of death among Chinese HIV patients.

The ministry has ordered increased cooperation and information sharing between health personnel involved in fighting HIV/AIDS and those working against TB. It further ordered free treatment and follow-up visits for co-infected patients. Under the new guidance, HIV/AIDS patients must be checked for TB at least once a year; TB workers, meanwhile, are required to persuade their patients to be tested for HIV. Diagnosis information must be confidentially recorded and reported to government agencies.

The World Health Organization estimates that China sees 1.3 million new TB cases each year. The nation's 700,000 HIV patients include 75,000 diagnosed with AIDS.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Eastern European Street Kids Facing 'HIV Epidemic'

Drug use and high-risk sexual behavior among vulnerable youths, together with concurrent stigma, are fueling an "underground HIV epidemic" in much of the former Soviet Union, says a recent UNICEF report. Eastern Europe and Central Asia are the world's only regions where new HIV infections continue to rise, according to UNAIDS.

"Today, street children in the region are dying of AIDS and drug use in much the same way as they died of cold, famine, and typhoid in the twentieth century," the UNICEF report states.

Last year, Russia reported an 8 percent increase in new HIV diagnoses, though some parts of the federation have seen a 700 percent increase since 2006. HIV prevention program coverage of injecting drug users has declined in Russia and Georgia, UNAIDS said.

"There's an unwillingness to acknowledge that there are young people and minors involved in these behaviors," said Nina Ferencic, report co-author and a regional HIV/AIDS specialist for UNICEF. "We hope to raise attention to the issues affecting children and young people who are either vulnerable, engaging in risky behaviors, or already living with HIV and AIDS."

Homeless and poor youths are especially at risk, given that one-third of new HIV cases in the region are among those ages 15-24. Of the estimated 3.7 million people who inject drugs in the region, one-fourth are believed to have HIV. In addition, many youths end up working in the sex trade.

A recent study suggested that up to 40 percent of homeless minors in St. Petersburg could have HIV. More than half of 319 participants ages 15-19 reported injecting drugs; 96 percent were sexually active; and a quarter had more than six sexual partners a year.

"Children and adolescents living on the margins of society need access to health and social welfare services, not a harsh dose of disapproval," said UNICEF Executive Director Anthony Lake.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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D.C. Pushes Female Condoms to Fight HIV Epidemic

In the hope that better access translates to more use, Washington is distributing the FC2 female condom citywide. The District has one of the country's highest HIV infection rates: A 2009 study found roughly 3 percent of residents age 12 and older were HIV-positive.

Five community groups are handing out 500,000 FC2 condoms during instruction sessions at beauty salons, barber shops, churches, and restaurants. The District also is running ads online and on about a third of the city's bus fleet. The ads, which show a cuddling couple, a female condom package, and the tagline "Get turned on to it," will run for three months and return next spring. "The female condom with pleasure points for her and him to tease, please and protect. Go on, give it a try," the copy suggests.

Health advocates note the female condom is as effective as the male condom in preventing HIV, STDs, and pregnancy. It also can be inserted up to eight hours prior to sex. Most importantly, it gives women control over whether protection is used. "It's something they themselves can initiate and they themselves have control over," said Dr. Nnemdi Kamanu Elias of the district's health department.

The CVS chain is selling FC2 condoms in all its District drug stores, making Washington the only place where people can get them outside a health clinic or community group.

"Everybody is doing a full-court press," said Mary Ann Leper, who is leading the US introduction of the FC2 condom for its manufacturer, Female Health Co. of Chicago.

Washington is not the first city to distribute female condoms, but its campaign is the most broadly based. New York City has distributed female condoms since 1998; last year, community groups there handed out 930,000.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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California Pressures Bristol-Myers Squibb on Cost of AIDS Drug

In the last decade, the number of clients seeking help from California's AIDS Drug Assistance Program has grown by 60 percent. Concurrently, ADAP's spending on drugs has ballooned by almost 200 percent, from $302 for each antiretroviral prescription a decade ago to $583 per prescription today. Now state officials are calling on one drug company in particular, Bristol-Myers Squibb (BMS), to help control drug costs.

BMS products account for about 30 percent of all California ADAP drug purchases. One of the most expensive and most commonly used is Reyataz, which costs $13,046 per year wholesale, according to the state controller's office.

Last month, Controller John Chiang wrote BMS asking it "to step up and join the other pharmaceutical companies that have found ways to reduce the cost of drugs to California."

Two-thirds of California's ADAP funding comes from the federal government or drug company rebates. The state contributes one-third, or about $71 million this year. Drug company rebates backfilled earlier state budget cuts to ADAP, but that probably will not be an option in future years, state officials said. Therefore, the state's proportion will be much larger next year.

BMS officials said they have no intention of giving AIDS patients the cold shoulder, citing the company's assistance programs. "We fully intend to respond directly to Controller Chiang," said BMS spokesperson Cristi Barnett. The company declined to speculate whether there would be price cuts on AIDS drugs.

Other drug makers - Merck, Johnson & Johnson, GlaxoSmithKline, and Gilead - have taken financial hits in order to help state ADAPs, said Michael Weinstein, president of Los Angeles-based AIDS Healthcare Foundation. That is not the case for BMS, he said.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Pregnant Teens Shun HIV Treatment for Fear of Stigmatization

Teenage girls in Zimbabwe who are sexually active remain a difficult group for health workers to target with HIV/AIDS prevention messages.

Despite the country's programs to prevent mother-to-child HIV transmission, some young mothers are unwilling or afraid of accessing antenatal health care. "We now test all pregnant women for HIV as part of attempts to protect the health of both the mother and child, but this is sometimes very difficult when we are working with teenagers," said midwife Nontando Siziba.

"Though they are sexually active, not all are willing to take the responsibility to take precautions. We have had cases where these young people are told not to breast-feed but do so anyway, saying if members of the community know they are not breast-feeding their child then they will know they are living with the virus," said Siziba. "It has become very frustrating."

"[Adolescents] are still failing to handle issues relating to stigma, and this has seen them failing to fully benefit from antenatal health care," said Brighton Gwezera, knowledge development and exchange manager for the Regional Psychosocial Support Initiative.

Because adolescents do not have enough information about HIV/AIDS and its relation to pregnancy, "We see resistance in accessing proper antenatal health care," said Gwezera. "What needs to be done is the setting up of more support groups for young people where they can freely discuss issues relating to their circumstances."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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China, India Should Open Wallet for AIDS War: Global Fund

Countries with emergent economies could help the Global Fund to Fight AIDS, TB and Malaria overcome an impending shortfall in resources, its executive director says.

"I believe that in a globalizing world, in a world where countries like China are joining, and want to join, world governance, at a time when the G-8 is becoming the G-20, it is right for these countries to take up a share of the burden," Michel Kazatchkine said at the conclusion of the 18th International AIDS Conference in Vienna.

Kazatchkine said he has already approached Beijing for help, and a trip to Delhi is scheduled for August. He is also lobbying the oil-rich states of the Gulf ahead of a Global Fund meeting in October that aims to secure $20 billion for projects in 2011-13.

"The Chinese told me they would think about it," Kazatchkine said. "Let's not forget that in terms of [gross national product] per head, China ranks in the hundreds in the world league table. I don't say it is a poor country," I would call it a country with poor people."

Raising scarce money could require innovative financing, such as the micro-tax on foreign exchange transactions proposed by some activists.

"I think it is not impossible, as far as Europe is concerned, to have a tax on euro transactions," Kazatchkine said. "But I am hearing that certain finance ministers want this tax to be used as a buffer for future bank crises, rather than go towards development aid."

The Global Fund has provided $964 million to China, 40 percent of which targets HIV/AIDS. In India, the fund has invested $995 million, two-thirds of which goes toward fighting HIV/AIDS.

Russia has set the precedent for transitioning from a recipient country to a Global Fund supporter. Flush with energy profits in 2006, officials there said they would reimburse the Global Fund for $270 million in projects.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Rage, Panic in AIDS Fight

President Barack Obama is reneging on his commitment to make big increases in global AIDS spending, say activists, causing some to pine for his predecessor, George W. Bush.

The Global Health Initiative, the Obama administration's $63 billion, six-year program, devotes $44 billion to HIV and TB. The remainder goes to malaria, maternal and child health programs and to the broad goal of "health systems strengthening." GHI is larger than Bush's ground-breaking President's Emergency Plan for AIDS Relief (PEPFAR); however, it seeks to make progress against a range of health problems, rather than focusing intently on AIDS.

"What it takes to save lives of those with HIV and those most at risk to contract it is a comprehensive approach that recognizes the roles of other diseases," said Gayle Smith, Obama's special assistant for development and democracy.

According to activists, the White House request for global AIDS spending for next fiscal year is just 2 percent above this year's amount. The administration is on track to spend less than planned by either GHI or the 2008 Lantos-Hyde Act, which renewed PEPFAR and authorized $48 billion from 2009 through 2013.

"The paradox is that the United States government and other funding partners have decided to either flat-line or reduce their spending just when funding should be ramped up so we could actually win the battle," said Paul Zeitz of the Global AIDS Alliance. "Bush made a commitment, and then circumstances changed. Despite the change, he kept his word," Zeitz noted.

In target countries, there is barely enough money to pay for those in treatment, and patients who need to start will soon be turned away, activists say. "The fact is, this crisis isn't looming. It's happening," said Joanne Carter, a board member of the Global Fund to Fight AIDS, TB and Malaria.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Findings from University of Washington, Department of Medicine Broaden Understanding of HIV/AIDS

New investigation results, 'Measuring depression levels in HIV-infected patients as part of routine clinical care using the nine-item Patient Health Questionnaire (PHQ-9),' are detailed in a study published in Aids Care. "Little is known about the psychometric properties of depression instruments among persons infected with HIV. We analyzed data from a large sample of patients in usual care in two US cities (n=1467) using the nine-item Patient Health Questionnaire (PHQ-9) from the PRIME-MD," scientists in the United States report.

"The PHQ-9 had curvilinear scaling properties and varying levels of measurement precision along the continuum of depression measured by the instrument. In our cohort, the scale showed a prominent floor effect and a distribution of scores across depression severity levels. Three items had differential item functioning (DIF) with respect to race (African-American vs. white); two had DIF with respect to sex; and one had DIF with respect to age. There was minimal individual-level DIF impact. Twenty percent of the difference in mean depression levels between African-Americans and whites was due to DIF," wrote P.K. Crane and colleagues, University of Washington, Department of Medicine.

The researchers concluded: "While standard scores for the PHQ-9 may be appropriate for use with individual HIV-infected patients in cross-sectional settings, these results suggest that investigations of depression across groups and within patients across time may require a more sophisticated analytic framework."

Crane and colleagues published their study in Aids Care (Measuring depression levels in HIV-infected patients as part of routine clinical care using the nine-item Patient Health Questionnaire (PHQ-9). Aids Care, 2010;22(7):874-85).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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