HIV Antibodies Do Control Infection: New Hope for Vaccines and Treatment

B-cells and neutralizing antibodies (NAbs) might control HIV levels better than scientists previously suspected, according to a single-patient study reported in the October issue of Nature Communications. The intriguing finding, the authors note, could open a new avenue for both preventive and treatment vaccines for HIV.

B-cells and antibodies represent an important arm of the immune system. When a vaccine is administered, it provokes the body into producing antibodies against a specific disease-causing microbe; that way, a vaccinated person exposed to the microorganisms will be protected. Therapeutic antibody vaccines are used for people already infected with a particular disease; in these cases, the vaccines help them control the infection.

Unfortunately, numerous vaccine studies have suggested that neutralizing antibodies don’t help prevent HIV infection. They also don’t appear to help control HIV disease progression very much once a person is infected.

To add a new perspective on the subject, Kuan-Hsiang G. Huang, PhD, and his colleagues from Oxford University in Oxford, England, had the unique opportunity to study for the first time the direct impact of B-cell and NAb levels on the control of HIV. This was possible because they had a patient who was HIV positive, not on antiretroviral treatment and had to have his B-cells depleted with chemotherapy to treat B-cell lymphoma. That he did not require treatment to control his HIV suggests that some immune mechanism was actively suppressing the virus.

The participant was 58 years old when he came down with symptoms indicating that he’d been recently infected with HIV. Three years earlier, he had been diagnosed with B-cell lymphoma, but the disease was mild enough that he did not require treatment. He was also previously infected with hepatitis B virus (HBV), but that disease was also not active. About 30 months after his HIV diagnosis, his lymphoma began to worsen, and he received Rituxan (rituximab). This treatment works by killing off B-cells.

About five months after starting Rituxan, the participant reported feeling unwell, with fevers and malaise. It was found that his HIV viral load had significantly increased, jumping from undetectable to more than 700,000 copies, and that his HBV infection had been reactivated. At the same time, he had a decline in B cells and a corresponding decline in neutralizing antibodies.

After he completed Rituxan therapy, his B cells and NAbs began to rebound, and shortly thereafter, his HIV levels returned to undetectable. In response to this finding, Huang and his colleagues commented that the increase in NAbs was tied to a reduction in HIV: “There is a clear relationship between the changes in NAb [levels] and [HIV levels] demonstrated in this study.”

It is possible that the reactivated HBV infection—which is known to occur during Rituxan therapy—could have been the reason the man’s HIV levels rose, and not the reduction in NAbs. The authors stated, however, the participant’s HIV levels became undetectable again quickly and spontaneously after NAbs began to rise, and that this drop occurred despite HBV levels remaining high.

The authors concluded: “This unique study suggests that B cells, and their secreted NAbs, can affect HIV viral load in chronic infection. This evidence, derived directly from observations in man, may inform the rational design of future immunotherapies and HIV vaccines.”

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.


TOGETHER WE REMAIN STRONG!

New Explanation for High HIV Infection Rates in African Women

Systemic infections such as malaria might explain why women in sub-Saharan Africa are so much more vulnerable to HIV infection than women in other parts of the world, according to reporting from allAfrica.com.

Researchers have long noted that women in sub-Saharan Africa are far more likely to become infected than women in resource-rich countries. A number of theories have been proposed to explain the discrepancy, including higher numbers of sex partners and sexually transmitted infections (STIs). None of these theories, however, have been able to fully account for the differing infection rates.

Now, Craig Cohen, MD, MPH, from the University of California in San Francisco, and his colleagues are proposing an alternative theory—cellular activation in the vagina due to infections not spread by sexual contact. Though researchers have previously found that these types of infections can activate immune cells in other parts of the body, they have not looked at immune cells in the genital tract before.

Cohen and his team closely examined immune cells from the vagina and cervix in women (ages 18 to 24) in Kisumu, Kenya, and compared them with vaginal cells in women in San Francisco. Cohen’s group found that the women in Kenya had much higher levels of immune activation in genital cells than women in San Francisco—and most important, these higher activation levels were not due to STIs or to sexual activity. Rather, researchers are now looking at endemic infections, such as malaria and schistosomiasis, as well as other culprits to help explain the higher activation levels.

“For the first time our observations suggest that differences in the genital tract immune milieu may be an important additional contributor,” Cohen told allAfrica.com.

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.


TOGETHER WE REMAIN STRONG!

New HIV Eradication Study in Progress

Cytheris has announced the launch and recruitment of a new Phase II study of the company’s interleukin-7 (IL-7) drug—combined with the entry inhibitor Selzentry (maraviroc) and the integrase inhibitor Isentress (raltegravir)—with the goal of eradicating HIV.

Current antiretroviral (ARV) therapy is quite potent. When it works well, it completely shuts down HIV reproduction. Unfortunately, a small reservoir of infected cells remains in the body, and when people stop taking their HIV medication, the virus quickly resumes replication.

Traditional ARVs can’t target HIV genetic material (HIV DNA) inside this reservoir of infected cells. This is because the cells are inactive; most ARVs only work in cells that are actively reproducing. Researchers are now exploring drugs that either wake up these resting cells or help purge their HIV DNA and, ultimately, make the virus vulnerable to HIV drugs. These strategies are one of several being explored with the goal of eradicating HIV from the human body (see “From Mice to Men” in the October/November issue of POZ).

One hopeful new therapy is IL-7. This naturally occurring cellular messenger (cytokine) helps different types of T-cells develop, mature and reproduce. IL-7 can also cause resting CD4 cells to “wake up.” It is this latter quality that researchers are exploring in the study now under way.

The study (ERAMUNE 01)—which is being conducted by a nonprofit French institute called the Objectif Recherche VAccin Sida (ORVACS) and headed by Christine Katlama, MD, from the Hopital Pitie-Salpetriere in Paris—is enrolling people with HIV who are on a fully suppressive ARV regimen and who are judged to have a very small reservoir of infected cells based on a measurement of HIV DNA in the blood. The study will enroll 28 people living with HIV in Paris, Milian, Barcelona and London.

Katlama and her colleagues will add Isentress and Selzentry to everyone’s regimen, an approach known as treatment intensification, to help maximize control of HIV replication. Eight weeks after people add Isentress and Selzentry, the research team will give them two cycles of IL-7 injections. The primary aim is to simply decrease the size of the HIV reservoir. Secondary goals include establishing the safety of this approach and, potentially, eradicating HIV.

“The unique hypothesis tested in this study is that with [IL-7 inducing CD4 cell activation and Isentress and Selzentry containing infection of CD4s] eventually [this will contribute] to viral reservoir reduction and potential eradication,” said Thérèse Croughs, MD, the chief medical officer of Cytheris.

A similar 28-patient study, ERAMUNE 02, is being conducted in the United States—in Chicago, San Francisco and New York—and is exploring Isentress or Selzentry treatment intensification in combination with an HIV-recombinant Ad5-based vaccine to boost the immune system’s response to HIV DNA.

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.


TOGETHER WE REMAIN STRONG!

Find New Ways to Finance AIDS Fight

Given long-term concerns about the sustainability of external funding of South Africa's HIV/AIDS efforts, the government should reach out to the private sector to find new ways to finance this work, the head of the South African Business Coalition on HIV/AIDS said Monday.

Coalition CEO Brad Mears noted that the worldwide recession has led international donors to reduce their contributions to the Global Fund to Fight AIDS, TB and Malaria. South Africa, with the world's largest HIV/AIDS epidemic, is dependent on external donors like the Global Fund and the US President's Emergency Plan for AIDS Relief program to help combat the virus.

However, South Africa also is one of the few African countries that can afford to commit significant funds to its epidemic. The private sector may be able to help bridge the gap, said Mears.

"Can we not pair donor funding with that of private equity to provide the capital injection needed to address human capacity constraints and develop much-needed infrastructure development?" Mears asked. The government, with the right leadership, could direct discussions with the private sector in this regard, he suggested.

Mears spoke ahead of the launch of the coalition's Community Fund, a campaign to raise 500 million rand (US $72 million) by the end of next year to support the government's goal of testing 15 million people by June 2011. The initiative is part of an overall plan to boost HIV prevention and treatment programs; the government aims to halve the number of new HIV infections between 2006 and 2011 and to ensure that 80 percent of patients needing antiretroviral treatment can access the medicines. Mears noted the Community Fund campaign will extend through next December.

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.


TOGETHER WE REMAIN STRONG!

Health Advocates, Porn Actors Meet

State officials on Monday held a fourth public meeting to discuss workplace protections and regulatory scrutiny of the adult-film industry.

Late last year, the Los Angeles-based AIDS Healthcare Foundation (AHF) petitioned California's Occupational Health and Safety Administration (Cal/OSHA) to amend its regulations in order to explicitly require condom use during vaginal and anal sex on adult-film sets. A porn actor's recent HIV diagnosis, the California industry's second in about a year, has intensified advocates' campaign for mandatory condom use during adult-film productions.

A current workplace law, created in the 1990s for the health care field, requires employers to take measures, including "barrier protection," to protect employees from blood-borne pathogens.

At Monday's gathering in Oakland, adult-film representatives asserted that their model of education, optional condom use, and regular STD testing is working.

"Our program works, over and over and over again," said Diane Duke, executive director of the industry group the Free Speech Coalition.

An attorney representing the industry, Frank Cambria, warned that clear, widely enforced condom regulations would push the production of porn underground or to other nations, where workers would have no protections. "This will have a profound impact on the industry," he said. "I think the path we're on is a good one .. But I don't think we're nearly there yet."

Cal/OSHA's chief counsel, Amy Martin, replied that condom use is already required by law. The issue at hand is whether to tailor an industry-specific ordinance to promote employers' understanding and compliance.

The industry "doesn't seem to think the rules apply to it," said Brian Chase, AHF's assistant general counsel. "They want to pretend that 'barrier' means something other than barrier," said Chase, who called for clear, simple rules and aggressive enforcement.

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.


TOGETHER WE REMAIN STRONG!

Colorado Transplant Patient Infected with AIDS Virus

On Friday, CDC said the first reported US HIV transmission through blood products in eight years occurred in 2008, in a Colorado kidney transplant patient.

An unidentified Missouri man in his 40s supplied the blood plasma that infected the patient. According to CDC, on his first visit to donate blood, the man concealed the fact that he had had anonymous sex with men and women. Men who have had any male-to-male sexual contact since 1977 are permanently deferred from donating blood in the United States, as are users of intravenous drugs not prescribed by a doctor, and persons who have accepted payment in exchange for sex.

CDC believes the man became infected with HIV in a small window of time before he donated - approximately nine days. At that time, he had not developed antibodies that would have been detected when his blood was tested before being shipped to surgical centers.

According to a CDC report, a laboratory tested the infected blood for HIV during the June 2008 donation and two tests came back negative. In August 2008, at an unidentified Colorado facility, the transplant patient received the man's plasma.

In November 2008, the man donated at the same center, and again reported no risk factors on the routine eligibility screening questionnaire. But his donated blood tested HIV-positive, and all products from his donation were destroyed. The man was indefinitely barred from additional donations, the report said.

An investigation found that only the Colorado patient, and another in Arkansas who died of cardiac disease just two days later, received the tainted products. The Colorado patient tested positive for HIV, and DNA sequencing found his virus to be 99 percent identical to that of the donor's. He has been placed on antiretroviral therapy.

The report noted that the donor, who initially refused to be interviewed by the Missouri Department of Health and Senior Services, eventually agreed and admitted to not disclosing sexual behavior that would have barred him from donating blood. CDC estimates the risk of HIV transmission from blood transfusion to be about 1 in 1.5 million.

The report, "HIV Transmission Through Transfusion - Missouri and Colorado, 2008," was published in CDC's Morbidity and Mortality Weekly Report (2010;59(41):1335-1339).

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.


TOGETHER WE REMAIN STRONG!

China Earmarks 800 Million Yuan for Mother-to-Child Transmission Prevention

China this year designated more than 800 million yuan (US $120 million) for efforts to prevent mother-to-baby transmission of HIV, syphilis, and hepatitis B virus, according to Ministry of Health sources.

This is a 10-fold increase above the figure budgeted for 2009, which addressed only mother-to-baby HIV transmission, said Zhang Lingli, director of the women's section in the ministry's Department of Maternal and Child Health Care and Community Health. "As there is an increasing proportion of women being infected with HIV, syphilis, and HBV, the central government is attaching great importance to the prevention of mother-to-child transmission to reduce the infection among babies and improve the health of women and children in general," Zhang said, adding that the project will cover more than 1,000 counties and assist 6 million mothers. MOH aims, by 2015, to test more than 80 percent of pregnant women for the three conditions, and to provide free treatment to more than 85 percent of infected mothers and their babies.

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.


TOGETHER WE REMAIN STRONG!


Back to Top

HIV Tests Negative for Porn Actors Who Performed with 'Patient Zero'

HIV tests conducted on the co-workers of an adult-film actor diagnosed with the virus in October have discovered no new infections, the co-founder of Vivid Entertainment told the Los Angeles Times on Friday.

"We can confirm that all performers who have been tested as a result of being exposed have tested negative," said Steven Hirsch of Vivid, one of several adult-film companies that temporarily suspended filming after reports of the infection.

The Adult Industry Medical Healthcare Foundation (AIM), which primarily serves the industry, reported the diagnosis. Upon discovering the case, AIM created a quarantine list of performers who had worked with the HIV-positive actor.

AIM would not tell Hirsch how many people are on the quarantine list or how many first-generation and second-generation exposures there are "due to confidentiality," he said. Hirsh said he will wait for final test results from one of the first-generation performers before Vivid starts filming again.

"We are just being super-cautious," Hirsch said. "We are certainly encouraged by today's news. We feel very confident that this has been contained."

AIM staff did not return phone calls Friday. A Los Angeles County Department of Public Health spokesperson said that agency had no new information.

While saying he was "certainly glad that no one else appears to be infected," Ged Kenslea, a spokesperson for the Los Angeles-based AIDS Healthcare Foundation, added that this is not the time to "let the industry off the hook for irresponsible behavior." AHF is calling for mandatory condom use on porn sets.

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.


TOGETHER WE REMAIN STRONG!

Teens with HIV Prefer Religion to ARVs

Observers say some HIV-positive Ugandan teenagers are abandoning their antiretroviral treatment, believing religion can cure them of the virus.

Baylor College of Medicine's Children's Foundation Uganda treats more than 4,000 HIV-positive children, 750 of whom are teenagers. "Over the years, a growing trend of adolescents and caregivers have withdrawn from treatment with a belief of having been cured of HIV/AIDS in church," said Cissy Ssuna, the foundation's counselor coordinator.

Ssuna cited the case of a 17-year-old girl who has lived with her aunt and uncle since her parents' deaths several years ago. The girl, who spends all her free time watching gospel programs on television, reading the Bible or praying in church, said she was cured by God six months ago, said Ssuna. She has stopped her ARV treatment and regularly gives testimonies about her "healing."

Ssuna said the practice is more common among Pentecostal churches, noting that while teens often make the decision to stop treatment on their own, peer pressure typically is involved, too.

By the time the youths return to treatment, it may be too late. A 2007 study by Makerere University's Infectious Disease Institute found that of 558 respondents undergoing HIV treatment, 1.2 percent had discontinued care because they believed they had been spiritually healed. While four out of the six eventually restarted their ARVs, three required more expensive, second-line salvage treatment.

Mary Kiwanuka, who has an HIV-positive teenage daughter, said television evangelists exert considerable influence. "These children are exposed to too much television, which shows people being healed," she said.

Bishop Dunstan Bukenya of Mityana advised HIV-positive believers to continue their ARV therapy, even as they pray for healing.

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.


TOGETHER WE REMAIN STRONG!

Vihiga Sees Success with Men's Anti-AIDS Clinic

As a way to improve outcomes, some clinics in Kenya are encouraging males to accompany their female partners to programs that aim to prevent mother-to-child HIV transmission (PMTCT).

"For two years now . we give special treatment to all men who accompany their wives to either pre[natal] or postnatal clinics," said Martha Opisa, head nurse at the health center in Vihiga. The facility used to see 40 clients a month seeking PMTCT services, she said. "But now, we now receive between 60 and 70 clients per month, almost doubling the original figure."

The clinics are part of the "Zingatia Maisha" program ("carefully consider life" or "positive action" in Swahili), funded by GlaxoSmithKline and the Kenyan government. Program implementation is through the Elizabeth Glaser Pediatric AIDS Foundation, the African Medical Research Foundation and the National Empowerment Network of People Living with HIV/AIDS.

"During the [men's] clinics, we also offer free counseling and testing of HIV to those who are willing," said Opisa. The clinic screens for STDs and TB, "and we offer treatment of any other disease the client may be suffering from," she said. The center offers prenatal lessons on baby care, family planning, hygiene, HIV infection, and prevention.

"It was not an easy decision," said one father, Pastor Joseph Muhembeli. Through the program, men encourage other men to attend the clinics with their wives. It succeeded because men "listen to other men," Muhembeli said. "Through lessons from the clinic, encouragement by support group members and other experts, we have been able to have two HIV-negative children," he added. The couple, who tested HIV-positive four years ago, have another daughter who also is HIV-negative.

"When we counsel couples, it is easier to disclose their status while they are together than having one partner to disclose to the other," Opisa said. "If they are reactive, it is also easy to enroll them on a PMTCT program."

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.


TOGETHER WE REMAIN STRONG!

New HIV/AIDS research has been reported by scientists at Center for Biomolecules and Complex Molecular Systems

Researchers detail in 'A reliable docking/scoring scheme based on the semiempirical quantum mechanical PM6-DH2 method accurately covering dispersion and H-bonding: HIV-1 protease with 22 ligands,' new data in HIV/AIDS. "In this study, we introduce a fast and reliable rescoring scheme for docked complexes based on a semiempirical quantum mechanical PM6-DH2 method. The method utilizes a PM6-based Hamiltonian with corrections for dispersion energy and hydrogen bonds," scientists in Prague, Czech Republic report.

"The total score is constructed as the sum of the PM6-DH2 interaction enthalpy, the empirical force field (AMBER) interaction entropy, and the sum of the deformation (PM6-DH2, SMD) and the desolvation (SMD) energies of the ligand. The main advantage of the procedure is the fact that we do not add any empirical parameter for either an individual component of the total score or an individual protein-ligand complex. This rescoring method is applied to a very challenging system, namely, the HIV-1 protease with a set of ligands. As opposed to the conventional DOCK procedure, the PM6-DH2 rescoring based on all of the terms distinguishes between binders and nonbinders and provides a reliable correlation of the theoretical and experimental binding free energies," wrote J. Fanfrlik and colleagues, Center for Biomolecules and Complex Molecular Systems.

The researchers concluded: "Such a dramatic improvement, resulting from the PM6-DH2 rescoring of all the complexes, provides a valuable yet inexpensive tool for rational drug discovery and de novo ligand design."

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.


TOGETHER WE REMAIN STRONG!

FDA Warns of Heart Risk with HIV Drug Combination

The Food and Drug Administration on Thursday announced that Invirase (saquinavir) labeling has been changed to warn of potentially life-threatening heart rhythm abnormalities when the HIV drug is used in combination with Norvir (ritonavir). In February, FDA warned patients and health care providers about this possibility.

When taken together, the two drugs can cause prolongation of the QT and PR intervals - indicators of heart rhythm activity seen on an electrocardiogram. "Patients at particular risk are those with underlying heart conditions or those who have existing heart rate or rhythm problems," FDA said.

"Prolongation of the QT interval may lead to a condition known as torsades de pointes, an abnormal heart rhythm," the FDA notice said. "With torsades de pointes, patients may experience lightheadedness, fainting or abnormal heart beats. In some cases, torsades de pointes may progress to a life-threatening irregular heart beat known as ventricular fibrillation."

"Prolongation of the PR interval may also lead to an abnormal heart rhythm known as heart block," the advisory said. "With heart block, patients may experience lightheadedness, fainting or abnormal heart beats."

FDA also is requiring a medication guide for patients using Invirase that will describe these risks. The agency advises patients not to discontinue Invirase without talking to their health care professional.

"Patients should talk to their doctor if they have any concerns about their treatment," said Edward Cox, MD, MPH, director of the Office of Antimicrobial Products in FDA's Center for Drug Evaluation and Research. "Certain drugs may interact with Invirase and increase the risk of developing these side effects, so patients should be sure to tell their doctor about other medicines they may be taking, including non-prescription medicines, vitamins, and herbal supplements."

For more information, visit: http://www.fda.gov/Drugs/DrugSafety/ucm230096.htm.

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.


TOGETHER WE REMAIN STRONG!

Connecting Discovery and Delivery: The Need for More Evidence on Effective Smoking Cessation Strategies for People Living with HIV/AIDS

Compared to the general population's smoking rate of 19.8 percent, smoking prevalence among people with HIV/AIDS is two to three times higher. The author of the current study cited discovery research showing that smokers with HIV/AIDS are more likely "to be nonadherent to treatment, have a greater chance of being diagnosed with an AIDS-defining condition or dying, and report lower quality of life" than nonsmokers with HIV/AIDS. She cited a recent study showing that 86 percent of smokers with HIV/AIDS would not benefit from standard smoking cessation programs.

Using the online database Web of Science, the author identified 1,532 articles with keywords related to smoking and HIV/AIDS published from 1980 through 2008. After those with no relevance were excluded, the remaining ones were classified as discovery, delivery or review.

"The present study found a lack of delivery research on smoking among this population and a scarcity of connections between discovery and delivery research," the author wrote.

"Although there is still a need for additional discovery of health effects associated with smoking for persons living with HIV/AIDS, it is time to disseminate evidence related to delivery of effective cessation interventions for this population.

"I have two recommendations to this end," the author noted. "(1) Researchers and practitioners in the HIV/AIDS field should increase their collaborations with tobacco control researchers and practitioners, who have experience in population-specific cessation programs, and (2) because most discovery researchers are likely working toward a delivery goal (i.e., facilitating the reduction of smoking among persons living with HIV/AIDS), discovery researchers should report their findings in the context of how their contribution might aid intervention development or implementation.

"Increasing collaboration among discovery and delivery researchers and linkages between discovery and delivery literature may facilitate more efficient synthesis of new evidence across the field and a faster transition from discovery of health risks to delivery of effective interventions."

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.


TOGETHER WE REMAIN STRONG!

Smoking-Related Health Risks Among Persons with HIV in the Strategies for Management of Antiretroviral Therapy Clinical Trial

Smoking prevalence is higher among HIV-positive persons than among the general population. In the current study, the researchers sought to determine smoking-related hazard ratios (HRs) and population-attributable risk (PAR) percentage for serious clinical events and death among HIV-positive persons.

For 5,472 HIV-positive persons enrolled from 33 countries in the Strategies for Management of Antiretroviral Therapy (SMART) clinical trial, the team evaluated the relationship between baseline smoking status, development of AIDS-related or serious non-AIDS events, and overall mortality.

Among participants, 40.5 percent were current smokers and 24.8 percent were former smokers. Compared to never smokers, adjusted HRs for current smokers were higher for overall mortality (2.4; P<.001), major cardiovascular disease (2.0; P=.002), non-AIDS cancer (1.8; P=.008) and bacterial pneumonia (2.3; P<.001). Compared to former smokers, current smokers also had higher adjusted HRs for these outcomes.

"The PAR percentage for current versus former and never smokers combined was 24.3 percent for overall mortality, 25.3 percent for major cardiovascular disease, 30.6 percent for non-AIDS cancer, and 25.4 percent for bacterial pneumonia," the authors concluded. "Smoking contributes to substantial morbidity and mortality in this HIV-infected population. Providers should routinely integrate smoking cessation programs into HIV health care."

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.


TOGETHER WE REMAIN STRONG!

Ten Years Fighting HIV/AIDS and Reaching Out to Gays

When a Cuban project to prevent HIV among men who have sex with men began 10 years ago, it was breaking new territory. MSM in Cuba were socially marginalized at the time of its first HIV/AIDS diagnosis in 1986, and the island's compulsory quarantine of those infected lasted into the early 1990s. Among other challenges, reaching MSM required overcoming years of state-sponsored homophobia.

"Although homosexuality had been mentioned before, up to that point no work had been done with men," said Raúl Regueiro, co-founder of the MSM-Cuba program.

"It was the first time the people most affected by HIV/AIDS participated in a program that was focused on educating people and on other aspects as well," said Regueiro, who works with the UN Development Program on HIV in Cuba. "By using peer education as a tool, [MSM] themselves urged each other to practice safe sex."

Of Cuba's 13,000 recorded HIV cases, eight in 10 are men. Of these men, over 80 percent are MSM, including 60 percent who are bisexual.

Today, the national MSM-Cuba program has 1,700 volunteer outreach workers in 14 provinces. It also has contributed significantly to research on sexual minorities. A 2006 study estimated the project had prevented about 3,000 infections among men. Though the rate of consistent condom use was still below 75 percent in 2003, studies in 2006 and 2009 found an increase in MSM's condom use with regular and casual partners. In addition, researchers are seeing a trend toward MSM living with stable partners.

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.


TOGETHER WE REMAIN STRONG!

Interventions for Young People in Australia to Reduce HIV and Sexually Transmitted Infections: A Systematic Review

The current study comprises a review of intervention programs that aim to reduce the burden of HIV and other STIs among young people in Australia.

After identifying articles from seven databases, the team reviewed intervention studies set in Australia and involving persons ages 12 to 25. They then developed a two-dimensional matrix consisting of "setting" and "intervention type" to categorize each study.

Most of the 42 studies that met the inclusion criteria were uncontrolled intervention studies. Twenty-three of the studies measured participation in chlamydia ± other STI testing; the highest participation rates were found in non-clinical and non-general practice health care settings. Four studies facilitated access to testing indirectly through the Internet or other media. Ten involved the provision of education and measured its impact on factors such as knowledge, attitudes and/or behavior. Three involved novel immunization strategies for either hepatitis B vaccine or human papillomavirus vaccine. Two studies assessed the impact of enhanced STI surveillance programs on STI prevalence rates.

"Proactive STI testing in non-clinical and some health care settings appears feasible and achieves higher testing rates than in general practice; however, more evaluation of testing strategies in general practice settings is required," the authors concluded. "New technologies such as the Internet and [Short Message Service] are useful adjuncts for influencing behaviors such as condom use and STI testing. Media campaigns that promote STI testing can have a positive impact on testing rates."

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.


TOGETHER WE REMAIN STRONG!

Belgian Archbishop's AIDS Comments Spark National Fury

Archbishop Andre-Joseph Leonard, head of the Belgian Roman Catholic Church, called a press conference Friday following outrage over remarks he made that AIDS is "sort of inherent justice."

In a recently published book, Leonard said he understood from numerous scientific papers that "AIDS at the beginning multiplied through sexual behavior with all sorts of partners or else through anal rather than vaginal sexual rapports." In the book, a Dutch translation of a 2006 book in French that already caused uproar, he rejects the notion that AIDS is "a punishment from God," instead "this epidemic is sort of intrinsic justice, not at all a punishment."

"All I'm saying is that sometimes there are consequences linked to our actions," said the archbishop. "I believe this is a totally decent, honorable and respectable stance."

Leonard assumed leadership of the Belgian Catholic Church from the Bishop of Bruges, who resigned in April after admitting sexual abuse. Just weeks ago, a church commission revealed nearly 500 cases of abuse by priests since the 1950s, including 13 victims who committed suicide.

At the press conference, Leonard said "HIV carriers merit respect" and "must not suffer discrimination."

HIV activists, gay advocates, and political party operatives quickly denounced Leonard's remarks. "It is unacceptable to say that people who are HIV-positive merited it," said Thierry Martin, head of the anti-AIDS group Prevention SIDA.

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.


TOGETHER WE REMAIN STRONG!

New HIV Cases Top One Thousand Again in Australia

New diagnoses of HIV in Australia reached 1,050 in 2009, the continuation of a decade-long climb and the highest figure in almost two decades.

"It's fair to say over the last decade there was a substantial increase and we are starting to stabilize out, just recently," said Dr. David Wilson, of the National Center in HIV Epidemiology and Clinical Research.

The climb in HIV diagnoses comes amid mixed success in addressing other STDs. Chlamydia diagnoses rose 4 percent in 2009 to 62,613. At the same time, rates of gonorrhea and syphilis improved as did the incidence of hepatitis C. Among those 15 to 19 years of age, a drop in injecting drug use is credited with lowering cases of hepatitis C by 80 percent in the last five years.

Wilson attributed the rise in HIV diagnoses to the fact that improved treatment has made the disease "not as scary as it was in the 1980s." While HIV diagnoses are increasing, mortality from HIV has declined since the 1990s. In 2009, nine deaths in Australia were attributed to AIDS, down from 26 in 2008. "We are in an era where we are seeing the lowest deaths associated with HIV than we have seen in history," Wilson said.

About 25 percent of the HIV-positive population is 55 or older, compared to 2.5 percent in 1985 and the 44 percent expected in 10 years, Wilson 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.


TOGETHER WE REMAIN STRONG!

Fighting HIV Among Inmates

The National Institutes of Health (NIH) is funding its first initiative to fight HIV in correctional facilities with $50 million in grants over the next five years.

The research grants, awarded by the NIH's National Institute on Drug Abuse (NIDA), will be distributed to organizations in several states, including Illinois.

"If you don't tackle these hard-to-reach populations, there's enough of them to sustain the epidemic," said Dr. Jacques Normand, director of NIDA's AIDS research program.

In Illinois, $7 million will cover three main initiatives: revamping HIV testing in prisons, examining the use of telemedicine for HIV-positive inmates, and keeping closer ties with HIV-positive inmates once they leave prison. Illinois prison officials will use the grant money to establish routine HIV testing on those entering the system unless an inmate opts out. Cook County Jail will switch to an opt-out approach this month.

The switch to routine testing is consistent with CDC guidelines and is expected to slash the number of inmates who are unaware of their HIV status, said Dr. Jeremy Young, an infectious-disease specialist with the University of Illinois at Chicago (UIC) and one of three lead investigators on the project.

In the telemedicine research project, investigators will examine a two-month-old pilot project involving UIC and the Illinois Department of Corrections. While a nurse is in the room with a patient, an HIV specialist examines the patient with the help of a camera and remote stethoscope. "It's basically just like a live visit," Young said.

To help keep track of HIV-positive inmates when they leave prison, the grant provides for additional case managers who help inmates secure mental health services, drug counseling, and participation in the state's AIDS Drug Assistance Program.

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.


TOGETHER WE REMAIN STRONG!

1 in 22 Blacks Will Get HIV, CDC Report Says

A new CDC report estimating the lifetime risk of HIV diagnosis for several populations found great disparities by racial/ethnic groups. Based on HIV surveillance, vital statistics, and census data from 37 states and Puerto Rico for 2007, an estimated 4.65 percent of blacks/African Americans would receive an HIV diagnosis during their lifetime, or 1 in 22, according to the new report.

The 1 in 22 risk was more than twice the estimated lifetime risk of HIV diagnosis for Hispanics/Latinos (1.92 percent, or 1 in 52) and eight times that of whites (0.59 percent, or 1 in 170), the report found.

The estimates of lifetime risk of HIV diagnosis are not representative of all HIV diagnoses in the United States. However, the data also were not considered unusual. A report published in 2008 found a similar high estimated lifetime risk of HIV diagnosis for blacks.

The new report, "Estimated Lifetime Risk for Diagnosis of HIV Infection Among Hispanics/Latinos - 37 States and Puerto Rico, 2007," was published in Morbidity and Mortality Weekly Report (2010;59(40):1297-1301).

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.


TOGETHER WE REMAIN STRONG!

Findings in HIV/AIDS Reported from M. Tagliamonte and co-researchers

Researchers detail in 'Constitutive expression of HIV-VLPs in stably transfected insect cell line for efficient delivery system,' new data in HIV/AIDS. "We have previously developed HIV-1 Pr55gag-based virus-like particles (HIV-VLPs) as presentation and delivery model using a transient Baculovirus expression system. Here we describe the establishment and characterization of stably transfected insect cell line for the constitutive and reproducible production of HIV-VLPs," researchers in Naples, Italy report.

"The persistence of HIV gag coding gene has been verified in clonal resistant insect cells and the protein expression has been confirmed by Western blot analysis. The resulting HIV-VLPs have been evaluated by standard transmission electron microscopy and their immunogenicity has been evaluated in vivo. Our results demonstrate that this strategy is highly efficient for constitutive expression of conformational enveloped VLPs which can be employed as presentation and delivery system for pathogen as well as tumor-associated antigens," wrote M. Tagliamonte and colleagues.

The researchers concluded: "This represents, to our knowledge, the first example of stably transfected insect cell line for the constitutive production of VLPs."

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.


TOGETHER WE REMAIN STRONG!

HIV Infects Porn Film Performer

An active adult-film performer working in the San Fernando Valley recently tested HIV-positive, a clinic that primarily serves the industry confirmed on Tuesday. It is the second HIV infection hitting the lucrative industry in about a year, renewing calls by AIDS advocates for state officials to mandate condom use on porn sets.

While the Sherman Oaks-based Adult Industry Medical Healthcare Foundation (AIM) declined to disclose the video companies involved with the new HIV case, at least two temporarily suspended production as a precaution: Vivid Entertainment and Wicked Pictures.

"We are quarantining and testing all exposed partners to the individual," said Jennifer Miller, an HIV/STD counselor for AIM. "We're doing what we can to notify the individuals involved."

"We did this as a precaution and will continue to monitor the situation," said Steven Hirsch, founder and co-chair of Van Nuys-based Vivid. Canoga Park-based Wicked Pictures, which describes its productions as "condom mandatory," said it halted filming to allow AIM to create a "comprehensive quarantine list."

Los Angeles County health officials said they have not yet received notification from AIM, but the clinic is required to report new HIV cases within seven days. The state Division of Occupational Safety and Health (Cal/OSHA) said on Tuesday that AIM had yet to notify them of a performer testing HIV-positive.

When Cal/OSHA attempted to follow up on reports of an adult-film performer testing HIV-positive last year, the performer filed a restraining order in Alameda County Superior Court barring AIM from releasing information to officials. That case is pending, said Amy Martin, Cal/OSHA's chief counsel.

"We're being stymied right now," said Martin. "We believe it's critically important that we be able to pursue this for the health and safety of the workers."

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.


TOGETHER WE REMAIN STRONG!

Reducing HIV Risk Behavior of Men Who Have Sex with Men Through Persuasive Computing: Results of the Men's INTernet Study-II

In the United States and similar countries, men who have sex with men (MSM) continue to be the group at highest risk of HIV/AIDS. "As the Internet becomes popular for seeking sex, online interventions to reduce sexual risk are critical," noted the authors, who undertook the current study to develop and test a highly interactive Internet-based HIV prevention intervention for MSM. A secondary objective was to demonstrate that good retention is possible in online trials.

The study was designed as a randomized controlled trial with three-, six-, nine-, and 12-month follow-up. In the research, which was conducted in 2008, 650 participants were randomized to an online, interactive risk reduction intervention or to a waitlist null control group.

During the 12-month period, retention was 76 percent to 89 percent. Compared to the control group at three-month follow-up, the intervention group showed a 16 percent reduction in reported unprotected anal intercourse (95 percent confidence interval [CI] of rate ratio: 0.70-1.01). No meaningful differences were noted at 12-month follow-up.

"Internet-based, persuasive computing programs hold promise as an effective new approach to HIV prevention for MSM, at least in the short term," the authors concluded. "Further, online trials can be conducted with acceptable retention provided strong retention protocols are employed. Four directions for future research are identified."

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.


TOGETHER WE REMAIN STRONG!

Condom Negotiation Strategies and Actual Condom Use Among Latino Youth

Determining which condom negotiation strategies are effective in obtaining, or avoiding, condom use among Latino youths was the goal of the current study.

The subjects - 694 Latino youths, ages 16 to 22, 61 percent female - were interviewed about condom negotiation strategies, perceptions of whether their partner wanted to use condoms, and actual condom use. Three strategies to obtain condom use - risk information, direct verbal/nonverbal communication, and insisting - were examined, as were four strategies for avoiding condom use - emotional coercion, ignoring condom use, disliking condoms, and seduction. Multiple linear regression was used to analyze the data, which included 574 youths who said they wanted to use or avoid using condoms.

Nearly 60 percent of the youths reported they wanted to use condoms, and nearly all these employed some strategy to obtain condom use. Compared to young women, young men who said they wanted to use condoms were more likely to do so. Risk information and direct verbal/nonverbal communication were effective strategies for obtaining condom use, even among youths who perceived their partners did not want to use condoms. Ignoring condom use was an effective avoidance strategy, even when youths thought their partners wanted to use condoms. In an unexpected finding, young men who expressed disliking condoms had higher condom use rates than young men not using this avoidance strategy.

"This research identified condom negotiation strategies that are effective among Latino youth, even when they believe their partners do not want to use condoms," the authors concluded. "Health care providers could encourage Latino youth to use such condom negotiation strategies."

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.


TOGETHER WE REMAIN STRONG!

China Court Hears First HIV Discrimination Suit

China's first suit challenging HIV-related employment discrimination was heard in court on Wednesday. The suit was brought by a man who alleges that, after he had passed written tests and interviews, he was denied a teaching position because medical screening had revealed he is HIV-positive.

"We're quite optimistic about this case . because this is the first case related to HIV and guaranteeing employment rights," lawyer Li Fangping said. The plaintiff, a recent college graduate who is identified in the suit by an alias, is asking the education department to award him the position.

"If we lose the lawsuit, then the very authority of the Employment Promotion Law will be challenged because it contains a clear rule that (employers) cannot violate a person's employment rights because he or she carries a disease," the attorney said.

The education department had justified the decision to deny the position "with the interests of the students and public in mind," Li said. The suit was brought against the department in Anqing city in the eastern province of Anhui.

The case comes at a time when heavy HIV/AIDS stigma in China shows small signs of abating. There is still significant discrimination against HIV-positive residents in the country in the areas of employment, education, and health care, however.

The official count of those with HIV in China is about 740,000, though activists put the number at much more than that. UNAIDS chief Michel Sidibe has estimated that some 50 million people in the country are at risk of HIV, mainly through unprotected sex or sharing needles.

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.


TOGETHER WE REMAIN STRONG!

HIV Drug Program in Peril

The Texas HIV Medication Program, which provides antiretroviral drugs and other life-saving medication to about 15,000 low-income residents, is facing a $23 million shortfall in the next two years, officials said.

Absent full funding of the program, officials are considering enrollment caps, stricter eligibility or dropping some drugs from the formulary. At the same time, some state officials note that effective HIV management can forestall even greater public outlays.

"I hope we don't cut people's medicines off and things like that. That could be a long-term, bigger cost if we cut that," said Jim Pitts (R-Waxahachie), the House's chief budget writer.

The medication program, which was founded in 1987, is at record enrollment. Rising unemployment, more widespread HIV testing, and the efficacy of antiretrovirals explain the growth, said Dwayne Haught, program manager of the Department of State Health Services.

"People are coming on the program and they're staying for much longer," Haught said. Almost 20 percent of enrollees have been in the program for at least 10 years, he said.

With pharmaceutical manufacturers' subsidies, Texas spends between $5,000 and $8,000 per year to sustain an enrollee on its AIDS Drug Assistance Program, the larger of the two components of the medication program. The smaller program, the State Pharmaceutical Assistance Program, serves about 1,300 people and is limited to those who are enrolled in a Medicare Part D prescription plan.

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.


TOGETHER WE REMAIN STRONG!

Call Out for Regular HIV Testing

A local non-profit AIDS service organization is offering rapid, anonymous HIV testing to encourage residents to find out their status. The services are part of an AIDS Committee of Guelph and Wellington County (ACGWC) campaign to promote regular testing among those who have engaged in higher-risk activities.

"Nearly 30 percent of people living with HIV in Ontario don't know they have the virus," the group said.

Since Oct. 6, ACGWC has offered the rapid tests at its offices on a drop-in basis. HIV testing also is available by appointment at Guelph's Sexual Health Clinic. The campaign includes advertising throughout the area, as well as digital messages in 17 Guelph bars and restaurants. Campaign messages also are on Facebook and Twitter.

"We're hoping that once people realize how easy it is to get tested, and how much support is available, more people will make testing a priority," campaign organizer Megan DePutter said in a press release. "If you test negative, you can rest your mind at ease but also obtain strategies to keep yourself safe," said DePutter, the group's prevention coordinator. "If you test positive, you can access life-saving medication, financial assistance and free, confidential support that can help you live well with the disease," she said.

More information about the campaign is available by calling 519-763-2255.

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.


TOGETHER WE REMAIN STRONG!

Why HIV-Specific Sex Laws Are Wrong

More than thirty states in the USA now have laws, specifically applicable to HIV alone and not other diseases. Many go so far as to make it a crime for people who know they are HIV-positive to have sex with others without telling their partners what their status is. Actual transmission of the virus is not required for a conviction.

It's perfectly simple, the proponents say, you can prevent transmission of HIV by sending people who kiss but don't tell to jail! It's not perfectly simple. Criminalization is ineffective and unconstitutional, and there was a time when state legislatures wouldn't pass laws of this kind. They do today, though. Here are five reasons why we can't allow this to become "the new normal" in American law:


- Criminalization does not prevent transmission.
Disclosure laws don't and can't work because so many people don't know their status or aren't comfortable talking about it. Effective prevention comes with using condoms and taking meds faithfully so virtually no live virus is found in the HIV-positive partner's blood and body fluids. Tax dollars are scarce, especially in this economy, so it's hard to justify spending them on law enforcement programs that only succeed in invading privacy and violating human rights.

- Criminalization actually increases transmission, by making people afraid to get tested.
People who know their HIV status can take steps to protect themselves and others - like starting treatment with HAART drugs and using a condom every time. Disclosure laws make that life-saving knowledge an element of a crime. Would you get tested if knowing your status could get you jail time?

- Nearly every prosecution to date has involved alcohol or drug use.
Individual substance abuse is a medical problem. So if you seriously want to modify the "offender's" behavior, not just punish someone for being different from you, send her or him to the nearest clinic, not the county jail. If you want to change group behavior, start with your nearest dating bar's "shots and a one-night stand" culture. A bar in Boston used to have a banner across the room saying, Friends don't let friends f--- drunk. It wasn't refined, but it made its point.

- It isn't always clear who is the "offender" in these cases - or even whether there is only one "offender."
It's the responsibility of both partners to ask each other, What's your status? Mine is... - and to use common sense in choosing whether to believe what they hear. If you're with someone you don't know all that well and the object of your passion says, Oh, of course not, not me, sometimes the best response is, I'm so happy for you! Now here's the condom, dear, peel open the package and let's put it on.

SOURCE: NAPWA - Positive Source Newsletter, Series 2 Volume 1 Issue 13


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.


TOGETHER WE REMAIN STRONG!

HIV Numbers Put Disease in Perspective

CDC's recent report that 53 percent of HIV-positive Chicago men who have sex with men are unaware of their infection - compared to 44 percent of infected MSM nationally - brought strong reactions from local HIV/AIDS advocates and service providers.

Thirty years into the epidemic, MSM continue to suffer the highest infection rates of any US population, more than half of all new HIV infections each year. The AIDS Foundation of Chicago's Jim Pickett, who was involved in drafting the recently released National HIV/AIDS Strategy, said, "For once, we have clear direction that gay men and MSM need to be prioritized. The resources need to follow the epidemic."

But while the strategy's goals of reducing HIV incidence, increasing access to care, and minimizing HIV-related health disparities are laudable, no distinct funding was set aside. "We cannot provide care in the absence of funding," said Pickett.

Olivia Sanchez, executive director of Project VIDA, said prevention efforts have stalled in part because HIV/AIDS is seen as treatable. "Young adults that hear about it don't see it as a disease that can kill people," contributing to unsafe sexual practices, she said.

"We're seeing complacency, particularly in lax prevention practices," said Dr. Renslow Sherer, co-founder of Chicago's first HIV/AIDS clinic at Cook County Hospital in 1983. "What one generation understood well is not being well-communicated to young people." However, he noted, "The good side of complacency is widespread acceptance. Some of the stigma [associated with being HIV-positive] is reduced. But I think it's terrible when that translates to lax personal behavior."

"It's not just about young people," Pickett said. "It's natural that we can't maintain a crisis mentality for 30 years." Providers need to work at better communicating a complicated message: "It's not as scary as it used to be, but you still don't want it."

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.


TOGETHER WE REMAIN STRONG!

Baltimore Leads in HIV Infection in Gay Men

CDC's recently released study involving men who have sex with men in 21 US cities found the proportion who were HIV-positive was greatest in Baltimore. In all, 38 percent of the about 500 MSM surveyed in Baltimore were infected. Of them, 73 percent were unaware of their infection, up from 62 percent in 2004-05.

While the survey findings are limited to men who frequent MSM-identified venues, local and federal officials say it is clear that testing and treatment lag for this most at-risk group.

"It's alarming, and it does point to the importance of ensuring access to HIV testing," said Jennifer Horvath, a CDC spokesperson.

The stigma against being gay remains strong, especially in black communities, said Richard Matens, Baltimore's assistant commissioner for chronic diseases. Stigma, a sense of invincibility, lack of health insurance, HIV fears - all are barriers to testing and treatment, said Collin Flynn, chief of the state's Center for HIV Surveillance.

Some people would rather admit injection drug use than homosexuality, Matens said. HIV interventions targeting injection drug users (IDUs) such as syringe-exchange programs have been effective in reducing the number of transmissions in Baltimore, he noted.

In 2008, the city had 200 new cases among IDUs, compared with 700 in 1994, Matens said. In 2001, MSM in Maryland trailed IDUs in new HIV cases. About six years ago, however, MSM surpassed IDUs in new cases.

The city has conducted focus groups in the gay community ahead of an awareness campaign, and it has chosen the Maryland Institute College of Art to create messages that resonate with MSM. Officials also do after-hours outreach in MSM clubs.

The high HIV rate is not likely to drop without more resources, said Heather Hauck, director of the state Infectious Disease and Environmental Health Administration.

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.


TOGETHER WE REMAIN STRONG!

Misconceptions of HIV Transmission - San Diego County HIV Educational Presentation

The Friends of AIDS Foundation invites you to attend “ Misconceptions of HIV Transmission”, an educational dinner presentation featuring Dr. Jorge Rodriguez, MD, Internal Medicine.

Dr. Rodriguez will host a direct and honest conversation about the misconceptions of HIV transmission.

Date: Wednesday, October 13th 2010

Time: 5:00 – 8:00pm

Location: The Center 3909 Centre Street San Diego, CA 92103

Other: Dinner will be served. Seating is limited. RSVP is Mandatory.

RSVP: Carolina Ramos (619) 692-2077 x 116

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.


TOGETHER WE REMAIN STRONG!

Understanding HIV's Infectious Grip

Australian scientists believe they know how HIV can establish itself in latent form in the human body, a mystery that has presented the foremost barrier to eradicating the virus by highly active antiretroviral therapy. The study proposes a mechanism through which HIV persists in latently infected resting CD4+ T cells.

"Once HIV gets into these cells, the virus can then go to sleep," said study co-author Sharon Lewin, director of The Alfred's Infectious Diseases Unit and co-head of the Burnet Institute's Center for Virology.

"These silently infected cells are not cleared by anti-HIV drugs or the immune system," Lewin said. "Once a patient stops the anti-HIV drugs, the virus can then wake up and get going again. Understanding this mechanism will enable new treatment options to be developed which could block latent infection."

"We have shown that a family of proteins, called chemokines, that guide the resting cells through the blood and into the lymph node tissue can 'unlock the door' and allow HIV to enter and set up a silent or latent infection," Lewin said.

In practice, the finding could help the development of potent new HIV treatments, possibly blocking latency while clearing active infection, Lewin said.

The global scientific community has "been working on HIV for close to 30 years, and it's really only now that we're beginning to see that a cure for HIV might be achievable and needs to be a major scientific priority," said Brendan Crabb, director of the institute.

The study, "Establishment of HIV-1 Latency in Resting CD4+ T Cells Depends on Chemokine-Induced Changes in the Actin Cytoskeleton," was published in the Proceedings of the National Academy of Science (2010;107(39):16934-16939).

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.


TOGETHER WE REMAIN STRONG!

Philippine Senators Scold Minister over Plan to Buy Condoms

To combat high birth rates in Philippine slums, the Health Ministry is seeking 400 million pesos (US $9 million) for condoms and other contraceptives. During testimony Wednesday at a public hearing about the 2011 national budget, Health Secretary Enrique Ona supported the plan and added that condoms could help prevent the spread of HIV.

After the hearing, however, top senators quickly criticized the proposal.

"If you want to use a condom, buy your own. Why let the government pay for it?" Vicente Sotto, senate majority leader, said after the hearing. "I will move for the [budget] cut of the contraceptives. All of it."

"I might have to cut that," said Juan Ponce Enrile, senate president. "I will cut family planning . condoms, pills, and injectable material. We will remove all of that." Instead, he said, the money should be used to support hospitals and disease control.

Last month, President Benigno Aquino said his government would provide contraceptives to poor couples who need them - prompting warnings from Roman Catholic officials. Bishops threatened street protests and suggested that Aquino, a practicing Catholic who took office in June after a landslide electoral victory, could be excommunicated.

Though the nation is 80 percent Catholic, an independent national survey in January found that up to 68 percent of voters want the government to provide all legal means of family planning. In 2010, the nation's population was 94.01 million, up from 76.5 million in the 2000 census.

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.


TOGETHER WE REMAIN STRONG!

Surge in Teenage Sex in Australia

A survey of Australian students in grades 10 and 12 reveals a surge in risky sexual behaviors over the past decade, while condom use has remained level. Students continue to report high awareness of HIV/AIDS. Knowledge of other STDs improved slightly during the time period.

"Rates of alcohol consumption among secondary students have increased markedly, as has the proportion of young people engaging in sex while under the influence of alcohol and drugs," said Paul Agius of Melbourne's La Trobe University.

"We also found that there is a marked increase in year 12 students having sex with multiple partners," Agius said. In 1997, one in five (19.6 percent) male 12th-graders reported three or more sex partners in the previous year; by 2008, that figure had nearly doubled (38.2 percent). Among female 12th-graders, the proportion reporting three or more sex partners in the past year also increased over the decade, from 12.9 percent to 27.2 percent.

HIV/AIDS awareness held steady over the study period. Young women reported having the highest overall awareness of the risks of unsafe sex, showing the need for public health campaigns targeting young men. "It is concerning that students appear to be better informed about HIV than either [STDs] or hepatitis, which are more common," Agius said.

In 1997, 71.1 percent of young men reported using a condom during their last sexual encounter; the 2008 figure was 70.9 percent. "Although consistent condom use remains moderately high, it is of some concern that condom use has not increased since 1997 despite related increases in sexual activity . and increased rates of [STDs]," said Agius.

Australia's teen pregnancy rate ranks among the highest in the developed world, and STDs among young people have risen in the past 10 years.

The study, "Sexual Behavior and Related Knowledge Among a Representative Sample of Secondary School Students Between 1997 and 2008," was published in the Australian and New Zealand Journal of Public Health (2010;34(5):476-481).

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.


TOGETHER WE REMAIN STRONG!

Report Addresses AIDS Health Care

The state's HIV/AIDS Minority Task Force has been holding statewide public comment sessions as it crafts its 2011 legislative agenda. During a recent stop in Springdale, the task force presented findings from the State Healthcare Access Research Project (SHARP) to an audience of about 40 HIV patients and providers of care and services.

Produced by Harvard Law School's Health, Law and Policy Clinic and the Treatment Access Expansion Project, the SHARP report has 22 recommendations for improving access to HIV/AIDS care in Arkansas. Reports have also been created for other, mostly Southern states. SHARP's recommends that Arkansas, among other suggestions:
*Provide state funding for its AIDS Drug Assistance Program. "Arkansas provides no state funding for HIV care, other than the state Medicaid match," the report states.
*Increase corporate taxes, even marginally. Over the last three decades, corporate taxes have declined from representing 31 percent of state general revenues to 6 percent.
*Increase Medicaid reimbursement rates. "Low reimbursement rates have greatly reduced Medicaid patients' access to qualified health care providers and specialists," it said.
*Establish "one-stop shops" for HIV medical and social services, which could also ease patients' travel burdens.
*Create a consumer office to incorporate patients' perspectives into state Department of Health daily operations.
*Improve coordination between STD surveillance and client services.
*Move daily surveillance tasks under the HIV/STD/Hepatitis C section chief, while leaving data analysis to technical experts in epidemiology and surveillance.

"Tax policies disproportionately burden low-income families, and state law makes it easier to increase regressive sales taxes than income taxes," the report notes. Nonetheless, the state's Medicaid eligibility income ceiling is one of the nation's lowest.

The task force presented the SHARP report to the General Assembly's Joint Public Health Committee earlier this year. Members plan to work with legislators on getting the Bureau of Legislative Research to evaluate the cost of prioritized policy recommendations, tailored to perhaps two to five bills.

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.


TOGETHER WE REMAIN STRONG!