State Cuts Jails' HIV Programs

Due to federal funding reductions, Massachusetts has cut $1.25 million for HIV testing and education in county jails and houses of correction. Sheriffs warn the decision will eliminate HIV educator positions, curb HIV testing, and end the monitoring of inmates by infectious-disease experts. The cuts, effective July 1, will not affect state prisons.

“I’m very concerned,” said Thomas M. Hodgson, Bristol County’s sheriff. “We want them to be tested for HIV because they need to be aware if they have it, and, number two, how to manage it.”

The federal cuts are being phased in over five years, but already Massachusetts has slashed $2.3 million. That has led to the elimination of eight positions in the state HIV/AIDS office, HIV testing campaigns, and training for and some contracts with community-based service providers.

“The decision to reduce these services is driven by the loss of funding, not the quality of the services,” said Kevin Cranston, director of the state Bureau of Infectious Diseases.

Jails tended to have higher HIV-positive rates when injecting drug use was a more common route of infection, Cranston said, but new cases are increasingly seen among men who have sex with men. Public health officials are asking HIV prevention groups to provide outreach in jails; however, many of these providers are financially stressed themselves, he said.

In one instance, the HIV diagnosis of an inmate led public health officials to track down eight other HIV cases among his non-incarcerated contacts, said Matthew Robitaille, HIV coordinator for the Bristol County sheriff’s office, whose position likely will be eliminated.

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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Valley Tattoo Shops, Artists Face Inspections

A law requiring California counties to enforce new safety rules for tattoo and body piercing shops goes into effect July 1. Under the Safe Body Art Act, these businesses will be subject to public health permitting, inspections and standards. The law will impact nearly 200 shops in Fresno County alone.

Currently, tattooing and body piercing are unregulated in much of the state - meaning health inspectors do not ensure equipment is sterilized, shops are clean or practitioners are trained.

“This is long overdue,” said Dave Olvera, manager of Tower Tattoos in Fresno’s Tower District. “Fresno is known for its bad shops. There are people working out of their homes. I saw a tattoo shop operating out of a gas station.” A health certificate from the county would reassure customers that safety standards are in place, he said.

The law requires shops to obtain annual permits from county health departments. It also requires individual practitioners to register. As part of registration, practitioners must undergo training on blood-borne diseases, get vaccinated against hepatitis B, and have more than six months’ experience in their field.

Fresno County recently began mailing out notices about the law to known body art practitioners; however, health officials concede that others exist.

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 Digs Prove Prosperous for South Dallas HIV Agency

Abounding Prosperity has already begun HIV testing at its new location on Martin Luther King Jr. Boulevard in Dallas, though it has not yet held a grand opening. People who do not self-identify as gay are more likely to come to the new office for testing and prevention counseling, said Kirk Myers, AP’s executive director. The organization is in the first year of a five-year CDC grant to expand HIV testing, especially among black men ages 17-29 who have sex with men (MSM).

The new site is in the middle of the business district and easy to access. “Male sex workers, the previously incarcerated - all come here,” said Myers. The rate of those testing HIV-positive in the AP program is very high, 6.6 percent, and Myers believes many of the infections are not recent. “We’re just bringing testing to the area,” he said. The AP office across from AIDS Arms’ Peabody Clinic is still open, he added.

One of AP’s successful new programs is “Let’s Talk About Sex,” a group targeting young black MSM peer networks to encourage protected sex. “We pay one person to host a party,” Myers said. “He invites his friends, and we come in and do an educational party.” In “Chat and Chew” meetings, one for men and one for transgender women, groups of 12-15 people meet for a seven-week series and address issues such as spirituality, homophobia, family, and attitudes about HIV.

[PNU editor’s note: For more information, visit http://aboundingprosperity.org/.]

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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Sudden Cardiac Death Risk Higher in HIV Patients

Sudden cardiac death, which occurs when the heart unexpectedly stops, was second only to AIDS as a leading cause of death among HIV patients in a new 10-year study. The results indicate that even if their virus is under control and they appear relatively healthy, HIV-positive people are 4.5 times more likely to die of sudden cardiac arrest than HIV-negative individuals.

Among the study’s subjects - 2,860 HIV patients receiving treatment at San Francisco General Hospital’s (SFGH) HIV/AIDS ward from 2000 to 2009 - 230 died: 57 percent from AIDS, 13 percent from sudden cardiac death, 11 percent from other natural diseases, and 19 percent from suicides, overdoses or unknown causes. Eighty-six percent of the cardiac deaths occurred suddenly, compared to about half of all heart-related deaths in the general population.

Among those who suffered sudden cardiac death, more than half had a history of smoking, heavy drinking or drug use; 80 percent already had been diagnosed with heart disease or had one or more risk factors; and one-third reported symptoms like chest pain or shortness of breath at their last clinic visit. Their T-cells counts were only slightly below average for all study patients.

Half the patients for whom lab results were available had undetectable viral loads when they died, suggesting that HIV alone is not causing the heart problems, according to authors Dr. Zian Tseng, a University of California-San Francisco electrophysiologist, and Dr. Priscilla Hsue, director of the HIV Cardiology Clinic at SFGH, and colleagues. They noted that HIV causes inflammation that could affect the heart. In addition, some HIV drugs are known to interrupt the heart’s electrical activity.

Thanks to effective treatment, Hsue said some HIV patients who were initially reluctant to adopt healthier lifestyles now are thinking, “‘I could live another 25 years if I take care of myself.’ And I’m really hammering on stop smoking, take blood pressure medication, watch your cholesterol.”

[PNU editor’s note: The study, “Sudden Cardiac Death in Patients with Human Immunodeficiency Virus Infection,” was published in the Journal of the American College of Cardiology (2012;59:1891-1896).]

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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US HIV Aid Has Prevented 741,000 Deaths: Study

Some 741,000 deaths from any cause were averted in 12 African countries receiving aid from the US President’s Emergency Plan for AIDS Relief, a new study suggests. Previous research has shown PEPFAR-associated declines in AIDS, but it was unclear whether there were any changes in mortality for other illnesses, researchers said.

“There were concerns that there’s been this shift in physicians and nurses [toward HIV clinics] to the detriment of other public health concerns,” said lead author Dr. Eran Bendavid, an infectious-diseases specialist from Stanford University. “We can’t find evidence of unintended harms, or benefits. More or less we find that PEPFAR seems to have been very effective at reducing deaths, probably mostly HIV-specific deaths.”

The study found that in 2003, the year PEPFAR was created, eight to nine deaths occurred per 1,000 adults in 27 African countries, which included nine PEPFAR recipients. By 2008, deaths had declined to four of every 1,000 adults in PEPFAR countries and seven in 1,000 for non-PEPFAR countries. Data were based on surveys of adult women who were asked about recent deaths in their families.

Critics said the more than $20 billion spent on PEPFAR during 2003-2008 could have been spent more wisely, such as on preventing pneumonia and diarrhea.

“No one says that HIV [funding] isn’t making a big difference; the question is whether other things would make an even bigger difference,” said Dr. Ezekiel Emanuel, a medical ethicist from the University of Pennsylvania-Philadelphia. “You cannot escape the ‘How do we allocate the money?’ question when we don’t have enough.”

[PNU editor’s note: The study, “HIV Development Assistance and Adult Mortality in Africa,” was published in the Journal of the American Medical Association (2012;307(19):2060-2067).]

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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Sanders Bill Aims to Lower HIV Drug Costs

The US Senate subcommittee on Primary Health and Aging held a hearing Tuesday to discuss cost as a barrier to HIV treatment for Americans. A new bill would end drugmakers’ exclusive rights to market new HIV/AIDS drugs, instead granting the companies monetary rewards from the government.

AIDS patients are dying not because there is no effective treatment but rather because they cannot afford antiretroviral drugs, a situation the “average American would be very upset to know,” said Sen. Bernie Sanders (I-Vt.), the sponsor of S 1138. The HIV drug Atripla costs “more than $25,000 per person per year” in the United States, compared to a generic version going for $200, Sanders said.

Under the bill, those who won patents for new HIV/AIDS drugs would qualify for a federally funded award. The money would be a substitute for the profits that would otherwise accrue during the firm’s monopoly period, Sanders said. Panelists at the hearing estimated that S 1138 could reduce the price of HIV drugs by at least 90 percent.

“The bottom line is that the goal of our laws and policies for medicines must be to develop drugs as quickly as possible ... and to get them out to every person who needs them as soon as possible,” Sanders said, adding that the bill also would save money for federal and state health programs.

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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FDA Panel Backs OraSure's In-Home HIV Test

A panel of outside experts voted unanimously on Tuesday to recommend that the Food and Drug Administration approve OraSure Technologies Inc.’s OraQuick In-Home HIV Test. The 17-member FDA advisory committee said the benefits of people knowing their HIV status - and seeking treatment, if positive - outweigh the risks of false results.

If approved, OraQuick would be the first over-the-counter, at-home HIV test. OraSure said it will likely retail the test for less than $60.

Panel members called on the company to conduct post-marketing studies to ensure OraQuick is accessible by under-served populations in a way that links testers to services, including confirmatory follow-up for those who have a positive result. Some of the experts urged clear labeling about false results; another concern was linking consumers who phone OraQuick’s hotline with questions to health care professionals.

The panel heard supportive testimony from more than two-dozen witnesses including HIV/AIDS activists and representatives from the African-American community and public health. OraQuick could help eliminate HIV stigma, a key barrier to testing, by being available just like other home testing kits at a local pharmacy, they said. Some of those testifying received money or assistance from OraSure.

FDA officials said the test was highly effective at detecting HIV infection, but some data indicated OraQuick lacks sufficient sensitivity to avoid false-negative results. One witness called on the agency to withhold approval until additional studies can raise the test’s accuracy to a standard in line with clinical settings.

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!