Treasure Coast Area 15 “Ready for the March on Washington” “Keep the Promise”

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Teens make strides with HIV protection

Created on 30 July 2012 Category: North America HIV News

American kids are mostly doing a better job of protecting themselves from HIV, the virus that causes AIDS, according to a new study from the Centers for Disease Control and Prevention.

In particular, black high school students have dramatically reduced sexual behaviors that can lead to HIV infection over the past 20 years.

“This is good news, but we still have more work to do,” said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, speaking at AIDS 2012, an international conference of more than 21,000 researchers and organizers meeting this week in Washington. “The heavy burden of HIV in the United States is neither inevitable, nor is it acceptable.”

Key changes from 1991 to 2011 include:

• The proportion of American high school students who have ever had sex fell from 54 percent to 47 percent. Among blacks, the proportion who have ever had sex fell even more sharply, from 82 percent to 60 percent.

• The proportion of students who had sex within the past three months declined from 38 percent to 34 percent overall. Among blacks, that number fell from 59 percent to 41percent.

• Among sexually active students, the proportion who used a condom the last time they had sex increased from 46 percent to 60 percent. Among black students, that rate grew from 48 percent to 65 percent.

While these trends are positive, the report notes that most of these improvements were achieved by 2001 or 2003, with few gains since then.

Significantly, the number of new HIV infections — which has fallen sharply from the peak in the mid-1990s — also has hit a plateau over the past decade, at about 50,000 a year, Fenton said.

Meanwhile, the average age at which teens begin having sex — 16 — hasn’t changed in 20 years, said CDC’s Laura Kann.

HIV rates are skyrocketing among specific populations, such as gay black youth, according to other research presented at the conference. Nearly 6 percent of gay black men under 30 are newly infected with the AIDS virus each year, according to a study presented Monday, with one in four black gay men infected by age 25.

“That is unconscionable,” Fenton said.

The CDC closely tracks teen sexual behavior, using its National Youth Risk Behavior Survey, a biennial survey of students in grades 9 to 12. That’s important, Fenton says, because 40 percent of new HIV infections are in those under 30, with 19,000 Americans that age becoming infected each year.

“The USA AIDS epidemic is largely a young person’s epidemic,” Fenton said. “They will face a lifetime of medical treatment, emotional issues and health care costs.”

New CDC efforts to fight HIV include increased testing and studies of ways to engage community groups, such as churches and families, to reduce stigma and support gay teens.

“You can’t change everybody,” Fenton said. “But you can work with people who are ready.”

HIV self-test raises questions

 

Created on 30 July 2012 Category: North America HIV News

In just a few months, over-the-counter HIV tests will be shelved alongside cold medicines and skin creams at neighborhood pharmacies, with the FDA’s approval this month of Oraquick, the first ever rapid, in-home test for an infectious disease.

“Our hope in approving the product is that more people will be able to test themselves and find out their HIV status,” said Rita Chapelle of the FDA office of public affairs.

Joan Duggan, a physician at the University of Toledo Medical Center, the former Medical College of Ohio, is not convinced that Oraquick will make a dent in new infection rates.

“This test is a two-edged sword. It’s a great thing to have available, but we have to be careful. There’s a huge potential for misuse,” she said.

Thousands of health-care professionals, including Dr. Duggan have administered an identical version of the test since 2004.

She demonstrated how to perform the test, moving a flat plastic wand under her lips to swab her upper and lower gums. She placed the moistened stick in a vial of fluid that detects the presence of HIV antibodies, and then she set a timer. Oraquick’s digital reading reveals HIV status in about 20 minutes. One reddish stripe signifies a negative result. Two stripes mean the test is positive.

Currently about 1.2 million people in the United States are HIV-positive, but about one in five of them do not realize that they have the disease, according to the Centers for Disease Control. Often unknowingly infecting others with HIV, this population is disproportionately responsible for new HIV infections. Each year, about 50,000 people in the United States, or one every 10.5 minutes, contract HIV.

“If we want to end this epidemic, people have to know their HIV status and use the appropriate measures to stop transmission,” said Dr. Duggan. For now, that requires visiting a clinic, an uncomfortable step that many avoid.

Jerry Kerr, the HIV prevention coordinator for the Lucas County Department of Health, said, “I know there are people who don’t get tested because they don’t want to talk about the kind of things that come up during an HIV counseling session, such as risks they’ve been taking.

“Some people don’t want it written down anywhere that they even went for an HIV test. You hear horror stories, databases of people who are HIV-positive that are accidentally uncovered,” he said.

Although health-privacy laws closely protect a patient’s HIV test outcome, unreasonable fears that insurance companies or employers could obtain this information prevent some people from getting tested.

“There’s stigma associated with HIV testing,” said Tyler Andrew TerMeer, Director of the Ohio AIDS Coalition. People may speculate that a woman who enters a clinic has been sleeping around or a man who enters is a closeted member of the gay community, he explained.

He imagined that sex workers who are reluctant to discuss their illegal activities would prefer the privacy of an in-home test as well.

“I think there’s also a group of individuals who feel safety is an issue and worry their partner would find out and become violent if they walked into a clinic,” he said.

Beginning this fall, these individuals — who otherwise would not subject themselves to testing — can buy a discreetly labeled Oraquick kit at a price ranging between $18 and $60 at any of 30,000 retail stores, which include Walmart, CVS, and Rite Aid.

Preserving total anonymity, OraQuick reveals HIV status to the user alone. “But that’s a preliminary test result that could turn out to be a false negative or a false positive,” said Dr. Duggan.

Although the test is close to infallible when used by medical professionals, about 1 in 5,000 people using the test at home will get a false positive. An estimated one in 12 people who have HIV will receive a false negative.

Dr. Duggan said she worries in particular that Oraquick buyers will fail to understand that the body usually does not produce enough HIV antibodies for the test to detect until three months after infection.

Someone who takes the test right after contracting the disease would receive a negative result, giving him or her a false sense of security and possibly keeping him or her out of medical care longer.

During these first months, those with HIV are extremely contagious.

“No matter how many times I tell people that they have to wait a minimum of 90 days, they don’t understand that window period,” said Michelle Coutcher, a social worker who frequently administers Orasure’s rapid test at the University of Toledo Medical Center.

“People are going to run out and use the test, and it’s going to give them false hope,” she said.

Dr. Duggan imagined many people would buy the test in a panic after risky encounters. “People are going to wake up in someone else’s bed after a bender thinking ‘Why did I do that?’ and run out to get the test,” she said.

“It clearly is paramount that people understand the window period,” said Ron Ticho, Senior Vice President of corporate communications at OraSure Technologies, which manufactures Oraquick.

He said the company considered 32 variations of package labeling when deciding how best to communicate that critical message.

Even guaranteed correct test results, though, would not put an end to the potential problems faced by in-home users.

Ms. Coutcher worries how home users of HIV tests will react if the tests turn out positive.

“Who’s going to be there to tell you it’s going to be OK? Who’s going to link you to mental health services, medications, physicians, and make sure to confirm that this truly is a positive?”

With early treatment and proper care, though, people who are HIV-positive have nearly normal life expectancies.

“The challenge is we don’t have any mechanism in place for knowing they’ve tested positive and getting them into early care and treatment,” said Mr. TerMeer, adding that misinformation about HIV abounds.

Orasure will set up a 24/7 telephone hot line in English and Spanish where staffers who have received 160 hours of training will answer questions from OraQuick users.

They will provide counseling and use the CDC’s referral database to direct HIV positive toward care.

Mr. Kerr said he expected OraQuick, in a roundabout way, to prompt more people to seek help at his own clinic.

“When people decide whether they want to part with what could be up to $60, I think a lot of people will rethink it and come to our free rapid test sites,” he said.

“People will be seeing the test there in pharmacies as … a reminder. It’s going to create more awareness about HIV, and that’s always a good thing,” he said.

$80 million Grants Could Shorten Waiting Lists For AIDS Drugs

Created on 30 July 2012 Category: North America HIV News

The Obama administration last week announced nearly $80 million in grants to increase access to AIDS care across the United States. But will the money be enough to eliminate waiting lists for the AIDS Drug Assistance Program?

Advocates aren’t sure. The program, known as ADAP, provides a safety net for people with HIV who have no means of paying for the drugs they need to fight the virus.

For the past few years, ADAP demand has outpaced funding. Nationwide, 1,800 people are now on a waiting list, with Georgia and Virginia accounting for more than half of those cases. The latest national data are here.

Murray Penner, of the National Alliance of State and Territorial AIDS Directors, says it’s hard to tell if the new funding will be enough to handle states’ waitlists. He thinks they will disappear, but only for a year or two.

“It’s very difficult to predict these things, because there are so many variables that go into the serving of individuals that need medications,” Penner said.

James Lark is one of the people affected. Now 47 years old, Lark was 30 when he learned that he was HIV-positive. He has gone in and out of phases when he takes care of his condition.

“I’ve been positive now for over 17 years, but when I first found out I just went with it,” Lark says. “My brother had passed away with AIDS. I was dead within, and just kept living my life and wasn’t taking my life seriously.”

Three years ago, Lark was homeless when he decided it was time to get a handle on his health. He qualified for Georgia’s AIDS Drug Assistance Program, which paid for his HIV drugs — nearly $20,000 a year.

Lark is now on government assistance and doesn’t have to depend on ADAP. But he says his Social Security benefits will end in September.

“That means I’ll have to go back on ADAP. And I’ll be on the waiting list,” he says.

Funding, drug costs and the number of people seeking treatment are constantly changing. All of those variables affect how many people are on the waiting list.

For example, Georgia recently adopted a policy of treatment upon diagnosis. Research indicates that means a longer, better life for many with HIV. But it also adds to the cost of care in a state that can’t meet current demand.

The pharmacy at Atlanta’s Ponce De Leon Center provides drugs and other services for more than 5,200 HIV/AIDS patients. But with the potential for hundreds of new patients, the center’s Jacque Muther isn’t sure how they’ll accommodate them.

“It’s going to be a big challenge,” Muther says. “I don’t know how they’re going to meet it. This new money is not going to resolve that.”

Genetic study shows how HIV controllers get their groove

HIV

The vast majority of people who are infected with HIV go on to develop AIDS. Their bodies become riddled with the virus, their immune systems falter, and they are besieged by life-threatening infections. But not everyone shares the same fate. Around 1 in every 300 people infected with HIV carry genetic trump cards that allow them to resist and control the virus. These “HIV controllers” can live with the virus for years. They never develop AIDS and they live long, healthy lives, even if they never take any medication. Their genetic secrets are slowly being revealed.

Since 2006, a massive group of international scientists have been recruiting and studying a large group of HIV controllers from around the world as part of the International HIV Controllers Study. All of the recruits have been HIV-positive for 10 years. Despite that, the levels of the virus in their blood are around 50 times lower than expected and they have healthy levels of helper T cells, the immune cells that are normally hit by HIV.

Led by Florencia Pereyra, Xiaoming Jia and Paul McLaren, the team compared the genes of almost 1,000 controllers with those of over 2,600 people who haven’t been so lucky at subjugating the virus. After looking at over 1.3 million points around their genomes, the team found that just 313 separate the controllers from the other recruits.

Amazingly, every single one of these variants sits within a specific part of our sixth chromosome, among a set of genes called class I HLAgenes. The proteins they produce form part of the internal security checks that defend us from infections. They grab small pieces of other proteins from inside our cells and display them on the outside, waving them under the noses of passing T-cells. If the T-cells recognise these pieces as parts of bacteria, viruses or other foreign invaders, they tell the infected cell to self-destruct and set the immune system on red alert.

All of this depends on a single groove in the HLA proteins. This is the bit that embraces the pieces of other proteins and displays them so prominently to the immune system. If this groove isn’t structured correctly, our defenders don’t get an advanced warning about threats.

True enough, the team found that the groove of a single protein called HLA-B is especially important. At five positions in the groove, the HIV controllers have different amino acids than those whose disease progresses normally. These five amino acids aren’t the only things separating the controllers from the others, but they have a major impact. One of them – the one at position 97 – is “associated with the most extremes of viral load” depending on the… amino acid [there].”

The link between these amino acids and the control of HIV is also very consistent. Pereyra did her protein comparisons using only the Europeans in her study (who formed the largest proportion of the sample). However, the results held true when she focused on the African-American group, and when she repeated the comparison in an independent group of HIV-infected Swiss patients. Again, people with different amino acids at certain key spots in HLA-B  proteins were more likely to keep the virus at bay.

It’s still not clear how exactly these genetic variations alter the shape of the HLA proteins, and how these changes affect the ability to control HIV. Nonetheless, the international study is off to a promising start and perhaps, it will help to inspire future vaccines or treatments against this most frustrating of foes.

Reference: Science http://dx.doi.org/10.1126/science.1195271

March on Washington DC July 2012

Positive Mind & Body Support Group Network and members who attended the March on Washington DC .
We where so happy being apart of this historical day and kudos for those who attended and those who made event in their communities, in marking this day “Keep the Promise”  “Pass the Message”” Not the Disease”
We need more of PLWHA and the Affected being apart of an event like this now and until the day we say
The WAR on HIV IS OVER! 

MARCH ON WASHINGTON DC “KEEP THE PROMISE” JULY 2012