Easing the HIV burden

From The Advocate

By Jeremiah Johnson 

In recent years, two remarkable studies have emerged that provide real solutions for people living with HIV who want to avoid passing the virus on to others. In 2011 the HIV Prevention Trials Network’s 052 study provided evidence that when someone living with HIV takes their medications every day, the risk of transmission was reduced by 96% when the HIV-positive partner had a level of HIV in their blood that was “undetectable,” or so low that it can’t easily be measured.

HPTN 052 focused on heterosexual couples, so it was momentous when earlier this year the PARTNER study in Europe announced similarly optimistic preliminary results for gay men. In that study so far, no new infections occurred in gay couples where the HIV- positive partner had an undetectable viral load.

Having grappled with my own HIV diagnosis over the past seven years, there has been something deeply profound and very personal about the findings of both studies. Ever since the HPTN 052 results were released, I’ve often pondered if my transition into living life with HIV might have been less traumatic had I known that treatment would help me avoid passing HIV on to my sexual partners.

When I tested positive for HIV in 2008, I suddenly saw myself as a vector of disease, and I wondered if HIV would leave me isolated and alone. While I soon found that sex was still possible, the stigma and my uncertainties about the risk of transmission ensured that negotiating sex was always fraught with fear and worry. Although I consistently disclosed my HIV status to men I had sex with, I could never be certain how the person across from me might react. Too many times, disclosure of my HIV status was met with unexpected and deeply painful verbal abuse.

Continue reading on Advocate.com.

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26th World AIDS Day: Get in there, do something, change things

From Huffington Post…
by

red ribbonPre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) have successfully returned sexual health to the national and international headlines. Not since the early years of the HIV epidemic has there been so much constructive dialogue, progress, and involvement by the public.

Long-term survivors, HIV organizations, scientists, public-health experts, and the generation that never knew a world without HIV joined hands on the 26th World AIDS Day in an effort to educate and advocate in commemoration of those we have lost to HIV and the people living with the infection today.

While a few still wage a lonely and wasteful fight against science and progress itself, it is time to acknowledge that we finally have the opportunity to move on from a monotonous, one-way conversation and use these new tools as catalysts for serious and much-needed change.

Of course, it doesn’t help when one of our favorite Star Trek actors throws all logic overboard and simply dismisses today’s generation as lazy, complacent and irresponsible, but it certainly shows that we haven’t progressed much since President Reagan’s infamous call to abstinence 27 years ago.

Six of the estimated 39 million people we lost worldwide to HIV were my friends and mentors. All six would have agreed with Meryl Streep’s Margaret Thatcher when she says in The Iron Lady, [I]f something’s wrong, they shouldn’t just whine about it. They should get in there and do something about it. Change things.”

Keep reading on Huffington Post.

The Body’s “10 Moments in HIV Empowerment in 2014”

From TheBody.com

logo_notopicsIt’s more than 30 years into the HIV/AIDS epidemic, and around 35 million people are living with HIV/AIDS,according to the Joint United Nations Program on HIV/AIDS (UNAIDS). About 50,000 new infections per year happen in the U.S. — and black and Latino Americans are disproportionately affected. Men who have sex with men — especially those of color — have among the highest infection rates across the globe.

The elusive search for a “cure” and a preventive vaccine may succeed one day — but unfortunately it may not be soon enough to help the millions of people living with HIV/AIDS today. But despite significant obstacles, there are some reasons for celebration this World AIDS Day. Here is our look at “10 Moments in HIV Empowerment in 2014.”

Read the 10 moments in HIV Empowerment on The Body

Pitt research shows low cholesterol in immune cells slows HIV progression

by Bill Buchanan, Pitt Men’s Study Clinic Coordinator

For decades we’ve wondered why some people don’t progress to AIDS as quickly as others. Now we’ve discovered at least one of the reasons, and you “non-progressors” out there can thank your parents. As for everyone else, this might turn into a new and innovative way to control HIV.

Pitt Men’s Study researchers looked at 30 years of data and samples provided by Study volunteers and studied dendritic cells and B cells, both important components of our immune systems. Those men who progressed slowly had dendritic cells and B cells that contain less cholesterol than the cells of men who progressed more quickly.

That’s right, low levels of cholesterol in the membranes of these cells is protective against HIV. Why? HIV needs cholesterol to transmit from one cell to another. If the transmission of HIV between cells is slowed down because there’s not enough cholesterol in the immune cells, the virus can’t multiply as quickly; and if the virus is not multiplying quickly, it can’t hurt one’s immune system as quickly. This study also indicated that this could be an inherited trait, since it was also observed using cells that were stored in the Pitt Men’s Study freezers before these volunteers become infected with HIV.

Dendritic cells are particularly crucial for HIV multiplying in our bodies because they pass the virus on to our T cells, the cells that are most responsible for viral replication. For most people today, taking highly active antiretroviral therapy interrupts viral replication and halts progression to AIDS. But now we know why some people progressed to AIDS more slowly than others without using HIV meds.

“We’ve known for two decades that some people don’t have the dramatic loss in their T cells and progression to AIDS that you’d expect without drug therapy,” said lead author Giovanna Rappocciolo, Ph.D., an assistant professor at Pitt’s Graduate School of Public Health. “Instead the disease is much slower to progress, and we believe low cholesterol in dendritic cells may be a reason.”

“We couldn’t have made this discovery without the dedication of our volunteers. Results like ours are the real pay-off of the past three decades of meticulous data and specimen collection,” said senior author Charles Rinaldo, Ph.D., chairman of Pitt’s Department of Infectious Diseases and Microbiology, and principal investigator of the Pitt Men’s Study.

This discovery was featured in the April 29, 2014 edition of mBio, the journal of the American Society for Microbiology.

IMPORTANT DISCLAIMER: The cholesterol discussed above is not the same as the cholesterol measured in routine blood tests. In fact, our study’s non-progressors had similar levels of blood cholesterol as the progressors did. Notably, we used statins to treat dendritic cells and B cells from HIV negative men in the study’s lab (in vitro), and this lowered the cholesterol in their membranes and shut down HIV transmission. However, we do not know if ingesting statins will have the same effect in people (in vivo) and do not endorse anyone relying on their blood cholesterol results or their use of statins to determine their HIV treatment.

 

Are long-acting HIV medications the key to better adherence?

By Mathew Rodriguez

If you haven’t heard of “GSK744,” it has the potential to become the first HIV medication that need only be taken once a month.

GSK744 (short for S/GSK1265744) is an investigational integrase inhibitor; it is a long-acting version of the U.S. FDA-approved HIV medication Tivicay (dolutegravir). What’s the big difference? Well, this new drug is being developed specifically to have a very long “half-life,” which refers to the time it takes to break down inside the body — GSK744 takes a lot longer to break down in the body than currently approved HIV meds. As a result, early studies suggest that — although the drug will need to be injected by a clinician — it may only need to be taken once every 30 days, or even longer.

The idea is that therapies like GSK744 could address adherence concerns because the regimen is only once-a-month instead of once-a-day, and the treatment would be administered and directly observed by a health care professional. (It’s also being investigated for possible use in pre-exposure prophylaxis for the same reason.)

That said, when it comes to adherence, what works for some will not work for others. Taking a daily pill gives some people the freedom to make their own travel schedules, to take their medication on their own terms and in comfortable settings. Some people won’t want to go to their doctor (and pay to see the doctor!) every month to get their medication, while some people may struggle with taking a daily reminder of their HIV status and might welcome a less-frequent dose.

Research on this drug — as well as other ones like it — is still in its early stages, and even if further studies prove successful, it will likely be years before any long-acting antiretrovirals are approved by the U.S. Food and Drug Administration. But still, excitement about long-acting regimens is on the rise. What do you think? Would you take advantage of long-acting injectables? Or do you prefer to take your medications on your own time in pill form? What would make you switch?

 

How Yoga helped me choose to live with HIV, instead of dying of AIDS

Alexander Smith explains his own viral mindfulness and how doing yoga’s corpse pose helped him appreciate his own life (from HIVplusmag.com) …

Alexander Smith
Alexander Smith

Difficult poses (asana) are expected in life and on the yoga mat. Hatha yoga is a style of yoga common in the West that focuses on poses and breathing. As we pose, we learn to sit with the pain and discomfort that arises in our bodies, and we become aware of the suffering in our minds that is attached to our thoughts and story. In a place of discomfort, we often let go of the breath (pranayama), which is there to strengthen and sustain us.

It is taught that shavasana — best known as the corpse pose or dead man’s pose — is the most difficult of all the poses. To assume the posture, lie down on your back, allow your feet to fall outward, rest your arms at your sides with palms facing upward, and let your breath follow its inherent inhaling and exhaling pattern. At the end of our practice we traditionally assume this pose. In the giant metaphor of sitting like a corpse, we have an empty space to release all effort in mind and body. Do nothing. Completely surrender. And experience the sweet spot of shavasana.

Yoga, meditation, and mindfulness drive us toward a strength that rises when we surrender everything. It reminds us that the happiness we seek is already here.

At the end of summer a couple of years ago I posed in my own version of a dead man. Facing the fact that my strain of HIV had mutated and developed a resistance to my current cocktail of antiretrovirals, I stood at a crossroads. After a decade I could stop taking pills and lean toward my own corpse pose. Set down the worry and frustration and struggle I experience in posing with this virus. Develop AIDS, catch an opportunistic infection or two, and be dead within a year.

As I surrendered in this pose I noticed that by focusing so much on my death I had distracted myself from stories of life. In a place of complete honesty and reproach, I made a decision to build me a life. I recommitted myself to regular practice of meditation and yoga — with compassion — and I started by cleaning my entire house, doing the laundry and dishes, feeding my body, and taking my medications.

When I checked the online schedule of yoga classes I saw a picture of a beautiful man and yogi. Posing. I recognized him from years earlier. We had shared a neutral greeting when I attended a class at his studio in Laguna Beach, Calif. I was super excited to think he would be teaching class that day. Perhaps he is my future husband, I thought hopefully. When I looked deeper for class details I realized the picture was in honor and memory of his life. My future husband was dead, but somehow I found comfort in the eerie coincidence — and I marveled at the beauty and strength in his pose.

Continue reading on HIVplusmag.com

Web admin’s note: A beginner’s Hatha Yoga class is held at the Shepherd Wellness Community in Bloomfield every Thursday from 5:30 p.m. – 7:00 p.m. The class is not sponsored by Shepherd Wellness but it is in a confidential and safe environment.  Class participants are asked to contribute as they are able. Suggested donation is $10 per week. Participants are asked to wear loose fitting clothing, bring a mat and pillows for comfort and to come on an empty stomach. We practice mindful meditation and gentle stretching to strengthen our inner core and well being.  Accommodations are made for everyone regardless of abilities, including chair options.

 

 

 

Health Alert – getting a flu shot if you’re HIV +

Getting a flu shot is good advice for pretty much anyone. Even more so if you’re HIV positive.

For patients with HIV, the Centers for Disease Control and Prevention (CDC) recommends getting the flu shot instead of the live attenuated flu vaccine or “FluMist.” The flu shot is an inactivated vaccine (containing a killed virus) that’s given with a needle. FluMist contains a weakened form of the live flu virus and is only approved for use in people ages 2 to 49 with unimpaired immune systems. Preventing the flu is important for people with HIV/AIDS due to an increased risk from serious influenza-related complications. Studies have shown an increased risk for heart and lung-related hospitalizations in people infected with HIV during influenza season, as well as a higher risk of influenza-related deaths. Other studies have indicated that influenza symptoms might be prolonged for certain HIV-infected people. And, no, you can’t get the flu from the vaccination. For more information about HIV and influenza, go to the CDC Website.

You can find a place to get the flu shot here. You can also ask your doctor for additional options.

The next generation of HIV/AIDS awareness

by Dr. Perry Halkitis
Saturday Oct 19, 2013

In the early days of the AIDS epidemic, treatment options were limited at best. Most who were living with HIV/AIDS, the majority of whom were gay men, attempted to find and use treatments that would save their lives and control the virus from causing further physical deterioration. Sadly, most Americans were blind to the efforts of the AIDS generation, yet a discourse around these efforts is beginning to enter the mainstream consciousness of our society. David France has beautifully captured the efforts of ACT UP, the leading activist group that fought bravely for the development of treatments, in his 2013 Oscar-nominated documentary, “How to Survive a Plague.” In a new film to be released at the end of this year, Hollywood actor Matthew McConaughey portrays Ron Woodroof, an electrician from Dallas who worked with underground pharmacies to smuggle alternative treatments for himself and other afflicted with AIDS in what became known as the “Dallas Buyers Club.” It is within this backdrop that thousands of gay men of all races and ethnicities first found out that they were living with HIV in the United States. Until 1985, when the virus was identified, most who were infected lived in fear and apprehension, and were often very progressed in their disease by the time they were diagnosed. As a result, life expectancy was extremely short after diagnosis. For most who had developed full-blown AIDS, and in the absence of any effective treatments, life expectancy was a matter of years.

Close to 30 years later, the landscape of the epidemic has changed dramatically. Testing for HIV is now as simple as a rapid oral antibody test that can be administered at home with a kit one purchases from pharmacy. A vast array of effective antiretroviral treatments helps to keep the virus at bay. In fact, a young gay man who is diagnosed shortly after infection, and who uptakes a treatments regimen to which he consistently adheres, can by all calculation have a close to normal life expectancy. Yet despite these medical advances, HIV remains a stigmatized disease and some 200,000 Americans are living with the virus undiagnosed. The perpetuation of the AIDS epidemic among a new generation of young gay men is anathema, made all the worse by the fact that a subset of these men remain undiagnosed and that among those diagnosed only some 20 percent adhere to their treatments such that their virus is reduced to undetectable levels.

Read the full article on edgeonthenet.com

What is the impact of the baby cured of H.I.V.?

iStock_000015778315XSmallYou may have read in the news recently about the baby who was deemed cured of H.I.V. (if not, read about it here).

We asked the Pitt Men’s Study medical director, Dr. Ken Ho, what these finding might mean for the rest of us, particularly men in the PMS/MACS. Here is what he had to say:

As exciting as the results are, I don’t see this case having much clinical significance for the men in our study. Simply put, this infant was infected, started on very early treatment, and achieved a “functional cure.” I think it is more proof of concept how early treatment in a young infant can lead to eradication of the latent viral reservoir. Infants and adults are very different from an immunologic standpoint and I suspect have different reservoirs. If you start an adult on early treatment, suppress the viral load, and stop treatment, the virus will almost always ultimately rebound.

So while I believe in early initiation of antiretroviral therapy, it is not because I believe there is a potential for “cure.” If it can be determined that early treatment of perinatally infected infants results in the same outcome as seen here then yes, I believe this will change treatment of perinatally infected infants. But for now, I do not think this will impact clinical management of HIV positive men.

Not too late to get your yearly flu vaccine

From AIDS.gov:

NIVW_web-button_180x150_AABy Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

***

As daylight hours get shorter and temperatures are falling, we’re not only approaching winter but also flu season. While we can all find ways to enjoy the change of seasons, no one enjoys the flu — a contagious respiratory illness caused by flu viruses spread between people. Seasonal flu is a special concern if you are a person living with HIV (PLWH) since HIV can make your body too weak to fight off the flu. HIV also increases your risk for serious flu-related complications. Experts agree that getting the flu vaccine is the most effective way to prevent the flu.

CDC has designated this week as National Influenza Vaccination Awareness Week, so we encourage you to learn more about the seasonal flu and take steps to protect yourself. Here are some resources to help you:

Remember, it is not too late to get your yearly flu vaccine to protect against the flu viruses experts predict will spread this season. As long as flu viruses are spreading and causing illness, vaccination can provide protection against the flu.