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HIV Care Today


Is There a Future for HIV-Infected Patients in "Deep Salvage"?
By Nelson Vergel, B.S.Ch.E., M.B.A.
May 3, 2011

"Deep salvage patients no longer exist. The ones in that situation are already dead or have responded to the latest HIV antiretrovirals."

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A "New" Antiretroviral Option Quietly Enters the Market
By Paul E. Sax, M.D.
April 25, 2011

There's a new antiretroviral option out there, a 400-mg extended-release tablet formulation of nevirapine that can be dosed once daily.

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Organ Transplants From HIV-Infected Donors
By Paul E. Sax, M.D.
April 18, 2011

On the heels of last month's report of HIV transmission from an organ donor -- covered here in Journal Watch -- comes this remarkable article in The New York Times about lifting the ban on organ donation from donors known to be HIV positive.

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Where Are the Clinical Trials That Focus on HIV-Affected Women?
By Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.
April 12, 2011

As I look back over the recent past in HIV research, I am impressed at what advancements we have made, yet disturbed at what little we know and have done regarding HIV prevention and treatment in women.

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Journal Club: Even When You Think You Should Wait, It's Probably Time to Start
By Paul E. Sax, M.D.
April 8, 2011

Both apply to certain patients in whom we might consider waiting to start treatment -- but both these studies suggest we do otherwise.

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Tips From the Frontlines on Providing the Best Possible HIV Care for Women
By Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.
April 5, 2011

We marked U.S. National Women and Girls HIV/AIDS Awareness Day on March 10. The theme this year was "Now it's time for you to decide: What can you do?" Although the day is meant to raise awareness among the general population, and although it passed weeks ago, in my opinion we need to have that awareness every day as health care providers. We regularly see people in our HIV agencies/organizations that, if health education had reached them the way it should, would have never walked through the door in the first place.

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The Healing Power of Being Present
By David Fawcett, Ph.D., L.C.S.W.
March 29, 2011

When I was going through clinical supervision before licensure, my mentor pointed out that one's particular therapeutic modality, be it cognitive, behavioral, psychodynamic, Gestalt or whatever, is often not as important for good clinical results as simply being present with the patient. Because at that time I was very focused on mastery of particular skills, I was somewhat incredulous. But I have since come to understand that beneath good technique there is indeed a realm of energetic exchange with a patient that is often non-verbal and that has great power for healing. I call it being present at both physical and emotional levels.

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Friday Fosfomycins
By Paul E. Sax, M.D.
March 18, 2011


  • This HIV transmission from a kidney donor is getting quite a bit of media play, as such complications always do. I was at a meeting this AM when one of my colleagues (an endocrinologist) commented how horrible she thought it was. Yes ... but here's what I told her: the risk of some sort of infectious complication from transplantation, despite all our vigilance, no matter what tests we use, will never be zero. The only way to make transplants 100% safe is to stop doing them entirely. And that's not going to happen, nor should it.
  • Someone told me that CROI 2012 will be in Seattle "in late February." CROI trivia hounds will recall it was in Seattle in 2002, when we all learned the MTD (maximal tolerated dose) of caffeine. No confirmation on the date (naturally) from the CROI web site, so I wouldn't book your flights just yet.
  • Those of you who do inpatient ID consults will recognize some of the absurd dynamics in play in this animated (literally) conversation. It's an extreme example, but I confess I laughed out loud a few times anyway (sorry).
  • Friday Fosfomycins
  • Speaking of inpatient ID consults, I'm on service right now, and of course it's staph, staph, and more staph. (First-year ID fellows sometimes think they're doing a Staph aureus fellowship.) All this staph means I've had the opportunity to get some anecdotal experience with ceftaroline for MRSA. Since we learn in Statistics 101 that there's nothing less scientific than anecdotal (especially early anecdotal) evidence, I'll resist the impulse and see how things go for a bit longer, and will only say that the drug is tricky for home IV administration since it needs to be mixed up each day. Any other impressions out there?
  • Finally, for a pretty pessimistic view of the "test and treat" HIV strategy, here's a discouraging review of how few of the people living with HIV are actually engaged in care. By the estimates presented here, just under 20% of HIV-infected individuals in the United States have an undetectable HIV viral load. If the data are right, this figure says it all -- and regardless of whether there are 209,773 or 209,774 out of 1,106,400 with suppressed HIV, there's plenty of room for improvement.

Hat tip to the inimitable Rochelle Walensky for the video!

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What Lies Ahead: An Activist's View of Promising HIV Treatment Research
By Nelson Vergel, B.S.Ch.E., M.B.A.
March 17, 2011

We live in parallel worlds rife with contradictions. As we fear more and more budget cuts; AIDS Drug Assistance Program (ADAP) problems; slow, or lack of, global access to HIV medications; and other concerns that keep popping up when attempting to control this epidemic, there are rays of hope that emerge, and motivate many of us working in treatment and research advocacy to keep moving forward.

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Speaking of Sex: Creating a Safe Place for Open Discussion
By David Fawcett, Ph.D., L.C.S.W.
March 16, 2011

It is one of the great ironies of a sex-drenched culture that sex, if it is spoken of at all, is too often described with code words and cute metaphors or, in health care settings, sometimes barely mentioned. Both practitioners and patients can be reluctant to speak frankly and this can impact both the quality of health information, as well as good decisions about healthy sexual practices. Health care providers need to take an honest look at their ability to be comfortable with sexuality and discussions of sex.

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This article was provided by TheBodyPRO.com.
 

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