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).
- 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!
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.
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.
The Risk and Rewards of Optimism
By David Fawcett, Ph.D., L.C.S.W.
March 10, 2011
"Smile, it can't be that bad!" My client Sam had just arrived in my office and was angry and upset that a total stranger had approached him with these words while he was shopping for groceries. "Can you believe that?" he asked before adding, "And that's not the first time that's happened." He was embarrassed that his mood was so obvious to everyone he encountered, yet defiant at his right not to mask his feelings from anyone.