•  HIV TREATMENT & PATIENT CARE

As HIV-Infected Patients Age, New Challenges Arise
HIV-infected patients are living longer in developed nations, thanks to the continued successes of HAART. However, questions abound: How does HIV affect age-related complications such as cardiovascular disease and diabetes? How can we help ensure that older patients with HIV get the support they need? In this article, Stephen Karpiak, Ph.D., examines how the "graying" of HIV may redefine what it means to be living with HIV -- and to care for HIV-infected patients -- in the United States.

The New York Times recently provided a dramatic overview of the issue. Click here to read.


New Findings Deepen Mystery of How Race Ties Into HIV Treatment
A new analysis of findings from the landmark ACTG 5095 study suggests that nonadherence is more likely to result in virologic failure for African-American patients than white patients. The reasons behind the discrepancy remain a mystery, though the researchers say it may be related to "genetic differences between blacks and whites in efavirenz metabolism or to undetected differences in adherence patterns attributable to other factors." The study was published in the Dec. 15, 2007 issue of the Journal of Acquired Immune Deficiency Syndromes.


Social Support Makes a World of Difference in HIV Medication Adherence
"Doctors, nurses and social workers can be seen as positive bearers of social support, and that can help clients be more medically compliant," says Lisa Cox, Ph.D., L.C.S.W., who runs the social work program at The Richard Stockton College of New Jersey. An HIV-infected patient's relationship with a team of health care providers and social workers can make or break his or her success with medications, according to Cox and others. This article discusses tips and strategies for professionals supporting medication adherence, with a particular focus on challenges facing social workers.


Antidepressants Improve Adherence and Treatment Outcomes in Depressed HIV-Infected Patients
People with HIV who are suffering from clinical depression miss more medication doses and don't respond as well to antiretroviral therapy (ART), according to a recent study published in Journal of Acquired Immune Deficiency Syndromes. But encouragingly, depressed patients who were given antidepressants did just as well on ART as HIV-infected patients who weren't depressed.

Click here to read the study abstract in the Dec. 20, 2007 edition of the Journal of Acquired Immune Deficiency Syndromes.

•  HIV/HAART-RELATED COMPLICATIONS

Dispelling Myths About HIV, Antiretrovirals and Body Fat
Myths and misunderstandings abound when it comes to body fat changes among HIV-infected patients. In this down-to-earth explanation, David Wohl, M.D., explains the truth behind some of the most common misconceptions -- among patients and health care providers alike -- about metabolic complications in HIV-infected patients.


Reporting Severe Adverse Effects: The FDA Wants to Know
As health care providers know all too well, severe unexpected adverse effects can appear long after a drug has won approval from the U.S. Food and Drug Administration (FDA) -- or can turn out to be more common or more dangerous than initially believed. To monitor the ongoing safety of HIV antiretrovirals and other medications, the FDA maintains a Web site that allows health care providers and patients to report suspected adverse reactions that were life-threatening, required hospitalization or resulted in permanent health damage. If one of your patients experienced a severe adverse effect while taking an approved medication, the FDA urges you to report it.


Black-White HIV Mortality Ratio in U.S. Has Widened in HAART Era, Study Finds
The disparity between white mortality rates and African-American mortality rates among HIV-infected patients has become wider since the advent of HAART, according to a study by Meharry Medical College researchers in Nashville, Tenn. The researchers hypothesized that "unequal diffusion of the HAART innovation" may explain the growing mortality gap.


An Overview of Drug-Resistant Staph Infections
HIV-infected patients are disproportionately affected by skin and soft tissue infections caused by antibiotic-resistant Streptococcus and Staphylococcus bacteria. This article offers an overview of staph infections in HIV-infected people, providing a brief history of the microbiology of these infections, outlining their epidemiology in the HIV-infected patient, and discussing available treatment and prevention options.

•  U.S. HIV/STD TRANSMISSION, TESTING

Needle Exchange Ban Lifted in Washington, D.C.
After eight long years, Washington, D.C.'s ban on needle exchange programs has finally come to an end. President George W. Bush has signed a government spending bill that allows the United States' capital city to use public funds for needle exchange -- a practice which has been shown to help reduce HIV risk among injection-drug users, but which was banned in 1999 by a Republican-controlled Congress. "For too long, Congress has unfairly imposed on the citizens of D.C. by trying out their social experiments there," said a Democratic congressman. "The consensus is clear that [needle exchange] programs save lives."

Following the spending bill's approval, The Washington Post reported that Washington, D.C., plans to spend $650,000 on needle exchange programs.


HIV Incidence Climbs Among Young N.Y.C. Men Who Have Sex With Men
Although HIV incidence in New York City has generally dropped over the last five years, rates are up by 32% among men younger than 30 who have sex with men, according to the New York City Department of Health and Mental Hygiene. HIV incidence has similarly increased among black and Hispanic men who have sex with men. This disturbing trend also highlights a widening generational gap: Among New York City men older than 30 who have sex with men, HIV incidence has dropped by 22%.


FDA Requires Warning That Nonoxynol 9 Can Increase HIV Risk
Contraceptives and spermicides in the United States that use nonoxynol 9 (N9) must now include a warning that N9 does not protect against sexually transmitted diseases, according to new rules from the U.S. Food and Drug Administration. The rules have been issued years after studies found that N9 can irritate an individual's vagina or rectum, causing inflammation that can actually increase the risk of HIV infection.


N.J. to Require Opt-Out HIV Testing for Pregnant Women, Some Newborns
Beginning in six months, HIV testing will be required for all pregnant women and some infants in New Jersey, unless women refuse the test in writing. Previous state law only required health care providers to offer HIV tests to pregnant women. The new law requires pregnant women to be tested for HIV as early as possible in their pregnancy and again during the third trimester, unless they opt out. The law also requires infants to be tested for HIV if the mother is HIV infected or if her HIV status is unknown when the baby is born.

•  U.S. POLICY, ADVOCACY, ACCESS/PRICING

Some New Antiretrovirals Not Listed on Medicare Web Site, but Still Covered
HIV-infected patients may not be able to find recently approved HIV antiretrovirals through Medicare's online drug plan finder, according to HIV advocates in California. The Web site is not always current, so new antiretrovirals such as raltegravir (MK-0518, Isentress) might not show up, the advocates say. However, since HIV medications are a protected class under Medicare Part D, raltegravir and other new HIV-related medications should still be covered by prescription drug plans; concerned patients are encouraged to talk to a benefits counselor.

•  NEWS & VIEWS

Woman Misdiagnosed With HIV Gets $2.5 Million
A woman who was misdiagnosed with HIV has been awarded $2.5 million in a lawsuit against her physician, who prescribed her antiretrovirals for nine years even though she was not HIV infected. The court found that Audrey Serrano's physician never ordered tests to confirm her HIV infection.


Black AIDS Institute Profiles the U.S. Presidential Contenders
Wondering which of the candidates will take the HIV epidemic in the United States seriously? This report from the Black AIDS Institute discusses the policies that could blunt the HIV epidemic among African Americans; and looks at candidates from both parties, reviewing what they have said and done (or failed to do) about HIV in the United States.

•  HIV OUTSIDE THE UNITED STATES

Veteran HIV Specialist Warns Against Paying Too Much Attention to HIV in Africa
Could the United States be spending too much of its money and attention on fighting HIV in developing countries? Leading HIV expert Daniel Halperin, Ph.D., argues in a New York Times opinion article that many people have tunnel vision when it comes to HIV. Although HIV funding in developing nations remains vital, he says, millions die of less "headline-grabbing" illnesses that desperately need attention. "If one were to ask the people of virtually any African village (outside some 10 countries devastated by AIDS) what their greatest concerns are, the answer would undoubtedly be the less sensational but more ubiquitous ravages of hunger, dirty water and environmental devastation," Halperin writes.