Welcome to The Body PRO Newsletter, a bi-weekly review of the latest breaking news and research in HIV medicine, aimed specifically at informing health care professionals.
January 27, 2009
In This Newsletter:
  • HIV in the Obama Era
  • HIV Treatment & Complications
  • HIV Transmission & Testing
  • HIV Movers & Shakers
  • Outside the United States

    President Barack ObamaObama Administration Agenda Unveiled; Includes Pledges to Fight HIV in U.S., Change Health Care and Improve Gay Rights
    The U.S. HIV community has finally entered a new era. U.S. President Barack Obama's agenda is now available on the official White House Web site, and it includes a list of plans that are likely to impact HIV care and prevention. Highlights of the agenda include the implementation of a national strategy to fight HIV, increased funding for scientific research, a bevy of changes to health insurance plans (including universal coverage), the lifting of the federal ban on needle exchange and steps to increase the rights of gay, lesbian, transgender and bisexual people.

    During his first week in office, President Obama also repealed the "global gag rule" (also known as the "Mexico City" Policy), which had banned U.S. funding for international health groups that perform or provide counseling for abortions.

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    Lipoatrophy, Blood Sugar Abnormalities More Common Among Latinos on HAART, Study Finds
    Latinos appear more likely than whites or blacks to develop metabolic complications after initiating antiretroviral therapy, according to a U.S. study published in the Jan. 1 issue of JAIDS. Although the study was relatively small, the findings were striking: Latinos on HAART were at a much higher risk for losing fat in their face, waist or arms, and also had a sharper increase in their levels of glucose and insulin resistance.

    Antiretroviral Adherence: 95% and Up Is Best, But Newer Drugs Are More Forgiving
    Although optimal adherence (95% or greater) officially remains a goal in antiretroviral therapy, new research suggests patients can periodically miss antiretroviral doses with little risk. A Spanish study published in the October issue of AIDS Research and Human Retroviruses suggests that HAART regimens consisting of the newer antiretrovirals are highly likely to retain their virologic efficacy even in the face of adherence rates as low as 80%.

    The Spanish study findings are far from the last word on this subject, however. In fact, a Canadian study, published in AIDS just weeks after the Spanish study, found that if a patient is taking an "older" HAART regimen (one that consists of antiretrovirals that were approved in 2004 or earlier) and misses more than one dose a week, his or her antiretrovirals will probably lose their effectiveness within the next few years.

    Newly Diagnosed HIV-Infected Patients Must Take Charge of Health Care, Study Suggests
    A new U.S. study helps drive home just how important it is that individuals who are newly diagnosed with HIV commit to their health care. The study, which appears in the Jan. 15 issue of Clinical Infectious Diseases, found that HIV-infected people who fail to follow through on their HIV clinic appointments during the first year after their diagnosis face a higher mortality risk than those who show up for their appointments. Although the study does not suggest a direct cause-and-effect relationship between missed appointments and patient mortality, it does suggest that it is critical for HIV-infected people to take charge of their health starting immediately upon their diagnosis.

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    Rare Blood Type May Provide Greater Immunity to HIV, Study Finds
    Are some individuals less vulnerable to HIV infection because of their blood? Possibly, according to a study by Canadian and Swedish researchers published on Jan. 12 in the online edition of Blood. The researchers found that a specific type of molecule (called Pk) is able to attract and neutralize HIV, thus preventing it from infecting immune cells. Approximately one in one million people has extremely high levels of Pk in the blood, making this group more resistant to HIV. Researchers hope to begin animal testing of an artificial "Pk booster" to determine if it can help protect against HIV infection.

    Circumcision May Protect Heterosexual Men From HIV in U.S., Study Says
    Could circumcision be as important an HIV prevention tool for men in the U.S. as it is in Africa? Possibly, according to the results of a new study published in the Jan. 1 issue of the Journal of Infectious Diseases. The study found that, among black, heterosexual men living in Baltimore who had been exposed to HIV, men who were uncircumcised were more than twice as likely to be HIV infected than men who were circumcised. Experts note that circumcision is less common among African Americans and Hispanic Americans, and that the procedure is not currently covered by Medicaid.

    HIV Can Pass Through Healthy Vaginal Tissue, Study Finds
    HIV appears to attack normal, healthy genital tissue in women and does not require breaks in the skin to infiltrate cells, according to a U.S. study presented at the American Society for Cell Biology 48th Annual Meeting last month. To reach their findings, researchers from Northwestern and Tulane universities introduced HIV with fluorescent, light-activated tracers to healthy samples of vaginal lining. The researchers observed as the HIV easily penetrated the healthy genital tissue.

    Videos Aim to Help Urban U.S. Women Learn Safer Sex Strategies
    Women in the U.S. and elsewhere are usually infected with HIV through unprotected sex with men, often because they do not feel empowered to negotiate safer sex. Rachel Jones, Ph.D., RN, a nursing professor at Rutgers University, is trying to change this: She is developing an "urban soap opera" video series based on women's real stories about their relationships with men. The first video in the series, which is available online, shows women facing choices that may put them in a high-risk situation; viewers then see how the women empowered themselves to make a responsible decision. The first video is part of a 12-part series that can also be viewed on a cell phone.

    In addition to the urban soap opera series, the project also features short videos with quick, down-to-earth tutorials on safer sex, including how to use a condom.

    Forced Sex Poses Greater HIV Risk for Women Than Consensual Sex, Researchers Find
    What factors put women who have been raped at such a high risk for HIV? Is it that the sheer violence of rape causes injuries that facilitate the entry of HIV? Or is it that individuals who commit rape are more likely to be HIV infected than those who do not? In this interview with The Body PRO, British researcher Anna Foss discusses these issues and stresses the importance of taking forced sex into account when establishing HIV intervention programs.

    High Childhood Sexual Assault Rates on Hawaiian Island Spur Need for Youth HIV Prevention
    Beyond its white sand beaches and lush gardens, many citizens of Kauai, Hawaii, endure poverty and violence -- including alarmingly high rates of childhood sexual assault, which has been linked to HIV risk. On Kauai, statistics indicate that an astonishing one in four girls and one in six boys will be sexually abused. "Victims of sexual assault need to know that they can have counseling and testing," says Marie-Claude Julsaint of the World YWCA (Young Women's Christian Association). As she explains in this interview with The Body PRO, her group has developed a fun, youth-friendly HIV prevention program geared toward Kauai's children.

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    Martin DelaneyHIV Activist Martin Delaney Honored for Heroic Efforts to Further HIV Treatment
    Martin Delaney, a pioneering U.S. HIV activist and the cofounder of the HIV organization Project Inform, has been honored for his long years of tireless work fighting HIV. "It is without hyperbole that I call Marty Delaney a public health hero," said Anthony S. Fauci, M.D., the director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), who recently presented Delaney with the NIAID Director's Special Recognition Award. Since the mid-1980s, Delaney has been a leader in providing HIV treatment information to health care providers and HIV-infected people. During the nascent years of HIV treatment, he played a key role in ensuring a rapid acceleration of the approval process for vital antiretrovirals in the U.S.

    Sadly, Delaney passed away from liver cancer shortly after receiving the NIAID award. Daniel Berger, M.D., has written a moving eulogy to Delaney, and Project Inform and NIAID have released statements on his passing. (If you knew Martin or were familiar with his work, please feel free to add your own comments to these articles.)

    Head of U.S. CDC Is Out; What Lies Ahead for HIV Prevention?
    Change is coming to HIV prevention efforts in the U.S. Julie Gerberding, M.D., M.P.H., the longtime head of the U.S. Centers for Disease Control and Prevention (CDC), lost her job on Inauguration Day. Some HIV advocates are happy to see her go. Read this summary from the HIV advocacy group Housing Works for a rundown of Dr. Gerberding's "lowlights" as well as advocates' hopes for the future of the CDC, which sets the tone for HIV and sexually transmitted disease prevention efforts throughout the United States.

    Longtime UNAIDS Director Peter Piot Steps Down
    One of the global HIV community's most well-known leaders has retired from his post. Peter Piot, M.D., Ph.D., was the head of UNAIDS for 13 years, where he worked strenuously to bring HIV to the attention of political leaders around the world. He also strived to make resource-poor countries acknowledge and empower gay men, women and injection drug users, as well as address the factors that put those people at risk for HIV infection. As he leaves UNAIDS behind, Dr. Piot hopes to create a global health institute in London, at which he aims to teach the next generation how to apply the lessons of the global battle against HIV to other diseases in resource-poor countries.

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    Unique Service Helps HIV-Infected People in India Find Love -- and Fight Stigma
    What do HIV-infected people do in traditional countries such as India, where marriage is all but required and arranged marriages are still commonplace? Fortunately, there are services such as the Y.R.G. Care Matrimonial Service: It mixes Western and Indian traditions -- dating services and arranged marriage -- to match up HIV-infected men and women. As U.S. researcher Caitlin Kennedy explains in this interview with TheBody.com, The Body PRO's sister site for the non-clinical HIV community, the service seems to be working -- not just at pairing up HIV-infected Indians, but also at fighting stigma. "All the people who had used the service ... [said] it showed other people in India that HIV-positive people could get married and live a normal life," Kennedy says.

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    Also Worth Noting

    Activist Central

      Push for the Freedom of Two Newly Imprisoned Iranian HIV Specialists

    After months in detention, the Alaei brothers -- Iranian HIV specialists -- have been sentenced to prison in Iran for allegedly plotting to overthrow the country's government. Join the more than 3,000 people who have signed a petition calling for the Alaeis' freedom, write a letter to the Iranian embassy in the United States or put pressure on your Congressional representatives.

      Speak Out Against the Jailing of HIV Activists in Senegal

    The eight-year prison terms recently handed down to nine gay men in Senegal have many people throughout the world fuming. To speak out against this injustice, you can contact Senegal's embassy in the U.S. by calling 202.234.0540 or getting in touch with your Congressional representatives.

      Support the Call for a National U.S. Strategy to Fight HIV

    Now that U.S. President Barack Obama has begun his term, one of the major priorities for many HIV activists is urging him to create a nationwide strategy to fight HIV within the U.S. Join the call by signing amfAR's online petition and letting your Congressional representatives know how you feel!

    CME/CE Central: Get the Credit You Deserve

    Experience insightful, clinically relevant presentations by top HIV clinician-researchers. Earn free CME/CE credit if you are a U.S. physician, registered nurse or pharmacist! All activities include slide decks and are available in audio as well as text.

    Evolving Options for First-Line Therapy: Highlights From ICAAC/IDSA 2008, by David Wohl, M.D.

    Reappraising Key Issues in HIV Clinical Management: Highlights From ICAAC/IDSA 2008, by Benjamin Young, M.D., Ph.D.

    CCR5 Antagonists and Tropism Testing in Clinical Practice, by David Hardy, M.D.

    Primary Drug Resistance and Strategies for First-Line HIV Treatment, by Ian Frank, M.D.

    Antiretroviral Strategy Update: Highlights From the XVII International AIDS Conference, by David Wohl, M.D.

    New Insights on HIV/HAART Complications & Coinfections: Highlights From the XVII International AIDS Conference, by David Wohl, M.D.

    African Americans and HIV: New Developments in Clinical Management, by Adaora Adimora, M.D.

    An Update on New HIV Antiretroviral Agents, by Edwin DeJesus, M.D.

    A wealth of additional activities awaits you at The Body PRO's CME/CE Central!