HIV Prevention in a Pill?

Yesterday an FDA advisory panel recommended approval of Truvada for pre-exposure phylaxis (PrEP) of HIV.  While many in the HIV and AIDS medical and research community support the move, many others fear that it will reduce the use of condoms, which are critical for HIV prevention.  The question is: Will those in high risk categories, those who engage in risky sexual behaviors or use intraveneous drugs, actually adhere to a medical prevention protocol, especially if they are already having difficulty consistently using condoms?  While I think it’s possible that there are those in committed relationships with someone who is HIV positive who may be able to tolerate the serious side effects, the majority of those at risk for contracting HIV may not be able to stick with the regimen. Studies have shown that getting tested and realizing that you are positive reduces the risk you will pass it on.  Just the awareness that someone is putting someone else in danger may deter people from risky behavior.  But getting tested and the use of a preventive medication requires that people actually care about their role in the spread of HIV.  The continued large number of new cases every year, which is approximately 50,000 according to the Centers for Disease Control, and the 21% increase in new cases in young men aged 13-29 is fueled by the 34% increase in cases among young gay and bisexual men.  It would be great if this could be another tool in the HIV prevention toolbox that doesn’t make people feel safe skipping the condom.  Let’s hope that the right message on this “HIV Prevention Pill” gets out and it...

HIV and STDs Still Worry Health Officials

If you engage in unprotected sex of any type or with any person you run the risk of contracting a potentially incurable disease.  Between misinformation and shame of their risky behavior people continue to contract HIV and other STDs and then spread them to other people.  We, as a nation, are not doing enough to prevent these diseases.  Is it the old puritan morality that makes people think that STDs are a punishment from God and too bad for the sinners who contract them?  It certainly isn’t very christian to look away while more people continue to suffer. The Centers for Disease Control (CDC) just released information in their Morbidity and Mortality Weekly Report that a new strain of gonorrhea that is resistant to all antibiotics has been identified in Japan.  Although it hasn’t been seen in the US or Canada yet, health officials are concerned.  Being treated with the wrong antibiotic can create resistant strains of diseases that don’t respond to even the last resort medications, cephalosporin-class antibiotics.  One of the possible reasons for this is that gonorrhea in the pharynx, contracted via oral sex is very difficult to treat with antibiotics. HIV also continues to be a problem in the United States and recent studies have shown that the areas of the US, especially in the South that are the poorest, continue to have the highest rates of HIV infection and AIDs.  Misinformation, for example that HIV is still a disease of only gay men, leads people to engage in risky behavior because they think they are immune.  Then, once they have contracted the disease, they may...

HIV: The Slow, But Constant Progress

It was only 30 years ago that HIV/AIDS was recognized as a disease but then it was called PCP for Pneumocystis pneumonia.  Scientists and the medical community didn’t know what caused it or how it was transmitted, but they did know that all of their patients died.  I remember hearing about it and feeling pretty scared and worried.  No, I didn’t know anyone who had it, but I sure knew people who were having sex!  That was the first news that anyone had, that the disease was communicated through bodily fluids.  The only thing that doctors could do was to help their patients die humanely.   Although it is still an epidemic and a problem in the United States progress is slowly being made.  Too slowly for many people, but a diagnosis is no longer a death sentence.  Of those who get tested and get a positive diagnosis, the information and subsequent treatment can reduce the chance that they will transmit the disease by 96%.  Even knowing that you have the disease reduces chances of transmission.  The problem that still lingers, beyond the lack of a real cure, only treatment, is that 25% of those who are infected with HIV do not know that they have it.  If you are having sexual intercourse, GET TESTED!  Protect yourself and your partners as well as the rest of us. Written by...

Research Offers Hope for HIV Cure

Could bone marrow transplants be the answer to HIV?  We continue to hope and researchers continue to work on finding the cure for HIV.  The HIV epidemic continues in the United States prompting President Obama’s recent strategy on fighting it.  56,000 people become infected in the US every year and over 1.1 million Americans are living with the disease.  Attempts to provide clean needles and condoms are just not cutting it. Without the motivation and inspiration of dedicated researchers and bold attempts to find solutions the epidemic will continue.  Naysayers who point out that new research hasn’t found the cure aren’t looking at it from the right angle. In Berlin last year, scientists transplanted a patient with HIV-resistant bone marrow and claim that he is now cured of HIV.  Doctors in Texas will attempt a similar procedure by using donated umbilical cord blood that has been screened for the HIV-resistant gene.  Due to the great risk of a bone marrow transplant this isn’t a solution for those with only HIV, but could be effective for those with leukemia that will die without the transplant.  HIV tests to let those with the disease know so that they are less likely to spread the disease is one of the strategies identified in the National HIV Strategy, as well as calling on all parts of our society, including the scientific and medical community, to participate in reducing the spread and caring for those who are infected.  This new study can invigorate  the research to continue the search for a cure and motivate the scientific community.   Let’s applaud their efforts, not point out that they haven’t...

One Step Closer in the Fight Against HIV/AIDS

Only months after President Barack Obama addressed the nation stressing a stronger focus on HIV prevention and improved treatment, significant progress is continuing to be made by researchers.  It looks like the research community is taking his words seriously!  A recent study published in Science has found the specific genes that some HIV infected people have that allows their immune systems to maintain low levels of HIV.  These individuals, called “Controllers”, never develop AIDS.  1,500 of them volunteered for the study providing valuable information that will eventually lead to treatments for controlling the HIV infection.  Small variants in the protein HLA-B alert the immune system that there is an infection.  Those who don’t have these controlling genes eventually suffer with AIDS. HIV infection is still a huge problem in the United States where the number of new cases continues to rise every year despite attempts to halt it’s spread.  The primary focus has been on condom use and those infected frequently don’t receive proper treatment.  President Obama has laid out a National HIV Strategy to reduce the incidence of the disease, increase access to care and reduce HIV-related health disparities.  President and Mrs. Obama were tested for HIV while visiting Kenya in 2006 to encourage men and women there to be tested to prevent spreading the disease.  This is also a large piece of the US strategy because research shows that people who have received positive results and know that they are HIV positive are less likely to engage in the risky behaviors which spread the infection.  Right now, this is the best defense we have but we need to keep pushing the envelope on research and prevention options.  If you think...