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...

Medical Marijuana Users Not Protected From Employer Drug Testing

Even for the states that have legalized marijuana for medical use under the Medical Use of Marijuana Act (MUMA), people who are taking advantage of the law are still at risk from their employers.  The act is intended to protect medical users from arrest but the protection does not extend to private businesses.  In at least 2 separate instances employees who were using marijuana for medical purposes were required to submit to drug tests for their employment and were subsequently fired.  Even though both of these people informed their employers about their medical use of marijuana and had supporting evidence from their doctors, the companies still followed through with their corporate policies. For people suffering from chronic pain or undergoing cancer treatment, marijuana can make a huge difference.  The talk show host, Montel Williams, has suffered with Multiple Sclerosis for years and found relief from constant neurological pain with marijuana.  He says that it improved his health and well being.  He supports this as a treatment so much that he is opening a medical marijuana dispensary in Sacramento, CA that he claims will be professional with a focus on patient care.  It’s truly sad that these sufferers are punished when they have found a treatment that works for them and enables them to function well enough to go back to work.  True medical use of marijuana does not provide an exemption for employers concerned with sticking stringently to the rules but it should.  Their lack of compassion in our “Drug Free” world is cruel and unacceptable. Written by...

Drug Testing for Welfare Recipients on the Rise

Kansas is one of the most recent states to try to pass laws requiring welfare recipients to submit to drug testing.  Although there are many opponents who claim that this will cost the state too much money to test all of these people, in the long run this will help to ensure that the money is going to the children and welfare dependents who need food and shelter.  Too many drug users are on welfare and using the state’s money to purchase drugs.  From any perspective this is not the intention of welfare and makes most taxpayers (including me!) angry.  In fact, many of the welfare recipients who were asked about the drug testing bill now headed to the Governer of Kansas support the concept.  They have seen friends and relatives using welfare funds inappropriately. The unfortunate side effect of passing laws such as this, and so far 30 states have proposed bills like this, but none have successfully been enacted, is that this doesn’t provide a support system for drug addicts.  The bills address different aspects of the problem, from receipt of welfare benefits, to applying for welfare, to receipt of food stamps.  Those who test positive may be referred for treatment but the treatment isn’t necessarily covered and then there is the question about how they will support themselves while undergoing treatment, if they actually take that step.  What about false positives?  Is there any recourse for those who receive an incorrect result?  Another worry is that some who really need financial aid, and may use it properl,y won’t even apply if they have to be tested.  Some...

Drug Testing Companies Are Getting More Effective

If you were hoping that your heroin use was tough to catch, you could be in trouble.  In October of last year the US Department of Transportation (DOT) changed their regulations for drug testing, lowering the cutoff levels for amphetamines and cocaine and adding the urine test for the heroin marker to its list of required tests.  The addition of the test for heroin creates complications for employers who need to test their drivers to ensure safer highways.  Heroin metabolizes quickly to 6-AM and then to morphine.  Previously a test for heroin was only conducted after a positive result for morphine.  Testing laboratories, such as Quest Diagnostics, have updated their arsenal of tests to include an oral fluid test that can accurately reveal five times more heroin use in the general US workforce than previously believed.  The oral fluid test is much easier to administer, making observation simpler, and oral fluid is more difficult to tamper with.   According to the Quest Diagnostics Drug Testing Index™ oral fluid testing with more than 320,000 oral-fluid samples from the general U.S. workforce from January to June 2010, detected a marker for heroin use at a rate of 0.04% compared to the 0.008% positivity rate for urine testing.  If you are a professional driver up for drug testing, it’s time to get clean! 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...